Duodenal Ulcer - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

DUODENAL ULCER A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

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., 1960Duodenal Ulcer: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84398-8 1. Duodenal Ulcer-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 duodenal ulcer. 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 DUODENAL ULCER ................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Duodenal Ulcer ........................................................................... 14 E-Journals: PubMed Central ....................................................................................................... 22 The National Library of Medicine: PubMed ................................................................................ 25 CHAPTER 2. NUTRITION AND DUODENAL ULCER ......................................................................... 71 Overview...................................................................................................................................... 71 Finding Nutrition Studies on Duodenal Ulcer............................................................................ 71 Federal Resources on Nutrition ................................................................................................... 78 Additional Web Resources ........................................................................................................... 78 CHAPTER 3. ALTERNATIVE MEDICINE AND DUODENAL ULCER ................................................... 81 Overview...................................................................................................................................... 81 National Center for Complementary and Alternative Medicine.................................................. 81 Additional Web Resources ........................................................................................................... 90 General References ....................................................................................................................... 97 CHAPTER 4. CLINICAL TRIALS AND DUODENAL ULCER ............................................................... 99 Overview...................................................................................................................................... 99 Recent Trials on Duodenal Ulcer................................................................................................. 99 Keeping Current on Clinical Trials ........................................................................................... 100 CHAPTER 5. PATENTS ON DUODENAL ULCER.............................................................................. 103 Overview.................................................................................................................................... 103 Patents on Duodenal Ulcer........................................................................................................ 103 Patent Applications on Duodenal Ulcer .................................................................................... 117 Keeping Current ........................................................................................................................ 122 CHAPTER 6. BOOKS ON DUODENAL ULCER ................................................................................. 125 Overview.................................................................................................................................... 125 Book Summaries: Federal Agencies............................................................................................ 125 Book Summaries: Online Booksellers......................................................................................... 127 Chapters on Duodenal Ulcer...................................................................................................... 130 CHAPTER 7. MULTIMEDIA ON DUODENAL ULCER ...................................................................... 135 Overview.................................................................................................................................... 135 Video Recordings ....................................................................................................................... 135 CHAPTER 8. PERIODICALS AND NEWS ON DUODENAL ULCER ................................................... 137 Overview.................................................................................................................................... 137 News Services and Press Releases.............................................................................................. 137 Newsletter Articles .................................................................................................................... 140 Academic Periodicals covering Duodenal Ulcer ........................................................................ 141 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................. 143 Overview.................................................................................................................................... 143 U.S. Pharmacopeia..................................................................................................................... 143 Commercial Databases ............................................................................................................... 145 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 149 Overview.................................................................................................................................... 149 NIH Guidelines.......................................................................................................................... 149 NIH Databases........................................................................................................................... 151 Other Commercial Databases..................................................................................................... 153 The Genome Project and Duodenal Ulcer.................................................................................. 153 APPENDIX B. PATIENT RESOURCES ............................................................................................... 157 Overview.................................................................................................................................... 157

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Patient Guideline Sources.......................................................................................................... 157 Finding Associations.................................................................................................................. 164 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 167 Overview.................................................................................................................................... 167 Preparation................................................................................................................................. 167 Finding a Local Medical Library................................................................................................ 167 Medical Libraries in the U.S. and Canada ................................................................................. 167 ONLINE GLOSSARIES................................................................................................................ 173 Online Dictionary Directories ................................................................................................... 175 DUODENAL ULCER DICTIONARY ........................................................................................ 177 INDEX .............................................................................................................................................. 237

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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 duodenal ulcer 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 duodenal ulcer, 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 duodenal ulcer, 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 duodenal ulcer. 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 duodenal ulcer, 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 duodenal ulcer. 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 DUODENAL ULCER Overview In this chapter, we will show you how to locate peer-reviewed references and studies on duodenal ulcer.

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

Meta-Analysis: The Efficacy of Intravenous H2-receptor Antagonists in Bleeding Peptic Ulcer Source: Alimentary Pharmacology and Therapeutics. 16(6): 1137-1142. June 2002. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Although a previous study found that intravenous H2-receptor antagonists were only weakly beneficial in patients with bleeding stomach (gastric) ulcer and of no benefit in patients with bleeding duodenal ulcer, patients with ulcer bleeding continue to receive such treatment. This article reports on a study undertaken to re-evaluate the effectiveness of intravenous H2 receptor antagonists in ulcer re-bleeding, surgery, and

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mortality, but updating the previous study. After two independent literature searches, randomized, placebo-controlled trials of intravenous H2 receptor antagonists in bleeding ulcer published between 1984 and 2000 were added to those from the initial meta-analysis. Pooled rates of rebleeding, surgery and death were recalculated, together with the relative risk reduction, absolute risk reduction, number needed to treat, and Mantel-Haenszel odds ratio. Results showed that intravenous H2 receptor antagonists did not significantly reduce rebleeding, surgery, or death in bleeding duodenal ulcer. There were small but significant reductions in rebleeding, surgery, and death in bleeding gastric ulcer. The authors conclude that because proton pump inhibitors have a greater inhibitory effect on gastric acid secretion than H2 receptor antagonists, they may be more effective in ulcer bleeding and should be further evaluated for that indication. 2 figures. 19 references. •

Uncomplicated Peptic Ulcer Disease: An Overview of Formation and Treatment Principles Source: Postgraduate Medicine. 93(4): 126-140. March 1993. Summary: Although gastric and duodenal ulcers may result from different types of imbalance between aggressive and defensive factors affecting the mucosa, both are treated with the same agents. In this article, the authors summarize the use of mucosal protective agents (antacids, sucralfate, and compounds containing bismuth), and of antisecretory agents (histamine2 receptor antagonists and omeprazole). The authors also briefly discuss the role of Helicobacter pylori infection in both gastric and duodenal ulcer formation and the use of triple-drug therapy to eradicate or suppress the organism. 1 figure. 3 tables. 25 references. (AA-M).

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Surgical Treatment of Peptic Ulceration Source: Current Opinion in Gastroenterology. 7(6): 900-905. December 1991. Summary: During the early 1990s, evidence has accrued that while the incidence of elective surgery for peptic ulcer disease over the past 20 years has declined, the need for emergency surgery has remained stable and has been seen in higher risk patients. This article reviews the use of surgical treatment of peptic ulceration. Topics include ulcer complications, particularly perforation; and the use of proximal gastric vagotomy, including post-operative recurrence, different recurrence rates dependent on the type of ulcer, and the laparoscopic performance of a modified proximal gastric vagotomy. 2 figures. 1 table. 25 annotated references. (AA-M).

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One-Week Triple Therapy with Esomeprazole Provides Effective Eradication of Helicobacter Pylori in Duodenal Ulcer Disease Source: Alimentary Pharmacology and Therapeutics. 14(12): 1605-1611. December 2000. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Esomeprazole is the first proton pump inhibitor to be developed as an optical isomer for the treatment of acid related diseases. This article reports on a study of 1 week triple therapy with esomeprazole for eradication of Helicobacter pylori bacteria in duodenal ulcer disease. Patients with H. pylori infection, confirmed by C urea13 breath test (UBT), and no current ulcer, were randomized to double blind treatment with esomeprazole 20 mg twice daily (n = 224) or omeprazole 20 mg twice daily (n = 224), in

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combination with amoxicillin 1 gram twice daily and clarithromycin 500 mg twice daily for 1 week. A negative UBT at both 4 and 8 weeks after completing therapy indicated successful H. pylori eradication. Between group differences in eradication rates were not statistically significant. Both regimens were well tolerated, with an adverse event profile and frequency typical of proton pump inhibitor plus antibiotic combination therapy. The most commonly reported adverse events were diarrhea and taste changes, which were most likely attributable to amoxicillin and clarithromycin, respectively. The 90 percent eradication rate exceeds that of current recommendations and national guidelines. 4 figures. 3 tables. 17 references. •

Prevalence of Helicobacter Pylori in Peptic Ulcer Disease Source: Alimentary Pharmacology and Therapeutics. 9 (Supplement 2): 59-69. 1995. Contact: Available from Mercury Airfreight International, Ltd. 2323 EF, Randolph Avenue, Avenel, NJ 07001. Summary: In this article, the authors investigate the prevalence of Helicobacter pylori (H. pylori) in peptic ulcer disease. The authors note that both duodenal and gastric ulcer disease are closely associated with H. pylori infection. An infected individual has an estimated lifetime risk of 10 to 20 percent for the development of peptic ulcer disease, a rate at least 3 to 4 fold higher than in noninfected subjects. Other factors that may influence the peptic ulcer risk in infected subjects are the amount of gastric acid production, which is increased in duodenal ulcer disease and decreased in gastric ulcer disease; the presence of gastric metaplasia in the duodenal bulb; smoking; and genetic factors. After eradication of the infection, the risk of recurrence of ulcer disease is reduced to below 10 percent for gastric ulcer disease and to almost 0 percent for duodenal ulcer disease. 3 tables. 110 references. (AA-M).

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Temporal Trends and Geographical Variations of Peptic Ulcer Disease Source: Alimentary Pharmacology and Therapeutics. 9 (Supplement 2): 3-12. 1995. Contact: Available from Mercury Airfreight International, Ltd. 2323 EF, Randolph Avenue, Avenel, NJ 07001. Summary: In this review article, the author describes the time trends and geographical variations of peptic ulcer disease, focusing on how the data might help researchers understand the role of Helicobacter pylori (H. pylori) in the development of the disease. The article covers early time trends; the use of mortality statistics; birth-cohort phenomena; birth-cohort phenomena in children; geographical variation of peptic ulcer in children; and general geographical distribution. The author notes that the temporal trends and geographical variation of gastric ulcer, duodenal ulcer, and gastric cancer show many similar characteristics. A brief discussion follows on the potential role of H. pylori in all three diseases. 8 figures. 31 references. (AA-M).

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Incidence and Risk Factors for Self-Reported Peptic Ulcer Disease in the United States Source: American Journal of Epidemiology. 147(6): 529-536. March 15, 1998. Contact: Available from American Journal of Epidemiology. Johns Hopkins University School of Hygiene and Public Health, 111 Market Place, Suite 840, Baltimore, MD 212026709. (410) 223-1600. Fax (410) 223-1620.

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Summary: Incidence and risk factors for peptic ulcer disease in the U.S. have not been well defined. This article reports on a study that used a digestive disease supplement to the 1989 National Health Interview Survey (NHIS) to examine the incidence and risk factors for peptic ulcer disease. During the 1989 NHIS, a population-based sample of 42,392 individuals responded to questions regarding doctor-diagnosed ulcers with confirmation by either an upper gastrointestinal series or endoscopy. Ulcers present during the previous 12 months were considered either incident ulcers if diagnosed during this period, or chronic active ulcers if diagnosed more than 12 months before the interview. The incidence of ulcers over the year prior to the interview was 5.27 per 1,000 adults. Whereas incident duodenal ulcer cases represented only 2.4 percent of all persons with a history of duodenal ulcer, the corresponding value for gastric ulcer was 8.7 percent. Risk factors for incident ulcers included increasing age, lower income and educational attainment, and musculoskeletal pain or headache. These were similar to risk factors for chronic active ulcers, except that smoking was an additional important risk factor for chronic active ulcers. Thus, incident peptic ulcers are common in the U.S. but represent a small proportion of persons with a history of ulcer disease. Smoking may be a stronger risk factor for chronic ulcers than for new ulcers. 8 figures. 2 tables. 31 references. (AA-M). •

Scope and Consequences of Peptic Ulcer Disease: How Important Is Asymptomatic Helicobacter Pylori Infection? Source: Postgraduate Medicine. 105(3): 100-102, 105-108, 110. March 1999. Summary: Peptic ulcer disease (PUD) is a worldwide problem, affecting 1 in 10 people. Similarly, Helicobacter pylori, the now undisputed culprit in most cases of PUD, is found virtually everywhere on the planet. Although the organism causes problems in only a minority of those who carry it, it is linked to a number of serious consequences. In this article, a panel of experts discusses the scope, risks, and relationships of H. pylori and peptic disease, cancer, and other disorders. Transmission is believed to be primarily person to person. The pathogen invariably damages the gastric mucosa, resulting in both structural and functional abnormalities. H. pylori causes histologic gastritis and is critical in the pathogenesis of the gastritis associated diseases: gastric ulcer, duodenal ulcer, gastric adenocarcinoma, and primary gastric lymphoma. Elimination of the infection results in healing of gastritis and cure of PUD. 2 tables. 28 references. (AA-M).

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Comparison of Rabeprazole 20 mg Versus Omeprazole 20 mg in the Treatment of Active Duodenal Ulcer: A European Multicentre Study Source: Alimentary Pharmacology and Therapeutics. 13(2): 179-186. February 1999. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Rabeprazole sodium is the newest member of a class of substituted benzimidazole molecules known as proton pump inhibitors. Other proton pump inhibitors have been shown to be effective in healing active duodenal ulcer. This article reports on a randomized, double blind, multicenter study, conducted at 25 European sites, that compared the efficacy and tolerability of rabeprazole and omeprazole in patients with active duodenal ulcers. One hundred and two (102) patients with active duodenal ulcer received rabeprazole 20 mg and 103 patients received omeprazole 20 mg once daily for 2 or 4 weeks, with ulcer healing monitored by endoscopy. After 2 weeks, complete ulcer healing was documented in 69 percent of patients given rabeprazole and

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in 62 percent of patients given omeprazole (not a significant difference). After 4 weeks, healing rates were 98 percent in the rabeprazole group and 93 percent in the omeprazole group (P = 0.083). At the end of the study, patients treated with rabeprazole had significantly greater improvement in daytime pain symptom relief than those treated with omeprazole. Both drugs were well tolerated over the 4 week treatment period. Mean changes from baseline to end point in fasting serum gastrin were significantly greater in the rabeprazole group, but at end point, mean values were well within normal limits for both groups. 2 figures. 3 tables. 31 references. (AA-M). •

Lifestyle, Stress, and Genes in Peptic Ulcer Disease: A Nationwide Twin Cohort Study Source: Archives of Internal Medicine. 158(7): 698-704. April 13, 1998. Contact: Available from American Medical Association. Subscriber Services Center, P.O. Box 10946, Chicago, IL 60610-0946. (800) 262-2350. Fax (312) 464-5831. E-mail: [email protected]. Summary: The familial accumulation of peptic ulcer disease observed in several studies may be attributable to genetic effects, aggregation of environmental exposure (shared environment), or both. This article reports on a study undertaken to examine the contribution of genetic and environmental factors to the pathogenesis of peptic ulcer disease in a nationwide population-based cohort of adult twins. The Finnish Twin Cohort consists of all same-sexed twin pairs born before 1958 with both twins alive in 1975. The total number of twin pairs is 13,888, of whom 4,307 are monozygotic (MZ) and 9,581 are dizygotic (DC) twins. Questionnaire surveys of twins were carried out in 1975, 1981, and 1990. One question asked whether a physician had ever made a diagnosis of gastric or duodenal ulcer. In addition, hospital discharge data from 1972 to 1991 were linked with the twin cohort to obtain those twin individuals who had been treated for gastric or duodenal ulcer. The contribution of lifestyle factors and stress was examined prospectively in an incidence study and by comparison of discordant pairs. The prevalence of peptic ulcer disease was 6.2 percent in men and 2.8 percent in women in 1975. There were 63 MZ and 86 DZ pairs concordant for peptic ulcer disease. In the model-fitting analysis, a model with both additive genetic and unshared environmental effects had the best fit. Thirty-nine percent of the liability to peptic ulcer disease was explained by genetic factors and 61 percent by individual environmental factors. In the incidence study, current smoking and high stress levels in men and regular use of analgesics in women predicted peptic ulcer disease during the followup from 1976 to 1991. In the analysis of discordant pairs, smoking in men and regular use of analgesics in both sexes were predictors of peptic ulcer disease. 5 tables. 41 references. (AA-M).

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Non-Helicobacter Pylori, Non-NSAID Peptic Ulcer Disease Source: Practical Gastroenterology. 25(9): 15, 18,20, 22. September 2001. Contact: Available from Shugar Publishing. 12 Moniebogue Lane, Westhampton Beach, NY 11978. (516) 288-4404. Fax (516) 288-4435. Summary: The majority of patients with peptic ulcers are infected with Helicobacter pylori bacteria but the organism may not always be responsible for the ulcer. Most patients have more than one risk factor for ulceration that then makes it difficult to establish the exact cause for the peptic ulcer. This article summarizes the current thinking in the etiology (cause) of peptic ulcer disease (PUD) and updates the reader on the prevalence and management of H. pylori, NSAID (nonsteroidal antiinflammatory drug) negative ulcer disease. Ulcer studies in the United States have found that

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approximately 20 percent of patients with duodenal ulceration have ulcer recurrence despite successful eradication of H. pylori. The phenomenon of non-H. pylori, nonNSAID mediate ulcer disease is also being increasingly recognized as defining a distinct subgroup of ulcer patients who have true idiopathic (with unknown cause) ulcer disease. The etiology for ulceration in these patients and their management is not well understood. The authors concludes that patients with an idiopathic duodenal ulcer have gastric (stomach) acid hypersecretion and are likely to have a more complicated course than their H. pylori-positive counterparts. 1 table. 18 references. •

Helicobacter Pylori-Positive Duodenal Ulcer: Three-Day Antibiotic Eradication Regimen Source: Alimentary Pharmacology and Therapeutics. 14(10): 1329-1334. October 2000. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: The most widely used treatments for ulcer healing and Helicobacter pylori eradication consists of a 1 to 2 week regimen of a proton pump inhibitor (PPI) plus two or three antimicrobials. This article reports on a study undertaken to evaluate the efficacy, safety, cost, and tolerance of a three day regimen with three antibiotics versus a 10 day treatment with a PPI inhibitor or versus a ranitidine bismuth citrate triple therapy. The study included 221 patients with endoscopically proven H. pylori positive duodenal ulcers. Recruited patients were assigned to one of four regimens: OAC (n = 55 patients) consisting of omeprazole, amoxycillin, clarithromycin; OACM (n = 56 patients), consisting of omeprazole, amoxycillin, clarithromycin, and metronidazole; RAC (n = 54 patients), consisting of ranitidine bismuth citrate, amoxycillin, and clarithromycin; or RACM (n = 56 patients) consisting of ranitidine bismuth citrate, amoxycillin, clarithromycin, and metronidazole. Fisher's exact test was used to compare data regarding healing and eradication in the four groups. The intention to treat eradication and ulcer healing rates for the RACM regimen were 95 percent and 98 percent, respectively. Statistically significant differences were observed, relating to the eradication and healing of ulcers, between RACM and either the RAC or OAC regimens. The authors conclude that the three day antibiotic therapy with amoxycillin, clarithromycin, and metronidazole, in addition to ranitidine bismuth citrate, is a very effective anti H. pylori regimen. 1 figure. 3 tables. 26 references.

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Prevalence and Pathogenesis of Duodenal Ulcer in Chronic Alcoholic Pancreatitis Source: Journal of Clinical Gastroenterology. 35(1): 71-74. July 2002. Contact: Available from Lippincott Williams and Wilkins, Inc. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300. Summary: The prevalence of duodenal ulcer (DU) has been considered high in patients with chronic pancreatitis; however, its pathogenesis is unclear. This article reports on a study that investigated the role of Helicobacter pylori infection in the pathogenesis of DU in this population. The study included 107 cases (97 men, 10 women) of chronic alcoholic pancreatitis (CAP) who were investigated between 1997 and 2001. Two control groups included 137 patients with DU only and 59 nonulcer dyspepsia patients. The results showed 15 of the 107 patients (14 percent) with CAP had active DU. There was a trend toward an association between the presence of diabetes mellitus and or steatorrhea and the occurrence of DU in patients with CAP. The rate of H. pylori infection was significantly higher in patients with CAP and DU than in those with only

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CAP but the rate was similar to that in patients with simple DU. There was no significant difference in prevalence of H. pylori between CAP patients without DU and dyspeptic patients. These data demonstrate that the prevalence of DU in CAP is relatively high. H. pylori infection seems to play the major pathogenic role in DU associated with CAP. 2 tables. 29 references. •

Density of Helicobacter pylori Infection in Patients with Peptic Ulcer Perforation Source: Journal of the American College of Surgeons. 186(6): 659-663. June 1998. Summary: The prevalence of severe ulcer complications requiring emergency surgery has not been reduced, despite the common use of H2 receptor antagonists and proton pump inhibitors. This article reports on a study in which Helicobacter pylori (HP) infection and the severity of histologic change was investigated were evaluated semiquantitatively in patients with peptic ulcer who required surgery. The authors reviewed a total of 113 consecutive patients (98 men and 15 women) operated on for perforation, hemorrhage, or stenosis of gastroduodenal ulcer between 1986 and 1995. HP detection was by immunohistochemical staining and the severity of gastritis was evaluated by histologic examination using Rauw's criteria. Although the number of operations for gastroduodenal ulcer declined significantly, the rate of emergency operations for gastroduodenal ulcer increased from 60 to 90 percent, with the result that the frequency of operations for perforation or bleeding remained virtually constant while that for stenosis decreased significantly. HP infection was more prevalent in perforated ulcer (92 percent) than hemorrhagic ulcer (55 percent) or stenotic ulcer (45 percent). The authors conclude that perforated ulcer was associated with significantly more severe HP infection and gastritis changes than hemorrhagic or stenotic ulcer. 4 tables. 33 references. (AA-M).

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Treatment of Peptic Ulcers Caused by Helicobacter Pylori Source: New England Journal of Medicine. 328(5): 349-350. February 1993. Summary: This article focuses on the treatment of peptic ulcers caused by Helicobacter pylori. The author stresses that every patient should undergo at least one attempt to eradicate the infection. Drug regimens discussed include bismuth and two antimicrobial drugs, notably tetracycline and metronidazole. Amoxicillin is discussed as an alternative to tetracycline. Other topics are new treatments, including a proton-pump inhibitor (omeprazole); guidelines for confirming eradication of the infection; recurrence of the ulcers; whether or not eradication of H. pylori must be confirmed; treatment of H. pylori infections that are non-symptomatic; and noninvasive testing of patients with dyspepsia.

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Cost-Effectiveness of Treatment Regimens for the Eradication of Helicobacter Pylori in Duodenal Ulcer Source: American Journal of Gastroenterology. 91(2): 239-245. February 1996. Summary: This article reports on a decision analysis study of three commonly used antimicrobial treatment regimens used to eradicate Helicobacter pylori in duodenal ulcer. Decision analysis is a technique that allows a quantitative analysis of treatment choices in complex clinical situations and allows for cost-effectiveness determinations in areas in which uncertainties exist. The three regimens studied were 2-week triple drug therapy (metronidazole, bismuth, tetracycline with H2 receptor antagonist); 2-week omeprazole and amoxicillin; and 2-week omeprazole and clarithromycin. Traditional H2 receptor antagonist therapy was used for comparison. A 2-year time period was chosen

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for study to allow sufficient time for relapse. Standard 2-week triple drug therapy was the least expensive strategy ($720), and conventional H2 receptor antagonist therapy was the most expensive ($1,791). Triple drug therapy is the optimal regimen in areas where metronidazole resistance rates are less then 36 percent and compliance is greater than 53 percent. Dual drug therapy with omeprazole and clarithromycin is effective in regions where metronidazole resistance is high or where it is anticipated that there would be poor compliance with the more complicated triple drug therapy regimen. 6 figures. 1 table. 44 references. (AA-M). •

Cost Effectiveness of Alternative Helicobacter Pylori Eradication Strategies in the Management of Duodenal Ulcer Source: Canadian Journal of Gastroenterology. 11(4): 323-331. May-June 1997. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Summary: This article reports on a study that constructed a model to estimate the cost effectiveness of nine alternative strategies for the management of patients diagnosed with uncomplicated duodenal ulcer. Two strategies of intermittent therapy with either ranitidine or omeprazole, one strategy of continuous maintenance treatment with ranitidine, and six strategies for ulcer healing and eradication of Helicobacter pylori infection were considered. Healing time curves were estimated by using published data, allowing for estimation of expected time for acute healing episodes. The expected number of weeks to heal per patient, in a one-year period, was estimated by combining healing time data with probability of ulcer recurrence. The authors found that patients who underwent any of the six H. pylori eradication regimens had fewer days with ulcer per year than those who underwent maintenance or intermittent ranitidine. Four eradication regimens had lower costs and better outcomes than rantidine therapy. In comparing H. pylori strategies, the two strategies of omeprazole plus one antibiotic (either amoxicillin or clarithromycin) are more costly than omeprazole plus two antibiotics (specifically amoxicillin and metronidazole or clarithromycin and metronidazole) and result in similar outcomes. Although omeprazole-based eradication regimens are more costly than rantidine bismuth triple therapy, they are associated with fewer recurrences of ulcer and days of symptoms. 4 figures. 6 tables. 24 references. (AAM).

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Cost Analysis of Alternative Treatments for Duodenal Ulcer Source: Annals of Internal Medicine. 123(9): 665-672. November 1, 1995. Summary: This article reports on a study to compare the costs of alternative strategies for the treatment of duodenal ulcer. A decision model was used to compare the costsper-cure of an endoscopically documented duodenal ulcer for three initial treatment strategies: H2-receptor antagonist therapy for 8 weeks; antibiotic therapy for Helicobacter pylori infection plus H2-receptor antagonist therapy; and urease test-based treatment. Side effects from combination therapy with antibiotics and H2-receptor antagonists and resulting costs were included from the perspective of a group practice model health maintenance organization. The cost analysis indicated that, regardless of the secondary treatment used for ulcer recurrence, initial therapy with antibiotics for H. pylori infection plus an H2-receptor antagonist provides the lowest cost per symptomatic cure. These cost savings and the lower recurrence rates associated with this treatment favor eradication of H. pylori as part of the initial treatment of duodenal ulcer. 4 figures. 4 tables. 38 references. (AA-M).

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Continuous and More Effective Duodenal Ulcer Healing Under Therapy with Bismuth and Two Antibiotics Than with Dual Therapy Comprising Omeprazole and Amoxicillin Source: European Journal of Gastroenterology and Hepatology. 10(10): 847-850. October 1998. Contact: Available from Rapid Science Publishers. 400 Market Street, Suite 750, Philadelphia, PA 19106. (800) 552-5866. Summary: This article reports on a study undertaken to determine the speed at which duodenal ulcers heal during eradication regimens with and without a high dose, antisecretory drug. A total of 101 patients with proven duodenal ulcer and a positive urease test were randomized into two groups: One group received the classic triple therapy (bismuth subnitrate, tetracycline, and metronidazole); the other received dual therapy (amoxicillin and omeprazole). All patients underwent a control endoscopy 2 and 6 weeks after the beginning of treatment. Eradication was assumed if a urease test and culture were negative in all specimens taken from antral and corpus mucosa. In total, 93 patients completed all 6 weeks of the study (45 patients in the triple therapy group and 48 patients in the dual therapy group). The disappearance of ulcer pain was faster in the group receiving omeprazole (dual therapy) than in the group receiving triple therapy. Although the 2-week healing rate was significantly higher in the patients treated with dual therapy, 12 out of 37 patients with a healed ulcer in the dual therapy group had relapse at 6 weeks (6 became symptomatic). Helicobacter pylori was eradicated in only 1 of these 12 patients. Fifteen of the 45 patients who received triple therapy had healed ulcers at 2 weeks, and of these, 14 remained healed at 6 weeks (H. pylori was eradicated in 8 patients). The 6-week healing rate with dual therapy (64.6 percent) was the same as with classic triple therapy (77.6 percent), but the eradication rate was lower in the dual therapy group (30.4 percent) than in the triple therapy group (51.5 percent). The authors conclude that a high dose of a proton pump inhibitor combined with amoxicillin results in rapid ulcer healing and disappearance of pain, but is associated with early ulcer relapse because H. pylori is not eradicated. Its addition to regimens with bismuth and antibiotics is not necessary to achieve ulcer healing. 3 tables. 16 references. (AA-M).

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Helicobacter Pylori in Peptic Ulcer Disease: NIH Consensus Conference Source: JAMA. Journal of the American Medical Association. 272(1): 65-69. July 6, 1994. Summary: This article reports on the National Institutes of Health (NIH) Consensus Development Conference on Helicobacter pylori in Peptic Ulcer Disease that brought together specialists in gastroenterology, surgery, infectious diseases, epidemiology, and pathology, as well as laypersons. The panel addressed issues including the causal relationship of H. pylori to upper gastrointestinal (GI) disease, the diagnosis and eradication of H. pylori infection, how eradication of H. pylori infection can benefit the patient with peptic ulcer disease, the relationship between H. pylori infection and gastric malignancy, which H. pylori-infected patients should be treated, and directions for future research in this area. The consensus panel concluded that ulcer patients with H. pylori infection require treatment with antimicrobial agents in addition to antisecretory drugs whether on first presentation with the illness or on recurrence, that the value of treating nonulcerative dyspepsia patients with H. pylori infection remains to be determined, and that the relationship between H. pylori infection and gastric cancers requires further exploration. (AA-M).

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Nonsteroidal Anti-inflammatory Drugs and Peptic Ulcer Disease: An Overview Source: Postgraduate Medicine. 89(7): 33-38, 40. May 15, 1991. Summary: This article reviews the association between nonsteroidal anti-inflammatory drugs (NSAIDs) and gastroduodenal ulcers, as well as current data about prophylaxis against NSAID-induced ulceration. The mechanism of action of NSAIDs seems to be both topical damage to the mucosal barrier and the systemic effect of a reduction in levels of mucosal prostaglandins. Patients especially at risk are the elderly, those with concomitant debilitating disease, those with a history of ulcers, and those taking corticosteroids. The author discusses the use of histamine2 blockers and misoprostol to reduce the incidence of NSAID-induced ulcers. 1 table. 31 references. (AA-M).

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Formulary Update: Treatment of Peptic Ulcer Disease: Focus on Sucralfate Source: Practical Gastroenterology. 15(4): 46-50, 52. April 1991. Summary: This article reviews the use of sucralfate, a basic aluminum salt of sulfated sucrose, for the treatment of duodenal ulcer. The authors discuss the pharmacology of sucralfate, pharmacokinetics, therapeutic uses for duodenal and gastric ulcers, the efficacy of sucralfate for maintenance therapy in preventing ulcer recurrence, stress ulcer prophylaxis, adverse effects, drug interactions, and dosage and administration. The authors conclude that sucralfate effectively heals a high percentage of duodenal and gastric ulcers following short-term therapy, significantly reduces ulcer recurrence when administered prophylactically, effectively prevents stress-related mucosal damage in susceptible patients, and it is associated with few adverse effects and documented drug interactions. 95 references.

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Peptic Ulcer Patients with Helicobacter Pylori Require Treatment with Antimicrobial Agents: Findings of an NIH Consensus Development Conference Source: Practical Gastroenterology. 18(7): 15-16. July 1994. Contact: Available from Shugar Publishing, Inc. 99B Main Street, Westhampton Beach, NY 11978. (631) 288-4404. Fax (631) 288-4435. E-Mail: [email protected]. Summary: This article summarizes and comments on a recent National Institutes of Health (NIH) Consensus Development Conference on Helicobacter Pylori and Peptic Ulcer. The author notes that the consensus panel recommends antimicrobial agents along with antisecretory drugs as the treatment of choice for peptic ulcer patients with H. pylori infection, whether on first presentation with the illness or on recurrence. The author discusses this recommendation, covering the history of H. pylori as a pathogenic factor in peptic ulcer disease; the importance of accurate diagnosis and the accuracy of various diagnostic tests presently in use; and therapeutic options, including efficacy, compliance, side effects, and cost factors. The article concludes with a section discussing patient selection.

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Peptic Ulcer Disease and Helicobacter pylori Infection Source: Current Opinion in Gastroenterology. 7(1): 108-115. February 1991. Summary: This review article covers peptic ulcer disease and Helicobacter pylori infection. Topics include the role of H. pylori as a causal agent in peptic ulcer disease; triple-antibacterial therapy for duodenal ulcer; nonsteroidal anti-inflammatory drugs and peptic ulcer disease; duodenitis and gastric metaplasia; the pathogenesis of duodenal ulcer; the antibacterial treatment of duodenal ulcer; gastric cancer and H.

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pylori; and H. pylori infections in patients with AIDS. The authors stress that H. pylori infection probably acts as a promotor in the earliest stages of gastric cancer; its eradication in patients with intestinal metaplasia may reduce the risk of gastric cancer. 1 figure. 62 annotated references. (AA-M). •

Helicobacter Pylori and Duodenal Ulcer: Evidence Suggesting Causation Source: Digestive Diseases and Sciences. 37(5): 769-772. May 1992. Summary: This review article explores the evidence that Helicobacter pylori (H. pylori) has a causative role in duodenal ulcers. The authors attempt to differentiate between association and causation and provide an analysis of factors leading to conclusion that H. pylori is a causative agent. Topics include asymptomatic carriers of the bacteria, the existence of a biological gradient, how a bacterium that infects the stomach antrum could be the cause of an ulcer in the duodenum, the effect of interventions against H. pylori, epidemiological characteristics, and the prevalence rate of H. pylori infection. The authors conclude that H. pylori alone is not sufficient in provoking the disease; environmental factors (e.g., smoking) and probably genetic factors are also important. 32 references.

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Stress and Personality in Patients with Chronic Peptic Ulcer Source: Journal of Clinical Gastroenterology. 16(3): 211-214. April 1993. Summary: This review article investigates the roles of stress and personality in patients with chronic peptic ulcer disease. Topics covered include a definition of stress and personality; acute life event stressors; stress as measured by the number of life events; chronic stressors in duodenal ulcer; patient perception of life events; social incongruity and duodenal ulcer; depression; and the personality pattern of patients with chronic peptic ulcer. The authors conclude that the association of psychosomatic factors with ulcers is weak. However, there is an association of chronic stress with ulcer when the stressor contains a component involving personal threat or goal frustration. 30 references.

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Is a One-Week Course of Triple Anti-Helicobacter Pylori Therapy Sufficient to Control Active Duodenal Ulcer? Source: Alimentary Pharmacology and Therapeutics. 15(7): 1037-1045. July 2001. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: Triple therapy currently forms the cornerstone of the treatment of patients with Helicobacter pylori positive duodenal ulcer. This article reports on a study undertaken to establish whether prolonged antisecretory therapy is necessary in patients with active duodenal ulcer. A total of 77 patients with H. pylori positive duodenal ulcer were included in the prospective, controlled, double blind study. All patients received a 7 day treatment with omeprazole 20 milligrams twice daily (b.d.), clarithromycin 500 milligrams b.d., and amoxicillin 1000 milligrams b.d. Patients in the omeprazole group underwent an additional 14 day therapy with omeprazole 20 milligrams; patients in the placebo group received placebo. Endoscopy was performed upon inclusion in the study and after 3 and 8 weeks. After 3 weeks, the healing rate was 89 percent in the omeprazole group and 81 percent in the placebo group. After 8 weeks, the ulcer healed in 97 percent of the patients in the total group. H. pylori was eradicated

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in 88 percent of patients in the omeprazole group and in 91 percent in the placebo group. No statistically significant differences between the groups were found in ulcer related symptoms or in ulcer healing. The authors conclude that in patients with H. pylori positive duodenal ulcer, a 7 day triple therapy alone is sufficient to control the disease. 5 figures. 3 tables. 18 references.

Federally Funded Research on Duodenal Ulcer The U.S. Government supports a variety of research studies relating to duodenal ulcer. 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 duodenal ulcer. 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 duodenal ulcer. The following is typical of the type of information found when searching the CRISP database for duodenal ulcer: •

Project Title: AUTOIMMUNE GASTRITIS INITIATED BY HELICOBACTER INFECTION Principal Investigator & Institution: Lorenz, Robinna G.; Associate Professor; Pathology and Immunology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 30-SEP-1999; Project End 30-JUN-2002 Summary: (Taken from the Investigator's Abstract) The bacteria, Helicobacter pylori, is a major pathogen which, in addition to infecting over half of the world's population, is linked to gastric and duodenal ulcer disease, mucosal-associated lymphomas, and adenocarcinoma. Infection with H.pylori initially leads to recruitment and activation of the non-specific innate immune response. These mononuclear cells secrete proinflammatory cytokines that directly affect the gastric epithelium, as well as recruit lymphocytes into the inflammatory focus. Very little is known about the characteristics of this immune infiltrate, its antigen specificity, or its role in subsequent development of gastric diseases; however, it has now been shown that infection with H.pylori can lead to the production of anti- parietal cell antibodies. This has led to the hypothesis that Helicobacter infection induces an autoimmune response that causes subsequent gastric epithelial cell destruction and pathology. A small animal model of Helicobacter infection, the H.felis mouse model, closely mimics the human disease and allows a careful analysis of the adaptive immune response to Helicobacter infection. The investigator has shown that it is the host T cell response that is crucial for the development of H.felis-associated gastric pathology. This has directed attention to the role of the cellular immune response, and its potential autoimmune nature, in the

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

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development of Helicobacter-associated gastric epithelial cell destruction and pathology. This grant application focuses on understanding the relationship between the cellular immune response to Helicobacter infection, and the development of subsequent gastric epithelial alterations. These changes in epithelial proliferation, differentiation, and cell death lead to clinical ulcer disease and increased metaplasia. In order to elucidate this immune/epithelial cell relationship and its sequelae, the investigators propose to identify the immune T lymphocyte subset critical for the development of Helicobacter- associated gastric pathology and to determine the mechanism by which Helicobacter-induced immune responses generate gastric epithelial pathology. The understanding of the basic mechanisms by which the host immune response to Helicobacter induces gastric epithelial pathology will lay the foundation for further studies on the regulation of the inflammatory response and the design of immunotherapies for Helicobacter infection and associated digestive diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DUODENAL MUCOSAL BICARBONATE SECRETION Principal Investigator & Institution: Barrett, Kim E.; Professor and Vice Chair for Research; Medicine; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 920930934 Timing: Fiscal Year 2002; Project Start 01-DEC-1984; Project End 31-JUL-2005 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DUODENAL MUSCOSAL DEFENSE MECHANISMS Principal Investigator & Institution: Kaunitz, Jonathan D.; Professor of Medicine; Brentwood Biomedical Research Institute Bldg. 114, Room 218 Los Angeles, Ca 90073 Timing: Fiscal Year 2002; Project Start 01-MAY-1999; Project End 30-APR-2007 Summary: (provided by applicant): Peptic ulcer disease is a major cause of morbidity and mortality in elderly and chronically ill populations. Despite major advances made about ulcer pathogenesis, complications of peptic ulcers still represent a significant problem in at-risk populations, especially in the elderly and those with significant comorbidities. Peptic ulceration represents a disturbance in the balance between aggressive factors (acid and pepsin) and defensive factors (mucosal bicarbonate secretion, blood flow, and mucus secretion). Of these, bicarbonate secretion is thought to be a primary defense mechanisms, due mainly to studies in which bicarbonate secretion is correlated to injury prevention, since, in general, increased bicarbonate secretion protects the mucosa from acid-induced injury. Nevertheless, the precise means by which an intrinsically leaky epithelium such as the duodenum can resist damage from intensely acid gastric juice remains unresolved. In the past few years, my laboratory has made the novel observation that provides unique insight into how duodenal villus epithelial cells, the prime targets of gastric acid, can resist injury. We formulated the 'intracellular HCO3' hypothesis in which intracellular, not extracellular bicarbonate serves as the principal duodenal mucosal defense mechanism. To test this hypothesis, we have devised a series of experiments designed to 'uncouple' bicarbonate secretion and mucosal protection. Subjects with the disease cystic fibrosis, despite copious gastric acid secretion and low duodenal pH, only rarely have duodenal ulcers. We believe that this is a result of bicarbonate being trapped in duodenal epithelial cells. We plan to test this hypothesis directly in mice deficient for the CFTR or cystic fibrosis gene product. Through the conduct of these studies, we hope to gain further insight into the

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mechanism of peptic ulceration, in the hopes of finding new treatments designed to prevent ulcer complications in our aging population, and to also gain additional insight into the pathogenesis of cystic fibrosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EARLY EVENTS IN DICLOFENAC ENTEROPATHY Principal Investigator & Institution: Moslen, Mary T.; Associate Professor; Pathology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2002; Project Start 15-SEP-2001; Project End 31-JUL-2005 Summary: (provided by applicant): Proposed research will critically test our new hypothesis that drug-protein adducts are causal factors in the pathogenesis of diclofenac-induced ulcers in the small intestine. This hypothesis stems from our novel observations that diclofenac forms adducts with enterocytes prior to ulceration and to a greater extent in the jejunal region most prone to ulceration. This classical NSAID is widely prescribed for arthritis, musculoskeletal injuries and pen-operative pain. Chronic use of classic NSAIDs, including diclofenac, is complicated by a >50 percent incidence of enteropathy (i.e., inflammation, lesions and blood loss) plus high risks of hospitalization and death secondary to intestinal perforation. Specific Aim I will characterize the hypothesized critical early sites of adduct formation utilizing immunohistochemistry, confocal microscopy, and 14C-diclofenac to localize the distribution and extent of adduction prior to structural alterations of enterocytes and villi in ulcer-prone regions of the intestine. A jejunum-to-jejunum anastamosis technique will assess alternative explanations for adduct accumulation at sites of ulcers. Specific Aim 2 will exploit regional difference in diclofenac-induced intestinal ulceration to define linkages between adduction and potentially relevant functional and chemical consequences. Experiments will determine if adduction of ulcer-prone regions is associated with impairments of vital functions or with evidence for oxidative stress. A temporal linkage between adduction and impaired capacity for repair by restitution will be specifically sought using a differentiated intestinal epithelial cell line provided by Dr Peter G Traber. A new collaboration with Dr Daniel Liebler will allow application of a novel proteomics approach to the identification of protein targets of diclofenac adduction. The sensitivity of the planned detection techniques, particularly the MS-MS fragmentation technique for adduct proteonomics, will enable analysis of tiny quantities of tissue obtained by microdissection or laser capture microdissection. Specific Aim 3 will critically test the purported role of oxidative stress by determining if the advancement to ulceration after adduct formation can be modified by intralumenal infusion of an antioxidant rescue or a lipid peroxide challenge. Current COX-inhibition based theories for NSAID-induced gastric ulcers do not account for the enteropathy problem. Therefore, information obtained from the proposed research about adducts as the initial molecular insult to enterocytes could provide a new mechanistic basis for development of intestine-safer NSAIDs or regimes of NSAID therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ETIOLOGICAL STUDIES OF GASTRIC CARCINOMA Principal Investigator & Institution: Correa, Pelayo; Boyd Professor; Pathology; Louisiana State Univ Hsc New Orleans New Orleans, La 70112 Timing: Fiscal Year 2003; Project Start 01-JUN-1981; Project End 30-JUN-2008 Summary: (provided by applicant): The goal of this Program Project has been and continues to be the multi-disciplinary study of the etiology of gastric cancer. This

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neoplastic disease is second only to lung cancer in incidence and mortality worldwide. In the United States gastric cancer rates have decreased considerably. There are, however, high-risk groups, especially African Americans, Amerindians, and immigrants from Asia, Northern/Eastern Europe and Latin America. It has become increasingly clear that a major etiologic factor is chronic infection with Helicobacter pylori. About one half of today.s world population is infected, especially groups of lower socioeconomic status. The International Agency for research on Cancer has classified Helicobacter infection as a class 1 carcinogen. There are great differences in the outcome of the infection. Most infections are mild and subclinical. Clinical infections may lead to duodenal ulcer accompanied by non-atrophic gastritis, which does not increase gastric cancer risk, or to multifocal atrophic gastritis, which may lead to gastric ulcer and gastric cancer. Our general hypothesis is that the immune and inflammatory responses determine the outcome of the infection. Our Program Project explores the dynamics of the response with immunologic and histopathologic techniques in adults and children (Project 1,2 and 3). Two epidemiologic projects are also proposed: 1) follow-up of the chemoprevention cohort, which explores the natural history of infection after eradication attempts (Project 1); and 2) study of the dynamics of infection and reinfection in children of a hyper-endemic area in search for answers to the critical events in initiating the possible carcinogenesis pathway, namely persistence of infection in childhood. (Project 3). COLLABORATING INSTITUTION(S): Delft laboratories, The Netherlands Emory University Medical Center Atlanta, GA University del Valle, Cali, Colombia University de Narino, Colombia University de Antioquia, Medellin, Colombia University of Texas School of Public Health, Houston TX APR NOTE: This Program Project Grant has addressed the etiology of gastric cancer for 20 years and is in the fifth cycle of funding. This competitive renewal application continues the unique and multidisciplinary study of gastric cancer. The general hypothesis put forward by this Program Project is that the immune and inflammatory responses determine the outcome of the Helicobacter pylori infection leading to gastric ulcer or gastric cancer. The Program includes 3 Projects and 4 Cores. It was felt at the accelerated review that the investigators had resolved all the problems identified in the last review. The Program Project has continued to build on the broad clinical, pathological, and molecular experience accumulated by the Principal Investigator and his program project staff. Two unique populations of H. pylori-infected individuals located in Colombia are being studied. In one population non-atrophic gastritis (NAG) is more common along with low gastric cancer rates and in the second population multi-focal atrophic gastritis (MAG) is more common with a much higher gastric cancer rate. A major strength of this research and the Program Project is the investigators' matchless understanding of the etiology of gastric cancer in these unique and well-characterized populations. These two populations (a major world-wide resource for studying H. pylori pathogenesis) constitute the major strength of this application along with the more than 18 years of study of this gastric cancer problem by the Principal Investigator in a program project environment. In a previous review there were problems with some of the work not being adequately described for an accurate assessment of its feasibility, but these deficiencies have been eliminated. The program is totally unique, has been highly successful in the past, and should make substantial progress in this new funding period. The recommended merit scores of all three projects was 1.4. Three of the cores, Histopathology, Administrative and Field Activites, and Genetic Characterization are rated superior, and the Administrative and Data Management Core is rated satisfactory. The Program is highly integrated and in a very special way makes the whole more valuable than the parts. This was a unanimous observation by the reviewers. The Program is recommended for 5 years of funding. Project 1, "Chemoprevention of gastric Dysplasia", is led by Elizabeth Fontham, Ph.D. The focus of this project continues to be

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an important population from Colombia who are at high risk for gastric cancer and who have been the focus of this program project since its inception. A unique cohort of subjects with MAG from this population were the subjects of an interventional study in the 1990's to examine the effect of beta carotene and Vitamin C and/or eradication of H. pylori on the progression of gastric precancerous histological lesions. Contact has been maintained with these subjects, around half of who are now H. pylori-negative. This project will continue to follow these subjects closely by endoscopy and clinical evaluation to determine whether the continuing natural history of progression in gastric preneoplasia is altered by the persistent eradication of H. pylori. A secondary aim will be to determine whether those subjects who become reinfected by H. pylori are infected by less virulent strains, as suggested by preliminary data. The project has many strengths, including its focus on a unique and well-defined clinically relevant population, and the expertise of the clinicians and pathologists, who have proven their ability to work cohesively under the supervision of Drs Correa and Fontham over many years. This project received an average merit rating of 1.4. Project 2. "Immune Response to H. pylori in Non-atrophic Gastritis and Multifocal Gastritis" is led by Augusto Ochoa, M.D. It has continued to improve since the first review. One major exception was the validation of using PBL responses to reflect the immune and inflammatory status of leukocytes in the gastric mucosa. This was addressed satisfactorily in the accelerated peer review. The investigators responded by stating that for the first third of the patients analyzed (numbering 20), in vitro PBL responses will be compared with in situ gastric tissue responses. If concordance is observed, the remaining patients in the study will be followed as initially proposed, with concentration of efforts on PBL analysis. If, on the other hand, concordance between the PBL vs. in situ tissue analysis is not observed, the investigators will be able to adjust their analysis to include both PBL's and in situ analysis of all remaining subjects. This response is entirely appropriate and alleviates the biggest uncertainty in the approach taken in Project 2 during the previous submission. The greatest strengths of this project include the unique patient resources available and the previous productivity of the investigators. The overall goal of defining differences in the host immune response between H. pylori-infected patients at risk of developing gastric cancer versus duodenal ulcers is very worthwhile, and within the capability of the investigators. The project has the potential to help dissect the relative contributions of host and bacteria to the development of gastric cancer. This project received an average merit rating of 1.4. Project 3, "Community Intervention-Follow-up of Colombian Children" is led by Karen Goodman in a consortium arrangement with The University of Texas School of Public Health. This project addresses important questions in an appropriate fashion. In the previous version of this project, a clerical effort resulting in the reviewers not seeing the final draft. This problem has been resolved with many of the perceived scientific problems also being clarified. The 3-drug therapy chosen was identified by the reviewers as "a peculiar combination". In the most recent submission, Metronidazole has been added to create a 4-drug therapy. This regimen is consistent with contemporary medical practices. This project received a merit rating of 1.4 Core A, Histopathology, is led by the Principal Investigator, Dr. Pelayo Correa. This laboratory will perform all the histological and histochemical processing and evaluation of the numerous biopsies taken from each of the projects. It is a critically important core for this program project. It will be essential for all three projects, especially Project 1. This laboratory has proven over many years that it is ideally equipped for these purposes, and Dr Correa, the Core director, has an unequalled expertise in the interpretation of gastric pathology. This is a superior core. Core B, "Genetic Characterization of H. pylori Strains" led by Barbara Schneider, Ph.D., provides resources for genotypic characterization of three putative virulence genes in H. pylori strains. The LiPA assay for this purpose is well validated and supported by the

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experience of its inventor, Dr. van Doorn, who will serve as a consultant. The highthroughput advantages of the LiPA assay will be exploited in Projects 1 and 2. It is not clear whether babA typing will also be done by LiPA or by other, independent PCR's. In addition development of non-invasive genotyping methods using fecal samples is proposed. This core received a superior rating. Core C, "Administrative and Data Management (New Orleans)" is led by Dr. Pelayo Correa, M.D. who is also the Principal Investigator of this grant application. This administrative effort has been quite successful in the past and is very well organized and efficient. This Core had the deficiency during the last review of an underpowered statistical analysis effort. Dr. Correa has addressed this deficiency, and both Ms. Du and Ms. Camargo have been assigned to work under Dr. Mera. The question during the last review was regarding the amount of time Dr. Mera could devote to this Program Project. His credentials are perfectly matched for this Program Project, but his time available was considered inadequate because of the large amount of statistical analysis needed by this Program Project. To satisfy this criticism, two new faculty were recruited the biostatistics area. One of these individuals, Dr. Velasco, is Spanish speaking and could help the program project and reports to Dr. Fontham, the Project Leader of Project 1. Most importantly, the new head of the Cancer Center Statistical Department (just hired the week of the current review at the full professor level) will give 15 percent of his time to this Program. This individual is highly qualified and very experienced with the types of statistical problems that will occur in these studies. Thus, the program project statistical effort is going to be run 25 percent time by Dr. Mera and 15% by the new senior faculty member with 2 capable support people at LSU. This is a strong addition to the Core and resolves the major statistical problem from the last review. This core received a satisfactory rating. Core D, "Administrative and Field Activities (Colombia)" is led by Luis Eduardo Bravo, M.D. As was stated previously this is an outstanding core. The cost effectiveness of this effort is remarkable. Past history of this effort and the intact staff from the previous funding period make this core effort convincing and very workable. Some of the details missing about data flow and quality assurance from the previous review were not entirely provided in this new submission, but the effort is still superior, as the overall coordination between the various units in Colombia and between Colombia and the US look strong. This core received a superior rating. Commentary related to Progress in the current funding period, Integrated Effort, Principal Investigator, Support to be negotiated for replacement and Human Subjects are unchanged from the previous review. REVISION NOTE: Modified to include review panel roster. INDIVIDUAL PROJECTS AND CORES PROJECT 1: Chemoprevention of Gastric Dysplasia: Long-term follow-up of a cohort treatment for H. pylori infection (Elizabeth T.H. Fontham, Dr. Ph.H., 15 percent effort) Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FUNCTIONAL ANALYSIS OF HELICOBACTER PYLORI VACA TOXIN Principal Investigator & Institution: Torres, Victor J.; Medicine; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2003; Project Start 01-DEC-2003; Project End 30-NOV-2006 Summary: (provided by applicant): Helicobacter pylori infection is a risk factor for duodenal ulcer disease and gastric cancer. One H. pylori virulence factor associated with disease is the vacuolating cytotoxin (VacA). VacA exerts a variety of effects on epithelial cells in vitro, including the formation of intracellular vacuoles and anionselective pores in the plasma membrane. VacA domains involved in assembly of the

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toxin into oligomeric structures or membrane channels have not been analyzed yet. Also, domains of VacA essential for toxin binding to cells have not yet been analyzed in any detail. The aims of this proposal are: (i) identification of domain(s) required for VacA assembly into oligomeric structures. To accomplish this aim, the yeast-two hybrid method is being used. Preliminary data suggest that the yeast-two hybrid system is suitable for the screening of oligomerization domains within VacA. (ii) mapping the cell binding domain(s) required for VacA binding to target cells. To achieve this aim, a library of VacA carboxyl-terminal deletions has been generated. The mutant recombinant toxins are being expressed in E. coli and tested for their cytotoxic activity as well as their ability to bind to cells. (iii) understanding the mechanism of the dominant-negative phenotype observed with the VacA delta6-27 deletion mutant. To fulfill this aim I am using the VacA recombinant system to determine the minimum amino acid sequence required for the delta6-27-VacA toxin to exhibit a dominantnegative phenotype. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMMUNE RESPONSE TO H PYLORI GASTRITIS Principal Investigator & Institution: Ochoa, Augusto C.; Associate Professor; Louisiana State Univ Hsc New Orleans New Orleans, La 70112 Timing: Fiscal Year 2003; Project Start 08-JUL-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Helicobacter pylori (H. pylori) infects over half of the world's population and is associated with multiple disease states ranging from gastritis and duodenal ulcer to gastric cancer and lymphomas. The mechanisms leading from infection to malignancy are not clearly established, but are prominently associated with the type of inflammatory response to the bacteria. In addition to inducing an antibody response, H. pylori causes a T cell response which initially appears to be a Th1 type with the production of IL2, IFNgamma, and TNFalpha and the development of gastritis. The type of gastritis has been divided into two major categories by its histologic appearance, non-atrophic gastritis (NAG), generally associated with duodenal ulcer disease, and Multi-focal atrophic gastritis (MAG), associated with gastric ulcers, epithelial dysplasia and gastric cancer. Most of the previous work has studied the immune response on patients with NAG, while little is known on patients with MAG. Our preliminary data comparing both groups of patients shows an increased infiltration by B cells and an enhanced expression of HLA-DR expression in patients with NAG, which markedly decreases in patients with MAG. In contrast the peripheral blood lymphocytes of patients with MAG show a significantly increased production of IFNgamma, IL5 and IL10 after stimulation with H. pylori antigens. However, our data also shows that H. pylori can impair the T cell response by diminishing the proliferation to mitogens, altering the expression of signal transduction proteins and, in patients with MAG, increasing the production of arginase, an enzyme known to diminish the T cell response. Therefore our hypothesis is that the immune response to H. pylori antigens differs in patients with NAG and MAG and therefore plays a central role in determining the type of gastritis developed by the host and its possible progression to gastric malignancy. To test this hypothesis we have developed the following specific aims: 1. To Compare the local inflammatory response in the gastric mucosa of patients with Nonatrophic antral gastritis (NAG) and patients with Multi-focal atrophic gastritis (MAG) using histopathology, immunohistochemistry and in situ hybridization techniques. 2. To compare the cellular immune response of peripheral blood lymphocytes and gastric mucosa lymphocytes to H. pylori antigens in patients with NAG and MAG. 3. To

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identify the mechanisms by which H. pylori impairs T cell signal transduction and T cell function in patients with H. pylori induced gastritis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INFLUENCE OF HELICOBACTER PYLORI AND DUODENAL ULCER ON ENTEROCYTES Principal Investigator & Institution: Isenberg, Jon I.; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 920930934 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INTERACTION OF HELICOBACTER PYLORI WITH PHAGOCYTES Principal Investigator & Institution: Allen, Lee-Ann H.; Internal Medicine; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 29-SEP-2000; Project End 30-JUN-2004 Summary: Description (Adapted from the applicant's abstract): Helicobacter pylori is a gram negative bacterium which colonizes the gastric epithelium of up to half of the world's population and plays a causative role in the development of gastric and duodenal ulcers and gastric adenocarcinoma. One of the hallmarks of H. pylori is its persistence, and bacteria are not cleared by the host immune system. This may be explained in part by the fact that H. pylori is readily phagocytosed by macrophages, but the internalized bacteria are not killed. Significantly, preliminary data obtained by the PI suggest the following hypothesis; H. Pylori survives for at least 20 hours inside macrophages by disrupting phagosome maturation. Moreover, this appears to occur by a novel mechanism that involves 1) delayed phagocytosis 2) homotypic fusion of early phagosomes and 3) bacteria-stimulated secretion of lysosomal enzymes from infected cells. The long-term objective of this study is to dissect the mechanism of H. pylori survival in macrophages at the molecular level and to identify the host and bacterial factors required for this process. Specifically, the PI will characterize the H. pylori phagosome in macrophages and use immunofluorescence and confocal microscopy to quantify phagosome pH; electron microscopy to determine phagosome structure; and video imaging of live cells to determine whether H. pylori phagosomes interact with the endosomal compartment. Subcellular fractionation and Western blotting, and immunoelectron microscopy, and antisense oligonucleotides will be used to define the roles of phosphatidylinositol 3-kinase, protein kinase C-zeta, and rab5 in phagocytosis of H. pylori. In addition, whether macrophage-activating cytokines and/or serum opsonins increase phagocytic killing of H. pylori will be determined. Finally, H. pylori mutants with known mutations in urease and VacA will be used to assess whether these bacterial factors are essential for bacterial survival inside macrophages. These data may be the first indication that H. pylori can disrupt phagosome maturation in macrophages. A complete dissection of this process at the molecular level may lead to novel therapies for treatment of H. pylori infection and reduce the significant morbidity associated with ulcer disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: UGI HEMORRHAGE AND BARRETTS EPITHELIUM Principal Investigator & Institution: Jensen, Dennis M.; Professor of Medicine; Ctr for Ulcer Research & Educ; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-JUL-1999; Project End 30-JUN-2004 Summary: My primary career goals related to this award are: 1) to pursue a program of investigator-initiated, hypothesis driven, high quality patient-oriented research in the specialty of digestive diseases, 2) to mentor young clinicians, with little or no research experience, in their career development as patient-oriented researchers, and 3) to continue to mentor and collaborate with other clinical researchers who are beyond the entry level as clinical investigators. Two NIH studies and several new collaborative studies support this research and mentoring proposal. The first NIH Grant, "Studies of UGI Hemorrhage and Endoscopic Hemostasis" evaluates patients with severe upper gastrointestinal bleeding (UGIB) from peptic ulcers, Dieulafoy's lesions, or Mallory Weiss tears. In three consecutive blinded, multicenter randomized trials, our hypothesis is that combination therapy (epinephrine and coagulation) will be significantly better than thermal therapy for initial hemostasis, reduction in early rebleeding rates, and reduction in hospital costs of care. The second NIH Grant, "Prevention of Ulcer Hemorrhage by H.pylori Eradication" is a multicenter, double-blind, randomized comparison of two different medical treatments to prevent recurrence of duodenal ulcer (DU) and gastric ulcer (GU) bleeding. The overall hypotheses to be tested are that 1) eradication of Helicobacter pylori (H. pylori) infection alone will cure most patients of their chronic peptic ulcers and will be substantially equivalent to H.pylori eradication plus full-dose H2RA maintenance in preventing recurrent ulcer hemorrhage and 2) ingestion of aspirin or other non-steroidal anti-inflammatory drugs or recurrence of H.pylori infection will account for all recurrences of ulcer hemorrhage during long-term follow-up. New collaborative studies are also proposed of Barrett's epithelium and prospective trials of variceal and non-variceal hemorrhage. In the mentoring program, new investigators will be trained to perform randomized prospective trials, endoscopic technology assessment studies, and patient-oriented research. This mentoring will be supplemented by didactic courses in biostatistics, seminars in study design, and other instruction in data management, form design for prospective trials, and protocol writing. Emphasis will be placed on planning, designing, and conducting actual prospective randomized studies. This award will enhance the applicant's research productivity and provide skilled mentoring for young investigators, so they can become independent patient-oriented investigators in digestive diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and

3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age.

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unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “duodenal ulcer” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for duodenal ulcer in the PubMed Central database: •

babA2- and cagA-Positive Helicobacter pylori Strains Are Associated with Duodenal Ulcer and Gastric Carcinoma in Brazil. by Oliveira AG, Santos A, Guerra JB, Rocha GA, Rocha AM, Oliveira CA, Cabral MM, Nogueira AM, Queiroz DM.; 2003 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=179833

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CagA Antibodies in Japanese Children with Nodular Gastritis or Peptic Ulcer Disease. by Kato S, Sugiyama T, Kudo M, Ohnuma K, Ozawa K, Iinuma K, Asaka M, Blaser MJ.; 2000 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=86021

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Clustering of South African Helicobacter pylori Isolates from Peptic Ulcer Disease Patients Is Demonstrated by Repetitive Extragenic Palindromic-PCR Fingerprinting. by Kidd M, Atherton JC, Lastovica AJ, Louw JA.; 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=88034

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Consensus and Variable Region PCR Analysis of Helicobacter pylori 3[prime prime or minute] Region of cagA Gene in Isolates from Individuals with or without Peptic Ulcer. by Rota CA, Pereira-Lima JC, Blaya C, Nardi NB.; 2001 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=87784

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Cytotoxic isolates of Helicobacter pylori from Peptic Ulcer Diseases decrease K+dependent ATPase Activity in HeLa cells. by Shanjana A, Archana A.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=280654

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Decreased Epithelial Cytokine Responses in the Duodenal Mucosa of Helicobacter pylori-Infected Duodenal Ulcer Patients. by Stromberg E, Edebo A, Svennerholm AM, Lindholm C.; 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=145289

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Detection of Campylobacter pyloridis in patients with antrum gastritis and peptic ulcers by culture, complement fixation test, and immunoblot. by von Wulffen H, Heesemann J, Butzow GH, Loning T, Laufs R.; 1986 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=269015

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Differences in Surface-Exposed Antigen Expression between Helicobacter pylori Strains Isolated from Duodenal Ulcer Patients and from Asymptomatic Subjects. by Thoreson AC, Hamlet A, Celik J, Bystrom M, Nystrom S, Olbe L, Svennerholm AM.; 2000 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=87400

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Discrimination between Cases of Duodenal Ulcer and Gastritis on the Basis of Putative Virulence Factors of Helicobacter pylori. by Yamaoka Y, Souchek J, Odenbreit S, Haas R, Arnqvist A, Boren T, Kodama T, Osato MS, Gutierrez O, Kim JG, Graham DY.; 2002 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=130665

5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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How often does surgery for peptic ulceration eradicate Helicobacter pylori? Systematic review of 36 studies. by Danesh J, Appleby P, Peto R.; 1998 Mar 7; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28480

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Identification of cagA Tyrosine Phosphorylation DNA Motifs in Helicobacter pylori Isolates from Peptic Ulcer Patients by Novel PCR-Restriction Fragment Length Polymorphism and Real-Time Fluorescence PCR Assays. by Owen RJ, Sharp SI, Chisholm SA, Rijpkema S.; 2003 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=165352

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Immunoblot Analysis of Humoral Immune Response to Helicobacter pylori in Children with and without Duodenal Ulcer. by Rocha GA, Oliveira AM, Queiroz DM, Carvalho AS, Nogueira AM.; 2000 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=86586

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Molecular Characterization of the 128-kDa Immunodominant Antigen of Helicobacter pylori Associated with Cytotoxicity and Duodenal Ulcer. by Covacci A, Censini S, Bugnoli M, Petracca R, Burroni D, Macchia G, Massone A, Papini E, Xiang Z, Figura N, Rappuoli R.; 1993 Jun 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=46808

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Non-operative treatment for perforated gastro-duodenal peptic ulcer in Duchenne Muscular Dystrophy: a case report. by Brinkman JM, Oddens JR, Van Royen BJ, Wever J, Olsman JG.; 2004; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=324410

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NOTE ON THE EPIDEMIOLOGY OF PEPTIC ULCER. by Wilson EB.; 1962 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=221099

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Parental history of gastric or duodenal ulcer and prevalence of Helicobacter pylori infection in preschool children: population based study. by Brenner H, Rothenbacher D, Bode G, Adler G.; 1998 Feb 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28471

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PCR-Based Restriction Pattern Typing of the vacA Gene Provides Evidence for a Homogeneous Group among Helicobacter pylori Strains Associated with Peptic Ulcer Disease. by Donati M, Storni E, D'Apote L, Moreno S, Tucci A, Poli L, Cevenini R.; 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=88623

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Predicting Chemically Induced Duodenal Ulcer and Adrenal Necrosis with Classification Trees. by Giampaolo C, Gray AT, Olshen RA, Szabo S.; 1991 Jul 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=52070

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Prevalence of CagA and VacA Antibodies in Children with Helicobacter pyloriAssociated Peptic Ulcer Compared to Prevalence in Pediatric Patients with Active or Nonactive Chronic Gastritis. by Alarcon T, Martinez MJ, Urruzuno P, Cilleruelo ML, Madruga D, Sebastian M, Domingo D, Sanz JC, Lopez-Brea M.; 2000 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=95968

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Testing for Helicobacter pylori in dyspeptic patients suspected of peptic ulcer disease in primary care: cross sectional study. by Weijnen CF, Numans ME, de Wit NJ, Smout AJ, Moons KG, Verheij TJ, Hoes AW.; 2001 Jul 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34540

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vacA Genotypes in Helicobacter pylori Strains Isolated from Children with and without Duodenal Ulcer in Brazil. by De Gusmao VR, Nogueira Mendes E, De Magalhaes Queiroz DM, Aguiar Rocha G, Camargos Rocha AM, Ramadan Ashour AA, Teles Carvalho AS.; 2000 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=87127

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

A case of abscess caused by a penetrating duodenal ulcer. Author(s): Yoshida H, Onda M, Tajiri T, Taniai N, Matsukura N, Tokunaga A, Yamashita K, Yoshiyasu M, Hashimoto M. Source: Hepatogastroenterology. 1999 July-August; 46(28): 2379-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10522001&dopt=Abstract

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A comparative therapeutic trial of sucralfate and ranitidine in initial healing and relapse rate of duodenal ulcer. Author(s): Agrawal BK, Prasad RN, Kumar P. Source: J Assoc Physicians India. 1990 September; 38 Suppl 1: 720-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2092028&dopt=Abstract

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A four-year follow-up of duodenal ulcer patients after Helicobacter pylori eradication. Author(s): Tepes B, Kavcic B, Gubina M, Krizman I. Source: Hepatogastroenterology. 1999 May-June; 46(27): 1746-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10430336&dopt=Abstract

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A meta-analysis comparing eradication, healing and relapse rates in patients with Helicobacter pylori-associated gastric or duodenal ulcer. Author(s): Leodolter A, Kulig M, Brasch H, Meyer-Sabellek W, Willich SN, Malfertheiner P. Source: Alimentary Pharmacology & Therapeutics. 2001 December; 15(12): 1949-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11736726&dopt=Abstract

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A multicenter study on eradication of Helicobacter pylori infection in patients with duodenal ulcer by lansoprazole-antibiotics combined therapy. Author(s): Yang JC, Yang KC, Hsu CT, Wang CS, Kuo CF, Wang TH. Source: J Microbiol Immunol Infect. 1999 March; 32(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11561564&dopt=Abstract

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A multicenter, double-blind, randomized, placebo-controlled comparison of nocturnal roxatidine in the treatment of active duodenal ulcer disease. Multicenter Roxatidine Cooperative Study Group. Author(s): Gilinsky NH, Bright-Asare P, Cobert BL, Fitch DD, Lanza FL, Kerr RM, Savitsky JP. Source: The American Journal of Gastroenterology. 1992 July; 87(7): 847-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1352083&dopt=Abstract

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A perforated duodenal ulcer in a child. Author(s): Sisil Kumara PD, Weerawardena WA, Esufali ST. Source: Ceylon Med J. 2000 September; 45(3): 133-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11192994&dopt=Abstract

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A role of Helicobacter pylori infection in the development of duodenal ulcer after adult living-related liver transplantation. Author(s): Hosotani Y, Kawanami C, Hasegawa K, Watanabe T, Ito T, Oike F, Kaihara S, Okazaki K, Tanaka K, Chiba T. Source: Transplantation. 2003 August 27; 76(4): 702-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12973113&dopt=Abstract

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A three-day course of intravenous omeprazole plus antibiotics for H. pylori-positive bleeding duodenal ulcer. Author(s): Sheu BS, Chi CH, Yang HB, Jen CM, Lin XZ. Source: Hepatogastroenterology. 1999 July-August; 46(28): 2363-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10521999&dopt=Abstract

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Acid and duodenal ulcer pain. Author(s): Kang JY. Source: Gastroenterology. 1990 August; 99(2): 603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2365209&dopt=Abstract

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Adenosine deaminase activity in the gastric mucosa of duodenal ulcer patients in relation to the severity of chronic gastritis and gastric acid secretion. Author(s): Namiot Z, Namiot A, Kemona A, Stasiewicz J, Gorski J. Source: Rocz Akad Med Bialymst. 2001; 46: 309-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11780574&dopt=Abstract

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Aging increases, and duodenal ulcer reduces the risk for intestinal metaplasia of the gastric corpus in Japanese patients with dyspepsia. Author(s): Tsukui T, Kashiwagi R, Sakane M, Tabata F, Akamatsu T, Wada K, Futagami S, Miyake K, Sueoka N, Hirakawa T, Kobayashi M, Fujimori T, Sakamoto C. Source: Journal of Gastroenterology and Hepatology. 2001 January; 16(1): 15-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11206310&dopt=Abstract

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Alpha1-antitrypsin deficiency may be a risk factor for duodenal ulcer in patients with Helicobacter pylori infection. Author(s): Elzouki AN, Toth E, Floren CH, Lindgren S, Fork FT, Sjolund K, Walder M, Eriksson S. Source: Scandinavian Journal of Gastroenterology. 2000 January; 35(1): 32-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10672831&dopt=Abstract

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Amoxycillin, clarithromycin and either sucralfate or pantoprazole for eradication of Helicobacter pylori in duodenal ulcer (a randomized controlled trial). Author(s): Vcev A, Vceva A, Kurbel S, Takac B, Stimac D, Ivandic A, Ostojic R, Barbir A, Hovat D, Mihaljevic S. Source: Wiener Klinische Wochenschrift. 2001 December 17; 113(23-24): 939-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11802510&dopt=Abstract

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Anterior seromyotomy with posterior truncal vagotomy in uncomplicated chronic duodenal ulcer. Author(s): Supe A, Bhalla R, Pandya SV, Doctor NH, Bapat VN. Source: Journal of Postgraduate Medicine. 1995 July-September; 41(3): 61-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10707716&dopt=Abstract

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Assessment of decisions in the treatment of Helicobacter pylori-related duodenal ulcer: a cost-effectiveness study. Author(s): Chen SY, Wang JY, Chen J, Zhang XD, Zhang SS. Source: Journal of Gastroenterology and Hepatology. 1999 October; 14(10): 977-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10530493&dopt=Abstract

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Association of interleukin 1 gene family polymorphisms with duodenal ulcer disease. Author(s): Garcia-Gonzalez MA, Lanas A, Savelkoul PH, Santolaria S, Benito R, Crusius JB, Pena AS. Source: Clinical and Experimental Immunology. 2003 December; 134(3): 525-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14632761&dopt=Abstract

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Autonomic control of heart period in duodenal ulcer patients insights from spectral analysis of heart rate variability. Author(s): Lucini D, Cerchiello M, Basilisco G, Cainelli M, Bianchi PA, Fiorelli G, Malliani A, Pagani M. Source: Autonomic Neuroscience : Basic & Clinical. 2000 November 1; 84(3): 122-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11111844&dopt=Abstract

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Autonomic nervous activity before and after eradication of Helicobacter pylori in patients with chronic duodenal ulcer. Author(s): Katoh K, Nomura M, Nakaya Y, Iga A, Nada T, Hiasa A, Ochi Y, Kawaguchi R, Uemura N, Honda H, Shimizu I, Ito S. Source: Alimentary Pharmacology & Therapeutics. 2002 April; 16 Suppl 2: 180-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11966539&dopt=Abstract

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Azithromycin in a triple therapy for H.pylori eradication in active duodenal ulcer. Author(s): Ivashkin VT, Lapina TL, Bondarenko OY, Sklanskaya OA, Grigoriev PY, Vasiliev YV, Yakovenko EP, Gulyaev PV, Fedchenko VI. Source: World Journal of Gastroenterology : Wjg. 2002 October; 8(5): 879-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378634&dopt=Abstract

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babA2- and cagA-positive Helicobacter pylori strains are associated with duodenal ulcer and gastric carcinoma in Brazil. Author(s): Oliveira AG, Santos A, Guerra JB, Rocha GA, Rocha AM, Oliveira CA, Cabral MM, Nogueira AM, Queiroz DM. Source: Journal of Clinical Microbiology. 2003 August; 41(8): 3964-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12904430&dopt=Abstract

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Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer. Author(s): Perri F, Festa V, Clemente R, Andriulli A. Source: Gastrointestinal Endoscopy. 1997 September; 46(3): 287. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9378226&dopt=Abstract

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Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer. Author(s): Sheu BS, Yang HB, Su IJ, Shiesh SC, Chi CH, Lin XZ. Source: Gastrointestinal Endoscopy. 1996 December; 44(6): 683-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8979058&dopt=Abstract

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Basal and pentagastrin stimulated acid secretion in duodenal ulcer subjects before and after Helicobacter pylori eradication: a 12-month follow-up study. Author(s): Louw JA, Young GO, Lucke W, Bridger S, Winter TA, Marks IN. Source: Ital J Gastroenterol Hepatol. 1998 August; 30(4): 363-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9789128&dopt=Abstract

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Basal and sham-feeding-stimulated salivary flow in duodenal ulcer patients and healthy subjects. Author(s): Richardson CT, Feldman M. Source: Scandinavian Journal of Gastroenterology. 1988 August; 23(6): 765-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3262916&dopt=Abstract

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Basal and stimulated gastrin levels and gastric acid output five months after therapy for Helicobacter pylori eradication in duodenal ulcer patients. Author(s): Gisbert JP, Boixeda D, Vila T, de Rafael L, Redondo C, de Argila CM. Source: Journal of Clinical Gastroenterology. 1996 March; 22(2): 90-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8742644&dopt=Abstract

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Bedtime administration of lansoprazole does not modify its greater efficacy vs ranitidine in the acute and long-term treatment of duodenal ulcer. Results from a multicentre, randomised, double blind clinical trial. Author(s): Russo A, Dattilo M. Source: Ital J Gastroenterol Hepatol. 1997 August; 29(4): 312-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9476183&dopt=Abstract

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Behaviour of acid secretion, gastrin release, serum pepsinogen I, and gastric emptying of liquids over six months from eradication of helicobacter pylori in duodenal ulcer patients. A controlled study. Author(s): Parente F, Maconi G, Sangaletti O, Minguzzi M, Vago L, Bianchi Porro G. Source: Gut. 1995 August; 37(2): 210-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7557570&dopt=Abstract

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Behaviour of healed duodenal ulcer on maintenance therapy: age related. Author(s): Gupta AK, Pal LS. Source: J Assoc Physicians India. 1999 November; 47(11): 1124-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10862334&dopt=Abstract

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Beta-endorphin in silent duodenal ulcer. Author(s): Tonnarini GF, Delle Fave G, Chianelli M, Mariani P, Negri M. Source: European Journal of Gastroenterology & Hepatology. 1995 April; 7(4): 357-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7600142&dopt=Abstract

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Bicarbonate secretory breakdown: explanation for increased incidence of duodenal ulcer with age? Author(s): Miller TA. Source: Gastroenterology. 1991 May; 100(5 Pt 1): 1471-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2013392&dopt=Abstract

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Billroth II resection with modified Nissen duodenojejunostomy for duodenal ulcer hemorrhage associated with duodenal stricture. Author(s): Meissner K. Source: Hepatogastroenterology. 1994 December; 41(6): 526-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7721237&dopt=Abstract

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Bismuth-based quadruple therapy using a single capsule of bismuth biskalcitrate, metronidazole, and tetracycline given with omeprazole versus omeprazole, amoxicillin, and clarithromycin for eradication of Helicobacter pylori in duodenal ulcer patients: a prospective, randomized, multicenter, North American trial. Author(s): Laine L, Hunt R, El-Zimaity H, Nguyen B, Osato M, Spenard J. Source: The American Journal of Gastroenterology. 2003 March; 98(3): 562-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650788&dopt=Abstract

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Bleeding duodenal ulcer and association with polymorphism of endothelial constitutive nitric oxide synthase gene. Author(s): Serrano T, Piazuelo E, Benito R, Santolaria S, Lanas A. Source: Digestive Diseases and Sciences. 2002 May; 47(5): 996-1000. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018926&dopt=Abstract

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Bleeding duodenal ulcer. A prospective evaluation of risk factors for rebleeding and death. Author(s): Branicki FJ, Boey J, Fok PJ, Pritchett CJ, Fan ST, Lai EC, Mok FP, Wong WS, Lam SK, Hui WM, et al. Source: Annals of Surgery. 1990 April; 211(4): 411-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2322036&dopt=Abstract

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Bleeding duodenal ulcer. Role of gastric acid hypersecretion. Author(s): Collen MJ, Kalloo AN, Sheridan MJ. Source: Digestive Diseases and Sciences. 1993 February; 38(2): 269-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8093870&dopt=Abstract

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Bleeding duodenal ulcer: is Helicobacter pylori a risk factor? Author(s): Kate V, Ananthakrishnan N, Badrinath S, Amarnath SK, Ratnakar C. Source: Indian J Gastroenterol. 1998 January; 17(1): 34-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9465519&dopt=Abstract

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Can patients with active duodenal ulcer fast Ramadan? Author(s): Hosseini-asl K, Rafieian-kopaei M. Source: The American Journal of Gastroenterology. 2002 September; 97(9): 2471-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358280&dopt=Abstract

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Chief cell mass after short-term ranitidine treatment for duodenal ulcer. Author(s): Testino G. Source: Hepatogastroenterology. 1992 August; 39(4): 358-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1427584&dopt=Abstract

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Childhood duodenal ulcer: is there any pathogenetic association with Helicobacter pylori urease? Author(s): Nijevitch A, Akhunov E, Khasanov R, Yelitcheva Z, Ousmanova I. Source: Journal of Gastroenterology. 2000; 35(3): 254-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10755699&dopt=Abstract

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Choledochoduodenal fistula from a penetrating duodenal ulcer. A case report. Author(s): Parekh D, Segal I, Ramalho RM. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1992 May 2; 81(9): 478-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1574751&dopt=Abstract

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Chronic gastritis and the distribution of parietal cells in duodenal ulcer patients and normals. Author(s): Beck H. Source: Apmis : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. 1992 April; 100(4): 377-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1581046&dopt=Abstract

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Clarithromycin and amoxicillin susceptibility of Helicobacter pylori strains isolated from adult patients with gastric or duodenal ulcer in Italy. Author(s): Franzin L, Pennazio M, Cabodi D, Paolo Rossini F, Gioannini P. Source: Current Microbiology. 2000 February; 40(2): 96-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10594221&dopt=Abstract

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Clinical image. Unusual endoscopic appearance of a bleeding duodenal ulcer. Author(s): Wolfsen HC. Source: Digestive Diseases (Basel, Switzerland). 1999; 17(5-6): 319. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10838490&dopt=Abstract

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Color coding of sutures in laparoscopic perforated duodenal ulcer: a new concept. Author(s): Wemyss-Holden S, White SA, Robertson G, Lloyd D. Source: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2002 June; 12(3): 177-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12080259&dopt=Abstract

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Comparative study of omeprazole and famotidine in the treatment of duodenal ulcer. Author(s): Kumar TR, Naidu MU, Shobha JC, Reddy DN, Subhash S, Chaubal C, Prasad R, Babu S. Source: Indian J Gastroenterol. 1992 April; 11(2): 73-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1428035&dopt=Abstract

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Comparison of lansoprazole-based triple and dual therapy for treatment of Helicobacter pylori-related duodenal ulcer: an Asian multicentre double-blind randomized placebo controlled study. Author(s): Wong BC, Xiao SD, Hu FL, Qian SC, Huang NX, Li YY, Hu PJ, Daldiyono, Manan C, Lesmana L, Carpio RE, Perez JY Jr, Fock KM, Kachintorn U, Phornphutkul K, Kullavanijaya P, Ho J, Lam SK. Source: Alimentary Pharmacology & Therapeutics. 2000 February; 14(2): 217-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10651663&dopt=Abstract

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Conceivable mechanisms by which Helicobacter pylori provokes duodenal ulcer disease. Author(s): Olbe L, Fandriks L, Hamlet A, Svennerholm AM. Source: Bailliere's Best Practice & Research. Clinical Gastroenterology. 2000 February; 14(1): 1-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10749085&dopt=Abstract

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Concept of mucosal plug in the etiology of duodenal ulcer. Author(s): Saha SK. Source: Indian J Gastroenterol. 2002 January-February; 21(1): 39-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11871841&dopt=Abstract

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Confined perforation of a post-bulbar duodenal ulcer. Author(s): Secil M, Goktay AY, Erkan N. Source: The Journal of Emergency Medicine. 2001 October; 21(3): 275-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11604283&dopt=Abstract

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Coping with first-time endoscopy for a select sample of Chinese patients with functional dyspepsia and duodenal ulcer: an observational study. Author(s): Cheng C, Hui WM, Lam SK. Source: Psychosomatic Medicine. 2002 November-December; 64(6): 867-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461191&dopt=Abstract

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Cost effectiveness of Helicobacter pylori eradication therapies in patients with duodenal ulcer. An analysis of triple therapy versus two dual therapy alternatives. Author(s): Tennvall GR, Norinder A, Ohlin B. Source: Pharmacoeconomics. 1999 September; 16(3): 297-306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10558041&dopt=Abstract

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Cure of duodenal ulcer after eradication of Helicobacter pylori. Author(s): George LL, Borody TJ, Andrews P, Devine M, Moore-Jones D, Walton M, Brandl S. Source: The Medical Journal of Australia. 1990 August 6; 153(3): 145-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1974027&dopt=Abstract

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Cure of Helicobacter pylori-positive active duodenal ulcer patients: a double-blind, multicentre, 12-month study comparing a two-week dual vs a one-week triple therapy. GISU (Interdisciplinary Group for Ulcer Study). Author(s): Di Mario F, Battaglia F, Dal Bo N, Leandro G, Benedetti E, Bottona E, Caroli A, Costan-Biedo F, De Bastiani R, Germana B, Andrea Grassi S, Madia D, Marcon V, Marin R, Monica F, Olivieri P, Orzes N, Pilotto A, Ronzani G, Saggioro A, Tafner G. Source: Dig Liver Dis. 2000 March; 32(2): 108-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10975783&dopt=Abstract

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Cure of refractory duodenal ulcer and infection caused by Helicobacter pylori by high doses of omeprazole and amoxicillin in a homozygous CYP2C19 extensive metabolizer patient. Author(s): Furuta T, Takashima M, Shirai N, Xiao F, Hanai H, Ohashi K, Ishizaki T. Source: Clinical Pharmacology and Therapeutics. 2000 June; 67(6): 684-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10872651&dopt=Abstract

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Curing Helicobacter pylori infection in patients with duodenal ulcer does not provoke gastroesophageal reflux disease. Author(s): Befrits R, Sjostedt S, Odman B, Sorngard H, Lindberg G. Source: Helicobacter. 2000 December; 5(4): 202-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11179984&dopt=Abstract

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Current status of and problems in the treatment of gastric and duodenal ulcer disease: introduction. Author(s): Aoki T. Source: World Journal of Surgery. 2000 March; 24(3): 249. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10658055&dopt=Abstract

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Death from hypovolemic shock caused by perforation of duodenal ulcer in a patient with angiosarcoma of the scalp. Author(s): Nishikawa T, Hakuno M, Asano K, Shigematsu N, Shiomi T, Okada Y. Source: The Keio Journal of Medicine. 2002 March; 51(1): 36-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11951377&dopt=Abstract

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Decreased epithelial cytokine responses in the duodenal mucosa of Helicobacter pylori-infected duodenal ulcer patients. Author(s): Stromberg E, Edebo A, Svennerholm AM, Lindholm C. Source: Clinical and Diagnostic Laboratory Immunology. 2003 January; 10(1): 116-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522049&dopt=Abstract

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Density of Helicobacter pylori may affect the efficacy of eradication therapy and ulcer healing in patients with active duodenal ulcers. Author(s): Lai YC, Wang TH, Huang SH, Yang SS, Wu CH, Chen TK, Lee CL. Source: World Journal of Gastroenterology : Wjg. 2003 July; 9(7): 1537-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854158&dopt=Abstract

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Detection of Helicobacter pylori-associated asymptomatic duodenal ulcer in a boy. Author(s): Shimizu T, Yarita Y, Suzuki R, Yamashiro Y. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2002 June; 44(3): 324-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11982907&dopt=Abstract

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Determination of alpha-1 antitrypsin genetic deficiency in duodenal ulcer by polymerase chain reaction. Author(s): Shahid A, Siddiqui AA, Sultana T, Qureshi H, Waqar MA, Zuberi SJ. Source: J Pak Med Assoc. 2002 December; 52(12): 545-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627901&dopt=Abstract

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Discrimination between cases of duodenal ulcer and gastritis on the basis of putative virulence factors of Helicobacter pylori. Author(s): Yamaoka Y, Souchek J, Odenbreit S, Haas R, Arnqvist A, Boren T, Kodama T, Osato MS, Gutierrez O, Kim JG, Graham DY. Source: Journal of Clinical Microbiology. 2002 June; 40(6): 2244-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037098&dopt=Abstract

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Distribution of vacA genotypes in Helicobacter pylori strains isolated from Brazilian adult patients with gastritis, duodenal ulcer or gastric carcinoma. Author(s): Ashour AA, Magalhaes PP, Mendes EN, Collares GB, de Gusmao VR, Queiroz DM, Nogueira AM, Rocha GA, de Oliveira CA. Source: Fems Immunology and Medical Microbiology. 2002 July 12; 33(3): 173-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12110479&dopt=Abstract

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Duodenal gastric metaplasia, duodenal ulcer and Helicobacter pylori infection. Author(s): Testino G, De Iaco E, Cornaggia M. Source: Dig Liver Dis. 2002 November; 34(11): 818. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546519&dopt=Abstract

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Duodenal Helicobacter pylori associated duodenal ulcer depend on gastric Helicobacter pylori status. Author(s): Vilaichone RK, Mahachai V, Tumwasorn S, Nunthapisud P, Wisedopas N, Kullavanijaya P. Source: J Med Assoc Thai. 2002 June; 85 Suppl 1: S97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12188459&dopt=Abstract

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Duodenal ulcer and eradication of Helicobacter pylori in a developing country. An 18-month follow-up study. Author(s): Coelho LG, Passos MC, Chausson Y, Costa EL, Maia AF, Brandao MJ, Rodrigues DC, Castro LP. Source: Scandinavian Journal of Gastroenterology. 1992 May; 27(5): 362-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1529269&dopt=Abstract

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Duodenal ulcer and pancreatitis associated with pancreatic arteriovenous malformation. Author(s): Aida K, Nakamura H, Kihara Y, Abe S, Okamoto K, Otsuki M. Source: European Journal of Gastroenterology & Hepatology. 2002 May; 14(5): 551-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11984154&dopt=Abstract

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Duodenal ulcer healing and acid secretory responses to modified sham feeding and pentagastrin stimulation. Author(s): Johnston DA, Marks IN, Young GO, Tigler-Wybrandi NA, Bridger S. Source: Alimentary Pharmacology & Therapeutics. 1990 August; 4(4): 403-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2103758&dopt=Abstract

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Duodenal ulcer healing rates in a one-year follow-up study with ranitidine bismuth citrate and antibiotics. Author(s): Wurzer H, Bardhan KD, Marcelino M, Jahnsen J, Allmaier M. Source: Hepatogastroenterology. 2001 November-December; 48(42): 1641-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11813591&dopt=Abstract

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Duodenal ulcer healing with 1-week eradication triple therapy followed, or not, by anti-secretory treatment: a multicentre double-blind placebo-controlled trial. Author(s): Colin R; Hepylog Investigator Study Group. Source: Alimentary Pharmacology & Therapeutics. 2002 June; 16(6): 1157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12030959&dopt=Abstract

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Duodenal ulcer hemorrhage treated by embolization: results in 28 patients. Author(s): De Wispelaere JF, De Ronde T, Trigaux JP, de Canniere L, De Geeter T. Source: Acta Gastroenterol Belg. 2002 January-March; 65(1): 6-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12014319&dopt=Abstract

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Duodenal ulcer in childhood in developing countries. Author(s): Ameh EA. Source: Indian Pediatrics. 2003 March; 40(3): 272. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12657770&dopt=Abstract

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Duodenal ulcer in China. Author(s): Tovey FI. Source: Journal of Gastroenterology and Hepatology. 1992 July-August; 7(4): 427-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1515570&dopt=Abstract

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Duodenal ulcer perforation in a twenty-month-old: an unusual complication of Haemophilus influenzae type B meningitis. Author(s): Sykora J, Jana T, Renata P, Frantisek S, Vladimir S, Jana V, Petr H. Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 September; 35(3): 3668. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352530&dopt=Abstract

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Duodenal ulcer profile in a high endemic area. Author(s): Durrani H. Source: J Assoc Physicians India. 1990 September; 38 Suppl 1: 692-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2092021&dopt=Abstract

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Duodenogastric reflux in healed duodenal ulcer. Author(s): Andrade JI, Hsien CT, Troncon LE. Source: The American Journal of Gastroenterology. 1990 July; 85(7): 903. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2371997&dopt=Abstract

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Effect of H2 antagonists on outcome of simple closure for perforated duodenal ulcer. Author(s): Koh KB, Chang KW. Source: Singapore Med J. 1992 October; 33(5): 472-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1360708&dopt=Abstract

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Effect of Helicobacter pylori eradicated therapy on water gastric emptying in patients with active duodenal ulcer. Author(s): Chang FY, Lu CL, Chen CY, Luo JC, Jium KL, Lee SD. Source: Journal of Gastroenterology and Hepatology. 2003 November; 18(11): 1250-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14535981&dopt=Abstract

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Effect of Helicobacter pylori eradication on duodenal ulcer scar in patients with no clinical history of duodenal ulcer. Author(s): Kim JS, Kim SG, Choi IJ, Park MJ, Kim BG, Jung HC, Song IS. Source: Alimentary Pharmacology & Therapeutics. 2002 February; 16(2): 275-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11860410&dopt=Abstract

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Effect of Helicobacter pylori eradication on the ulcer recurrence rate after simple closure of perforated duodenal ulcer: retrospective and prospective randomized controlled studies. Author(s): McFarlane G. Source: The British Journal of Surgery. 2002 April; 89(4): 493; Author Reply 493-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952605&dopt=Abstract

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Effect of Helicobacter pylori eradication on the ulcer recurrence rate after simple closure of perforated duodenal ulcer: retrospective and prospective randomized controlled studies. Author(s): Wara P. Source: The British Journal of Surgery. 2002 April; 89(4): 493; Author Reply 493-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952604&dopt=Abstract

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Effect of Helicobacter pylori eradication on the ulcer recurrence rate after simple closure of perforated duodenal ulcer: retrospective and prospective randomized controlled studies. Author(s): Kate V, Ananthakrishnan N, Badrinath S. Source: The British Journal of Surgery. 2001 August; 88(8): 1054-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11488789&dopt=Abstract

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Effect of Helicobacter pylori infection on 24 hour intragastric acidity in patients with gastritis and duodenal ulcer. Author(s): Wagner S, Gladziwa U, Haruma K, Varrentrapp M, Gebel M. Source: Gut. 1992 August; 33(8): 1024-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1398225&dopt=Abstract

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Effect of intravenous and oral omeprazole on 24-hour intragastric acidity in duodenal ulcer patients. Author(s): Cederberg C, Thomson AB, Mahachai V, Westin JA, Kirdeikis P, Fisher D, Zuk L, Marriage B. Source: Gastroenterology. 1992 September; 103(3): 913-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1499942&dopt=Abstract

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Effect of rebamipide in treatment of Helicobacter pylori-associated duodenal ulcer: attenuation of chemokine expression and nitrosative damage. Author(s): Choi KW, Lee YC, Chung IS, Lee JJ, Chung MH, Kim NY, Kim SW, Kim JG, Roe IH, Lee SW, Jung HY, Choi MG, Hahm KB, Hong WS, Kim JH. Source: Digestive Diseases and Sciences. 2002 February; 47(2): 283-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11855542&dopt=Abstract

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Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Author(s): Graham DY, Lew GM, Klein PD, Evans DG, Evans DJ Jr, Saeed ZA, Malaty HM. Source: Annals of Internal Medicine. 1992 May 1; 116(9): 705-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1558340&dopt=Abstract

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Effect of xiaokuiling prescription on the expression of HSP72, HSP B in gastric mucosa of patients with Helicobacter pylori-associated duodenal ulcer. Author(s): Yi P, Li G, Liu S, Luo S, Tao X. Source: J Tongji Med Univ. 2001; 21(4): 310-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12539556&dopt=Abstract

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Effectiveness and pharmacokinetics of omeprazole in children with refractory duodenal ulcer. Author(s): Kato S, Shibuya H, Hayashi Y, Tseng SW, Nakagawa H, Ohi R. Source: Journal of Pediatric Gastroenterology and Nutrition. 1992 August; 15(2): 184-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1403468&dopt=Abstract

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Endoscopic local injection of ethanolamine oleate and thrombin as an effective treatment for bleeding duodenal ulcer: a controlled trial. Author(s): Moreto M, Zaballa M, Suarez MJ, Ibanez S, Ojembarrena E, Castillo JM. Source: Gut. 1992 April; 33(4): 456-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1582586&dopt=Abstract

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Epidemiology of duodenal ulcer perforation: a study on hospital admissions in Norfolk, United Kingdom. Author(s): Canoy DS, Hart AR, Todd CJ. Source: Dig Liver Dis. 2002 May; 34(5): 322-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12118948&dopt=Abstract

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Eradication of Helicobacter pylori has no effect on gastric acidity in duodenal ulcer patients--evaluation of 24-h pH monitoring. Author(s): Racz I, Szabo A, Csondes M, Pecsi G, Goda M. Source: Journal of Physiology, Paris. 2001 January-December; 95(1-6): 469-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11595477&dopt=Abstract

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Eradication of Helicobacter pylori in duodenal ulcer disease tetracycline & furazolidone vs. metronidazole & amoxicillin in omeprazole based triple therapy. Author(s): Mansour-Ghanaei F, Fallah MS, Shafaghi A. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 March; 8(3): Pi27-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889461&dopt=Abstract

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Eradication of Helicobacter pylori infection in patients with duodenal ulcer and nonulcer dyspepsia and analysis of one-year reinfection rates. Author(s): Della Libera E, Rohr MR, Moraes M, Siqueira ES, Ferrari AP Jr. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2001 June; 34(6): 753-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11378663&dopt=Abstract

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Eradication therapy with rabeprazole versus omeprazole in the treatment of active duodenal ulcer. Author(s): Catalano F, Terminella C, Branciforte G, Bentivegna C, Brogna A, Scalia A. Source: Digestion. 2002; 66(3): 154-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481161&dopt=Abstract

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Expression of class I and II MHC receptors in Helicobacter pylori-positive patients with active gastritis and duodenal ulcer. Author(s): Suleymanov Z. Source: Turk J Gastroenterol. 2003 September; 14(3): 168-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14655059&dopt=Abstract

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Extended parietal cell vagotomy in the treatment of perforation, hemorrhage and stenosis due to duodenal ulcer. Author(s): Li SY, An P, Liang ZJ, Yuan SJ, Yu J. Source: Chinese Medical Journal. 1992 April; 105(4): 289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1618010&dopt=Abstract

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Factors affecting duodenal ulcer healing. Four double-blind trials in 193 patients. Author(s): Moshal MG, Spitaels JM, Khan F, Mason J, Naidoo V, Schlemmer L. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1982 February 6; 61(6): 202-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10391798&dopt=Abstract

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Factors contributing to releak after surgical closure of perforated duodenal ulcer by Graham's Patch. Author(s): Kumar K, Pai D, Srinivasan K, Jagdish S, Ananthakrishnan N. Source: Trop Gastroenterol. 2002 October-December; 23(4): 190-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833709&dopt=Abstract

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Factors influencing development of bulbar deformity in duodenal ulcer disease. Author(s): Haq SA, Hasan M, Rahman MT, Khan AK. Source: Bangladesh Med Res Counc Bull. 1992 April; 18(1): 23-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1417663&dopt=Abstract

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Factors predicting failure of endoscopic injection therapy in bleeding duodenal ulcer. Author(s): Brullet E, Calvet X, Campo R, Rue M, Catot L, Donoso L. Source: Gastrointestinal Endoscopy. 1996 February; 43(2 Pt 1): 111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8635702&dopt=Abstract

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Failure of single night-time dose of H2-receptor antagonists in the treatment of duodenal ulcer patients with bulbar stenosis. Author(s): Materia A, Genco A, Silecchia G, Basso N. Source: The American Journal of Gastroenterology. 1989 November; 84(11): 1462-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2816881&dopt=Abstract

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Failure to confirm association of vac A gene mosaicism with duodenal ulcer disease. Author(s): Go MF, Cissell L, Graham DY. Source: Scandinavian Journal of Gastroenterology. 1998 February; 33(2): 132-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9517522&dopt=Abstract

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Famotidine vs ranitidine h.s. in acute duodenal ulcer. A multicentre endoscopic trial. Author(s): Bianchi Porro G, Lazzaroni M, Barbara L, Corinaldesi R, Blasi A, Mangiameli A, Capurso L, Koch M, Cheli R, Bovero E, et al. Source: Ital J Gastroenterol. 1991 February; 23(2): 65-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1747505&dopt=Abstract

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Fatal gastroduodenal necrosis after injection sclerotherapy for bleeding duodenal ulcer. Author(s): Goldberg PA, Krige JE. Source: Journal of Clinical Gastroenterology. 1993 March; 16(2): 136-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8463616&dopt=Abstract

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Fine structure of active and healed duodenal ulcer. Author(s): Bode G, Malfertheiner P, Mader U, Stanescu A, Ditschuneit H. Source: The American Journal of Gastroenterology. 1991 February; 86(2): 179-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1704181&dopt=Abstract

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Fine-needle aspiration biopsy of an intra-abdominal inflammatory mass secondary to a penetrating duodenal ulcer mimicking neoplasm. Author(s): Mai AL, Mai KT. Source: Diagnostic Cytopathology. 2001 November; 25(5): 301-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11747219&dopt=Abstract

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First randomized controlled trial with sucralfate versus H2-antagonists in the treatment of duodenal ulcer non-responders to initial treatment with sucralfate. Author(s): Dobrilla G, Amplatz S, Andreoli R, Vallaperta PA. Source: Hepatogastroenterology. 1990 April; 37(2): 239-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2187788&dopt=Abstract

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First-degree atrioventricular block in a young duodenal ulcer patient treated with a standard oral dose of ranitidine. Author(s): Allegri G, Pellegrini K, Dobrilla G. Source: Agents Actions. 1988 July; 24(3-4): 237-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3177090&dopt=Abstract

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Fistula involving portal vein and duodenum at the site of a duodenal ulcer in a patient after previous extrahepatic bile duct resection and brachytherapy. Author(s): Povoski SP, Shamma'a JM. Source: Digestive Surgery. 2003; 20(1): 53-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637806&dopt=Abstract

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Five day and ten day triple therapy (amoxicillin, furazolidone and metronidazole) in the treatment of duodenal ulcer. Author(s): Zaterka S, Eisig JN, Chinzon D, Boyd HK, Bastos A, Dias T, Laudanna AA. Source: Revista Do Hospital Das Clinicas. 1996 September-October; 51(5): 162-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9216092&dopt=Abstract

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Five-day bismuth-free triple therapy for the eradication of Helicobacter pylori and reduction of duodenal ulcer relapse. Author(s): Coelho LG, Passos MC, Chausson Y, Castro Lde P. Source: The American Journal of Gastroenterology. 1991 August; 86(8): 971-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1858763&dopt=Abstract

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Five-day triple therapy in Helicobacter pylori-positive duodenal ulcer: an eighteenmonth follow-up. Author(s): Catalano F, Catanzaro R, Branciforte G, Bentivegna C, Cipolla R, Brogna A, Nuciforo G. Source: Journal of Clinical Gastroenterology. 2000 September; 31(2): 130-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10993428&dopt=Abstract

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Five-year maintenance treatment with ranitidine: effects on the natural history of duodenal ulcer disease. Author(s): Susi D, Neri M, Ballone E, Mezzetti A, Cuccurullo F. Source: The American Journal of Gastroenterology. 1994 January; 89(1): 26-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8273793&dopt=Abstract

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Flow cytometric analysis of cell proliferation kinetics during duodenal ulcer healing. Author(s): Kobayashi I, Kawano S, Tsuji S, Nakama A, Sawaoka H, Masuda E, Nagano K, Fusamoto H, Kamada T. Source: Journal of Gastroenterology and Hepatology. 1998 April; 13(4): 376-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9641300&dopt=Abstract

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Functional characteristics of duodenal ulcer patients and their first-degree relatives. Author(s): Vuoristo M, Pikkarainen P, Samloff IM, Sipponen P, Kekki M, Siurala M. Source: Scandinavian Journal of Gastroenterology. Supplement. 1991; 186: 52-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1759129&dopt=Abstract

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Furazolidone versus metronidazole in quadruple therapy for eradication of Helicobacter pylori in duodenal ulcer disease. Author(s): Malekzadeh R, Ansari R, Vahedi H, Siavoshi F, Alizadeh BZ, Eshraghian MR, Vakili A, Saghari M, Massarrat S. Source: Alimentary Pharmacology & Therapeutics. 2000 March; 14(3): 299-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10735922&dopt=Abstract

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Gallbladder sensitivity to CCK in duodenal ulcer disease, highly selective and truncal vagotomy. Author(s): Masclee AA, Jansen JB, Corstens FH, Lamers CH. Source: Hepatogastroenterology. 1996 March-April; 43(8): 400-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8714233&dopt=Abstract

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Gasless laparoscopic treatment of perforated duodenal ulcer: a case report. Author(s): Viani MP, Intra M, Pinto A, Ceretti AP, Maruotti RA. Source: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 1997 August; 7(4): 249-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9448121&dopt=Abstract

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Gastric acid secretion and plasma gastrin during short-term treatment with omeprazole and ranitidine in duodenal ulcer patients. Author(s): Lazzaroni M, Sangaletti O, Bianchi Porro G. Source: Hepatogastroenterology. 1992 August; 39(4): 366-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1427586&dopt=Abstract

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Gastric acid secretion, parietal cell sensitivity, and endoscopic characteristics of duodenal ulcer patients with and without stigmata of recent bleeding. Author(s): Hui WM, Lam SK. Source: Gastrointestinal Endoscopy. 1992 May-June; 38(3): 361-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1607090&dopt=Abstract

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Gastric acid secretory response in Helicobacter pylori-positive patients with duodenal ulcer disease. Author(s): Jacobson K, Chiba N, Chen Y, Barrientos M, James C, Riddell RH, Hunt RH. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 2001 January; 15(1): 29-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11173324&dopt=Abstract

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Gastric bicarbonate secretion and release of prostaglandin E2 are increased in duodenal ulcer patients but not in Helicobacter pylori-positive healthy subjects. Author(s): Mertz-Nielsen A, Hillingso J, Frokiaer H, Bukhave K, Rask-Madsen J. Source: Scandinavian Journal of Gastroenterology. 1996 January; 31(1): 38-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8927938&dopt=Abstract

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Gastric chief cell mass in duodenal ulcer. Author(s): Perasso A, Testino G, Ansaldi F. Source: Acta Gastroenterol Latinoam. 1993; 23(1): 5-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8237265&dopt=Abstract

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Gastric corpus IL-8 concentration and neutrophil infiltration in duodenal ulcer patients. Author(s): Uemura N, Oomoto Y, Mukai T, Okamoto S, Yamaguchi S, Mashiba H, Taniyama K, Sasaki N, Sumii K, Haruma K, Kajiyama G. Source: Alimentary Pharmacology & Therapeutics. 1997 August; 11(4): 793-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9305491&dopt=Abstract

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Gastric emptying and Helicobacter pylori infection in duodenal ulcer disease. Author(s): Perri F, Ghoos YF, Maes BD, Geypens BJ, Ectors N, Geboes K, Hiele MI, Rutgeerts PJ. Source: Digestive Diseases and Sciences. 1996 March; 41(3): 462-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8617116&dopt=Abstract

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Gastric histology and plasma gastrin response to a meal in patients with duodenal ulcer disease after five years treatment with ranitidine. Author(s): Penston JG, Dixon JS, Selway SA, Wormsley KG. Source: Alimentary Pharmacology & Therapeutics. 1990 August; 4(4): 381-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2103756&dopt=Abstract

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Gastric metaplasia and duodenal ulcer disease in children infected by Helicobacter pylori. Author(s): Gormally SM, Kierce BM, Daly LE, Bourke B, Carroll R, Durnin MT, Drumm B. Source: Gut. 1996 April; 38(4): 513-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8707079&dopt=Abstract

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Gastric metaplasia in the duodenal bulb shows increased mucosal interleukin-8 activity in Helicobacter pylori-positive duodenal ulcer patients. Author(s): Noshiro M, Kusugami K, Sakai T, Imada A, Ando T, Ina K, Nobata K, Morise K, Kaneko H, Ito M, Nishio Y. Source: Scandinavian Journal of Gastroenterology. 2000 May; 35(5): 482-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10868450&dopt=Abstract

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Gastric mucosal expression and luminal release of growth factors in gastric carcinoma and duodenal ulcer patients before and after eradication of Helicobacter pylori. Author(s): Konturek PC, Bielanski W, Bobrzynski A, Hahn EG, Konturek SJ. Source: Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society. 1997 September; 48(3): 375-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9376620&dopt=Abstract

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Gastric outlet obstruction caused by prepyloric mucosal diaphragm mimicking duodenal ulcer: a case report. Author(s): Nissan A, Seror D, Udassin R. Source: Acta Paediatrica (Oslo, Norway : 1992). 1997 January; 86(1): 116-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9116415&dopt=Abstract

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Gastrin-releasing peptide, acid secretion, Helicobacter pylori, and duodenal ulcer: another epiphenomenon? Author(s): Graham DY. Source: Gastroenterology. 1996 April; 110(4): 1325-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8613030&dopt=Abstract

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Genetic markers and duodenal ulcer. Author(s): Shahid A, Zuberi SJ, Siddiqui AA, Waqar MA. Source: J Pak Med Assoc. 1997 May; 47(5): 135-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9230579&dopt=Abstract

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Genomic fingerprinting and genotyping of Helicobacter pylori strains from patients with duodenal ulcer or gastric cancer from different geographic regions. Author(s): Li L, Graham DY, Gutierrez O, Kim JG, Genta RM, El-Zimaity HM, Go MF. Source: Digestive Diseases and Sciences. 2002 November; 47(11): 2512-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452388&dopt=Abstract

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Geographic differences in the distribution of intestinal metaplasia in duodenal ulcer patients. Author(s): El-Zimaity HMT, Gutierrez O, Kim JG, Akamatsu T, Gurer IE, Simjee AE, Graham DY. Source: The American Journal of Gastroenterology. 2001 March; 96(3): 666-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280531&dopt=Abstract

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Giant duodenal ulcer: a new look at a variant of a common illness. Author(s): Rathi P, Parikh S, Kalro RH. Source: Indian J Gastroenterol. 1996 January; 15(1): 33-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8840631&dopt=Abstract

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GR122311X (ranitidine bismuth citrate), a new drug for the treatment of duodenal ulcer. Author(s): Bardhan KD, Dekkers CP, Lam SK, Nowak A, Schaffalitzky de Muckadell OB, Schutze K, Tildesley G, Kler L, Forster JK, Lacey LF, et al. Source: Alimentary Pharmacology & Therapeutics. 1995 October; 9(5): 497-506. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8580269&dopt=Abstract

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H. pylori in the pathogenesis of duodenal ulcer: interaction between duodenal acid load, bile, and H. pylori. Author(s): Graham DY, Osato MS. Source: The American Journal of Gastroenterology. 2000 January; 95(1): 87-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10638564&dopt=Abstract

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H. pylori-negative duodenal ulcer prevalence and causes in 774 patients. Author(s): Gisbert JP, Blanco M, Mateos JM, Fernandez-Salazar L, Fernandez-Bermejo M, Cantero J, Pajares JM. Source: Digestive Diseases and Sciences. 1999 November; 44(11): 2295-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10573377&dopt=Abstract

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Helicobacter pylori (Campylobacter pylori) and duodenal ulcer. Author(s): Goodwin CS, Gordon A, Burke V. Source: The Medical Journal of Australia. 1990 July 16; 153(2): 66-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2366700&dopt=Abstract

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Helicobacter pylori and bleeding duodenal ulcer: prevalence of the infection and role of non-steroidal anti-inflammatory drugs. Author(s): Gisbert JP, Gonzalez L, de Pedro A, Valbuena M, Prieto B, Llorca I, Briz R, Khorrami S, Garcia-Gravalos R, Pajares JM. Source: Scandinavian Journal of Gastroenterology. 2001 July; 36(7): 717-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11444470&dopt=Abstract

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Helicobacter pylori and duodenal ulcer. Evidence suggesting causation. Author(s): Megraud F, Lamouliatte H. Source: Digestive Diseases and Sciences. 1992 May; 37(5): 769-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1563322&dopt=Abstract

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Helicobacter pylori and early duodenal ulcer status post-treatment: a review. Author(s): Meyer JM, Silliman NP, Dixon CA, Siepman NY, Sugg JE, Hopkins RJ. Source: Helicobacter. 2001 June; 6(2): 84-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422462&dopt=Abstract

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Helicobacter pylori eradication after duodenal ulcer perforation. Author(s): Oncel M, Kurt N, Kucuk HF, Uzun H, Eser M, Sagiroglu T, Vural S, Olcay E. Source: Indian J Gastroenterol. 2001 November-December; 20(6): 251. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11817789&dopt=Abstract

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Helicobacter pylori genotyping from positive CLOtests in patients with duodenal ulcer. Author(s): Mattar R, Laudanna AA. Source: Revista Do Hospital Das Clinicas. 2000 September-October; 55(5): 155-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11175575&dopt=Abstract

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Helicobacter pylori infection delays ulcer healing in patients operated on for perforated duodenal ulcer. Author(s): Kumar D, Sinha AN. Source: Indian J Gastroenterol. 2002 January-February; 21(1): 19-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11871831&dopt=Abstract

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Helicobacter pylori infection in patients with perforated chronic duodenal ulcer. Author(s): Khanna AK, Pandey S, Jain AK, Nath G, Kumar M. Source: Indian J Gastroenterol. 2001 September-October; 20(5): 204. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11676339&dopt=Abstract

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Helicobacter pylori infection, cagA status, and duodenal ulcer disease in children. Author(s): Elitsur Y. Source: The Journal of Infectious Diseases. 2000 September; 182(3): 1007-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10950811&dopt=Abstract

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Helicobacter pylori influence on gastric acid secretion in duodenal ulcer patients diagnosed for the first time. Author(s): Testino G, Cornaggia M, De Iaco F. Source: Panminerva Medica. 2002 March; 44(1): 19-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11887086&dopt=Abstract

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Helicobacter pylori transmission between a boy with duodenal ulcer and his father. Author(s): Shimizu T, Oguchi S, Yamashiro Y, Segawa O, Ohkura R, Wakisaka N, Yamamoto T. Source: The Pediatric Infectious Disease Journal. 1999 July; 18(7): 655-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10440449&dopt=Abstract

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Helicobacter pylori-associated antibodies in patients with duodenal ulcer, gastric and oesophageal adenocarcinoma. Author(s): Grimley CE, Holder RL, Loft DE, Morris A, Nwokolo CU. Source: European Journal of Gastroenterology & Hepatology. 1999 May; 11(5): 503-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10755253&dopt=Abstract

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Helicobacter pylori-induced duodenal ulcer frequently coincides with gastrooesophageal reflux disease. Author(s): Mc Namara D, Buckley M, O'Morain C. Source: Dig Liver Dis. 2002 August; 34(8): 542-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12502209&dopt=Abstract

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Helicobacter pylori-positive duodenal ulcer: three-day antibiotic eradication regimen. Author(s): Catalano F, Branciforte G, Catanzaro R, Cipolla R, Bentivegna C, Brogna A. Source: Alimentary Pharmacology & Therapeutics. 2000 October; 14(10): 1329-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11012478&dopt=Abstract

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Helicobacter pyroli infection and acid secretion in patients with duodenal ulcer in Japan. Author(s): Chiba T, Watanabe T, Ito T. Source: Gut. 2001 June; 48(6): 871-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11394388&dopt=Abstract

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High prevalence of reflux symptoms in duodenal ulcer patients who develop gastrooesophageal reflux disease after curing Helicobacter pylori infection. Author(s): Manes G, Mosca S, De Nucci C, Lombardi G, Lioniello M, Balzano A. Source: Dig Liver Dis. 2001 November; 33(8): 665-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11785711&dopt=Abstract

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HLA-DQA1 DNA typing in patients with duodenal ulcer by the PCR-RFLP method. Author(s): Teramae N, Azuma T, Kodama T, Kashima K, Kawai K. Source: Gastroenterol Jpn. 1992 June; 27(3): 425. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1352510&dopt=Abstract

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Hypersecretory duodenal ulcer and Helicobacter pylori infection: a four-year followup study. Author(s): Capurso G, Martino G, Grossi C, Annibale B, Delle Fave G. Source: Dig Liver Dis. 2000 March; 32(2): 119-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10975785&dopt=Abstract

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Identifiable Helicobacter pylori strains or factors important in the development of duodenal ulcer disease. Author(s): Figura N. Source: Helicobacter. 1997 July; 2 Suppl 1: S3-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9432351&dopt=Abstract

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Images in clinical medicine. Perforated duodenal ulcer. Author(s): Molmenti EP. Source: The New England Journal of Medicine. 1997 May 22; 336(21): 1499. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9154769&dopt=Abstract

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Immunoblot analysis of humoral immune response to Helicobacter pylori in children with and without duodenal ulcer. Author(s): Rocha GA, Oliveira AM, Queiroz DM, Carvalho AS, Nogueira AM. Source: Journal of Clinical Microbiology. 2000 May; 38(5): 1777-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10790098&dopt=Abstract

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Immunogenetic factors of predisposition to duodenal ulcer in Caucasian population of western Siberia. Author(s): Kurilovich SA, Shlykova LG, Konenkov VI. Source: Int J Circumpolar Health. 2001 April; 60(2): 258-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11507979&dopt=Abstract

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Impact of Helicobacter pylori eradication on heartburn in patients with gastric or duodenal ulcer disease -- results from a randomized trial programme. Author(s): Malfertheiner P, Dent J, Zeijlon L, Sipponen P, Veldhuyzen Van Zanten SJ, Burman CF, Lind T, Wrangstadh M, BayerdOrffer E, Lonovics J. Source: Alimentary Pharmacology & Therapeutics. 2002 August; 16(8): 1431-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182742&dopt=Abstract

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Impact of ranitidine on prognosis after simple closure of perforated duodenal ulcer. Author(s): Singh K, Chhina RS, Ghosh A, Kaura R. Source: Trop Gastroenterol. 1999 April-June; 20(2): 90-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10484900&dopt=Abstract

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Impaired fibrinolysis and increased protease levels in gastric and duodenal mucosa of patients with active duodenal ulcer. Author(s): Herszenyi L, Plebani M, Carraro P, De Paoli M, Cardin R, Di Mario F, Kusstatscher S, Naccarato R, Farinati F. Source: The American Journal of Gastroenterology. 1997 May; 92(5): 843-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9149198&dopt=Abstract

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Impairment of gastric secretion modulation in duodenal ulcer and in long-term PPI treatment: quantitative morphologic findings and pathophysiologic implications. Author(s): Bechi P, Bacci S, Cianchi F, Amorosi A, Nesi G, Dei R, Romagnoli P. Source: Digestive Diseases and Sciences. 2001 September; 46(9): 1952-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11575448&dopt=Abstract

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Improving management of duodenal ulcer disease. Author(s): Bateson MC, Diffey BL. Source: Postgraduate Medical Journal. 1997 November; 73(865): 717-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9519185&dopt=Abstract

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Incidence of duodenal ulcer healing after 1 week of proton pump inhibitor triple therapy for eradication of Helicobacter pylori. The Lansoprazole Helicobacter Study Group. Author(s): Harris AW, Misiewicz JJ, Bardhan KD, Levi S, O'Morain C, Cooper BT, Kerr GD, Dixon MF, Langworthy H, Piper D. Source: Alimentary Pharmacology & Therapeutics. 1998 August; 12(8): 741-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9726387&dopt=Abstract

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Index of suspicion. Case 3. Diagnosis: hematemesis resulting from gastritis, duodenal ulcer and hemophilia A. Author(s): Colli J, Thomas D, Dane L. Source: Pediatrics in Review / American Academy of Pediatrics. 1998 December; 19(12): 429, 432. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9849075&dopt=Abstract

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Individualized treatment of duodenal ulcer disease. A pilot study. Author(s): Di Mario F, Battaglia G, Pasqualetti P, Grassi SA, Leandro G, Vio A, Germana B, Vianello F, Dotto P, Naccarato R. Source: Hepatogastroenterology. 1992 June; 39(3): 273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1354634&dopt=Abstract

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Influence of the timing of administration of 300 mg ranitidine on 24-hour gastric pH in patients acute duodenal ulcer. Author(s): Cortot A, Guillemot F, Moreau J, Soule JC, Veyrac M, Alberola B, Pappo M. Source: Alimentary Pharmacology & Therapeutics. 1992 August; 6(4): 487-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1420740&dopt=Abstract

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Inhibitory potency of twice-a-day omeprazole on gastric acidity is enhanced by eradication of H. pylori in duodenal ulcer patients. Author(s): Thomson AB, Keelan M, Lastiwka R, Appelman-Eszczuk S, Zuk L, Drozdowski L, Prentice A, Sinclair P. Source: Digestive Diseases and Sciences. 2003 October; 48(10): 2045-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14627354&dopt=Abstract

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Interleukin 1beta polymorphisms increase risk of hypochlorhydria and atrophic gastritis and reduce risk of duodenal ulcer recurrence in Japan. Author(s): Furuta T, El-Omar EM, Xiao F, Shirai N, Takashima M, Sugimura H, Sugimurra H. Source: Gastroenterology. 2002 July; 123(1): 92-105. Erratum In: Gastroenterology 2002 September; 123(3): 957. Sugimurra Haruhiko [corrected to Sugimura Haruhiko]. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105837&dopt=Abstract

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Is a one-week course of triple anti-Helicobacter pylori therapy sufficient to control active duodenal ulcer? Author(s): Tepes B, Krizman I, Gorensek M, Gubina M, Orel I. Source: Alimentary Pharmacology & Therapeutics. 2001 July; 15(7): 1037-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11421880&dopt=Abstract

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Is Helicobacter pylori eradication therapy indicated in Indian patients with duodenal ulcer? Author(s): Ganish Pai C. Source: Indian J Gastroenterol. 1998 July-September; 17(3): 115-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9695404&dopt=Abstract

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Is Helicobacter pylori-negative duodenal ulcer masked by the high prevalence of H. pylori infection in the general population? Author(s): Higuchi K, Arakawa T, Fujiwara Y, Uchida T, Tominaga K, Watanabe T, Kuroki T. Source: The American Journal of Gastroenterology. 1999 October; 94(10): 3083-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10520889&dopt=Abstract

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Is maintenance therapy required for duodenal ulcer disease? Author(s): Kalro RH, Amarapurkar DN. Source: J Assoc Physicians India. 1990 September; 38 Suppl 1: 743-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2092032&dopt=Abstract

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Is there an optimal degree of acid suppression for healing of duodenal ulcers? A model of the relationship between ulcer healing and acid suppression. Author(s): Burget DW, Chiverton SG, Hunt RH. Source: Gastroenterology. 1990 August; 99(2): 345-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2142113&dopt=Abstract

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Khat chewing is a risk factor of duodenal ulcer. Author(s): Raja'a YA, Noman TA, al Warafi AK, al Mashraki NA, al Yosofi AM. Source: East Mediterr Health J. 2001 May; 7(3): 568-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690783&dopt=Abstract

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Khat chewing is a risk factor of duodenal ulcer. Author(s): Raja'a YA, Noman TA, Al-Warafi AK, Al Mashraki NA, Al Yosofi AM. Source: Saudi Med J. 2000 September; 21(9): 887-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11376372&dopt=Abstract

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Kinetics of gastric epithelial cells in duodenal ulcer: local environmental factors controlling the proliferation and differentiation of gastric epithelial cells. Author(s): Kawai K, Rokutan K. Source: Journal of Gastroenterology. 1995 June; 30(3): 428-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7647913&dopt=Abstract

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Lack of association between pro-inflammatory genotypes of the interleukin-1 (IL-1B 31 C/+ and IL-1RN *2/*2) and gastric cancer/duodenal ulcer in Korean population. Author(s): Lee SG, Kim B, Choi W, Lee I, Choi J, Song K. Source: Cytokine. 2003 February 21; 21(4): 167-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12788304&dopt=Abstract

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Lansoprazole is superior to ranitidine as maintenance treatment for the prevention of duodenal ulcer relapse. Author(s): Bardhan KD, Crowe J, Thompson RP, Trewby PN, Keeling PN, Weir D, Crouch SL. Source: Alimentary Pharmacology & Therapeutics. 1999 June; 13(6): 827-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10383514&dopt=Abstract

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Lansoprazole versus omeprazole for duodenal ulcer healing and prevention of relapse: a randomized, multicenter, double-masked trial. Author(s): Dobrilla G, Piazzi L, Fiocca R. Source: Clinical Therapeutics. 1999 August; 21(8): 1321-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10485504&dopt=Abstract

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Lansoprazole-based triple therapy versus ranitidine bismuth citrate-based dual therapy in the eradication of Helicobacter pylori in patients with duodenal ulcer: a multicenter, randomized, double-dummy study. Author(s): Luzza F, Giglio A, Ciliberto E, Belmonte A, Cavaliere C, Sacca N, Frandina C, Fiocca R, Trimboli V, Pallone F. Source: Clinical Therapeutics. 2001 May; 23(5): 761-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11394734&dopt=Abstract

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Laparoscopic closure of perforated duodenal ulcer. Author(s): Khoursheed M, Fuad M, Safar H, Dashti H, Behbehani A. Source: Surgical Endoscopy. 2000 January; 14(1): 56-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10653237&dopt=Abstract

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Laparoscopic modified taylor procedure in the treatment of duodenal ulcer: technique and outcome after 5-year follow-up. Author(s): Petrakis I, Vassilakis SJ, Vrachassotakis N, Koutsoumpas V, Chalkiadakis G. Source: European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes. 1999; 31(6): 471-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10861343&dopt=Abstract

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Laparoscopic omental patch repair for perforated duodenal ulcer. Author(s): Kok KY, Mathew VV, Yapp SK. Source: The American Surgeon. 1999 January; 65(1): 27-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9915527&dopt=Abstract

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Laparoscopic surgery for duodenal ulcer: first results of a multicenter study applying a personal procedure. Author(s): Gomez-Ferrer F, Ballyque JG, Azagra S, Bycha-Castelo H, Castro-Sousa F, Espalyeu P, Rodero D, Estour E. Source: Hepatogastroenterology. 1999 May-June; 46(27): 1517-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10430286&dopt=Abstract

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Laparoscopic vagotomy: a new tool in the management of duodenal ulcer disease. Author(s): Kum CK, Goh P. Source: The British Journal of Surgery. 1992 September; 79(9): 977. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1422777&dopt=Abstract

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Life events, personality, and physical risk factors in recent-onset duodenal ulcer. A preliminary study. Author(s): Levenstein S, Prantera C, Varvo V, Spinella S, Arca M, Bassi O. Source: Journal of Clinical Gastroenterology. 1992 April; 14(3): 203-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1564296&dopt=Abstract

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Liver penetration by a duodenal ulcer in a young woman. Author(s): Novacek G, Geppert A, Kramer L, Wrba F, Herbst F, Schima W, Gangl A, Potzi R. Source: Journal of Clinical Gastroenterology. 2001 July; 33(1): 56-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11418793&dopt=Abstract

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Long term behaviour of healed duodenal ulcer with and without maintenance therapy. Author(s): Kumar N, Anand BS. Source: J Assoc Physicians India. 1990 September; 38 Suppl 1: 707-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2092025&dopt=Abstract

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Longitudinal study of influence of Helicobacter pylori on current risk of duodenal ulcer relapse. The Hvidovre Ulcer Project Group. Author(s): Clausen MR, Franzmann MB, Holst C, Sorensen TI, Christoffersen P, Matzen P, Krag E. Source: Scandinavian Journal of Gastroenterology. 1992 May; 27(5): 421-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1529279&dopt=Abstract

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Long-term effects of Helicobacter pylori eradication on gastric antral mucosa in duodenal ulcer patients. Author(s): Zerbib F, Lenk C, Sawan B, Cayla R, Broutet N, Carles B, de Mascarel A, Megraud F, Lamouliatte H. Source: European Journal of Gastroenterology & Hepatology. 2000 July; 12(7): 719-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929896&dopt=Abstract

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Long-term follow-up and serologic assessment after triple therapy with omeprazole or lansoprazole of Helicobacter-associated duodenal ulcer. Author(s): Fanti L, Ieri R, Mezzi G, Testoni PA, Passaretti S, Guslandi M. Source: Journal of Clinical Gastroenterology. 2001 January; 32(1): 45-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11154169&dopt=Abstract

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Long-term results of selective vagotomy plus antrectomy in treatment of duodenal ulcer. Author(s): Wu X, Li N, Han J, Liu F, Xu Z, Li J. Source: Zhonghua Wai Ke Za Zhi. 2002 November; 40(11): 834-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487857&dopt=Abstract

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Low incidence of Helicobacter pylori infection in patients with duodenal ulcer and chronic liver disease. Author(s): Shahin WA, Abdel-Baset EZ, Nassar AK, Atta MM, Kabil SM, Murray JA. Source: Scandinavian Journal of Gastroenterology. 2001 May; 36(5): 479-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346200&dopt=Abstract

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Low serum alpha 1 antitrypsin in duodenal ulcer--a family study. Author(s): Shahid A, Siddiqui AA, Zuberi SJ, Sultana T, Waqar MA, Qureshi H. Source: J Pak Med Assoc. 2000 September; 50(9): 318-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043024&dopt=Abstract

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Low-dose antacids versus ranitidine in the short-term treatment of patients with duodenal ulcer. Endoscopic and histologic placebo-controlled study. Author(s): Mach T, Bogdal J. Source: Mater Med Pol. 1992 July-September; 24(3): 201-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1307655&dopt=Abstract

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Luminal Nalpha-methyl histamine stimulates gastric acid secretion in duodenal ulcer patients via releasing gastrin. Author(s): Konturek PC, Konturek SJ, Sito E, Kwiecien N, Obtulowicz W, Bielanski W, Hahn EG. Source: European Journal of Pharmacology. 2001 January 26; 412(2): 181-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11165229&dopt=Abstract

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Maintenance therapy of duodenal ulcer with H2-receptor antagonists--a metaanalysis. Author(s): Palmer RH, Frank WO, Karlstadt R. Source: Alimentary Pharmacology & Therapeutics. 1990 June; 4(3): 283-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1983324&dopt=Abstract

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Maintenance therapy with colloidal bismuth subcitrate reduces duodenal ulcer relapse. Author(s): Bardhan KD, Singh S, Morris P, Thompson M, Hinchliffe RF, Cary BA, Wall RM, Blakemore CB. Source: Ital J Gastroenterol Hepatol. 1997 April; 29(2): 128-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9646192&dopt=Abstract

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Management of duodenal ulcer bleeding. Author(s): Lai KC, Lam SK. Source: Chinese Medical Journal. 1998 January; 111(1): 3-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10322643&dopt=Abstract

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Management of Helicobacter pylori in duodenal ulcer: a cost-effectiveness analysis. Author(s): Garcia-Altes A, Jovell AJ, Serra-Prat M, Aymerich M. Source: Alimentary Pharmacology & Therapeutics. 2000 December; 14(12): 1631-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11121912&dopt=Abstract

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Management of perforated duodenal ulcer in a resource poor environment. Author(s): Hill AG. Source: East Afr Med J. 2001 July; 78(7): 346-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11957256&dopt=Abstract

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Management strategies for duodenal ulcer in India in the helicobacter pylori era: an economic analysis. Author(s): Ghoshal UC, Das A. Source: Natl Med J India. 2002 May-June; 15(3): 140-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186326&dopt=Abstract

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Massive necrosis of the gastric wall with gastric perforation after injection therapy of a bleeding duodenal ulcer. Author(s): Opacic M, Pulanic R, Vucelic B, Tentor D, Skegro M, Rustemovic N. Source: Endoscopy. 1995 November; 27(9): 707-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8903989&dopt=Abstract

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Massive tracheal necrosis due to compression by an innominate artery aneurysm associated with a grade IV Chagasic megaesophagus and chronic duodenal ulcer. Author(s): Sader AA, Cherri J, Ceneviva R. Source: Chest. 1999 September; 116(3): 837-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492299&dopt=Abstract

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Mechanism of action of Roter (bismuth subnitrate) in patients with duodenal ulcer disease and healthy volunteers. Author(s): Pugh S, Lewin MR. Source: Journal of Gastroenterology and Hepatology. 1990 July-August; 5(4): 382-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2129809&dopt=Abstract

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Melatonin production in patients with duodenal ulcer. Author(s): Malinovskaya N, Komarov FI, Rapoport SI, Voznesenskaya LA, Wetterberg L. Source: Neuroendocrinol Lett. 2001 April; 22(2): 109-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11335887&dopt=Abstract

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Metastatic choriocarcinoma presenting as a bleeding duodenal ulcer. Author(s): Odelowo OO, Naab T, Dewitty RL. Source: J Assoc Acad Minor Phys. 2001 July; 12(3): 144-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11851202&dopt=Abstract

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Microflora of gastric biopsies from patients with duodenal ulcer and gastric cancer: a comparative study of patients from Korea, Colombia, and the United States. Author(s): Osato MS, Gutierrez O, Kim JG, Steinbach G, Graham DY. Source: Digestive Diseases and Sciences. 1998 October; 43(10): 2291-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9790468&dopt=Abstract

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Modified intraparietal vagotomy in the treatment of perforated duodenal ulcer. Author(s): Druzijanic N, Juricic J, Bakovic A, Kraljevic D. Source: Hepatogastroenterology. 1997 September-October; 44(17): 1346-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9356853&dopt=Abstract

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Molecular fingerprinting of Helicobacter pylori strains from duodenal ulcer patients. Author(s): Cellini L, Di Campli E, Di Candia M, Marzio L. Source: Letters in Applied Microbiology. 2003; 36(4): 222-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641715&dopt=Abstract

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Morning versus evening dose: a comparison of three H2-receptor blockers in duodenal ulcer healing. Author(s): Khasawneh SM, Affarah HB. Source: The American Journal of Gastroenterology. 1992 September; 87(9): 1180-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1519576&dopt=Abstract

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Morphometric estimation of acid output in duodenal ulcer associated with Helicobacter pylori infection. Author(s): Rodriguez Tellez M, Valenzuela Barranco M, Caballero Plasencia A, Martin Ruiz J, Lopez-Andrade A, Carmona Soria I, Herrerias Gutierrez J. Source: Rev Esp Enferm Dig. 1999 August; 91(8): 549-58. English, Spanish. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10491487&dopt=Abstract

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Mucosal expression and luminal release of epidermal and transforming growth factors in patients with duodenal ulcer before and after eradication of Helicobacter pylori. Author(s): Konturek PC, Ernst H, Konturek SJ, Bobrzynski AJ, Faller G, Klingler C, Hahn EG. Source: Gut. 1997 April; 40(4): 463-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9176072&dopt=Abstract

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Multivariate analysis of risk factors for development of duodenal ulcer in Helicobacter pylori-infected patients. Author(s): Regula J, Hennig E, Burzykowski T, Orlowska J, Przytulski K, Polkowski M, Dziurkowska-Marek A, Marek T, Nowak A, Butruk E, Ostrowski J. Source: Digestion. 2003; 67(1-2): 25-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12743437&dopt=Abstract

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Natural history of severe duodenal ulcer disease. Author(s): Konar A, Das AS, De PK, Roy A, Mazumder DN. Source: Indian J Gastroenterol. 1998 April; 17(2): 48-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9563218&dopt=Abstract

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Neurobiology of psychologic predictors of duodenal ulcer healing. Author(s): Friedman EH. Source: Journal of Clinical Gastroenterology. 1996 July; 23(1): 81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8835914&dopt=Abstract

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New H2-receptor antagonist--roxatidine acetate--in treatment of duodenal ulcer. Author(s): Amarapurkar DN, Parikh SS, Desai HG. Source: J Assoc Physicians India. 1993 August; 41(8): 496-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7904993&dopt=Abstract

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New one-week, low-dose triple therapy for the treatment of duodenal ulcer with Helicobacter pylori infection. Author(s): Huang WH, Ho AS, Shyu RY, Lee SC, Lee MM, Hsu CT. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1998 August; 61(8): 448-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9745160&dopt=Abstract

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Nine years of maintenance treatment with ranitidine for patients with duodenal ulcer disease. Author(s): Penston JG, Wormsley KG. Source: Alimentary Pharmacology & Therapeutics. 1992 October; 6(5): 629-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1420753&dopt=Abstract

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Nizatidine as maintenance treatment of duodenal ulcer. Clinical results. Author(s): Lerebours E, Michel P, Hochain P, Berkelmans I. Source: Scandinavian Journal of Gastroenterology. Supplement. 1994; 206: 52-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7863254&dopt=Abstract

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Nocturnal gastric secretion in duodenal ulcer patients and healthy controls. Ranges and reproducibility. Author(s): Boyd EJ, Wormsley KG. Source: Scandinavian Journal of Gastroenterology. 1992; 27(1): 44-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1736341&dopt=Abstract

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Non-Helicobacter pylori related duodenal ulcer disease in children. Author(s): Elitsur Y, Lawrence Z. Source: Helicobacter. 2001 September; 6(3): 239-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11683927&dopt=Abstract

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Non-operative management of perforated duodenal ulcer. Author(s): Gul YA, Shine MF, Lennon F. Source: Ir J Med Sci. 1999 October-December; 168(4): 254-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10624365&dopt=Abstract

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Nonoperative treatment of reperforated duodenal ulcer: report of three cases. Author(s): Koyama Y, Hayashi T, Fujita N, Kaneko K, Takano Y, Sato N, Hatakeyama K. Source: Surgery Today. 2000; 30(11): 1034-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110403&dopt=Abstract

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Occurrence and relapse of bleeding from duodenal ulcer: respective roles of acid secretion and Helicobacter pylori infection. Author(s): Capurso G, Annibale B, Osborn J, D'Ambra G, Martino G, Lahner E, Delle Fave G. Source: Alimentary Pharmacology & Therapeutics. 2001 June; 15(6): 821-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11380320&dopt=Abstract

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Omeprazole and regulation of cytokine profile in Helicobacter pylori-infected patients with duodenal ulcer disease. Author(s): Kountouras J, Boura P, Lygidakis NJ. Source: Hepatogastroenterology. 2000 September-October; 47(35): 1301-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11100337&dopt=Abstract

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Omeprazole therapy and salivary flow rate in duodenal ulcer patients. Author(s): Namiot Z, Stasiewicz J, Kralisz M, Kozuszynska-Topor M, Markowski AR, Aljanaby FK, Kemona A, Gorski J. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 March-April; 7(2): 276-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11257735&dopt=Abstract

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Omeprazole triple therapy versus omeprazole quadruple therapy for healing duodenal ulcer and eradication of Helicobacter pylori infection: a 24-month follow-up study. Author(s): Mantzaris GJ, Petraki K, Archavlis E, Amberiadis P, Christoforidis P, Kourtessas D, Chiotakakou E, Triantafyllou G. Source: European Journal of Gastroenterology & Hepatology. 2002 November; 14(11): 1237-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439119&dopt=Abstract

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Omeprazole versus famotidine in the short-term treatment of duodenal ulcer disease. Author(s): Delle Fave G, Annibale B, Franceschi M, Quatrini M, Cassetta MR, Torsoli A. Source: Alimentary Pharmacology & Therapeutics. 1992 August; 6(4): 469-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1420739&dopt=Abstract

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Omeprazole versus ranitidine in the treatment of resistant duodenal ulcer. Author(s): Tulassay Z, Szalay F, Acharya M. Source: Gut. 1992 June; 33(6): 863. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1624176&dopt=Abstract

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One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease. Author(s): Tulassay Z, Kryszewski A, Dite P, Kleczkowski D, Rudzinski J, Bartuzi Z, Hasselgren G, Larko A, Wrangstadh M. Source: European Journal of Gastroenterology & Hepatology. 2001 December; 13(12): 1457-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11742194&dopt=Abstract

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One week regimen of esomeprazole based triple therapy is sufficient for duodenal ulcer healing and Helicobacter pylori eradication in patients with duodenal ulcer disease. Author(s): Boon YH, Vu C, Kaushik S, Cheng CS, Chiu TC, Chian LC. Source: European Journal of Gastroenterology & Hepatology. 2002 August; 14(8): 905; Author Reply 905. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172417&dopt=Abstract

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One week triple therapy for Helicobacter pylori associated duodenal ulcer disease. Author(s): Luman W, Ling KL, Ng HS. Source: Singapore Med J. 1999 December; 40(12): 738-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10709423&dopt=Abstract

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One-week triple therapy with esomeprazole provides effective eradication of Helicobacter pylori in duodenal ulcer disease. Author(s): Veldhuyzen Van Zanten S, Lauritsen K, Delchier JC, Labenz J, De Argila CM, Lind T, Treichel HC, Stubberod A, Cockeram A, Hasselgren G, Gothe L, Wrangstadh M, Sinclair P. Source: Alimentary Pharmacology & Therapeutics. 2000 December; 14(12): 1605-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11121908&dopt=Abstract

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Pancreatic arteriovenous malformation associated with duodenal ulcer and H. pylori infection. Author(s): Regenet N, Tuech JJ, Pessaux P, Aube C, Rousselet MC, Arnaud JP. Source: International Journal of Pancreatology : Official Journal of the International Association of Pancreatology. 2001; 29(2): 113-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11876248&dopt=Abstract

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Pathogenesis and therapy of gastric and duodenal ulcer disease. Author(s): Shiotani A, Graham DY. Source: The Medical Clinics of North America. 2002 November; 86(6): 1447-66, Viii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12510460&dopt=Abstract

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Perforated duodenal ulcer associated with an incarcerated hiatal hernia: report of a case. Author(s): Otsuka Y, Nara S, Ito K, Nakajima K, Mieno H, Konishi T. Source: Surgery Today. 2002; 32(12): 1085-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12541028&dopt=Abstract

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Perforated duodenal ulcer disclosing medium chain acyl-CoA dehydrogenase deficiency. Author(s): Kairamkonda V, Dalzell M, Losty PD, Davidson C. Source: Archives of Disease in Childhood. 2003 January; 88(1): 88-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495980&dopt=Abstract

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Perforated duodenal ulcer in a child. Author(s): Mohta A, Shrivastava UK, Gupta BP, Gupta A. Source: Indian Pediatrics. 2002 June; 39(6): 578-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12084954&dopt=Abstract

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Pneumatosis cystoides intestinalis associated with ascites and pyloric stenosis secondary to a chronic duodenal ulcer: case report. Author(s): Muyembe VM. Source: East Afr Med J. 2002 December; 79(12): 667-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12678452&dopt=Abstract

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Prevalence and pathogenesis of duodenal ulcer in chronic alcoholic pancreatitis. Author(s): Chebli JM, de Souza AF, Gaburri PD, Bastos KV, Ribeiro TC, Filho RJ, Chebli LA, Castro Ferreira LE. Source: Journal of Clinical Gastroenterology. 2002 July; 35(1): 71-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12080230&dopt=Abstract

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Prevalence of Helicobacter pylori vacA, cagA and iceA genotypes in Nigerian patients with duodenal ulcer disease. Author(s): Smith SI, Kirsch C, Oyedeji KS, Arigbabu AO, Coker AO, Bayerdoffer E, Miehlke S. Source: Journal of Medical Microbiology. 2002 October; 51(10): 851-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435064&dopt=Abstract

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Prevalence of reflux esophagitis in patients with duodenal ulcer and gastric ulcer. Author(s): Amano Y, Komazawa Y, Ishimura N, Fujishiro H, Ishihara S, Adachi K, Kinoshita Y. Source: Journal of Gastroenterology. 2003; 38(5): 514-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768398&dopt=Abstract

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Primary hyperparathyroidism with duodenal ulcer and H. pylori infection. Author(s): Sato H, Abe K, Oshima N, Kawashima K, Hamamoto N, Moritani M, Mak R, Ishihara S, Adachi K, Kawauchi H, Kinoshita Y. Source: Intern Med. 2002 May; 41(5): 377-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12058887&dopt=Abstract

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Quadruple therapy for symptomatic spontaneous duodenal ulcer disease. Author(s): Bateson MC. Source: Postgraduate Medical Journal. 2001 July; 77(909): 447-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11423595&dopt=Abstract

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Quality of life and relapse of duodenal ulcer before and after eradication of Helicobacter pylori. Author(s): Wilhelmsen I, Berstad A. Source: Scandinavian Journal of Gastroenterology. 1994 October; 29(10): 874-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7839092&dopt=Abstract

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Quality of Life in duodenal ulcer. Author(s): Korman MG. Source: Scandinavian Journal of Gastroenterology. Supplement. 1993; 199: 28-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8171296&dopt=Abstract

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Quality of life in gastroenterology. Interest of a specific questionnaire for duodenal ulcer patients. Author(s): Bonfils S. Source: Scandinavian Journal of Gastroenterology. Supplement. 1994; 206: 37-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7863251&dopt=Abstract

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Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer. Author(s): Hosking SW, Ling TK, Yung MY, Cheng A, Chung SC, Leung JW, Li AK. Source: Bmj (Clinical Research Ed.). 1992 August 29; 305(6852): 502-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1392995&dopt=Abstract

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Ranitidine and antacids in the prevention of duodenal ulcer relapse in Greece. Author(s): Kalantzis N, Theodoropoulos G, Katsaros D, Tzivras M, Fertakis A, Archimandritis A. Source: Hepatogastroenterology. 1992 June; 39(3): 277-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1505904&dopt=Abstract

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Ranitidine in duodenal ulcer: phenomena of “primary failure” and “secondary failure”. Author(s): Agarwal BD. Source: J Assoc Physicians India. 1990 August; 38(8): 604. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2246221&dopt=Abstract

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Recurrent duodenal ulcer haemorrhage: a pharmacoeconomic comparison of various management strategies. Author(s): Ghoshal UC, Aggarwal R, Baba CS. Source: Expert Opinion on Pharmacotherapy. 2003 September; 4(9): 1593-603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943489&dopt=Abstract

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Recurrent giant longitudinal duodenal ulcer with massive hemorrhage in a Helicobacter pylori-negative patient. Author(s): Fujimoto M, Shimizu I, Horie T, Inoue H, Okazaki M, Niki M, Shiraishi T, Fujiwara S, Murata M, Yamamoto K, Iuchi A, Hino A, Ito S. Source: J Med Invest. 2001 August; 48(3-4): 210-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11694961&dopt=Abstract

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Regression of duodenal gastric metaplasia in Helicobacter pylori positive patients with duodenal ulcer disease. Author(s): Ciancio G, Nuti M, Orsini B, Iovi F, Ortolani M, Palomba A, Amorosi A, Surrenti E, Ilani SM, Surrenti C. Source: Dig Liver Dis. 2002 January; 34(1): 16-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11926569&dopt=Abstract

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Regulation of gastric acid secretion by gastrin in duodenal ulcer patients and healthy subjects. Author(s): Eysselein VE, Kovacs TO, Kleibeuker JH, Maxwell V, Reedy T, Walsh JH. Source: Gastroenterology. 1992 April; 102(4 Pt 1): 1142-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1551523&dopt=Abstract

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Relationship between the birth cohort pattern of Helicobacter pylori infection and the epidemiology of duodenal ulcer. Author(s): Harvey RF, Spence RW, Lane JA, Nair P, Murray LJ, Harvey IM, Donovan J. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 August; 95(8): 51925. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145391&dopt=Abstract

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Risk factors for duodenal ulcer disease. Author(s): Abu Farsakh NA. Source: Saudi Med J. 2002 February; 23(2): 168-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11938392&dopt=Abstract

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Role of serum fasting gastrin in screening for hypergastrinemic syndromes in duodenal ulcer disease. Author(s): Di Mario F, Plebani M, Gottardello L, Battaglia G, Vianello F, Farinati F, Del Favero G. Source: Clinical Biochemistry. 1992 April; 25(2): 121-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1623579&dopt=Abstract

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Sequential treatment for Helicobacter pylori eradication in duodenal ulcer patients: improving the cost of pharmacotherapy. Author(s): Hassan C, De Francesco V, Zullo A, Scaccianoce G, Piglionica D, Ierardi E, Panella C, Morini S. Source: Alimentary Pharmacology & Therapeutics. 2003 September 15; 18(6): 641-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12969091&dopt=Abstract

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Significance of an exaggerated meal-stimulated gastrin response in pathogenesis of Helicobacter pylori-negative duodenal ulcer. Author(s): Kamada T, Haruma K, Kusunoki H, Miyamoto M, Ito M, Kitadai Y, Yoshihara M, Chayama K, Tahara K, Kawamura Y. Source: Digestive Diseases and Sciences. 2003 April; 48(4): 644-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741450&dopt=Abstract

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Simple closure of chronic duodenal ulcer perforation in the era of Helicobacter pylori: an old procedure, today's solution. Author(s): Datsis AC, Rogdakis A, Kekelos S, Zografos K, Sarantopoulou A, Spilliotis J. Source: Hepatogastroenterology. 2003 September-October; 50(53): 1396-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14571746&dopt=Abstract

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Smoking does not contribute to duodenal ulcer relapse after Helicobacter pylori eradication. Author(s): Borody TJ, George LL, Brandl S, Andrews P, Jankiewicz E, Ostapowicz N. Source: The American Journal of Gastroenterology. 1992 October; 87(10): 1390-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1415092&dopt=Abstract

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Somatostatin in gastric juice in normal subjects and patients with duodenal ulcer. Author(s): Sumii K, Sumioka M, Yoshihara M, Tari A, Haruma K, Kajiyama G. Source: Digestive Diseases and Sciences. 1992 July; 37(7): 1020-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1352198&dopt=Abstract

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Sonographic diagnosis and successful nonoperative management of sealed perforated duodenal ulcer. Author(s): Fujii Y, Asato M, Taniguchi N, Shigeta K, Omoto K, Itoh K, Suzukawa M. Source: Journal of Clinical Ultrasound : Jcu. 2003 January; 31(1): 55-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478655&dopt=Abstract

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Spontaneous nonfistulous barium reflux into the biliary tract: association with duodenal ulcer disease. A report of four cases. Author(s): Prober A, Tobi M, Niv Y. Source: Journal of Clinical Gastroenterology. 1992 July; 15(1): 75-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1500666&dopt=Abstract

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Sucralfate in management of duodenal ulcer. Author(s): Kar P, Gupta P, Jain A, Aggarwal A. Source: J Assoc Physicians India. 1992 July; 40(7): 494. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1484055&dopt=Abstract

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Suppression of Helicobacter pylori reduces gastrin releasing peptide stimulated gastrin release in duodenal ulcer patients. Author(s): Beardshall K, Moss S, Gill J, Levi S, Ghosh P, Playford RJ, Calam J. Source: Gut. 1992 May; 33(5): 601-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1612474&dopt=Abstract

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Synchronous perforation of a Meckel's diverticulum and duodenal ulcer. Author(s): Proye C. Source: Journal of the Royal College of Surgeons of Edinburgh. 2002 October; 47(5): 713; Author Reply 713. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463714&dopt=Abstract

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The effectiveness of (IgG-ELISA) serology as an alternative diagnostic method for detecting Helicobacter pylori infection in patients with gastro-intestinal bleeding due to gastro-duodenal ulcer. Author(s): Garcia-Diaz E, Castro-Fernandez M, Romero-Gomez M, Vargas-Romero J. Source: Rev Esp Enferm Dig. 2002 December; 94(12): 725-36. English, Spanish. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12733331&dopt=Abstract

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The histological maturity of regenerating mucosa of healed duodenal ulcer and ulcer recurrence after treatment with H2-antagonist. Author(s): Pan S, Liao CH. Source: The American Journal of Gastroenterology. 1990 August; 85(8): 949-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1973870&dopt=Abstract

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The incidence of Helicobacter pylori is not increased in obese people, but the risk of duodenal ulcer is higher in H. pylori-positive people of high obesity. Author(s): Archimandritis AJ, Chronaki M, Kalogeras D, Galanopoulos G, Grigoriadis P, Tzivras M. Source: Journal of Clinical Gastroenterology. 2003 February; 36(2): 184-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544208&dopt=Abstract

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The influence of cholecystokinin on gastric myoelectrical activity in duodenal ulcer following Helicobacter pylori eradication--an electrogastrographic study. Author(s): Budzynski A, Bobrzynski A, Lorens K, Konturek PC, Thor P, Konturek SJ. Source: Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society. 2002 June; 53(2): 171-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12120894&dopt=Abstract

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The laparoscopic approach to modified Taylor's procedure in the treatment of chronic duodenal ulcer: an improved technique. Author(s): Lirici MM, Buess G, Becker HD. Source: Surgical Laparoscopy & Endoscopy. 1992 September; 2(3): 199-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1341531&dopt=Abstract

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The sixth decision regarding perforated duodenal ulcer. Author(s): Lagoo S, McMahon RL, Kakihara M, Pappas TN, Eubanks S. Source: Jsls. 2002 October-December; 6(4): 359-68. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500837&dopt=Abstract

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The systemic cellular immune response in the Helicobacter pylori-associated duodenal ulcer and chronic antral gastritis. Author(s): Yuceyar H, Saruc M, Kokuludag A, Terzioglu E, Goksel G, Isisag A. Source: Hepatogastroenterology. 2002 July-August; 49(46): 1177-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12143230&dopt=Abstract

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Three-day intravenous triple therapy is not effective for the eradication of Helicobacter pylori infection in patients with bleeding gastro-duodenal ulcer. Author(s): Romero-Gomez M, Martinez-Delgado C, Hergueta P, Navarro JM, GarridoSerrano A, Santos O, Montojo C. Source: Alimentary Pharmacology & Therapeutics. 2003 November 15; 18(10): 1023-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14616169&dopt=Abstract

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Triple therapy for 7 days vs. triple therapy for 7 days plus omeprazole for 21 days in treatment of active duodenal ulcer with Helicobacter pylori infection. A double blind placebo controlled trial. Author(s): Marzio L, Cellini L, Angelucci D. Source: Dig Liver Dis. 2003 January; 35(1): 20-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12725603&dopt=Abstract

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Twenty-four-hour intragastric pH-metry: H2-receptor antagonist restoration of nightly gastric spontaneous alkalinization in duodenal ulcer healing. Author(s): Bianco A, Cagossi M, Piraccini R, Greco AV. Source: Riv Eur Sci Med Farmacol. 1992 September-October; 14(5): 281-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1364062&dopt=Abstract

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Ulcer recurrence following duodenal ulcer healing with omeprazole, ranitidine, or placebo: a double-blind, multicenter, 6-month study. The Omeprazole Duodenal Ulcer Study Group. Author(s): Graham DY, Colon-Pagan J, Morse RS, Johnson TL, Walsh JH, McCullough AJ, Marks JW, Sklar M, Stone RC, Cagliola AJ, et al. Source: Gastroenterology. 1992 April; 102(4 Pt 1): 1289-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1551535&dopt=Abstract

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Ulcer-healing drugs are required after eradication of Helicobacter pylori in patients with gastric ulcer but not duodenal ulcer haemorrhage. Author(s): Lai KC, Hui WM, Wong BC, Hu WH, Lam SK. Source: Alimentary Pharmacology & Therapeutics. 2000 August; 14(8): 1071-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10930902&dopt=Abstract

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Ulcerogenesis: integrating the roles of Helicobacter pylori and acid secretion in duodenal ulcer. Author(s): Peura DA. Source: The American Journal of Gastroenterology. 1997 April; 92(4 Suppl): 8S-13S; Discussion 13S-16S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9127621&dopt=Abstract

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Ultrasound evidence of gas in the fissure for ligamentum teres: a sign of perforated duodenal ulcer. Author(s): Patel SV, Gopichandran TD. Source: The British Journal of Radiology. 1999 September; 72(861): 901-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10645199&dopt=Abstract

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Ultrastructural study of antral G cells in patients with duodenal ulcer: effect of Helicobacter pylori eradication. Author(s): Sugamata M, Ihara T, Todate A, Sugamata M, Hirakawa R, Yoshida Y, Yamanaka T, Miyata M, Miura M. Source: Helicobacter. 1997 September; 2(3): 118-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9432338&dopt=Abstract

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Ultrastructural study of the gastric mucosa and Helicobacter pylori in duodenal ulcer patients. Author(s): Al-Muhtaseb MH, Abu-Khalaf AM, Aughsteen AA. Source: Saudi Med J. 2000 June; 21(6): 569-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11500709&dopt=Abstract

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Ultrastructure of parietal cells before and after extended parietal cell vagotomy in patients with duodenal ulcer and their complications. Author(s): Li S, Chen P, An P, Liu C, Yuan S, Chen L. Source: Chinese Medical Journal. 1995 December; 108(12): 898-901. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8728940&dopt=Abstract

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Ureteroduodenal fistula: a rare complication of duodenal ulcer. Author(s): Wu ST, Lee SS, Ma CP, Chang SY, Yu DS. Source: The Journal of Urology. 2000 February; 163(2): 546. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10647678&dopt=Abstract

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Use of omeprazole in the management of giant duodenal ulcer: results of a prospective study. Author(s): Fischer DR, Nussbaum MS, Pritts TA, Gilinsky NH, Weesner RE, Martin SP, Giannella RA. Source: Surgery. 1999 October; 126(4): 643-8; Discussion 648-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10520910&dopt=Abstract

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Use of spinal manipulative therapy in the treatment of duodenal ulcer: a pilot study. Author(s): Forbes J. Source: Journal of Manipulative and Physiological Therapeutics. 1995 NovemberDecember; 18(9): 637-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8775029&dopt=Abstract

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vacA genotypes in Helicobacter pylori strains isolated from children with and without duodenal ulcer in Brazil. Author(s): De Gusmao VR, Nogueira Mendes E, De Magalhaes Queiroz DM, Aguiar Rocha G, Camargos Rocha AM, Ramadan Ashour AA, Teles Carvalho AS. Source: Journal of Clinical Microbiology. 2000 August; 38(8): 2853-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10921938&dopt=Abstract

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VacA genotyping directly from gastric biopsy specimens and estimation of mixed Helicobacter pylori infections in patients with duodenal ulcer and gastritis. Author(s): Hennig EE, Trzeciak L, Regula J, Butruk E, Ostrowski J. Source: Scandinavian Journal of Gastroenterology. 1999 August; 34(8): 743-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10499473&dopt=Abstract

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Vagal effects on acid and pepsin secretion and serum gastrin in duodenal ulcer and controls. Author(s): Hirschowitz BI, Groarke J. Source: Digestive Diseases and Sciences. 1993 October; 38(10): 1874-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8404408&dopt=Abstract

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Vagotomy for duodenal ulcer resistant to H2-receptor antagonists. Author(s): Vassilakis JS, Xynos E, Mantidis A, Zoras OJ, Nikolopoulos N. Source: Digestion. 1989; 44(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2574693&dopt=Abstract

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Very-low dose antacid in treatment of duodenal ulcer. Comparison with cimetidine. Author(s): Zaterka S, Cordeiro F, Lyra LG, Toletino MM, Miszputen SJ, Jorge JL, Silva EP, Vieira FE, Modena JL, Massuda HK, et al. Source: Digestive Diseases and Sciences. 1991 October; 36(10): 1377-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1914758&dopt=Abstract

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Views on esomeprazole-based triple therapy to treat duodenal ulcer disease and Helicobacter pylori infection. Author(s): Singh-Ranger G. Source: European Journal of Gastroenterology & Hepatology. 2002 June; 14(6): 703; Author Reply 703. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072608&dopt=Abstract

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Well-being and gastrointestinal symptoms among patients referred to endoscopy owing to suspected duodenal ulcer. Author(s): Dimenas E, Glise H, Hallerback B, Hernqvist H, Svedlund J, Wiklund I. Source: Scandinavian Journal of Gastroenterology. 1995 November; 30(11): 1046-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8578162&dopt=Abstract

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What are appropriate end-points for Helicobacter pylori eradication in the treatment of duodenal ulcer? Author(s): Williams MP, Pounder RE. Source: Drugs. 1998 July; 56(1): 1-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664194&dopt=Abstract

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CHAPTER 2. NUTRITION AND DUODENAL ULCER Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and duodenal ulcer.

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

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

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The following is a typical result when searching for recently indexed consumer information on duodenal ulcer: •

Diet therapy of peptic ulcer disease. Source: Hollander, D. Nutrition-and-the-M.D (USA). (February 1988). volume 14(2) page 1-2. alcoholic beverages digestive disorders therapeutic diets fatty acids caffeine 07320167

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

A 3-day anti-Helicobacter pylori therapy is a good alternative for bleeding peptic ulcer patients with Helicobacter pylori infection. Author(s): Division of Gastroenterology, Department of Medicine, VGH-Taipei, Shih-Pai Rd, Sec 2, Taipei, Taiwan, 11217, ROC. Source: Hsieh, Y H Lin, H J Tseng, G Y Perng, C L Chang, F Y Lee, S D Hepatogastroenterology. 2001 Jul-August; 48(40): 1078-81 0172-6390

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A comparative study of misoprostol and ranitidine in the healing of duodenal ulcers. A double-blind controlled trial. Source: Simjee, A E Spitaels, J M Pettengell, K E Manion, G L S-Afr-Med-J. 1987 July 4; 72(1): 15-7 0038-2469

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A four-year follow-up of duodenal ulcer patients after Helicobacter pylori eradication. Author(s): Medical Center Rogaska, Rogaska Slatina, Slovenia. Source: Tepes, B Kavcic, B Gubina, M Krizman, I Hepatogastroenterology. 1999 MayJune; 46(27): 1746-50 0172-6390

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A three-day octreotide-containing helicobacter pylori eradication therapy for cure of peptic ulcers. Author(s): Second Department of Internal Medicine, Evangelismos Hospital, Athens University, Greece. [email protected] Source: Ladas, S D Malamou Lada, H Economou, G Tassios, P S Raptis, S A Hepatogastroenterology. 1998 May-June; 45(21): 761-4 0172-6390

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Absorption of bismuth from two bismuth compounds before and after healing of peptic ulcers. Author(s): The Pharmacy, University of Bergen, Norway. [email protected] Source: Hundal, O Bergseth, M Gharehnia, B Andersen, K J Berstad, A Hepatogastroenterology. 1999 Sep-October; 46(29): 2882-6 0172-6390

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Acupuncture treatment for duodenal ulcer. Author(s): Mohacs Hospital, Hungary. Source: Debreceni, L Denes, L Acupunct-Electrother-Res. 1988; 13(2-3): 105-8 0360-1293

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Amoxycillin, clarithromycin and either sucralfate or pantoprazole for eradication of Helicobacter pylori in duodenal ulcer (a randomized controlled trial). Author(s): Internal Clinic, Clinical Hospital Osijek. [email protected] Source: Vcev, A Vceva, A Kurbel, S Takac, B Stimac, D Ivandic, A Ostojic, R Barbir, A Hovat, D Mihaljevic, S Wien-Klin-Wochenschr. 2001 December 17; 113(23-24): 939-41 0043-5325

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An alternative non-macrolide, non-imidazole treatment regimen for curing Helicobacter pylori and duodenal ulcers: ranitidine bismuth citrate plus amoxicillin. The RBC H. pylori Study Group. Author(s): Veterans Administration Medical Center, Houston, TX 77030, USA. Source: Graham, D Y Breiter, J R Ciociola, A A Sykes, D L McSorley, D J Helicobacter. 1998 June; 3(2): 125-31 1083-4389

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An epidemiological study of gastric to duodenal ulcer ratio in Asian countries. Author(s): Department of Preventive Medicine, Kyoto Prefectural University of Medicine, Japan. Source: Kawai, K Watanabe, Y Hayashi, K Gastroenterol-Jpn. 1991 July; 26 Suppl 326770 0435-1339

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An evaluation of sucralfate in the treatment of peptic ulcer disease. A 'clinical real life study' of 54 patients in Indiana. Source: Province, W D 2nd Farag, R S Indiana-Med. 1987 October; 80(10): 926-9 07468288

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Capsaicin-sensitive mechanisms and experimentally induced duodenal ulcers in rats. Source: Maggi, C A Evangelista, S Abelli, L Somma, V Meli, A J-Pharm-Pharmacol. 1987 July; 39(7): 559-61 0022-3573

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Characterization of dopamine receptor subtypes involved in experimentally induced gastric and duodenal ulcers in rats. Author(s): Department of Pharmacology, L.M. College of Pharmacy, Navrangpura, Ahmedabad, India. Source: Desai, J K Goyal, R K ParMarch, N S J-Pharm-Pharmacol. 1999 February; 51(2): 187-92 0022-3573

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Clinical and experimental observations on treatment of peptic ulcer with wei yang an (easing peptic-ulcer) capsule. Author(s): Hunan Institute of Gerontology. Source: Zhou, Z Hu, Y Pi, D Fan, S Yang, Z Wang, Z Gao, J Peng, Q Yao, S Liu, L JTradit-Chin-Med. 1991 March; 11(1): 34-9 0254-6272

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Colloidal bismuth pectin: an alternative to bismuth subcitrate for the treatment of Helicobacter pylori--positive duodenal ulcer. Author(s): Department of Gastroenterology, First Municipal People's Hospital of Guangzhou, P.R. China. Source: Nie, Y Li, Y Wu, H Sha, W Du, H Dai, S Wang, H Li, Q Helicobacter. 1999 June; 4(2): 128-34 1083-4389

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Comparing the cost-effectiveness of drug regimens in the treatment of duodenal ulcers. Author(s): Academy of Finland/University of Helsinki. Source: Sintonen, H Alander, V J-Health-Econ. 1990 June; 9(1): 85-101 0167-6296

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Comparison of solcoseryl and epidermal growth factors (EGF) in healing of chronic gastroduodenal ulcerations and mucosal growth in rats. Author(s): Institute of Physiology, Academy of Medicine, Krakow, Poland. Source: Konturek, S J Brzozowski, T Dembinski, A Warzecha, A Drozdowicz, D Hepatogastroenterology. 1988 February; 35(1): 25-9 0172-6390

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Continuous maintenance with low-dose lansoprazole versus Helicobacter pylori eradication in the prevention of duodenal ulcer recurrence. Author(s): Department of Gastroenterology, L.Sacco University Hospital, Milan, Italy.

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Source: Parente, F Bargiggia, S Bollani, S Colombo, Hepatogastroenterology. 1998 Jul-August; 45(22): 990-3 0172-6390

E

Porro,

G

B

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Critical effect of Helicobacter pylori infection on the effectiveness of omeprazole for prevention of gastric or duodenal ulcers among chronic NSAID users. Author(s): Department of Medicine, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA. Source: Graham, David Y Helicobacter. 2002 February; 7(1): 1-8 1083-4389

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Distribution of prostaglandin E2 in gastric and duodenal mucosa: possible role in the pathogenesis of peptic ulcer. Author(s): Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea. Source: Park, S M Yoo, B C Lee, H R Chung, H Lee, Y S Korean-J-Intern-Med. 1992 January; 7(1): 1-8 0494-4712

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Duodenal ulcer disease: to treat H. pylori infection or not? Author(s): Division of Gastroenterology, University of Missouri School of Medicine, Columbia 65212. Source: Marshall, J B Pharmacoeconomics. 1992 April; 1(4): 298-9 1170-7690

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Duodenal ulcer healing rates in a one-year follow-up study with ranitidine bismuth citrate and antibiotics. Author(s): 2nd Medical Department, General Hospital, Graz, Austria. [email protected] Source: Wurzer, H Bardhan, K D Marcelino, M Jahnsen, J Allmaier, M Hepatogastroenterology. 2001 Nov-December; 48(42): 1641-7 0172-6390

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Duodenal ulcer relapse after eradication of Helicobacter pylori. Author(s): Department of Microbiology, Auckland Hospital. Source: Morris, A Lane, M Hamilton, I Samarasinghe, D Ali, M R Brown, P Nicholson, G N-Z-Med-J. 1991 August 14; 104(917): 329-31 0028-8446

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Duodenal ulcer. Who should have long-term maintenance therapy? Author(s): Washington University, School of Medicine, St. Louis. Source: Zuckerman, G Postgrad-Med. 1987 October; 82(5): 52-3, 57-8, 60 0032-5481

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Effect of ayurvedic medicines on beta-glucuronidase activity of Brunner's glands during recovery from cysteamine induced duodenal ulcers in rats. Source: Nadar, T S Pillai, M M Indian-J-Exp-Biol. 1989 November; 27(11): 959-62 00195189

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Effect of continuous intravenous infusion of secretin preparation (secrepan) in patients with hemorrhage from chronic peptic ulcer and AGML. Author(s): First Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan. Source: Watanabe, Y Tsumura, H Nohmi, A Gastroenterol-Jpn. 1988 October; 23(5): 50613 0435-1339

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Effect of hyperprolactinaemia as induced by pituitary homografts under kidney capsule on gastric and duodenal ulcers in rats. Author(s): Department of Pharmacology, Jawaharlal Institute of Post-Graduate Medical Education & Research, Pondicherry, India. Source: Asad, M Shewade, D G Koumaravelou, K Abraham, B K Balasinor, N Ramaswamy, S J-Pharm-Pharmacol. 2001 November; 53(11): 1541-7 0022-3573

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Effect of lapachol, a naphthaquinone isolated from Tectona grandis, on experimental peptic ulcer and gastric secretion. Source: Goel, R K Pathak, N K Biswas, M Pandey, V B Sanyal, A K J-Pharm-Pharmacol. 1987 February; 39(2): 138-40 0022-3573

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Effect of meal on intragastric pH in patients with duodenal ulcer. Author(s): PMRC Research Centre, Jinnah Postgraduate Medical Centre, Karachi. Source: Shahid, A Zuberi, S J Alam, S E J-Pak-Med-Assoc. 1992 February; 42(2): 45-6 0030-9982

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Enprostil and ranitidine: comparative efficacy and safety in patients with duodenal ulcer. Author(s): Gastroenterology Unit, Flinders Medical Centre, SA. Source: Mackinnon, M Alp, M Austad, W I Byrnes, D Cowen, A Duggan, J Pirola, R Thomas, M Ward, M Aust-N-Z-J-Med. 1987 June; 17(3): 316-20 0004-8291

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Eradication of Campylobacter pylori and recurrence of duodenal ulcer. A six-month follow-up study. Author(s): Gastroenterology Department, NIMTS Hospital, Athens, Greece. Source: Mouzas, I A Kalantzis, N Gabriel, P Kallimanis, G Papantoniou, P Mavrogiannis, H Acta-Gastroenterol-Latinoam. 1990; 20(3): 159-61 0300-9033

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Eradication of Helicobacter pylori in duodenal ulcer disease tetracycline & furazolidone vs. metronidazole & amoxicillin in omeprazole based triple therapy. Author(s): Gastrointestinal & liver Diseases Research center, Guilan University of Medical Sciences, Rasht, Iran. [email protected] Source: Mansour Ghanaei, Fariborz Fallah, Mohammad S Shafaghi, Afshin Med-SciMonit. 2002 March; 8(3): PI27-30 1234-1010

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First randomized controlled trial with sucralfate versus H2-antagonists in the treatment of duodenal ulcer non-responders to initial treatment with sucralfate. Author(s): Division of Gastroenterology, General Regional Hospital, Bolzano, Italy. Source: Dobrilla, G Amplatz, S Andreoli, R Vallaperta, P A Hepatogastroenterology. 1990 April; 37(2): 239-41 0172-6390

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First-degree atrioventricular block in a young duodenal ulcer patient treated with a standard oral dose of ranitidine. Author(s): Emergency Department, General Regional Hospital, Bolzano, Italy. Source: Allegri, G Pellegrini, K Dobrilla, G Agents-Actions. 1988 July; 24(3-4): 237-42 0065-4299

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Food intolerance in duodenal ulcer patients, non ulcer dyspeptic patients and healthy subjects. A prospective study. Author(s): II. Medizinische Klinik, Stadtisches Krankenhaus Munchen-Bogenhausen. Source: Kaess, H Kellermann, M Castro, A Klin-Wochenschr. 1988 March 1; 66(5): 208-11 0023-2173

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GC and C3 serum groups in peptic ulcer. Author(s): Department of Pathologic Physiology, Laikon General Hospital, University of Athens, Greece. Source: Archimandritis, A Douvara, M Grigoris, S Tjivras, M Davaris, P Fertakis, A Hum-Hered. 1992; 42(3): 198-200 0001-5652

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Human tolerability and pharmacodynamic study of Tisacid tablet in duodenal ulcer patients. A prospective, randomized, self-controlled clinicopharmacological study. Author(s): 1st Department of Medicine, University Medical School, Pecs, Hungary.

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Source: Nagy, L Tarnok, F Past, T Mozsik, G Deak, G Tapsonyi, Z Fendler, K Javor, T Acta-Med-Hung. 1988; 45(2): 231-47 0236-5286 •

Intragastric and intraoesophageal pH monitoring in duodenal ulcerpatients: effect of the new histamine H2-receptor antagonist ramixotidine. Author(s): Cattedra di Patologia Medica III, Universita degli Studi di Milano, Italy. Source: Molgora, M Basilisco, G Bozzani, A Camboni, G Bianchi, P A Eur-J-ClinPharmacol. 1989; 37(4): 405-7 0031-6970

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Is 1-week treatment for peptic ulcer healing sufficient and safe? Author(s): Digestive Diseases Service, Miguel Servet Hospital, Zaragoza, Spain. Source: Garcia, S Fuentes, J Ducons, J A Barrera, F Yus, C Gomollon, F Rev-Esp-EnfermDig. 2000 January; 92(1): 5-12 1130-0108

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Low-dose antacid therapy in the treatment of duodenal ulcer--a multicentre doubleblind trial vs. misoprostol. Author(s): Dept. of Medicine, University of Frankfurt. Source: Caspary, W F Hengels, K J Kunert, H Rosch, W Rohner, H G Spuhler, S Nauert, C Z-Gastroenterol. 1991 September; 29(9): 411-6 0044-2771

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Medical treatment of peptic ulcer disease. Author(s): Division of Gastroenterology, Medical College of Pennsylvania, Philadelphia. Source: Rubin, W Med-Clin-North-Am. 1991 July; 75(4): 981-98 0025-7125

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Misoprostol and dalargin for the inpatient treatment of duodenal ulcer in the USSR. Author(s): GD Searle & Co., Chicago, Illinois 60680. Source: Dajani, E Z Penin, V A Sokolov, L K Vahtangishvilli, R BogdaNovember, A Afonskaya, N Ivanishvilli, L Zharova, Y Efremova, I J-Assoc-Acad-Minor-Phys. 1991; 2(1): 18-22 1048-9886

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Mucosa protectives: sucralfate and colloidal bismuth subcitrate in peptic ulcer disease. Author(s): Div. Gastroenterology-Hepatology, Academic Medical Center, Amsterdam. Source: Tytgat, G N Nio, C Y Z-Gastroenterol. 1987 August; 25 Suppl 3152-61 0044-2771

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Pirenzepine prevents cysteamine-induced formation of gastroduodenal ulcers and reduction of mesenteric circulation. Author(s): Institute of Medical Pharmacology, University of Pisa, Italy. Source: Bernardini, M C Blandizzi, C Morini, G Chiavarini, M Impicciatore, M Del Tacca, M Arch-Int-Pharmacodyn-Ther. 1989 Nov-December; 302242-54 0003-9780

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Ranitidine bismuth citrate plus clarithromycin: a dual therapy regimen for patients with duodenal ulcer. Author(s): Houston Institute for Clinical Research, TX 77074, USA. Source: Lanza, F L Sontag, S J Ciociola, A A Sykes, D L Heath, A McSorley, D J Helicobacter. 1998 September; 3(3): 212-21 1083-4389

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Recurrent giant longitudinal duodenal ulcer with massive hemorrhage in a Helicobacter pylori-negative patient. Author(s): Department of Internal Medicine, Miyoshi Prefectural Hospital, Tokushima, Japan. Source: Fujimoto, M Shimizu, I Horie, T Inoue, H Okazaki, M Niki, M Shiraishi, T Fujiwara, S Murata, M Yamamoto, K Iuchi, A Hino, A Ito, S J-Med-Invest. 2001 August; 48(3-4): 210-5 1343-1420

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Relapsed duodenal ulcer after cure of Helicobacter pylori infection. Author(s): Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan.

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Source: Miwa, H Matsushima, H Terai, T Tanaka, H Kawabe, M Namihisa, A Watanabe, S Sato, N J-Gastroenterol. 1998 August; 33(4): 556-61 0944-1174 •

Risk factors for duodenal ulcer in north India. Author(s): Maulana Azad Medical College, New Delhi. Source: Jain, A Buddhiraja, S Khurana, B Singhal, R Nair, D Arora, P Gangwal, P Mishra, S K Uppal, B Gondal, R Kar, P Trop-Gastroenterol. 1999 Jan-March; 20(1): 36-9 0250-636X

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Site-and cytoprotective drugs in the short-term treatment of peptic ulcer. What is their current role? Author(s): Divisione di Gastroenterologia ed Endoscopia Digestiva, Ospedaale L Sacco, Milano, Italy. Source: Bianchi Porro, G Parente, F Ital-J-Gastroenterol. 1990; 22 Suppl 15-10 0392-0623

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Sucralfate and other non-antisecretory agents in the treatment of peptic ulcer disease. Author(s): Department of Gastroenterology and Hepatology, Medical University Clinic Bergmannsheil, Ruhr University, Bochum, W. Germany. Source: May, B Methods-Find-Exp-Clin-Pharmacol. 1989; 11 Suppl 1113-6 0379-0355

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Sucralfate delays gastric emptying of liquids and solids in duodenal ulcer patients. Author(s): Department of Medicine, Yale University School of Medicine, Hospital of Saint Raphael, New Haven, CT 06511. Source: Petersen, J M Caride, V J Prokop, E K Troncale, F J McCallum, R W Int-J-RadAppl-Instrum-B. 1989; 16(4): 389-95 0883-2897

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The effect of prostacyclin and its analogues on cysteamine-induced duodenal ulceration of rats. Author(s): First Department of Medicine, University Medical School, Szeged, Hungary. Source: Nafradi, J Balint, G A Varro, V Acta-Med-Hung. 1988; 45(1): 127-30 0236-5286

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The hemodynamic changes of gastroduodenal regional blood flow after Helicobacter pylori eradication in patients with duodenal ulcer scar. Author(s): Department of Internal Medicine, Kaohsiung Medical College Hospital, Taiwan, Republic of China. Source: Wu, D C Wang, W M Lu, C Y Su, Y C Lin, S R Liu, C S January, C M KaohsiungJ-Med-Sci. 1999 Jan; 15(1): 19-25 1607-551X

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The influence of relapse rate on the choice of duodenal ulcer therapy. Source: Anonymous Drug-Ther-Bull. 1987 October 5; 25(20): 77-80 0012-6543

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The physiology of postvagotomy duodenal ulcer healing: a prostaglandin connection. Author(s): Department of Surgery, Audie L. Murphy Veterans Administration Hospital, San Antonio, Texas. Source: Levine, B A Sirinek, K R Surgery. 1987 October; 102(4): 587-94 0039-6060

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Zinc compounds, a new treatment in peptic ulcer. Author(s): Department of Pharmacology, Laboratorios Vinas S.A., Barcelona, Spain. Source: Escolar, G Bulbena, O Drugs-Exp-Clin-Res. 1989; 15(2): 83-9 0378-6501

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The following is a specific Web list relating to duodenal ulcer; 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: •

Vitamins Vitamin A Source: Healthnotes, Inc.; www.healthnotes.com Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com

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Minerals Betaine Hydrochloride Source: Healthnotes, Inc.; www.healthnotes.com Bromelain/Quercetin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,941,00.html Quercetin Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Prima Communications, Inc.www.personalhealthzone.com

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Food and Diet Cabbage Source: Healthnotes, Inc.; www.healthnotes.com Coffee Source: Healthnotes, Inc.; www.healthnotes.com Garlic Alternative names: Allium sativum Source: Healthnotes, Inc.; www.healthnotes.com High-Fiber Diet Source: Healthnotes, Inc.; www.healthnotes.com Tea Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND DUODENAL ULCER Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to duodenal ulcer. 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 duodenal ulcer 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 “duodenal ulcer” (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 duodenal ulcer: •

A controlled study of gastric freezing for the treatment of duodenal ulcer. Author(s): ROSE H, FORDTRAN JS, HARRELL R, FRIEDMAN B. Source: Gastroenterology. 1964 July; 47: 10-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14184339&dopt=Abstract

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A controlled study on the use of propantheline and amylopectin sulfate (SN-263) for recurrences in duodenal ulcer. Author(s): Sun DC, Ryan ML. Source: Gastroenterology. 1970 June; 58(6): 756-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4912656&dopt=Abstract

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A controlled trial of carbenoxolone sodium capsules in the treatment of duodenal ulcer. Author(s): Montgomery RD, Lawrence IH, Manton DJ, Mendl K, Rowe P. Source: Gut. 1968 December; 9(6): 704-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4887691&dopt=Abstract

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A controlled trial of glycopyrronium and l-hyoscyamine in the long-term treatment of duodenal ulcer. Author(s): Kaye MD, Rhodes J, Beck P, Sweetnam PM, Davies GT, Evans KT. Source: Gut. 1970 July; 11(7): 559-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4916211&dopt=Abstract

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A double blind trial of carbenoxolone sodium (duogastrone) in duodenal ulcer therapy with endoscopic diagnosis and follow up. Author(s): Brown P, Salmon PR, Htut T, Read AE. Source: Gut. 1972 April; 13(4): 324. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4556021&dopt=Abstract

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A double-blind controlled clinical trial of mastic and placebo in the treatment of duodenal ulcer. Author(s): Al-Habbal MJ, Al-Habbal Z, Huwez FU. Source: Clinical and Experimental Pharmacology & Physiology. 1984 SeptemberOctober; 11(5): 541-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6395994&dopt=Abstract

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A double-blind trial of carbenoxolone sodium capsules in the treatment of duodenal ulcer. Author(s): Cliff JM, Milton-Thompson GJ. Source: Gut. 1970 February; 11(2): 167-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4909817&dopt=Abstract

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A trial of amylopectin sulfate (SN-263) and propantheline bromide in the long term treatment of chronic duodenal ulcer. Author(s): Cocking JB. Source: Gastroenterology. 1972 January; 62(1): 6-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4551010&dopt=Abstract

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A trial of deglycyrrhizinated liquorice in the treatment of duodenal ulcer. Author(s): Feldman H, Gilat T. Source: Gut. 1971 June; 12(6): 449-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4933135&dopt=Abstract

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Acupuncture treatment for duodenal ulcer. Author(s): Debreceni L, Denes L. Source: Acupuncture & Electro-Therapeutics Research. 1988; 13(2-3): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2904207&dopt=Abstract

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Aetiology of duodenal ulcer: an investigation into the buffering action and effect on pepsin of bran and unrefined carbohydrate foods. Author(s): Tovey FI. Source: Postgraduate Medical Journal. 1974 November; 50(589): 683-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4619652&dopt=Abstract

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Amylopectin sulfate, propantheline and recurrent duodenal ulcer. Author(s): Littman A. Source: Gastroenterology. 1970 June; 58(6): 913-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4912660&dopt=Abstract

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Bleeding duodenal ulcer: treatment with bio-flavonoids and diet; report on 36 cases. Author(s): WEISS S, WEISS J, WEISS B. Source: The American Journal of Gastroenterology. 1958 June; 29(6): 629-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13533386&dopt=Abstract

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Campylobacter pylori and gastroduodenal ulcer disease. A prospective study in a Swedish population. Author(s): Gad A, Hradsky M, Furugard K, Malmodin B. Source: Scandinavian Journal of Gastroenterology. Supplement. 1989; 167: 81-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2575789&dopt=Abstract

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Carbenoxolone in the treatment of duodenal ulcer. Author(s): Craig O, Hunt T, Kimerling JJ, Parke DV. Source: The Practitioner. 1967 July; 199(189): 109-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5343152&dopt=Abstract

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Cholecystokinin in the control of gastric acid and plasma gastrin and somatostatin secretion in healthy subjects and duodenal ulcer patients before and after eradication of Helicobacter pylori. Author(s): Konturek JW. Source: Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society. 1994 December; 45(4 Suppl 1): 3-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7787215&dopt=Abstract

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Clinical study of Duogastrone in the treatment of duodenal ulcers. Author(s): Amure BO.

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Source: Gut. 1970 February; 11(2): 171-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4909818&dopt=Abstract •

Colloidal bismuth pectin: an alternative to bismuth subcitrate for the treatment of Helicobacter pylori--positive duodenal ulcer. Author(s): Nie Y, Li Y, Wu H, Sha W, Du H, Dai S, Wang H, Li Q. Source: Helicobacter. 1999 June; 4(2): 128-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10382127&dopt=Abstract

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Comparison of motor cortex-induced flexor muscle activity inhibition by hard pressure on various parts of the body and by light pinch of abdomen of animals with gastro-duodenal ulcers. Author(s): Hisamitsu T, Wu C, Takeshige C. Source: Acupuncture & Electro-Therapeutics Research. 1987; 12(3-4): 171-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2895565&dopt=Abstract

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Comparison of ranitidine and high-dose antacid in the treatment of prepyloric or duodenal ulcer. A double-blind controlled trial. Author(s): Lauritsen K, Bytzer P, Hansen J, Bekker C, Rask-Madsen J. Source: Scandinavian Journal of Gastroenterology. 1985 January; 20(1): 123-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3887547&dopt=Abstract

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Controlled double blind trial of carbenoxolone in gastric and duodenal ulcer. Author(s): Hadzic N, Vrhovac B, Kallai L. Source: Int J Clin Pharmacol. 1974 December; 10(4): 309-18. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4613674&dopt=Abstract

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Controlled trial of hypnotherapy in relapse prevention of duodenal ulceration. Author(s): Colgan SM, Faragher EB, Whorwell PJ. Source: Lancet. 1988 June 11; 1(8598): 1299-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2897556&dopt=Abstract

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Cost-effectiveness of Helicobacter pylori eradication therapy in duodenal ulcer disease. Author(s): Jonsson B. Source: Scandinavian Journal of Gastroenterology. Supplement. 1996; 215: 90-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8722390&dopt=Abstract

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Current concepts in the medical treatment of duodenal ulcer. Author(s): Kettering RF.

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Source: The Surgical Clinics of North America. 1971 August; 51(4): 835-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4939419&dopt=Abstract •

Deglycyrrhizinated liquorice in duodenal ulcer. Author(s): Tewari SN, Wilson AK. Source: The Practitioner. 1973 June; 210(260): 820-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4581313&dopt=Abstract

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Deglycyrrhizinated liquorice in the treatment of chronic duodenal ulcer. Author(s): Balakrishnan V, Pillai MV, Raveendran PM, Nair CS. Source: J Assoc Physicians India. 1978 September; 26(9): 811-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=370079&dopt=Abstract

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Deglycyrrhizinised liquorice in duodenal ulcer. Author(s): Larkworthy W, Holgate PF, McIllmurray MB, Langman MJ. Source: British Medical Journal. 1977 October 29; 2(6095): 1123. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=589019&dopt=Abstract

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Deglycyrrhizinized liquorice in duodenal ulcer. Author(s): Whiting B, Thomson TJ. Source: British Medical Journal. 1971 October 2; 4(778): 48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5096890&dopt=Abstract

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Deglycyrrhizinized liquorice in the treatment of chronic duodenal ulcer. A retrospective endoscopic survey of 32 patients. Author(s): Larkworthy W, Holgate PF. Source: The Practitioner. 1975 December; 215(1290): 787-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=772652&dopt=Abstract

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Dietary factors in relation to the distribution of duodenal ulcer in India as assessed by studies in rats. Author(s): Jayaraj AP, Tovey FI, Clark CG, Hobsley M. Source: Journal of Gastroenterology and Hepatology. 2001 May; 16(5): 501-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11350544&dopt=Abstract

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Dietary supplementation with pectin in the maintenance treatment of duodenal ulcer. A controlled study. Author(s): Kang JY, Tay HH, Guan R, Math MV, Yap I, Labrooy SJ. Source: Scandinavian Journal of Gastroenterology. 1988 January; 23(1): 95-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3278367&dopt=Abstract

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Discussion on methods of psychosomatic medicine; the “duodenal ulcer personality”a psychometric approach. Author(s): HAMILTON M. Source: Proc R Soc Med. 1958 November; 51(11): 949-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13614411&dopt=Abstract

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Do chillies influence healing of duodenal ulcer? Author(s): Kumar N, Vij JC, Sarin SK, Anand BS. Source: British Medical Journal (Clinical Research Ed.). 1984 June 16; 288(6433): 1803-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6428553&dopt=Abstract

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Does amylopectin sulfate work in duodenal ulcer or not? Author(s): Littman A. Source: Gastroenterology. 1972 January; 62(1): 141-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4551006&dopt=Abstract

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Double-blind trial of carbenoxolone sodium capsules in duodenal ulcer therapy, based on endoscopic diagnosis and follow-up. Author(s): Brown P, Salmon PR, Thien-Htut, Read AE. Source: British Medical Journal. 1972 September 16; 3(828): 661-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4568356&dopt=Abstract

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Drugs in the treatment of gastric and duodenal ulcer. Author(s): Langman MJ. Source: Drugs. 1977 August; 14(2): 105-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=19225&dopt=Abstract

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Duodenal ulcer in military patients. Author(s): ZOLLINGER RM, THOMAS DE, GLASS AJ, SCOTT NM, COHEN A, HEDBERG C. Source: Military Medicine. 1964 April; 129: 289-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14169228&dopt=Abstract

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Duodenal ulcer is associated with low dietary linoleic acid intake. Author(s): Grant HW, Palmer KR, Riermesma RR, Oliver MF. Source: Gut. 1990 September; 31(9): 997-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2210468&dopt=Abstract

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Duodenal ulcer prevalence: experimental evidence for the possible role of dietary lipids. Author(s): Jayaraj AP, Tovey FI, Lewin MR, Clark CG.

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Source: Journal of Gastroenterology and Hepatology. 2000 June; 15(6): 610-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10921413&dopt=Abstract •

Duodenal ulcer prevalence: research into the nature of possible protective dietary lipids. Author(s): Paul Jayaraj A, Tovey FI, Hobsley M. Source: Phytotherapy Research : Ptr. 2003 April; 17(4): 391-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12722147&dopt=Abstract

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Effect of ayurvedic medicines on beta-glucuronidase activity of Brunner's glands during recovery from cysteamine induced duodenal ulcers in rats. Author(s): Nadar TS, Pillai MM. Source: Indian J Exp Biol. 1989 November; 27(11): 959-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2620935&dopt=Abstract

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Effect of xiaokuiling prescription on the expression of HSP72, HSP B in gastric mucosa of patients with Helicobacter pylori-associated duodenal ulcer. Author(s): Yi P, Li G, Liu S, Luo S, Tao X. Source: J Tongji Med Univ. 2001; 21(4): 310-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12539556&dopt=Abstract

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Effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer. Author(s): Chao JC, Hung HC, Chen SH, Fang CL. Source: World Journal of Gastroenterology : Wjg. 2004 February 15; 10(4): 560-566. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14966917&dopt=Abstract

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Endoscopic controlled trial of four drug regimens in the treatment of chronic duodenal ulceration. Author(s): Kassir ZA. Source: Ir Med J. 1985 June; 78(6): 153-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3891678&dopt=Abstract

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Fiber diet and antacids in the short-term treatment of duodenal ulcer. Author(s): Rydning A, Berstad A. Source: Scandinavian Journal of Gastroenterology. 1985 November; 20(9): 1078-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3003883&dopt=Abstract

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Food intolerance in duodenal ulcer patients, non ulcer dyspeptic patients and healthy subjects. A prospective study. Author(s): Kaess H, Kellermann M, Castro A.

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Source: Klin Wochenschr. 1988 March 1; 66(5): 208-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3361798&dopt=Abstract •

Gastric acid secretion in patients with duodenal ulcer treated for one year with anticholinergic drugs. Author(s): Kaye MD, Beck P, Rhodes J, Sweetnam PM. Source: Gut. 1969 October; 10(10): 774-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5350103&dopt=Abstract

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Healing of duodenal ulcer with an antacid regimen. Author(s): Peterson WL, Sturdevant RA, Frankl HD, Richardson CT, Isenberg JI, Elashoff JD, Sones JQ, Gross RA, McCallum RW, Fordtran JS. Source: The New England Journal of Medicine. 1977 August 18; 297(7): 341-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=876324&dopt=Abstract

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High fiber good or low fiber bad for duodenal ulcers? Author(s): Baron JH. Source: Lancet. 1982 October 30; 2(8305): 980. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6127473&dopt=Abstract

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Influence of smoking on healing rate of duodenal ulcer in response to cimetidine or high-dose antacid. Author(s): Korman MG, Shaw RG, Hansky J, Schmidt GT, Stern AI. Source: Gastroenterology. 1981 June; 80(6): 1451-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7227770&dopt=Abstract

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Irritable colon and duodenal ulcer. Author(s): HEFFERNON EW, HIMMEL M. Source: Gp. 1963 March; 27: 125-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13963704&dopt=Abstract

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Khat chewing is a risk factor of duodenal ulcer. Author(s): Raja'a YA, Noman TA, Al-Warafi AK, Al Mashraki NA, Al Yosofi AM. Source: Saudi Med J. 2000 September; 21(9): 887-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11376372&dopt=Abstract

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Medical management and treatment of duodenal ulcer. Author(s): Muller-Wieland K, Ossenberg FW. Source: Adv Psychosom Med. 1971; 6: 152-68. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4948340&dopt=Abstract

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Natural history of peptic ulcer in children. Five-year prospective endoscopic examinations. Part II. Healing of duodenal ulcer. Author(s): Michalowicz-Wojczynska E, Swiatkowski P, Teisseyre M. Source: Mater Med Pol. 1988 January-March; 20(1): 36-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3221724&dopt=Abstract

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Prevention of duodenal ulcer formation in the rat by dietary vitamin A supplementation. Author(s): Mahmood T, Tenenbaum S, Niu XT, Levenson SM, Seifter E, Demetriou AA. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1986 January-February; 10(1): 74-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3945046&dopt=Abstract

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Protective effect of UL-409, a herbal formulation against physical and chemical factor induced gastric and duodenal ulcers in experimental animals. Author(s): Mitra SK, Gopumadhavan S, Hemavathi TS, Muralidhar TS, Venkataranganna MV. Source: Journal of Ethnopharmacology. 1996 July 5; 52(3): 165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8771458&dopt=Abstract

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Psychological factors predictive of surgical success in patients with intractable duodenal ulcer; a study of male veterans. Author(s): THOROUGHMAN JC, PASCAL GR, JENKINS WO, CRUTCHER JC, PEOPLES LC. Source: Psychosomatic Medicine. 1964 September-October; 26: 618-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14219241&dopt=Abstract

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Relationship between bender-gestalt test scores and the response of patients with intractable duodenal ulcer to surgery. Author(s): PASCAL GR, THOROUGHMAN JC. Source: Psychosomatic Medicine. 1964 September-October; 26: 625-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14223294&dopt=Abstract

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The effect of treatment with Hisar mineral water from the Momina-Salza spa on gastric secretion and acidity in duodenal ulcer patients - a study with pentagastrin (preliminary report). Author(s): Minchev M, Stanchev I, Dinkov I, Badev I, Mutafchiev I. Source: Folia Med (Plovdiv). 1980; 22(4): 40-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6790379&dopt=Abstract

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The medical treatment of duodenal ulceration? Author(s): Salter RH.

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Source: Br J Clin Pract. 1972 February; 26(2): 63-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5016908&dopt=Abstract •

The medical treatment of gastric and duodenal ulcer. Author(s): Langman MJ. Source: Postgraduate Medical Journal. 1968 August; 44(514): 603-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5679279&dopt=Abstract

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Use of spinal manipulative therapy in the treatment of duodenal ulcer: a pilot study. Author(s): Forbes J. Source: Journal of Manipulative and Physiological Therapeutics. 1995 NovemberDecember; 18(9): 637-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8775029&dopt=Abstract

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Use of spinal manipulative therapy in the treatment of duodenal ulcer: a pilot study. Author(s): Haywood J, Kirk D, Sanders D. Source: Journal of Manipulative and Physiological Therapeutics. 1995 February; 18(2): 117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7790783&dopt=Abstract

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Use of spinal manipulative therapy in the treatment of duodenal ulcer: a pilot study. Author(s): Pikalov AA, Kharin VV. Source: Journal of Manipulative and Physiological Therapeutics. 1994 June; 17(5): 310-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7930964&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to duodenal ulcer; 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 Allergies and Sensitivities Source: Healthnotes, Inc.; www.healthnotes.com Chronic Candidiasis Source: Healthnotes, Inc.; www.healthnotes.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Gastritis Source: Healthnotes, Inc.; www.healthnotes.com Gastritis Source: Integrative Medicine Communications; www.drkoop.com Gastroesophageal Reflux Disease Source: Healthnotes, Inc.; www.healthnotes.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hyperparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com

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Sarcoidosis Source: Integrative Medicine Communications; www.drkoop.com Schizophrenia Source: Healthnotes, Inc.; www.healthnotes.com Stomach Inflammation Source: Integrative Medicine Communications; www.drkoop.com Ulcers Source: Prima Communications, Inc.www.personalhealthzone.com •

Chinese Medicine Anwei Pian Alternative names: An Wei Pian Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Baiji Alternative names: Common Bletilla Tuber; Rhizoma Bletillae Source: Chinese Materia Medica Haipiaoxiao Alternative names: Cuttlebone; Os Sepiae Source: Chinese Materia Medica

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Herbs and Supplements Aloe Alternative names: Aloe vera, Aloe barbadensis, Aloe ferox , Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Aloe Vera Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10001,00.html Aluminum Hydroxide Source: Healthnotes, Inc.; www.healthnotes.com Amino Acids Overview Source: Healthnotes, Inc.; www.healthnotes.com Bovine Colostrum Source: Healthnotes, Inc.; www.healthnotes.com

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Bromelain Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,760,00.html Bupleurum Alternative names: Bupleurum chinense, Bupleurum falcatum Source: Healthnotes, Inc.; www.healthnotes.com Calendula Alternative names: Calendula officinalis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Calendula Alternative names: Calendula officinalis Source: Healthnotes, Inc.; www.healthnotes.com Capsaicin Source: Integrative Medicine Communications; www.drkoop.com Capsicum Frutescens Source: Integrative Medicine Communications; www.drkoop.com Carnosine Source: Healthnotes, Inc.; www.healthnotes.com Cayenne Alternative names: Capsicum frutescens, Capsicum spp., Capsaicin, Chili Pepper, Red Pepper Source: Integrative Medicine Communications; www.drkoop.com Chamomile Alternative names: Matricaria recutita Source: Healthnotes, Inc.; www.healthnotes.com Chili Pepper Source: Integrative Medicine Communications; www.drkoop.com Comfrey Alternative names: Symphytum officinale Source: Healthnotes, Inc.; www.healthnotes.com Comfrey Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Corydalis Alternative names: Corydalis turtschaninovii, Corydalis yanhusuo Source: Healthnotes, Inc.; www.healthnotes.com

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Devil's Claw Alternative names: Harpagophytum procumbens, Harpagophytum zeyheri Source: Integrative Medicine Communications; www.drkoop.com Devil's Claw Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,970,00.html Digestive Enzymes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10051,00.html DMSO Source: Healthnotes, Inc.; www.healthnotes.com Famotidine Source: Healthnotes, Inc.; www.healthnotes.com Fiber Source: Healthnotes, Inc.; www.healthnotes.com Flavonoids Source: Healthnotes, Inc.; www.healthnotes.com Forskolin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10025,00.html Gentian Alternative names: Gentiana lutea Source: Healthnotes, Inc.; www.healthnotes.com Glucosamine Source: Healthnotes, Inc.; www.healthnotes.com Glutamine Source: Healthnotes, Inc.; www.healthnotes.com Glutamine Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10030,00.html Glycyrrhiza glabra Source: Integrative Medicine Communications; www.drkoop.com

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Glycyrrhiza Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Golden Seal Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Greater Celandine Alternative names: Chelidonium majus Source: Healthnotes, Inc.; www.healthnotes.com Harpagophytum Procumbens Source: Integrative Medicine Communications; www.drkoop.com Harpagophytum Zeyheri Source: Integrative Medicine Communications; www.drkoop.com Horehound Alternative names: Marrubium vulgare Source: Healthnotes, Inc.; www.healthnotes.com Horseradish Alternative names: Cochlearia armoracia Source: Healthnotes, Inc.; www.healthnotes.com Hyoscyamine Source: Healthnotes, Inc.; www.healthnotes.com Licorice Alternative names: Glycyrrhiza glabra, Glycyrrhiza uralensis Source: Healthnotes, Inc.; www.healthnotes.com Licorice Alternative names: Glycyrrhiza glabra, Spanish Licorice Source: Integrative Medicine Communications; www.drkoop.com Licorice Source: Prima Communications, Inc.www.personalhealthzone.com Liquorice Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Marshmallow Alternative names: Althea officinalis Source: Healthnotes, Inc.; www.healthnotes.com Marshmallow Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca

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Meadowsweet Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Musa Banana Alternative names: Plantain, Banana; Musa sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Nizatidine Source: Healthnotes, Inc.; www.healthnotes.com Omeprazole Source: Healthnotes, Inc.; www.healthnotes.com Piper Nigrum Alternative names: Black Pepper Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Plantain Alternative names: Plantago lanceolata, Plantago major Source: Healthnotes, Inc.; www.healthnotes.com Prickly Ash Alternative names: Zanthoxylum clava-herculis, Zanthoxylum americanum Source: Healthnotes, Inc.; www.healthnotes.com Red Pepper Source: Integrative Medicine Communications; www.drkoop.com Ribes Alternative names: Black Currant; Ribes nigrum L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Spanish Licorice Source: Integrative Medicine Communications; www.drkoop.com Terminalia Alternative names: Myrobalans; Terminalia arjuna Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Turmeric Alternative names: Curcuma longa Source: Healthnotes, Inc.; www.healthnotes.com Yohimbe Alternative names: Pausinystalia yohimbe Source: Healthnotes, Inc.; www.healthnotes.com

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

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CHAPTER 4. CLINICAL TRIALS AND DUODENAL ULCER Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning duodenal ulcer.

Recent Trials on Duodenal Ulcer The following is a list of recent trials dedicated to duodenal ulcer.8 Further information on a trial is available at the Web site indicated. •

Peptic Ulcer Hemorrhage Study Condition(s): Peptic Ulcer Hemorrhage Study Status: This study is currently recruiting patients. Sponsor(s): Wyeth-Ayerst Research Purpose - Excerpt: This study will evaluate the effect of two regimens of intravenous pantoprazole versus intravenous ranitidine on intragastric pH after endoscopic hemostatic therapy in patients with bleeding peptic ulcer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00037570

•

Peptic Ulcer Hemorrhage Study Condition(s): Peptic Ulcer Hemorrhage Study Status: This study is currently recruiting patients. Sponsor(s): Wyeth-Ayerst Research

8

These are listed at www.ClinicalTrials.gov.

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Purpose - Excerpt: To evaluate the efficacy and safety of intravenous pantoprazole in the prevention of rebleeding in patients with bleeding peptic ulcer disease after successful endoscopic hemostatic therapy. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00040495

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “duodenal ulcer” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

•

For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

•

For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

•

For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

•

For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

•

For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

•

For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

•

For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

•

For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

Clinical Trials 101

•

For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

•

For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

•

For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

•

For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 5. PATENTS ON DUODENAL ULCER 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.9 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 “duodenal ulcer” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on duodenal ulcer, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Duodenal Ulcer By performing a patent search focusing on duodenal ulcer, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

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

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

1,3-dioxane derivatives, method of their synthesis and anti-peptic ulcer agent Inventor(s): Tomiyama; Akira (Togura, JP), Tomiyama; Tsuyoshi (Sakaki, JP) Assignee(s): Kotobuki Seiyaku Co., Ltd. (nagano, Jp) Patent Number: 4,631,292 Date filed: July 31, 1984 Abstract: A series of new 1,3-dioxane derivatives are disclosed. These compounds have an outstanding anti-peptic ulcerative activity and are useful as novel anti-peptic ulcer agents. Such compounds are synthesized by reacting a 1,3-butanediol derivative with suitable ketone. Excerpt(s): The principal object of the present invention is the provision of a novel antipeptic ulcer agent. Another important object of the present invention is the provision of a novel compound having advantageous pharmaceutical properties. Still another object of the present invention is the provision of a pharmaceutical composition useful as an anti-peptic ulcerative agent. Web site: http://www.delphion.com/details?pn=US04631292__

•

Anti-peptic ulcer agent Inventor(s): Kurihara; Masaaki (Saitamaken, JP), Ohta; Keiichiro (Saitamaken, JP) Assignee(s): Lederle (japan), Ltd. (tokyo, Jp) Patent Number: 5,039,699 Date filed: March 27, 1989 Abstract: An anti-peptic ulcer agent comprising (a) a powdery material which includes tocopheryl retinoate, light silicic anhydride, and an antioxidant; (b) a low substituted hydroxypropylcellulose; and (c) polyvinylpyrrolidone which is orally administrable. Excerpt(s): It is known that tocopheryl retinoate is an ester originating from.alpha.tocopherol and vitamin A acid. It aids in the prevention of skin degradation and in curing peptic ulcer by increasing submucosal and mucosal growth. Attempts have been previously made to provide preparations of tocopheryl retinoate using powderization methods. These methods including powderizing by means of adsorption on a pharmaceutically acceptable adhesive agent such as silicic anhydride, or by means of the spray dry method. Tablets are then prepared from the powdery material, or hard capsules are prepared from soft capsules, upon admixture with an appropriate oily substance. It is to be noted, however, that a disadvantage of these preparation is that the active ingredient, tocopheryl retinoate, cannot adequately adhere to ulcer lesions when orally administered. Thus, these preparations fail to effectively exhibit the tissue growth activity inherent in tocopheryl retinoate. The present invention provides an anti-ulcer agent containing tocopheryl retinoate as an active ingredient. More particularly, the present invention is concerned with an anti-peptic ulcer agent prepared from a formulation adapted so as to effectively exhibit anti-peptic ulcer activity which is inherent in its active ingredient, tocopheryl retinoate. This active ingredient also exhibits a potent tissue growth activity on submucosa and mucosa.

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Web site: http://www.delphion.com/details?pn=US05039699__ •

Anti-peptic ulcer agent Inventor(s): Wakasugi; Junichiro (Tokyo, JP) Assignee(s): Daiichi Pharmaceutical Co., Ltd. (tokyo, Jp) Patent Number: 5,336,503 Date filed: March 31, 1992 Abstract: A pharmaceutical composition for treating a peptic ulcer, which comprises a myosin light chain kinase inhibitor as an active ingredient and a pharmaceutical additive. The myosin light chain inhibitor reduced the gastric acid secretion and is considered an excellent anti-ulcer agent. Excerpt(s): This invention relates to a composition and method of treating or preventing agent for peptic ulcer which comprises an inhibitor for myosin light chain kinase (hereinafter abbreviated as MLCK) as an active ingredient. The presence of unbuffered acid appears to be an essential contributory factor in the pathogenesis of peptic ulcers such ae gastric ulcer, duodenal ulcer gastritis and the like. Therefore, the treatment of the peptic ulcer has concentrated on the reduction of acidity, that is, an inhibition of gastric acid secretion. In view of this, an H.sub.2 -antagonist such as cimetidine, famotidine, ranitidine and a proton pump inhibitor such as omeprazole have been developed and used clinically as anti-ulcer agents. Acid secretion by the stomach is carried out by the parietal cells of the gastric epithelium. Histamine, gastrin and acetylcholine directly bind to their respective receptors in a parietal cell that induces a cascade of intracellular events inducing acid secretion. The initial events involve changes in the concentration of intracellular second messengers. Histamine receptor linked to adenylate cyclase influences intracelluar levels of cAMP which causes an increase in protein kinase A activity and cytoplasmic Ca.sup.2+ concentration (hereinafter abbreviated as [Ca.sup.2+ ]i). The occupation of gastrin and muscarinic receptors leads to 1,4,5-inositol triphosphate (hereinafter abbreviated as 1,4,5-IP.sub.3) formation which causes a release of Ca.sup.2+ from intracellular store. Web site: http://www.delphion.com/details?pn=US05336503__

•

Benzimidazolyl-thio-tetrahydroquinolines containing the same

and

anti-peptic

ulcer

compositions

Inventor(s): Chihiro; Masatoshi (Naruto, JP), Morita; Seiji (Tokushima, JP), Nakagawa; Kazuyuki (Tokushima, JP), Uchida; Minoru (Komatsushima, JP) Assignee(s): Otsuka Pharmaceutical Co., Ltd. (tokyo, Jp) Patent Number: 4,738,970 Date filed: June 16, 1987 Abstract: Novel tetrahydroquinoline derivatives and salts thereof and novel imidazopyridine derivatives and salts thereof, both having excellent anti-peptic ulcer activities, and are useful as treating agents for peptic ulcers such as gastric ulcer, duodenum ulcer and the like. Excerpt(s): The present invention relates to novel tetrahydroquinoline derivatives and salts thereof, and to novel imidazopyridine derivatives and salts thereof, both having

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excellent anti-peptic ulcer activities. More particularly, the present invention relates to novel tetrahydroquinoline derivatives and salts thereof, and to novel imidazopyridine derivatives and salts thereof, process for preparing the same and anti-peptic ulcer compositions containing the same as the active ingredient. Novel tetrahydroquinoline derivatives and salts thereof represented by the general formula (1) and novel imidazopyridine derivatives and salts thereof represented by the general formula (20) possess excellent anti-peptic ulcerative activities, and are useful as treating agents for peptic ulcers such as gastric ulcer, duodenum ulcer and the like. Production rate of hydrochloric acid contained in gastric juice secreted from the gastric mucosa is controlled by various physiological factors, among of which biochemical mechanisms relating to the production rate of hydrogen ion (H.sup.+) affect eventually as the ratelimiting factors thereto. Web site: http://www.delphion.com/details?pn=US04738970__ •

Cell-protective composition for preventing or treating of peptic ulcer Inventor(s): Cizkova; Jirina (Praha, CS), Dlabac; Antonin (Praha, CS), Kasafirek; Evzen (Praha, CS), Kohout; Jirj (Praha, CS), Korbova; Libuse (Praha, CS), Krejci; Ivan (Praha, CS), Krepelka; Jiri (Praha, CS), Pesak; Milan (Praha, CS), Plaisner; Vaclav (Praha, CS), Pospisil; Arnost (Praha, CS), Sturc; Antonin (Praha, CS), Vanzura; Jiri (Hradec Kralove, CS) Assignee(s): Spojene Podniky Pro Zdravotnickou Vyrobu (praha, Cs) Patent Number: 5,182,285 Date filed: April 6, 1990 Abstract: A cell-protective composition for preventing or treating of a peptic ulcer due to topical endogenous lesion of gastric or duodenal mucous membrane comprises as a physiologically active component the cyclo-(1-alanyl-amino-1cyclopentanecarbonyl)cyclodipeptide. The subject composition is designated for administration by oral or parenteral route. It is substantially non-toxic and well tolerated, and acts beneficially, even at low dosage level. Excerpt(s): The invention relates to a cell-protective composition for preventing and/or treating endogenous lesions of cells and tissues, especially those of the gastric or duodenal mucous membrane. The subject composition is designated for administration by oral or parenteral route; it has only slight toxicity, is well tolerated and acts beneficially even at low dosage level. The invention provides for a cell-protective composition for preventing and/or treating endogenous lesions of cells and tissues, especially those of the gastric or duodenal mucous membrane. The subject composition comprises as the physiologically active component a specific spirocyclic dipeptide, cyclo(1-alanyl-1-amino-1-cyclopentanecarbonyl). This peptide compound was originally developed and tested by the inventors' team in SPOFA corporate research in connection with an extensive study of new spirocyclic dipeptides and their action on the central nervous system. The aforenamed compound and a structurally defined series of related analogs are the subject of patent protection here and abroad. More specifically, they are described by U.S. Pat. application No. 538,096, presently abandoned and refiled as a continuation-in-part application No. 915,834. The parent application relates to novel biologically active 2,5-piperazinedione derivatives (resulting from cyclization of the corresponding dipeptides) and to a method for the preparation thereof, and also to pharmaceutical compositions comprising t hose physiologically active compounds. These compounds were originally found to produce valuable specific effects on the

Patents 107

central nervous system of mammals. The 2, 5-piperazinedione derivatives of the preceding application evidence surprising biological effects, particularly on the memory of animals. This was shown using the respective standard pharmacological tests, socalled "conditioned response" and "passive avoidance response" duration tests. Similar activity was previously observed by others in the MSH-inhibiting factor (melanostimulating hormone--ie. MIF, melanostatin). This substance, however, must be administered parentally, preferably by subcutaneous route, since upon oral administration, it undergoes rapid enzymatic inactivation in the gastrointestinal tract. Contrary to this natural agent, the aforementioned cyclo(1-alanyl-1-amino-1cyclopentanecarbonyl) compound of the preceding invention, highly potent in the passive avoidance test when administered s.c., either immediately after use or 30 minutes prior to the retention, also evidences similar activity on oral administration of doses of the same order of magnitude, and its effects is protracted over a time period of many hours. Further pharmacological assays also revealed that the compound inhibits the development of tolerance to the cataleptic effect after repeated administration of neuroleptics. In the standard experimental model that is used for approximating the development of tardive dyskinesias, oral administration of the compound significantly inhibited the tolerance after isofloxythepin, the long acting neuroleptic drug. The compound, administered p.o., also significantly inhibits the decrease of the homovanillic acid content in the corpus striatum of rats and prevents the development of supersensitivity of the dopaminergic receptors in the same tissue. Accordingly, this agent can be expected to have an anti-dyskinetic effect. The MSH-inhibiting factor (MIF, melanostatin) is active under experimental conditions only after subcutaneous administration. As explained in the preceding patent application and its C.I.P. successor, the subject 2, 5-piperazinedione derivatives, even on oral administration, exert their action mostly at an equal or higher potency level as compared with that of melanostatin, and their effect subsists over a prolonged time period. These derivatives are useful primarily in the treatment of memory disturbances, tardive dyskinesias and Parkinson disease. Web site: http://www.delphion.com/details?pn=US05182285__ •

Chinese drug composition for treatment of peptic ulcer and preparation thereof Inventor(s): Chen; Wendi (10-2 Changgujie, Zhenhailu, Xiamen, Fujian 361003, CN), Chen; Yuyao (504 Guoshuijushuselou, 91 Chengxilu, Datongzheng, Tong-an County, Xiamen, Fujian 361000, CN), Zhang; Yongchuan (Block A, 12F- Guomao Dasha, Hubinnanlu, Xiamen, Fujian 361004, CN) Assignee(s): None Reported Patent Number: 6,344,219 Date filed: October 26, 1998 Abstract: The present invention provides a Chinese drug composition for the treatment of peptic ulcer comprising oil of Chenopodium ambrosiodes and oil of Adina pilulifera in a ratio of 18-70:0.5-5 by weight and preparation thereof. The Chinese drug composition possesses therapeutic effect on peptic ulcer to mammal animals including human, and intensely inhibits pyloric spirillum. Excerpt(s): The present invention is related to the drug for the treatment of gastric disease especially to a Chinese drug composition for the treatment of peptic ulcer and preparation thereof. Peptic ulcer is a common, frequently-occurring disease with high incidence. The aim of the therapy of peptic ulcer is to eliminate symptoms, promote

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healing, and to prevent relapse and complications. At present the medicines used in the treatment of peptic ulcer still do not meet the therapeutical demands. The drugs utilizing in the treatment of peptic ulcer at present are all exiting the defects of expensive price, obvious side effects, and high relapse. In Chinese medicine, peptic ulcer related to the categories of "epigastric pain", "stomachache caused by the dominant liver-energy" and so on. The mechanism of the disease mostly is concerned with the deficiency of qi in the spleen and stomach, or the stagnation of vital energy caused by cold-evil, or the obstruction of the stomach caused by damp-heat, or the internal stagnation of the blood and so on. The hindrance of functional activities of qi yields the pain, and the stagnation of qi leads to blood stasis, or prolonged diseases involves the collateral, the prolonged blood stasis in the interior changes into heat then the flesh was rotted and the muscles was injured and the ulcer was formed. "NeiJing SuWen: JuTongLun (Plain Question of Canon of Internal Medicine: On the Pain)": "the cold-evil accumulated between the stomach and intestinal under the half-superficies and halfinterior position so that pain was formed due to the blood failed to circulate and the small collateral was blocked", "the cold-evil accumulated in the stomach and intestinal adversely evolved from upside resulted in pain and vomit". In clinics, many cases were categorized in cold-evil accumulating in stomach, stagnation of qi leads to blood stasis, Ye Tian-shi of Qing dynasty gave a brilliant exposition on the therapeutical method: "What is the essential of (stomach disease)! The beginning of the disease mentioned above is occurred at the channel then goes into the collateral as a result of prolonged pain, channel is the principal pathogeny and collateral controls the blood, therefore the treatment of qi and blood is abundantly clear". ("Lin Zheng Zhi Nan Yi An, Wei Wan Tong (Medical Record Guides of clinical Symptoms Epigastric pain)"). Li Dong-huan pointed out in "Nei Wei Shang Pian Huo Lun, Fei Shi Pi Wei Xu Fang (On the recognition of the Nature of internal and traumatic injuries, Formula of the deficiency of Spleen and Stomach due to Lung)". "Fire has been exhausted and can not be transported and transformed, in addition of the invasion by cold-evil, all of this accumulated as fullness pain. Dispelled it with pungent hot medicine and associated with sweet-bitter ones to use bland flavor drug for clearing up then qi become gentle and stomach become harmony, as a result the pain would be relieved". Web site: http://www.delphion.com/details?pn=US06344219__ •

Drug for treatment of gastric and duodenal peptic ulcer disease Inventor(s): Babulova; Anna (Bratislava, CS), Benes; Ludek (Bratislava, CS), Nosalova; Viera (Bratislava, CS) Assignee(s): Slovenska Akademia Vied (bratislava A/ Nikova, Cs) Patent Number: 5,112,850 Date filed: May 23, 1990 Abstract: A composition for the treatment of gastric and duodenal peptic ulcer disease which is a combination of trapencaine and rantidine is disclosed. Excerpt(s): The invention concerns a drug acting on gastric and duodenal peptic ulcers. Its effective component is the combination of a gastroprotective and antiulcer drug with specific effect against Campylobacter pylori and of a typical representative of antisecretory drugs, belonging to H.sub.2 antagonists. The efficacy of the combination is significantly greater than the effect of each drug administered separately. The mechanism of antiulcer action is characteristic of each drug used for the treatment of gastric and duodenal peptic ulcer disease. The drugs inhibiting gastric acid secretion

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which are available so far, such as antagonists of histamine H.sub.2 receptors e.g. cimetidine, renitidine, mifentidine (P. Del Soldato et al., Pharmacology 30, 45 (1985), Brimblecombe R. W. et al., Gastroenterology 74, 339 (1987), Daly M. et al., Br. J. Pharmacol. 72, 49 (1981) lack gastric cytoprotective effect as well as antimicrobial activity against Campylobacter pylori, a microorganism which has been reported to influence directly the development of gastric ulcers and thus to be a possible therapeutic target (Mc Nulty, J. Antimicrob. Chemother. 19, 281 (1987) ). Inhibitors of H, K-ATP ase and bismuth salts have been used in the therapy of peptic ulcer disease (A. Garner: Advances in Drug Therapy of Gastro-Intestinal Ulceration, J. Wiley et Sons Ltd., Chichester, W. Sussex, 1989) as well as anticids and prostaglandins (Ishihava K., Digestion 39, 162 (1988). The combined treatment had a profound effect both on acute gastric lesions induced by the nonsteroidal antiinflammatory drug phenylbutazone in a dose of 200 mg/kg p.o. in rats and on gastric lesions induced by restraint stress with water bath immersion, as expressed by the reduction of lesion length or by the inhibition of lesion development. Web site: http://www.delphion.com/details?pn=US05112850__ •

Immunogenic compositions and methods for the treatment and prevention of gastric and duodenal ulcer disease Inventor(s): Gevas; Philip C. (Honolulu, HI), Grimes; Stephen (Davis, CA), Karr, Jr.; Stephen L. (Davis, CA), Littenberg; Richard L. (Kai Lua, HI) Assignee(s): Aphton Corporation (woodland, Ca) Patent Number: 5,023,077 Date filed: January 24, 1989 Abstract: Immunogenic compositions useful for the treatment or prevention of gastric or duodenal ulcer disease are disclosed. The immunogenic compositions effectively operate by inducing antibodies in a subject which selectively neutralize specific peptide gastric hormones and inhibit the binding of the hormones to physiological receptors thus limiting the secretion of stomach acid. Pharmaceutical compositions comprising effective amounts of the immunogenic compositions and methods of treatment using the compositions are also disclosed. Excerpt(s): Peptic ulcer disease exists in two forms, duodenal ulcers and gastric ulcers. Central to the cause of duodenal ulcers, is the production of excess stomach acid and pepsin and a rapid gastric emptying time. This results in an increase in duodenal exposure to secreted acid and enzymes, and in mucosal damage. The second form of the disorder, gastric ulcer disease, is caused by increased stomach acid and a breakdown of the complex stomach defenses that normally protect the gastric mucosa from acid damage. Although the two conditions have different etiologies, both benefit from a reduction in gastric acid secretion. Because excess stomach acid is a central cause of ulcers, antacid preparations are commonly used as one method of treatment. This method merely neutralizes stomach acid after it is produced. Consequently, large quantities of antacids must be consumed on an ongoing basis to neutralize acid which is continually produced in the stomach. Antacids do not cure the disease because they do not affect the source of acid production. Web site: http://www.delphion.com/details?pn=US05023077__

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Method for treatment of gastro intestinal disorders Inventor(s): Borody; Thomas J. (144 Great North Rd., Five Dock, AU) Assignee(s): None Reported Patent Number: 5,196,205 Date filed: June 12, 1990 Abstract: A method is disclosed for preventing recurrence of duodenal ulcer associated with Campylobacter pylori infection in a patient suffering from duodenal ulcer disease associated with Campylobacter pylori infection by administering a pharmaceutically acceptable bismuth compound; a first antibiotic selected from the group consisting of tetracycline and penicillins and second antibiotic which is metronidazole. Excerpt(s): C. pylori is a recently described bacterium found to cause chronic histological gastritis. Its causal role in peptic ulceration is less clear and even less so in non-ulcer dyspepsia. Its role could be more effectively studied if effective therapy for its eradication were devised. Until recent times, C. pylori has been found to be difficult to eradicate using known chemotherapeutic agents. Although many antibiotics can suppress C. pylori growth in vitro, in vivo the mucosal concentration appears to be inadequate and penetration of the usual gastric mucus layer poor. Hence, development of an adequate in vivo eradication method for chronic C. pylori infection has been difficult. Moreover, adequate prediction of in vivo results cannot be predicted from in vitro work. European Patent Application No. 206,625 and Australian Patent Application No. 59026/86 describe the use of bismuth together with a single antibiotic for the treatment of C. pylori. However, bismuth alone achieves low (30 to 70%) initial clearance rates for C. pylori and recurrence of the infection approaches 100% by twelve months post therapy. Bismuth together with a single antibiotic, namely amoxicillin, appears to be relatively effective as a short term means of reducing the symptoms but it is now clear that the use of bismuth together with a single antibiotic frequently fails to eradicate the infection and has a high rate of infection recurrence (Rauws, Erik A. J. et al: Gastro-enterology, 1988; 94: 33-40). Web site: http://www.delphion.com/details?pn=US05196205__

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Microwave resonance therapy Inventor(s): Sit'ko; Sergei P. (61-B Volodymytska St, Kiev, 252033, UA) Assignee(s): None Reported Patent Number: 5,507,791 Date filed: August 30, 1994 Abstract: The invention relates to a method of treating primarily functional disturbances like dyskinesias, vegetative dystonies, dishormonoses, parethes and reversible organic damages of human organism, e.g., gastric or duodenal ulcer, osteochondropathies, similar osteo-articular diseases, tissue damages, including wounds made with cold or firearms, etc., by means of acting on biologically active (acupuncture) points (BAPs) with low power (nonthermal) electromagnetic radiation of extremely high (EHF) frequency. A first subset of BAPs are defined on the basis of a preliminary diagnosis of the set of biologically active points (BATs) which are potentially able to result in therapeutical effects. At least on BAP from the first subset is subjected to millimeter electromagnetic radiation with a gradual alteration of its frequency and power density

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(10.sup.-20 W/Hz-cm.sup.2 to 10.sup.-10 W/Hz-cm.sup.2) to provide a steady responsive reaction in the damaged areas. The first subset of BAPs are alternatingly treated by irradiating at the characteristic frequency determined in the previous step. Once the patient's sensor reactions cease from treatment of the first subset of BAPs, a second subset of BAPs is selected, and the treatment process is repeated decreasing the power density. The BAPs are meridionally connected with the damaged organ. Preferably, the chiral sensitivity of the patient's organism is determined, and the treatments include irradiation with electromagnetic radiation polarized in accordance with the chiral sensitivity of patient's organism. Excerpt(s): The invention relates to a method for treating primarily functional disturbances like dyskinesias, vegetative dystonies, dishormonoses, parethes and reversible organic damage of human organism, e.g., gastric or duodenal ulcers, osteochondropathies, similar osteo-articular diseases, tissue damage, including wounds made with cold or firearms, etc., by means of acting on biologically active (acupuncture) points (abbreviated further as "BAPs") with low power (nonthermal) electromagnetic radiation of extremely high frequency (EHF). In this specification, hereinafter the terms "EHF electromagnetic radiation" and "microwave radiation" are regarded to be synonyms. The potential of EHF electromagnetic waves for application as a medical treatment was established rather long ago. However, its interaction with living cells, cell structures and the organism as a whole remains the subject of active experimental and theoretical investigation (see, for instance, Andreyev Ye.A., Bely M.U., Sit'ko S.P., "Reaction of Human Organism on the Electromagnetic Radiation of Millimeter Range," Vestnik Academia Nauk SSSR, 1985, 1, 24-32 (in Russian); and Andreyev Ye.A., Bely M.U., Sit'ko S.P., "Manifestation of Characteristic Eigenfrequences of Human Organism," Dopovidi AN UkrSSR B, 1984, 10, 56-59 (in Ukrainian)). These documents are each entirely incorporated herein by reference. Web site: http://www.delphion.com/details?pn=US05507791__ •

Peptic ulcer treatment method Inventor(s): Katz; Laurence B. (Lawrenceville, NJ), Rosenthale; Marvin E. (Princeton, NJ), Shriver; David A. (Martinsville, NJ) Assignee(s): Ortho Pharmaceutical (raritan, Nj) Patent Number: 4,707,495 Date filed: October 28, 1985 Abstract: A method of treating peptic ulcer disease by topical application of a prostaglandin analog is described. Excerpt(s): The present invention relates generally to a method of treatment for peptic ulcers and particularly to an ulcer treatment method that utilizes a synthetic prostaglandin analog that is applied topically to the skin of a mammal to be treated. Prostaglandins are a family of 20 carbon, oxygen-containing fatty acids that are biochemically derived from arachidonic acid. There are approximately twenty naturally occurring prostaglandins and numerous analogs or congeners have been synthesized. The reduction of the acid burden of the gastrointestinal tract has long been recognized as a potential therapeutic approach for the management of peptic ulcer disease. Prostaglandin E.sub.1 (PGE.sub.1), prostaglandin E.sub.2 (PGE.sub.2) and several PGE analogs or congeners have been shown to have gastric antisecretory activity in both laboratory animals and man. However, the clinical usefulness of these compounds as

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gastric antisecretory agents has been limited by the appearance of gastrointestinal side effects, namely nausea, vomiting, intestinal colic and diarrhea. Web site: http://www.delphion.com/details?pn=US04707495__ •

Pharmaceutical composition for treating gastrointestinal disease Inventor(s): Zhao; Xinxian (Shenzhen, CN) Assignee(s): None Reported Patent Number: 5,464,620 Date filed: July 1, 1994 Abstract: The invention relates to a pharmaceutical composition, which is useful in the treatment of gastrointestinal disorders, especially gastric ulcer, duodenal ulcer and gastritis. The pharmaceutical composition is composed of Rhizoma coptidis extract, Radix scutellariae extract, and Radix astragali extract. Processes for producing these components are provided. Excerpt(s): The invention relates to a new herb's drug which is comprising of Rhizoma coptidis extract, Radix scutellariae extract, and Radix astragali extract. The new drug is useful for the treatment of gastrointestinal disease, especially gastric ulcer, duodenal ulcer and gastritis. The pathogenesis of peptic ulcer disease is not completely understood. It is clear that gastric acid and pepsin secretion are necessary for the development of a peptic ulcer. However, factors relating to mucosal resistance to acid and pepsin are also important, particularly in gastric ulcer disease. Currently, drugs are available that have some effect on each of these factors. For example, antacids, H.sub.2 -receptor antagonists, anticholinergics, mucosal protective agents, pancreatic enzyme replacement products et. al were used for treatment gastrointestinal disease. Although peptic ulcers occur only in the presence of gastric acid, they are not necessarily related to an overproduction of acid, as is commonly assumed. Some people who produce low levels of acid develop ulcers, while there are others produce large amounts yet ulcerfree. A number of factors can effect ulcer. For example, stress and the use of nonsteroidal anti-inflammatory drugs like aspirin are the most frequently encountered. Cigarette smoking and alcohol use may exacerbate existing ulcers, but it has not been proved that they actually cause them. Also, contrary to popular belief, spicy foods do not appear to a cause. More important fact, which is relative to ulcer, is helicobacter pylori. In fact, at recently some reports have been shown that Helicobacter Pylori is associated with gastritis, duodenal and gastric ulcers, non-ulcer dyspepsia and hypochlorhydria. Helicobacter pylori is susceptible to Rhizoma coptidis and Radix scutellariae. The minimal inhibitory concentration (MIC) of Radix scutellariae extract and its active ingredient baicalin against helicobacter pylori is 250 and 125.mu.g/ml, respectively. Web site: http://www.delphion.com/details?pn=US05464620__

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Pharmaceutical preparation for the treatment of peptic ulcer Inventor(s): Azmuko; Andrei A. (ulitsa Ukhtomskaya, 13, kv. 21, Moscow, SU), Bespalova; Zhanna D. (Kuntsevskaya ulitsa, 1/5, kv. 229, Moscow, SU), Bulgakov; Sergei A. (Ruzheiny pereulok, 4, kv. 17, Moscow, SU), Ivanov; Vladimir N. (Kavkazsky bulvar, 38, kv. 18, Moscow, SU), Medvedev; Oleg S. (Berezhkovskaya naberezhnaya, 14, kv. 32, Moscow, SU), Polonsky; Vladimir M. (prospekt Mira, 91, korpus 3, kv. 386, Moscow, SU), Rozhanskaya; Nadezhda I. (ulitsa Dmitria Ulyanova, 4, korpus 2, kv. 226, Moscow, SU), Sax; Tatyana R. (ulitsa Marshala Timoshenko, 34, kv. 115, Moscow, SU), Smagin; Vsevolod G. (ulitsa Vesnina, 30, kv. 17, Moscow, SU), Smirnov; Vladimir N. (Juzhinsky pereulok, 3, kv. 7, Moscow, SU), Titov; Mikhail I. (Kuntsevskaya ulitsa, 1/5, kv. 368, Moscow, SU), Vinogradov; Valentin A. (Khoroshevskoe shosse, 34, kv. 38, Moscow, SU) Assignee(s): None Reported Patent Number: 4,565,805 Date filed: July 20, 1984 Abstract: A pharmaceutical preparation or the treatment of peptic ulcer comprising an active principle, notably a peptide of the following structure:Tyr-D-Ala-Gly-Phe-LeuArgand a pharmaceutically acceptable vehicle. Excerpt(s): The present invention relates to the art of pharmacology and, more specifically, to a novel pharmaceutical preparation for the treatment of peptic ulcer. It is known in the art that various preparations can be employed in gastroenterology for the treatment of peptic ulcer such as anticholinergic agents--atropine, glycopyrolate, antacids--aluminium hydroxide, calcium carbonate and the like (cf. Cristensen et al., Gastroenterology. 1977, v. 73, pp. 1170-1178). The antiulcerous effect of anticholinergic preparations and antacids is based on their ability of lowering acidity of the gastric juice, wherefore these preparations are administered in high doses. The use of such doses of the preparations is accompanied by the development of numerous side effects. Web site: http://www.delphion.com/details?pn=US04565805__

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Phytodrug for management of peptic ulcer and methods of preparing and using same Inventor(s): Akah; Peter (Nsukka, NG), Fumen; Dogara S. (Kaduna State, NG), Gamaniel; Shingu K. (Abuja, NG), Shittu; Hafsatu (Abuja, NG), Wambebe; Charles O. N. (Abuja, NG) Assignee(s): National Institute for Pharmaceutical Research and Development (abuja, Ng) Patent Number: 6,083,509 Date filed: January 11, 1999 Abstract: A phytochemical composition for management of peptic ulcer conditions in humans is provided. The composition is a hot water extract of powdered Indigofera arrecta plant leaves. The extract may be prepared by contacting the powdered leaves with hot water for a period of time, filtering the extraction mixture, concentrating the filtrate in vacuo and freeze drying the concentrated filtrate. The extract is admixed with magnesium carbonate, dried maize starch, talc and magnesium stearate to form a homogenous mass which is filled into capsules. The capsules are ingested orally to

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provide an analgesic effect. Also described are methods for making the extract and the methodology for using the extract. Excerpt(s): The present invention relates to the field of phytodrugs, and in particular the invention relates to phytodrugs for management of peptic ulcer conditions in humans and methods of preparing and using same. Peptic ulcer has been defined as a benign lesion of gastric or duodenal mucosa occurring at a site where the mucosal epithelium is exposed to acid and pepsin. It is a gastro-intestinal problem that has been prevalent in society. The occurrence of the disease has been associated with over-indulgence, inappropriate habit, anxiety and stress. Considerable energy and resources have been expended towards relieving symptoms of peptic ulcer which usually manifests as an excruciating pain, especially in the upper abdomen. For centuries neutralization of gastric acid secretion with antacids and H2-receptor antagonists, provide the only relief from the pains of peptic ulcer. The drugs are generally expensive. Consequently, the socioeconomic impact of peptic ulcer disease on the society can only be imagined. In the foregoing assertion, efforts have been made to find a suitable palliative and/or curative agent for the treatment of peptic ulcer conditions from medicinal plants. Web site: http://www.delphion.com/details?pn=US06083509__ •

Prophylactic or therapeutic agent for diseases attributable to infection with helicobacters Inventor(s): Hirayama; Fumihiro (Fukuoka, JP), Sakurai; Nobuhiro (Fukuoka, JP), Sano; Mitsuharu (Fukuoka, JP), Yokoyama; Yoshito (Fukuoka, JP) Assignee(s): Welfide Corporation (osaka, Jp) Patent Number: 6,221,864 Date filed: December 23, 1999 Abstract: The present invention relates to an agent for the prophylaxis and treatment of diseases caused by Helicobacter infections, which comprises (S)-1-cyclopropyl-1,4dihydro-7-[2-(N,N-dimethylaminomethyl)morpholino]-6fluoro-8-methoxy-4oxoquinoline-3-carboxylic acid or a pharmaceutically acceptable salt thereof. The prophylactic and therapeutic agent of the present invention is effective even when used alone in a small dose for a short time, is almost free of problematic side effects such as tolerance and diarrhea, and is low toxic and capable of safe and ensured bacterial eradication. It is useful for the prophylaxis and treatment of diseases caused by Helicobacter infections, particularly, gastritis, gastric ulcer, duodenal ulcer, malignant lymphoma and gastric cancer. Excerpt(s): The present invention relates to a pharmaceutical agent containing (S)-1cyclopropyl-1,4-dihydro-7-[2-(N,N-dimethylaminomethyl)morpholino]-6fluoro-8methoxy-4-oxoquinoline-3-carboxylic acid or a pharmaceutically acceptable salt thereof, which agent is useful for the prophylaxis and treatment of diseases caused by Helicobacter infections, particularly gastritis, gastric ulcer, duodenal ulcer, gastric malignant lymphoma and gastric cancer. By the development of antisecretory drugs, such as histamine H.sub.2 antagonist and proton pump inhibitor, peptic ulcers, inclusive of a number of ulcers that heretofore required an operation, can now be cured by drug therapy. In view of the fact that most of the ulcers once cured are subject to recurrence and relapse, however, a maintenance therapy over a long period of time is considered to be necessary even after a complete cure, and even during the maintenance therapy, recurrence and relapse are highly frequently observed. In 1988, Marrshall B. J.

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et. al. (Lancet ii: 1437-42, 1988) applied eradication of Helicobacter pylori (H. pylori) to H. pylori positive gastric/duodenal ulcer cases, and reported a noticeable decrease in the relapse of duodenal ulcer. Thereafter in 1992, Graham D. Y. et. al. (Ann. Intern. Med. 116:705-708, 1992.) and in 1993, Hentschel E. et. al. (N. Engl. J. Med. 328:308-312, 1993) successively reported that relapse of peptic ulcer decreased significantly in the group subjected to eradication of H. pylori. Given the strong suggestion of the relationship between H. pylori infection, and gastritis and gastric/duodenal ulcer, a bacterial eradication therapy has been tentatively applied to patients with gastric/duodenal ulcer. Web site: http://www.delphion.com/details?pn=US06221864__ •

Prostaglandins E and anti ulcers containing same Inventor(s): Kato; Ichie (Kawanishi, JP), Oda; Tomio (Itami, JP), Ueno; Ryuji (Kyoto, JP), Ueno; Ryuzo (Nishinomiya, JP) Assignee(s): K.k. Ueno Seiyaku Oyo Kenkyujo (osaka, Jp) Patent Number: 5,225,439 Date filed: April 5, 1991 Abstract: The novel 13, 14-dihydro-15-keto prostaglandins E of the invention have remarkable preventive effects against ulcers. Further, the novel 13,14-dihydro-15-ketoprostaglandins E of the invention have an advatage that they have none of side effects which prostaglandin E intrinsically has, or can remarakably reduce such effects of the prostaglandin E. Therefore, the novel 13, 14-dihydro-15-keto prostaglandins E of the invention are effective for animal and human use for treatment and prevention of ulcers, such as duodenal ulcer and gastric ulcer. Excerpt(s): The present invention relates to a novel type of prostaglandin E and ulcer preventive agents containing the same. Prostaglandin is a generic term for various prostanoic acids and is classified into various groups, such as E, F, A, B, C, D, and H, according to the manner in which keto and/or hydroxyl groups are introduced in fivemembered ring portions. Prostaglandins will stimulate the uterine muscle and, in addition, they have various physiological and pharmacological actions, such as vasodilation, inhibition of platelet aggregation, and inflammatory action. While evaluating the pharmacological activities of derivatives of the aforesaid metabolic products, the present inventor found that the derivatives, such as esters salts, one having a protective group on the carboxyl group as well as one having free carboxyl group, one having substituent groups at the 16-, 17-, 19-, and/or 20-positions, one in which the carbon at the 11- position has a methyl group or a hydroxymethyl group, and one having an alkoxy group at the terminal of a.omega. chain, exhibited antiulcer activities, and that they showed no trace or a significantly reduced degree of such central and peripheral physiological effects as were simultaneously appeared as a side effect and were inherent to known or common PGE which had been recognized as having antiulcer activities. Web site: http://www.delphion.com/details?pn=US05225439__

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Treating inflammation via the administration of specific sulfatase enzymes and/or sulfation inhibitor Inventor(s): Hemmerich; Stefan (San Francisco, CA), Imai; Yasuyuki (Tokyo, JP), Rosen; Steven D. (San Francisco, CA) Assignee(s): The Regents of the University of California (oakland, Ca) Patent Number: 5,695,752 Date filed: June 30, 1995 Abstract: Compositions are administered to a patient (preferably by injection and locally) to treat a variety of conditions including inflammation associated with trauma and with certain aspects of diseases such as rheumatoid arthritis, psoriasis, insulindependent diabetes, cutaneous lymphomas, duodenal ulcer, chronic proctitis, lymphocytic thyroidiris, hemorphagic shock, reperfusion injury during transplantation and multiple sclerosis. The compositions are pharmaceutically acceptable injectable formulations which include an active component in a pharmaceutically acceptable carrier. The active component is a chlorate or selenate which inhibits the natural biochemical sulfation process and/or a sulfatase enzyme which removes a sulfate from a specific position of a saccharide molecule which makes up a part of a natural ligand for L-selectin. Removal of the sulfate from the ligand hinders the ability of the ligand to bind to its natural receptor (i.e. L-selectin) and thereby hinders a biochemical chain of events which results in inflammation. Excerpt(s): The present invention relates generally to treating inflammation by preventing the metabolic addition of a sulfate to a natural ligand and/or the removal of a sulfate moiety from a specific position on a natural ligand to thereby hinder the attachment of the ligand to a receptor. More specifically, the invention relates to locally administering compounds such as non-toxic chlorates which metabolically prevent the addition of a sulfate moiety to a selectin ligand and/or administering specific sulfatase compounds which remove sulfate moieties resulting in desirable effects for alleviation of inflammation. There have been a number of research efforts investigating the role of carbohydrates in physiologically relevant recognition. (See Brandley, B. K., and Schnaar, R. L., J. Leuk. Biol. (1986) 40:97; and Sharon, N., and Lis, H., Science (1989) 246:227). Oligosaccharides are well positioned to act as recognition molecules due to their cell surface location and structural diversity. Many oligosaccharide structures can be created through the differential activities of a smaller number of glycosyltransferases. Their diverse structures, then, can be generated with relatively few gene products, suggesting a plausible mechanism for establishing the information necessary to direct a wide range of cell-cell interactions. Examples of differential expression of cell surface carbohydrates and putative carbohydrate binding proteins (lectins) on interacting cells have been described (see Dodd, J., and Jessel, T. M., J. Neurosci. (1985) 5:3278; Regan, L. J., et al., Proc. Natl. Acad. Sci. USA (1986) 83:2248; Constantine-Paton, M., et al., Nature (1986) 324:459; and Tiemeyer, M., et al., J. Biol. Chem. (1989) 263:1671). Adhesion of circulating leukocytes to stimulated vascular endothelium is a primary event of the inflammatory response. Several receptors have been implicated in this interaction, including a family of putative lectins called selectins that includes L-selectin, LAM-1 (gp90.sup.MEL, Leu8), P-selectin (GMP-140 (PADGEM, CD62) and E-selectin (ELAM-1) (Gong, J.-G., et al., Nature (1990) 343:757; Johnston, G. I., et al., Cell (1989) 56:1033; Geoffroy, J. S., and Rosen, S. D., J. Cell Biol. (1989) 109:2463; Lasky, L. A., et al., Cell (1989) 56:1045). All three of the presently known selectins have been shown to recognize carbohydrates (see Lasky, Science, 258:964-969, 1992). Endogenous ligands for these receptors are being identified.

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Web site: http://www.delphion.com/details?pn=US05695752__ •

Use of zinc hyaluronate against peptic ulcer Inventor(s): Forrai; Gaborne (Budapest, HU), Illes; Janos (Budapest, HU), Matuz; Judit (Budapest, HU), Neszmelyi; Erzsabet (Budapest, HU), Saghy; Katalin (Budapest, HU), Stefko; Bela (Budapest, HU), Szporny; Laszlo (late of Budapest, HU) Assignee(s): Richter Gedeon Vegyeszeti Gyar Rt. (budapest, Hu) Patent Number: 6,656,921 Date filed: September 21, 2000 Abstract: The invention relates to pharmaceutical compositions against peptic ulcer as well as to a method of treating peptic ulcer. The compositions contain and the method of treatment employs zinc hyaluronate as an active ingredient having a molecular weight in the range of 500,000 to 1,200,000 daltons. Excerpt(s): The invention relates to pharmaceutical compositions with activity against peptic ulcer containing a zinc associate (complex) of hyaluronic acid as well as a process for the preparation thereof. The invention furthermore relates to the use of the zinc associate (complex) of hyaluronic acid, i.e. zinc hyaluronate for the preparation of pharmaceutical compositions of activity against peptic ulcer and a method for the treatment and prevention of peptic ulcer. The invention also relates to the use of zinc hyaluronate for the prevention of reinfection after the healing of peptic ulcer. The macromolecule known as hyaluronic acid usually occurring in the form of its sodium salt, is a compound known for more than 50 years. It had first been described by Meyer et al [J. Biol. Chem. 107, 629 (1934)]. Hyaluronic acid is a highly viscous native glucosaminoglycan containing alternating.beta.1-3 glucuronic acid and.beta.1-4 glucosamine moieties, its molecular weight is between 50000 and several millions. Hyaluronic acid is found in the connective tissues of all mammals; it occurs in higher levels in the skin, vitreous body of the eye, synovial fluid, umbilical cord as well as cartilaginous tissue. Web site: http://www.delphion.com/details?pn=US06656921__

Patent Applications on Duodenal Ulcer As of December 2000, U.S. patent applications are open to public viewing.10 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 duodenal ulcer:

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

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Analogs of human basic fibroblast growth factor Inventor(s): Pantoliano, Michael W.; (Boxford, MA), Sharp, Celia M.; (Doylestown, PA), Springer, Barry A.; (Wilmington, DE) Correspondence: Sterne, Kessler, Goldstein & Fox Pllc; 1100 New York Avenue, N.W., Suite 600; Washington; DC; 20005-3934; US Patent Application Number: 20010020004 Date filed: April 5, 2001 Abstract: The present invention relates to novel muteins of human basic fibroblast growth factor with superagonist properties. Both protein and the respective encoding nucleic acid species are disclosed. The invention also embodies vectors and host cells for the propagation of said nucleic acid sequences and the production of said muteins. Also disclosed are methods for stimulating cell division, treating a wound, treating ischemia, treating heart disease, treating neural injury, treating peripheral vascular disease, treating a gastric ulcer and treating a duodenal ulcer. Excerpt(s): This application claims the benefit of the filing date of provisional application 60/068,667 filed on Dec. 23, 1997, which is herein incorporated by reference. The present invention relates to the identification of new muteins of human basic fibroblast growth factor that are unusually potent stimulators of cell division. Fibroblast growth factors (FGFs) are an evolutionarily conserved, large family of mitogenic proteins that stimulate mitosis in mesodermal and neuroectodermal cell lineages (Basilico, C. and Moscatelli, D., Advances in Cancer Research 59:115-165, Eds. Vande Woude, G. F. and Klein, G. (1992)). These proteins also bind heparin and are often referred to in the literature as heparin binding growth factors (HBGFs). Family members share a high degree of nucleic acid and amino acid sequence homology. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Anti peptic ulcer activity of an extract of a plant flower woodfordia fruticosa Inventor(s): Banerjee, Sukdeb; (Kolkata, IN), Bhattacharya, Samir; (Kolkata, IN), Das, Pratap K.; (Kolkata, IN), Goswami, Suchandra; (Kolkata, IN), Sahu, Niranjan P.; (Kolkata, IN), Sett, Suchandra; (Kolkata, IN) Correspondence: Burns, Doane, Swecker & Mathis, L.L.P.; P.O. Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20040022875 Date filed: March 27, 2003 Abstract: The present invention provides a pharmaceutical composition comprising an effective amount of an extract or lyophilized extract or at least one bioactive fraction obtained from plant woodfordia ftuticosa along with one or more pharmaceutically acceptable additives/carriers for treating ulcer caused by the conditions such as stress induced ulcer, peptic ulcer, cold restraint induced ulcer, drug induced ulcer and acid induced ulcer, also used as specific inhibitor of gastric H.sup.+,K.sup.+-ATPase and anti-Helicobacter pylori activity. Excerpt(s): This application claims priority under 35 U.S.C.sctn. 119 of provisional application Serial No. 60/367,490, filed Mar. 27, 2002, hereby expressly incorporated by reference. This application is also a continuation of said '490 provisional. Traditional herbal preparations are known for centuries to protect against peptic ulcer diseases, the

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aetiopathological basis of which were not known in those periods. Current day knowledge about the underlying biochemical mechanism for most of the gastric ulcers and majority of the duodenal ulcers deserve appropriate consideration and due weightage while consolidating the claim regarding the efficacy of a plant extract. In a Program on `Discovery, Development & Commercialization of New Bioactive & Traditional Preparations`, coordinated by Council of Scientific Research, the Applicant has been collecting, extracting & screening different potential plants and their parts for their bioefficay against various diseases. Gastric ulcer is one such disease. Based on screening through appropriate experimental model(s), the applicant has selected a plant flower as our target for the development of an effective anti ulcer medicine. This invention envisages to claim the potential of an extract obtained from the flower of Woodfordia fruticosa to act as an effective therapy against peptic ulcer diseases. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Apparatus and method for debilitating or killing microorganisms within the body Inventor(s): Ganz, Robert A.; (Minnetonka, MN), Melgaard, Hans L.; (North Oaks, MN) Correspondence: James V. Harmon; Pillsbury Center, Suite 2000; 220 South Sixth Street; Minneapolis; MN; 55402; US Patent Application Number: 20030191459 Date filed: April 9, 2002 Abstract: A surgical apparatus has a body portion that includes a shaft terminating in a distal head or tip and a means for directing light radiation from the apparatus onto the lining of a body cavity for treating an ailment in a body cavity of a patient as for example a gastrointestinal ailment of a patient such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, gastric lymphoma, ulcerative colitis, or Crohn's disease as well as for treating diseases of the circulatory system, urogenital systems and other body cavities. The method of use of the apparatus comprises inserting the shaft of the apparatus into a body cavity, e.g., stomach or colon, of the patient to place the distal tip of the shaft in the desired position. The body cavity of the patient is then irradiated with light radiation so as to kill or debilitate microorganisms lining the body cavity without serious destruction of the body tissue of the patient to thereby improve or alleviate one or more of the symptoms of the ailment. A probiotic comprising innocuous bacteria can be administered to the patient to reestablish the growth of normal microbial flora when used in the gastrointestinal tract. Excerpt(s): This invention relates to an apparatus and method for the destruction of micro-organisms on or within a body cavity of a patient through the use of radiation. Infections involving the human gastrointestinal tract are extremely common, involving many millions of people on an annual basis. These infections include bacteria, viruses, and fungi, and are responsible for significant illness, morbidity and, in many cases, death. While the invention has utility in destroying microorganisms in various parts of the body, e.g., the stomach, bowel, lungs, peritoneal cavity, urinary tract, etc., it is particularly useful in the treatment of gastrointestinal infections. It has recently been shown that the most common gastrointestinal infection in the world is due to Helicobacter pylori, a bacterial pathogen that infects the stomach and duodenum. In the United States, for example, Helicobacter pylori is found in approximately 20% of the adult population. It is a chronic gut infection and, once acquired, is notoriously difficult to cure. Most infectious bacteria can be readily destroyed by the human immune system; however, Helicobacter pylori lives in the lumen of the stomach and on the surfaces of

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the stomach and duodenal cells, making it relatively resistant to a host immune response, even if vigorous. Its position has, however, been taken advantage of in the treatment method and apparatus employed in the present invention. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Compositions for preventing and treating digestive organs diseases Inventor(s): Araki, Hiromasa; (Yamatokoriyama-shi, JP), Kakehi, Kazuaki; (Nara-shi, JP), Kawabata, Atsufumi; (Yamatotakada-shi, JP), Kawai, Kenzo; (Matsubara-shi, JP), Kuroda, Ryotaro; (Osaka-shi, JP), Nishikawa, Hiroyuki; (Kashiba-shi, JP), Nishimura, Sachiyo; (Sakurai-shi, JP), Tanaka, Shuichi; (Sennan-gun, JP) Correspondence: Browdy And Neimark, P.L.L.C.; 624 Ninth Street, NW; Suite 300; Washington; DC; 20001-5303; US Patent Application Number: 20030166553 Date filed: August 22, 2002 Abstract: The present invention provides a composition for safely and effectively preventing and treating digestive organs diseases, particularly, gastric ulcer, duodenal ulcer, gastritis, diarrhea, enteritis and the like. There is also provided a composition having a novel mechanism of action in order to solve the problems which was difficult to be solved by the side effect previously known mechanisms of action. More particularly, there is provided a pharmaceutical composition containing an ingredient which activates PAR-2 as an essential ingredient, which is useful for inhibiting gastric acid secretion, promoting digestive tract mucus secretion, protecting digestive tract mucosa, repairing tissue of digestive organs, and preventing and treating digestive organs diseases. Excerpt(s): The present invention relates to compositions for preventing and treating digestive organs diseases, especially, compositions for preventing and/or treating gastric ulcer, duodenal ulcer, gastritis, diarrhea, enteritis and the like. Peptic ulcer such as gastric ulcer, duodenal ulcer and the like are resulted from the disruption of a balance between aggressive factors and protective factors. Example of disruptioninducing factors include drugs (e.g., non-steroidal anti-inflammatory agents, adrenocortical hormone agents, antibiotics, anti-cancer agents, oral hypoglycemic agents), stress, alcohols, corrosive drugs, cirrhosis, anisakid spp., eating habits and the like. At present, aggressive factor inhibitors, protective factor enhancers, and combinations thereof are clinically used. As the aggressive factor inhibitors, there are clinically used antacids (e.g., sodium bicarbonate and aluminum hydroxide gel, magnesium oxide etc.), anticholinergics (e.g., atropine sulfate, pirenzepine hydrochloride etc.), H2-receptor antagonists (e.g., cimetidine, ranitidine, famotidine, nizatidine, roxatidine etc.), proton pump inhibitors (e.g., omepurazor, ransoprazol, ransoprazol sodium etc.), anti-gastrin drugs (e.g., proglumide, secretin, urogastorone), and anti-pepsin drugs (sucrose sulfate ester, sucralfate etc.) and the like. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Diagnosis and treatment of gastrointestinal disease Inventor(s): Wang, Timothy C.; (Acton, MA) Correspondence: Wolf Greenfield & Sacks, PC; Federal Reserve Plaza; 600 Atlantic Avenue; Boston; MA; 02210-2211; US Patent Application Number: 20030049698 Date filed: October 8, 2002 Abstract: The invention relates to methods for the diagnosis and treatment of gastrointestinal disease. More specifically, the invention relates to methods for the diagnosis and treatment of duodenal ulcer disease and gastric atrophy. Excerpt(s): Gastrin is a peptide hormone synthesized in the stomach that stimulates acid secretion through direct action on parietal cells. Gastrin is initially synthesized as progastrin (nonamidated form), which is processed to glycine-extended gastrin (e.g., G17-Gly, G-34-Gly, or G-Gly: nonamidated forms), and then to amidated gastrin (G-17 and G-34; amidated forms). The role of amidated gastrins has been the primary focus of research in the art involving Helicobacter pylori (H. pylori) as a disease causative agent. It is now well established that H. pylori is a causative agent for both peptic ulcer disease (duodenal ulcer disease) and gastric-atrophy/gastric-cancer. Scientists have long been perplexed as to how one causative agent can lead to the development of two such distinct clinical outcomes. Various studies have reported on the possible links between H. pylori infection and an elevation in amidated gastrin (G-17) levels. G-17 levels are, reportedly, slightly higher in ulcer patients compared to non-ulcer patients. More recent studies, however, report that elevated G-17 levels are not predictive of an ulcer phenotype. In addition, G-17 levels are, reportedly, elevated in patients who develop gastric atrophy and/or gastric cancer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Novel thiourea compounds and the pharmaceutical compositions containing the same Inventor(s): Kim, Hee Doo; (Seoul, KR), Lee, Jee Woo; (Seoul, KR), Oh, Uh Taek; (Kyunggi-do, KR), Park, Hyeung Geun; (Seoul, KR), Park, Young Ho; (Seoul, KR), Suh, Young Ger; (Kyunggi-do, KR), Yi, Jung Bum; (Kyunggi-do, KR) Correspondence: Finnegan Henderson Farabow; Garrett & Dunner; 1300 I Street NW; Washington; DC; 20005; US Patent Application Number: 20030212140 Date filed: February 20, 2003 Abstract: The present invention relates to thiourea compounds and the pharmaceutical compositions containing the same, and particularly, to novel thiourea compounds as an antagonist against vanilloid receptor (VR) and the pharmaceutical compositions thereof. As diseases associated with the activity of vanilloid receptor, pain, acute pain, chronic pain, neuropathic pain, post-operative pain, migraine, arthralgia, neuropathies, nerve injury, diabetic neuropathy, neurodegeneration, neurotic skin disorder, stroke, urinary bladder hypersensitiveness, irritable bowel syndrome, a respiratory disorder such as asthma or chronic obstructive pulmonary disease, irritation of skin, eye or mucous membrane, fervescence, stomach-duodenal ulcer, inflammatory bowel disease and inflammatory diseases can be enumerated. The present invention provides a pharmaceutical composition for prevention or treatment of these diseases.

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Excerpt(s): The present invention relates to thiourea compounds and the pharmaceutical compositions containing the same, and particularly, to thiourea compounds with superior efficacy as an antagonist against vanilloid receptor (VR) and the pharmaceutical compositions thereof. As diseases associated with the activity of vanilloid receptor, pain, acute pain, chronic pain, neuropathic pain, post-operative pain, migraine, arthralgia, neuropathies, nerve injury, diabetic neuropathy, neurodegeneration, neurotic skin disorder, stroke, urinary bladder hypersensitiveness, irritable bowel syndrome, a respiratory disorder such as asthma or chronic obstructive pulmonary disease, irritation of skin, eye or mucous membrane, fervescence, stomachduodenal ulcer, inflammatory bowel disease and inflammatory diseases can be enumerated. The present invention provides pharmaceutical compositions for prevention or treatment of these diseases. Yet, the diseases described above are only for enumeration, not to limit the scope of clinical application of vanilloid receptor antagonist. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pharmaceutical composition useful in the prevention or treatment of peptic ulcers Inventor(s): Kimura, Nobutake; (Irumi-gun, JP), Kodama, Yoshikatsu; (Gifu-shi, JP) Correspondence: Platon N. Mandros; Burns, Doane, Swecker & Mathis, L.L.P.; P.O. Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20020039579 Date filed: July 13, 2001 Abstract: An inhibitor composition of Helicobacter pylori adhesion in the stomach comprises (1) anti-urease antibodies obtained from eggs laid by hens which have been immunized against H. pylori urease and (2) an inhibitor of gastric acid secretion. This inhibitor is capable of completely eliminating H. pylori from the stomach, so it is useful for the prevention or treatment of diseases caused by infection of H. pylori such as peptic ulcers. Excerpt(s): The present invention relates to an inhibitor of Helicobacter pylori adhesion and pharmaceutical compositions for oral administration useful for the effective prevention or treatment of peptic ulcers caused by Helicobacter pylori. At present it is believed that eradication of H. pylori from the stomach is essential for completely treating peptic ulcers. The combination of an antibiotic and an inhibitor of gastric acid secretion has been generally proposed as a therapy for eradication of H. pylori as described below. H. pylori is a gram-negative spiral rod-shaped bacterium having flagella at one end and colonizing the human gastric mucosa. B. J. Marshall and J. R. Warren in Australia reported in 1983 that this bacterium was frequently detected in stomach biopsy specimens from patients with gastritis or gastric ulcers. 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 duodenal ulcer, 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

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Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “duodenal ulcer” (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 duodenal ulcer. You can also use this procedure to view pending patent applications concerning duodenal ulcer. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “duodenal ulcer” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on duodenal ulcer: •

Ulcer Story: The Authoritative Guide to Ulcers, Dyspepsia, and Heartburn Source: New York, NY: Plenum Publishing. 1996. 415 p. Contact: Available from Plenum Publishing. 233 Spring Street, New York, NY 110131578. (800) 221-9369 or (212) 620-8000. PRICE: $29.95. ISBN: 0306452758. Summary: This book brings the general reader up to date on the causes and treatments of ulcers, dyspepsia, and heartburn. The book is divided into seven parts. The first begins with a review of upper gut anatomy; chapters on physiology and terminology are designed to assist those with a nonmedical background. Technical terms and short forms are redefined at the beginnings of relevant chapters. Next is a brief history of peptic ulcer and gastroesophageal reflux. Part One ends with a discussion of the epidemiology of ulcers, dyspepsia, and heartburn. Part Two discusses the causes of peptic ulcer. The anti-arthritis NSAIDs and infection of the gastric mucosa with

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Helicobacter pylori are the principal causes of peptic ulcers. Part Three discusses dyspepsia, the cardinal symptom of ulcers. A brief description of gastric and duodenal ulcers, a review of rare and atypical ulcers, and a discussion of ulcer complications follow the discussion of dyspepsia. Part Four focuses on gastroesophageal reflux (GER), the mechanism underlying heartburn and esophagitis. The author notes that heartburn is often confused with dyspepsia, both ulcers and esophagitis depend upon gastric acid, and both diseases are healed with anti-ulcer drugs. Part Five addresses related subjects, including non-ulcer dyspepsia, abdominal bloating, noncardiac chest pain, and gastric and esophageal cancers. In Part Six, the author reviews the drugs prescribed and operations performed for peptic ulcers or gastroesophageal reflux disease. Part Seven focuses on diagnostic tests and research activities that support the treatment options for ulcer, heartburn, dyspepsia, and other symptoms. The author offers a British perspective on health care. A subject index concludes the volume. 397 references. (AA-M). •

Guide to Laparoscopic Surgery Source: Malden, MA: Blackwell Science, Inc. 1998. 169 p. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail: [email protected]. Website: www.blackwell-science.com. PRICE: $54.95. ISBN: 086542649X. Summary: This book reviews the important aspects of laparoscopy that every surgeon needs to know. The authors address the needs of trainees in all surgical disciplines, as well as the concerns of qualified surgeons, urologists, and gynecologists. The emphasis is on procedures and practical approaches; four sections are included. In the introduction, the authors review the advantages and disadvantages of laparoscopy, risk factors, combined laparoscopy and open surgery, physiological changes during laparoscopy, anesthesia during the procedures, and postoperative management. The second section on equipment, instruments, basic techniques, problems and solutions includes: imaging and viewing, sterilization and maintenance of optics and the camera, creation of the pneumoperitoneum access, gasless laparoscopy, Veress needle procedures, primary cannula insertion, open cannulation (Hasson's technique), secondary cannula, extraperitoneal laparoscopy, instruments for dissection, diathermy and electrocautery, hemostasis, laser, ultrasound, high velocity water jet, ligation and suturing, and specimen extraction. The section on setting up in the operating theater covers hand instruments, equipment, patient position and preparation, and setting up for the procedure. The final section on laparoscopic procedures themselves, covers diagnostic laparoscopy, laparoscopic ultrasonography, adhesiolysis, cholecystectomy (gallbladder removal), management of common bile duct stones, appendectomy, laparoscopic Nissen's fundoplication, gastroenterostomy, truncal vagotomy, laparoscopy for perforated duodenal ulcer, splenectomy, laparoscopy for undescended testicles, varicocele, laparoscopic simple nephrectomy (kidney removal), and inguinal hernia repair. The book is illustrated with numerous line drawings of the equipment and procedures being discussed. A subject index concludes the book.

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Clinical Practice of Gastroenterology. Volume One Source: Philadelphia, PA: Current Medicine. 1999. 783 p. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website:

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www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: This lengthy textbook brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. This first volume includes 86 chapters in four sections: esophagus, stomach and duodenum, small bowel, and colon. Specific topics include normal esophageal physiology, gastroesophageal reflux disease (GERD), motor disorders of the esophagus, esophageal foreign bodies, esophagitis, esophageal trauma, esophageal surgery, gastric and duodenal histology and histopathology, gastroduodenal motility and motility disorders, abdominal pain, nausea and vomiting, dyspepsia (heartburn), Helicobacter pylori, gastric and duodenal ulcer, gastric cancer, gastric infection, gastric surgery, small intestine anatomy and physiology, symptoms and signs of small bowel disease, maldigestion and malabsorption, intestinal obstruction and pseudoobstruction, immunologic disorders, small intestinal malignancies (cancer), short bowel syndrome, Whipple's disease, infectious diarrhea, parasitic diseases of the small intestine, foodborne diseases of the small intestine, gastroenteritis, Crohn's disease, anatomy and physiology of the colon, irritable bowel syndrome (IBS), secretory diarrhea, constipation and fecal impaction, fecal incontinence, gas and flatulence, gastrointestinal bleeding, colitis (including ulcerative colitis), diverticulitis and diverticular hemorrhage, appendicitis, benign tumors of the colon and polyposis syndrome, malignant tumors of the colon, and anorectal disorders. The chapters include figures, algorithms, charts, graphs, radiographs, endoscopic pictures, intraoperative photographs, photomicrographs, tables, and extensive references. The volume concludes with a detailed subject index and a section of color plates. •

Ulcer Disease: Investigation and Basis for Therapy Source: New York, NY: Marcel Dekker, Inc. 1991. 528 p. Contact: Available from Marcel Dekker, Inc. P.O. Box 5005, Monticello, NY 12701-5185. (800) 228-1160 or (212) 696-9000. Fax (914) 796-1772. E-mail: [email protected]. PRICE: $195.00. ISBN: 0824782267. Summary: This textbook gives medical researchers and practicing clinicians a review of the origins, presentations, therapies, and human investigation of ulcer disease. Topics include the pathophysiology of peptic ulcer; epidemiology; biological rhythms in gastrointestinal function and processes; the clinical presentation of ulcer disease; nonsteroidal anti-inflammatory drug gastropathy; hemorrhage from gastric or duodenal ulceration; antacid therapy; H2-receptor antagonists; omeprazole; prostaglandins; sucralfate; antioxidants; endoscopic therapy of peptic ulcer disease; surgical treatment; statistical methods in trials of anti-ulcer drugs; clinical research organizations; pharmaceutical industry perspectives; and cost-effectiveness in the treatment of peptic ulcer disease. Each chapter includes numerous tables, figures and references; a subject index concludes the volume.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT

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NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “duodenal ulcer” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “duodenal ulcer” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “duodenal ulcer” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

A Colour Atlas of Seromyotomy for Chronic Duodenal Ulcer (Single Surgical Procedures) by T. Vincent Taylor; ISBN: 0723410135; http://www.amazon.com/exec/obidos/ASIN/0723410135/icongroupinterna

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Advances in Peptic Ulcer Pathogenesis by W.D.W. Rees (Editor); ISBN: 0746200625; http://www.amazon.com/exec/obidos/ASIN/0746200625/icongroupinterna

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Campylobacter Pylori in Gastritis and Peptic Ulcer Disease by Martin J. Blaser (Editor); ISBN: 0896401626; http://www.amazon.com/exec/obidos/ASIN/0896401626/icongroupinterna

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Campylobacter Pylori in Gastritis and Peptic Ulcer Disease; ISBN: 4260141627; http://www.amazon.com/exec/obidos/ASIN/4260141627/icongroupinterna

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Chronic duodenal ulcer by Christopher Wastell; ISBN: 0407135650; http://www.amazon.com/exec/obidos/ASIN/0407135650/icongroupinterna

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Chronic Duodenal Ulcer: Discussions in Patient Management by McHardy; ISBN: 0874885604; http://www.amazon.com/exec/obidos/ASIN/0874885604/icongroupinterna

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Classic Papers in Peptic Ulcer (Classic Papers Series) by J.G. Williams (Editor), et al; ISBN: 1870026454; http://www.amazon.com/exec/obidos/ASIN/1870026454/icongroupinterna

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Clinicians Manual on Peptic Ulcer by Loft; ISBN: 1858730708; http://www.amazon.com/exec/obidos/ASIN/1858730708/icongroupinterna

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Color Atlas of Seromyotomy for Chronic Duodenal Ulcer by T. Vincent Taylor; ISBN: 0874895111; http://www.amazon.com/exec/obidos/ASIN/0874895111/icongroupinterna

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De-Nol: Mucosal Protection and Peptic Ulcer Disease by G.N.J. Tytgat (Editor); ISBN: 3805546173; http://www.amazon.com/exec/obidos/ASIN/3805546173/icongroupinterna

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Duodenal Ulcer (ARR) by K G Wormsley; ISBN: 0443017093; http://www.amazon.com/exec/obidos/ASIN/0443017093/icongroupinterna

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Duodenal Ulcer: Analyses of 293 Randomized Clinical Trials by T. Poynard (Editor), J.P. Pignon (Editor); ISBN: 0861962117; http://www.amazon.com/exec/obidos/ASIN/0861962117/icongroupinterna

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Famotidine: A Further Development in the Modern Treatment of Peptic Ulcer Disease (Digestion, Vol 32) by A. Bettarello (Editor); ISBN: 3805542542; http://www.amazon.com/exec/obidos/ASIN/3805542542/icongroupinterna

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Gastric irradiation in peptic ulcer; ISBN: 0226644979; http://www.amazon.com/exec/obidos/ASIN/0226644979/icongroupinterna

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Helicobacter pylori in peptic ulcer disease (SuDoc HE 20.3046:12/1) by U.S. Dept of Health and Human Services; ISBN: B00010L288; http://www.amazon.com/exec/obidos/ASIN/B00010L288/icongroupinterna

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Helicobacter pylori in peptic ulcer disease : January 1988 through November 1993 : 1191 citations (SuDoc HE 20.3615/2:93-6) by Marian E. Beratan; ISBN: B00010HZUW; http://www.amazon.com/exec/obidos/ASIN/B00010HZUW/icongroupinterna

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Helicobacter Pylori, Gastritis and Peptic Ulcer; ISBN: 3540520309; http://www.amazon.com/exec/obidos/ASIN/3540520309/icongroupinterna

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Herbal Cures of Duodenal Ulcers by Frank Roberts; ISBN: 0722502842; http://www.amazon.com/exec/obidos/ASIN/0722502842/icongroupinterna

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M1 Selective Muscarinic Antagonists in Peptic Ulcer Therapy by W. Kromer, et al; ISBN: 3805549253; http://www.amazon.com/exec/obidos/ASIN/3805549253/icongroupinterna

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Mechanisms of Peptic Ulcer Healing: Proceedings of the 59th Falk Symposium Held in Freiburg-Im-Breisgau, Germany, October 15-17, 1990 (Falk Symposium, Vol 59) by A. Garner, et al; ISBN: 0792389557; http://www.amazon.com/exec/obidos/ASIN/0792389557/icongroupinterna

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Peptic Ulcer by Douglas W. Piper; ISBN: 0867920017; http://www.amazon.com/exec/obidos/ASIN/0867920017/icongroupinterna

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Peptic ulcer; ISBN: 8716003225; http://www.amazon.com/exec/obidos/ASIN/8716003225/icongroupinterna

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Peptic Ulcer by Herman Kaplan; ISBN: 0874888794; http://www.amazon.com/exec/obidos/ASIN/0874888794/icongroupinterna

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Peptic Ulcer Disease by Hirshowitz; ISBN: 0444008322; http://www.amazon.com/exec/obidos/ASIN/0444008322/icongroupinterna

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Peptic Ulcer Disease (Contemporary Issues in Gastroenterology, Vol 3) by Frank P. Brooks (Editor); ISBN: 0443083681; http://www.amazon.com/exec/obidos/ASIN/0443083681/icongroupinterna

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Peptic Ulcer Disease and Other Acid-Related Disorders by David Zakim, Andrew J. Dannenberg; ISBN: 0962918008; http://www.amazon.com/exec/obidos/ASIN/0962918008/icongroupinterna

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Peptic Ulcer Healing by Francis A. Jones (Editor), et al; ISBN: 0852002300; http://www.amazon.com/exec/obidos/ASIN/0852002300/icongroupinterna

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Peptic ulcer healing : recent studies on carbenoxolone; ISBN: 083911222X; http://www.amazon.com/exec/obidos/ASIN/083911222X/icongroupinterna

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Peptic Ulcer: Clinical Surgery International Series by D.C. Carter (Editor); ISBN: 0443027285; http://www.amazon.com/exec/obidos/ASIN/0443027285/icongroupinterna

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Pharmacology of Peptic Ulcer Disease by Stanley B. Benjamin; ISBN: 3540528407; http://www.amazon.com/exec/obidos/ASIN/3540528407/icongroupinterna

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Stomach and duodenal ulcers (SuDoc HE 20.3002:ST 6) by U.S. Dept of Health and Human Services; ISBN: B00010P8M4; http://www.amazon.com/exec/obidos/ASIN/B00010P8M4/icongroupinterna

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The herbal cures of duodenal ulcer and gall stones by Frank Roberts; ISBN: 0722501412; http://www.amazon.com/exec/obidos/ASIN/0722501412/icongroupinterna

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Titration curves for gastric secretion : a study on duodenal ulcer and gastric ulcer with particular reference to the effect of glycopyrronium by Marie Kristensen; ISBN: 8774374338; http://www.amazon.com/exec/obidos/ASIN/8774374338/icongroupinterna

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Twenty-Five Years of Peptic Ulcer Research in Hungary: From Basic Sciences to Clinical Practices by Nagy Mozsik, et al; ISBN: 9630574365; http://www.amazon.com/exec/obidos/ASIN/9630574365/icongroupinterna

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Vagotomy; latest advances with special reference to gastric and duodenal ulcers diseases by F. Holle; ISBN: 0387068015; http://www.amazon.com/exec/obidos/ASIN/0387068015/icongroupinterna

Chapters on Duodenal Ulcer In order to find chapters that specifically relate to duodenal ulcer, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and duodenal ulcer using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “duodenal ulcer” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on duodenal ulcer: •

Duodenal Ulcer Source: in Brandt, L., et al., eds. Clinical Practice of Gastroenterology. Volume One. Philadelphia, PA: Current Medicine. 1999. p. 273-281. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: Despite a decrease in incidence since the 1950s, duodenal ulcer disease continues to affect 200,000 to 400,000 people each year, with estimated direct and indirect costs approaching $3 to $4 billion. This chapter on duodenal ulcer is from a lengthy textbook that brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. The authors review the physiology of gastric acid secretion, the pathophysiology and clinical features of duodenal ulcers, and the evolution of therapy for this condition. Gastric acid plays a critical role in the pathophysiology of duodenal ulcer; people with duodenal ulcers secrete 70 percent more acid during the day (meal stimulated) and 150 percent more acid at night (basally stimulated) than people without ulcer. Etiologic factors include Helicobacter pylori infection, nonsteroidal anti-inflammatory drug (NSAID) use, and hypersecretory states (e.g., Zollinger Ellison syndrome). Epigastric pain (abdominal pain above the stomach) is the most common symptom of duodenal ulcer, but is neither sensitive nor specific for the disease. Usually, the diagnosis is made either by upper gastrointestinal series or by esophagogastroduodenoscopy (EGD); the latter is the preferred method. Important general measures in the treatment of duodenal ulcer disease include the cessation of smoking and the discontinuation of NSAID use, if possible. Drug therapy, used for both acute phases and maintenance therapy, is effective

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in healing duodenal ulcers and reducing recurrence rates. 6 figures. 3 tables. 53 references. •

Current Role of Surgery in Peptic Ulcer Disease Source: in Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 797-809. Contact: Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736. Summary: Effective medical treatment of peptic ulcer disease (PUD) and improved techniques of controlling upper gastrointestinal (GI) hemorrhage (bleeding) nonoperatively have greatly limited the role of surgery in PUD. This chapter on the current role of surgery in PUD is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include the historical basis for the surgical treatment of PUD, the physiological basis for peptic ulcer surgery, operations for duodenal ulcer, Roux-en-Y gastrojejunostomy, operations for benign gastric (stomach) ulcer, early and late postoperative, disorders associated with delayed gastric emptying and gastric stasis, bile (alkaline) reflux gastritis, gastric adenocarcinoma, syndromes associated with rapid gastric emptying, and current controversies on the role of surgery in peptic ulcer disease. The chapter includes a minioutline with page citations, full-color illustrations, and extensive references. 12 figures. 2 tables. 77 references.

•

Peptic Ulcer Disease: Overview and Management Source: in Freston, J.W. Diseases of the Gastroesophageal Mucosa: The Acid-Related. Totowa, NJ: The Humana Press, Inc. 2001. p.3-27. Contact: Humana Press, Inc. 999 Riverview Dr., Suite 208 Totowa, NJ 07512. (973) 2561699. Fax (973) 256-8341. E-mail: [email protected] PRICE: $99.50, plus shipping and handling. ISBN: 089603965X. Summary: Gastric acid-related diseases are among the most commonly encountered disorders in clinical practice. This chapter on the overview and management of peptic ulcer disease (PUD) is from a text that emphasizes the diagnosis and treatment of these conditions. Topics covered in the chapter include the changing epidemiology (incidence and prevalence) of PUD, the pathogenesis and etiology (cause) of PUD, diagnostic considerations, the pharmacology of antiulcer medications, and the medical treatment of PUD. PUD encompasses both gastric and duodenal ulcers. The authors stress that the high prevalence of PUD results in significant morbidity, mortality, and economic costs. 3 figures. 3 tables. 101 references.

•

Gastritis and Peptic Ulcer Disease in Children Source: in Brandt, L., et al., eds. Clinical Practice of Gastroenterology. Volume Two. Philadelphia, PA: Current Medicine. 1999. p. 1294-1300. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2).

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Summary: Gastritis in children remains underrecognized and poorly characterized. This chapter on gastritis and peptic ulcer disease in children is from a lengthy textbook that brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. This chapter covers anatomy and physiology; etiology, pathology and clinical features; nonerosive, nonspecific gastritis or chronic active gastritis; specific and distinctive types of gastritis; peptic ulcer disease (PUD), and duodenitis. Specific types of gastritis covered include Crohn's disease, chronic granulomatous disease, eosinophilic gastropathy, allergic gastropathy, Menetrier's disease, chronic varioliform gastritis, graft versus host disease, and cytomegalovirus. The author notes that in children with chronic peptic ulcer disease, duodenal ulcers are far more prevalent than are gastric ulcers. Secondary PUD usually occurs in association with an identifiable ulcerogenic agent or circumstance, including ulcers caused by physiologic stress, drugs, and those associated with other diseases. The ulcers are more often acute and are more prevalent in the stomach than in the duodenum. The treatment of specific disorders in children is similar to that in adults. The difference in treatment results from the issues specific to children: the management of fluid and electrolyte balance in resuscitation; dosage, palatability and appropriate form of medications; and the potential adverse effects of medications. 3 tables. 34 references. •

Peptic Ulcer Disease and Its Complications Source: in Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 747-781. Contact: Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736. Summary: Peptic ulcer disease refers to ulcerations of the stomach, duodenum, or both, but peptic ulcers can develop in any portion of the gastrointestinal tract that is exposed to acid and pepsin in sufficient concentration and duration. This chapter on peptic ulcer disease (PUD) and its complications is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include the pathophysiology of peptic ulceration, including epithelial disease mechanisms, abnormalities in gastric acid secretion, acid homeostasis, and gastroduodenal motility, Helicobacter pylori, nonsteroidal antiinflammatory drugs (NSAIDs), other ulcerogenic drugs, and hypersecretory conditions; epidemiology, including trends in the frequency of peptic ulcer disease, cigarette smoking, alcohol, diet, diseases associated with peptic ulcer, emotional stress, and genetics; clinical features of uncomplicated peptic ulcers; diagnostic tests, including radiography and endoscopy; treatments for peptic ulcer disease, including H2 receptor antagonists, proton pump inhibitors, antacids, sucralfate, miscellaneous antiulcer medications, surgery, treatment of peptic ulcers associated with NSAID therapy, and treatment of refractory peptic ulcers; specific management recommendations, including duodenal ulcer, gastric ulcer, and maintenance therapy; complications of peptic ulcer disease, including hemorrhage, perforation, penetration, and obstruction; physiologic stress and peptic injury; and Cameron ulcers (linear gastric erosions in hiatal hernias). The chapter includes a mini-outline with page citations, fullcolor illustrations, and extensive references. 12 figures. 2 tables. 449 references.

Books

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Surgery for Peptic Ulcer Disease and Postgastrectomy Syndromes Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 1441-1454. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: The surgical treatment of peptic ulcer is most frequently required when complications of previously unappreciated ulcers occur. This chapter on surgery for peptic ulcer disease (PUD) and postgastrectomy syndromes is from a lengthy, twovolume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. The chapter covers elective surgery for PUD, surgery for duodenal ulcer, surgery for gastric ulcer, surgical treatment of peptic ulcer complications (hemorrhage, perforation, obstruction), and complications of the surgery for peptic ulcer, including recurrent ulcer, dumping syndrome, postvagotomy diarrhea, alkaline reflux gastritis, delayed gastric emptying, and gastric cancer. 13 figures. 3 tables. 132 references.

•

Peptic Ulcers: When the Stomach Digests Itself Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 58-95. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on peptic ulcer disease (PUD) is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. The author briefly reviews the function of gastric acid and pepsin in digesting food in the stomach, noting that at times this process malfunctions and the stomach can and does digest a part of its own lining or the lining of the duodenum. When this happens, the resulting injury is called a peptic ulcer, which is essentially a localized, usually circular, loss of surface lining of the stomach or duodenum, rarely more than an inch in diameter. The author describes how the stomach normally protects itself against damage from acid and pepsin, the risk factors for peptic ulceration (including cigarette smoking, genetic factors, the use of aspirin and other drugs, and the presence of helicobacter pylori bacteria), the symptoms of a peptic ulcer, and the complications of gastric and duodenal ulcer (obstruction, perforation, bleeding). Also discussed are diagnosis of PUD (including the diagnostic tests used), the differences between gastric and duodenal ulcers, the role of diet in therapy for ulcers, the importance of lifestyle changes (no tobacco, caffeine, or alcohol use), drug therapy (including antacids, H2 blockers, anticholinergic drugs, cytoprotective drugs), the Zollinger Ellison syndrome, drugs and substances which can injure the stomach and upper intestine, and the stomach after surgical procedures (long term complications and care). 5 tables.

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

Video Recordings An excellent source of multimedia information on duodenal ulcer is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “duodenal ulcer” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use 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 “Videorecording (videotape, videocassette, etc.).” Type “duodenal ulcer” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on duodenal ulcer: •

Peptic Ulcer Source: Timonium, MD: Milner Fenwick. 1990. Contact: Available from Milner Fenwick. 2125 Greenspring Drive, Timonium, MD 21093. (800) 432-8433. PRICE: $250. Summary: An introduction for the patient with duodenal or gastric ulcers, this film helps the patient identify ulcer symptoms, explains tests that may be required, and discusses medications. It also covers side effects of medications and possible complications of ulcers. It also provides an explanation of the bacteria campylobacter pylori recently found to be associated with ulcers. (AA-M).

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CHAPTER 8. PERIODICALS AND NEWS ON DUODENAL ULCER Overview In this chapter, we suggest a number of news sources and present various periodicals that cover duodenal ulcer.

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

Gastroduodenal ulcer risk reduced with rofecoxib treatment Source: Reuters Medical News Date: May 20, 2003

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•

H. pylori eradication prevents peptic ulcer rebleeding over long term Source: Reuters Medical News Date: August 17, 2000

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Heart failure, diabetes, anticoagulants increase risk of peptic ulcer bleeding Source: Reuters Medical News Date: January 17, 2000

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FDA approves new proton pump inhibitor for reflux disease, duodenal ulcers Source: Reuters Medical News Date: August 23, 1999

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Helicobacter pylori prevalence in duodenal ulcer suggests modified treatment Source: Reuters Medical News Date: July 13, 1999

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Antibiotic therapy prevents hemorrhage linked to duodenal ulcer Source: Reuters Medical News Date: April 27, 1999

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H. pylori testing does not predict presence or absence of peptic ulcer in elderly Source: Reuters Medical News Date: February 11, 1999

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Children with duodenal ulcer disease benefit from eradication of H. pylori Source: Reuters Medical News Date: December 25, 1998

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Omeprazole effective as maintenance therapy after duodenal ulcer healing Source: Reuters Medical News Date: September 28, 1998

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H. pylori eradication without acid suppression enough for peptic ulcer healing Source: Reuters Medical News Date: July 28, 1998

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H. pylori uncommon cause of peptic ulcer in HIV-infected patients Source: Reuters Medical News Date: June 30, 1998

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Dual Therapy Eradicates H. Pylori And Heals Duodenal Ulcers Source: Reuters Medical News Date: March 27, 1998

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Lansoprazole Slows Duodenal Ulcer Recurrence Source: Reuters Medical News Date: January 27, 1998

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Smoking Does Not Affect Duodenal Ulcer Healing Rates And H pylori Eradication Source: Reuters Medical News Date: January 02, 1998

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Peptic Ulcer Cure Would Bring Large Economic And Medical Savings Source: Reuters Medical News Date: May 07, 1997

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Diets High In Fiber And Vitamin A Reduce Duodenal Ulcer Risk Source: Reuters Medical News Date: January 03, 1997

Periodicals and News

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FDA Approves New Therapy To Cure The Cause Of Most Duodenal Ulcers Source: Reuters Medical News Date: August 13, 1996

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Famotidine Prevents Peptic Ulcers In Patients Receiving Long-Term NSAIDs Source: Reuters Medical News Date: May 30, 1996

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Duodenal Ulcers Caused By H Pylori Respond To Dual-Therapy Source: Reuters Medical News Date: April 03, 1996

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Sucralfate's Action On Duodenal Ulcers Defined Source: Reuters Medical News Date: March 13, 1996

•

Omeprazole Aids Duodenal Ulcer Healing But Does Not Eliminate H. Pylori Source: Reuters Medical News Date: December 19, 1995

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “duodenal ulcer” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or

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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “duodenal ulcer” (or synonyms). If you know the name of a company that is relevant to duodenal ulcer, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “duodenal ulcer” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “duodenal ulcer” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on duodenal ulcer: •

Peptic Ulcers: New Understandings, New Treatments Source: Mayo Clinic Health Letter. 17(9): 1-2. September 1999. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465. Summary: Peptic ulcers are no longer necessarily considered a chronic condition that the patient must learn to live with. They can now often be cured, and for many people, treatment involves only a week or two of antibiotic therapy. This health newsletter article explores new understanding of and new treatments for peptic ulcers. The article first describes the symptoms of peptic ulcers (gastric or duodenal), which can include gnawing pain under the breastbone, flare ups of pain at night, pain relieved by eating food or by taking antacids or acid blockers, and, less commonly, vomiting blood, dark blood in stools, nausea or vomiting, unexplained weight loss, and pain in the upper back. The author then describe the bacteria Helicobacter pylori and its role as the cause of most peptic ulcers. Peptic ulcers can also be caused by daily use of pain relievers (nonsteroidal antiflammatory drugs), smoking, and other risk factors. Doctors use two methods to locate ulcers: an upper gastrointestinal (GI) series, and endoscopy. Other tests may be used to determine the presence of H. pylori, including blood and breath tests. Doctors typically use a two pronged treatment approach of antibiotics to kill H. pylori and acid reducing drugs to limit the amount of digestive acids in the GI tract. Acid reducing drugs can include H2 blockers and proton pump inhibitors. One table summarizes old beliefs about ulcers and the new understanding of each topic (for example, that stress causes ulcers when in fact H. pylori is responsible for 80 percent of ulcers). One sidebar compares the symptoms of peptic ulcer and gastroesophageal reflux disease (GERD). 1 figure. 1 table.

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Academic Periodicals covering Duodenal Ulcer Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to duodenal ulcer. In addition to these sources, you can search for articles covering duodenal ulcer that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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

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

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to duodenal ulcer: Antacids •

Oral - U.S. Brands: Advanced Formula Di-Gel; Alamag; Alamag Plus; Alenic Alka; Alenic Alka Extra Strength; Alka-Mints; Alkets; Alkets Extra Strength; Almacone; Almacone II; AlternaGEL; Alu-Cap; Aludrox; Alu-Tab; Amitone; Amphojel; Antacid Gelcaps; Antacid Liquid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202047.html

Anticholinergics/Antispasmodics •

Systemic - U.S. Brands: Anaspaz; A-Spas S/L; Banthine; Bentyl; Cantil; Cystospaz; Cystospaz-M; Donnamar; ED-SPAZ; Gastrosed; Homapin; Levbid; Levsin; Levsin/SL; Levsinex Timecaps; Pro-Banthine; Quarzan; Robinul; Robinul Forte; Symax SL http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202049.html

Caffeine •

Systemic - U.S. Brands: Cafcit; Caffedrine Caplets; Dexitac Stay Alert Stimulant; Enerjets; Keep Alert; Maximum Strength SnapBack Stimulant Powders; NoDoz Maximum Strength Caplets; Pep-Back; Quick Pep; Ultra Pep-Back; Vivarin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202105.html

Clarithromycin •

Systemic - U.S. Brands: Biaxin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202667.html

Histamine H 2 -Receptor Antagonists •

Systemic - U.S. Brands: Axid; Axid AR; Mylanta AR Acid Reducer; Pepcid; Pepcid AC Acid Controller; Pepcid I.V.; Pepcid RPD; Tagamet; Tagamet HB; Zantac; Zantac EFFERdose Granules; Zantac EFFERdose Tablets http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202283.html

Lansoprazole •

Systemic - U.S. Brands: Prevacid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202787.html

Omeprazole •

Systemic - U.S. Brands: Prilosec http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202423.html

Penicillins •

Systemic - U.S. Brands: Amoxil; Bactocill; Beepen-VK; Betapen-VK; Bicillin L-A; Cloxapen; Crysticillin 300 A.S.; Dycill; Dynapen; Geocillin; Geopen; Ledercillin VK; Mezlin; Nafcil; Nallpen; Omnipen; Omnipen-N; Pathocil; Pen Vee K; Pentids; Permapen; Pfizerpen; Pfizerpen-AS http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202446.html

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Rabeprazole •

Systemic - U.S. Brands: AcipHex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500054.html

Sodium Bicarbonate •

Systemic - U.S. Brands: Arm and Hammer; Pure Baking Soda; Bell/ans; Citrocarbonate; Soda Mint http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202525.html

Sucralfate •

Oral - U.S. Brands: Carafate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202533.html

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

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

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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

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

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

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

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

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

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

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

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

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

11

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

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

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

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

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

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

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

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

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

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

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

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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

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

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

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

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

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

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

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

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

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

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

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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

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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/

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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

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

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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/

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

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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

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

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

12

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

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

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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 Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “duodenal ulcer” (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 24567 200 958 23 40 25788

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

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

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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). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

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

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

The Genome Project and Duodenal Ulcer In the following section, we will discuss databases and references which relate to the Genome Project and duodenal ulcer. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20

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. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “duodenal ulcer” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for duodenal ulcer: •

Duodenal Ulcer due to Antral G-cell Hyperfunction Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=126840

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Duodenal Ulcer, Hyperpepsinogenemic I Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=126850

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Tremor, Nystagmus, and Duodenal Ulcer Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=190310 Genes and Disease (NCBI - Map)

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

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

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

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

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

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Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome,

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Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html •

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “duodenal ulcer” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html.

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

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on duodenal ulcer 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 duodenal ulcer. 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 duodenal ulcer. 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 “duodenal ulcer”:

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Other guides Crohn's Disease http://www.nlm.nih.gov/medlineplus/crohnsdisease.html Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Peptic Ulcer http://www.nlm.nih.gov/medlineplus/pepticulcer.html Preventing Disease and Staying Healthy http://www.nlm.nih.gov/medlineplus/preventingdiseaseandstayinghealthy.html Ulcerative Colitis http://www.nlm.nih.gov/medlineplus/tutorials/ulcerativecolitisloader.html Ulcerative Colitis http://www.nlm.nih.gov/medlineplus/ulcerativecolitis.html

Within the health topic page dedicated to duodenal ulcer, the following was listed: •

General/Overviews JAMA Patient Page: Peptic Ulcers Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZA5EFJUSC &sub_cat=194

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Diagnosis/Symptoms Endoscopy/Gastroscopy Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/endogastro.pdf Helicobacter pylori Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/hpylori/test.html Upper Endoscopy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/index.htm Upper GI Series Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/uppergi/index.htm

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Treatment H. pylori: The Key to Cure for Most Ulcer Patients Source: Centers for Disease Control and Prevention http://www.cdc.gov/ulcer/keytocure.htm

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History of Ulcer Diagnosis and Treatment Source: Centers for Disease Control and Prevention http://www.cdc.gov/ulcer/history.htm Ulcers: What You Can Do to Heal Your Ulcer Source: American Academy of Family Physicians http://familydoctor.org/186.xml •

Specific Conditions/Aspects Bleeding Ulcers Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00086 Gastritis Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/gastritis/index.htm Have a Stressful Job? You Must Have an Ulcer.Right? Source: Centers for Disease Control and Prevention http://www.cdc.gov/ulcer/myth.htm NSAIDs and Peptic Ulcers Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/nsaids/index.htm Zollinger-Ellison Syndrome Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/zollinger/index.htm

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Children Peptic Ulcers Source: Nemours Foundation http://kidshealth.org/parent/medical/digestive/peptic_ulcers.html Ugh! Ulcers Source: Nemours Foundation http://kidshealth.org/kid/grownup/conditions/ulcers.html

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From the National Institutes of Health What I Need to Know about Peptic Ulcers Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/pepticulcers_ez/index.htm

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Latest News Wiping Out Stomach Bug Improves Cholesterol Level Source: 02/18/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16136 .html

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Organizations American College of Gastroenterology http://www.acg.gi.org/ American Gastroenterological Association http://www.gastro.org/ National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases http://www.cdc.gov/ncidod/dbmd/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

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Prevention/Screening Digestive Health Tips Source: American College of Gastroenterology http://www.acg.gi.org/patientinfo/healthtips/index.html

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Research Combination Treatment for Peptic Ulcers at High Risk for Recurrent Bleeding Source: American College of Physicians http://www.annals.org/cgi/content/full/139/4/I-12 Effects of Antibiotic Treatment for Helicobacter pylori on Normal Bowel Bacteria Source: American College of Physicians http://www.annals.org/cgi/content/full/139/6/I-42 Past Antibiotic Use Affects Resistance and Outcomes of Helicobacter pylori Infection Source: American College of Physicians http://www.annals.org/cgi/content/full/139/6/I-10

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Teenagers Ulcers Source: Nemours Foundation http://kidshealth.org/teen/diseases_conditions/digestive/ulcers.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 duodenal ulcer. CHID offers summaries that

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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: •

Do You Have H. Pylori? Source: Research Triangle Park, NC: Glaxo Wellcome, Inc. 1996. 2 p. Contact: Available from Glaxo Wellcome Education Resource Center. 5 Moore Drive, Research Triangle Park, NC 27709. (800) 824-2896. PRICE: Single copy free; bulk copies available. Summary: Recent discoveries have shown that an important cause of most duodenal ulcers may be an infection with a bacterium called Helicobacter pylori. This brochure familiarizes readers with H. pylori and its potential role in duodenal ulcers. While stress and diet may play a role in aggravating an ulcer, it is likely that H. pylori is usually the root cause. This enables treatment programs that eliminate H. pylori and reduce the risk of ulcer recurrence. The brochure describes duodenal ulcers and their symptoms; how H. pylori could cause an ulcer; how to know if H. pylori is implicated in an individual patient; and the good chance of success in eradicating H. pylori. The back cover of the brochure summarizes the basic facts covered in the text. One illustration depicts the bacterium itself; another shows a simple outline of the stomach, with the duodenum labelled. 2 figures.

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All About Ulcers: How They're Caused, How They're Treated, and How You Can Help Prevent Their Return Source: Deerfield, IL: TAP Pharmaceuticals Inc. 1997. 6 p. Contact: Available from TAP Pharmaceuticals Inc. Medical Services, Bannockburn Lake Office Plaza, 2355 Waukegan Road, Deerfield, IL 60015. (800) 478-9526. PRICE: Single copy free. Summary: This brochure provides basic information about ulcers, their causes, treatment, and prevention. Ulcers in the digestive tract are like open sores; similar to sores elsewhere, the top layer of tissue is gone and the sore is hollowed out, like a crater. Ulcers in the stomach are called gastric ulcers; those in the duodenum are called duodenal ulcers. The brochure lists and discusses possible causes of ulcers, including Helicobacter pylori bacteria, nonsteroidal anti-inflammatory drugs (NSAIDs), cigarette smoking, excess stomach acid, emotional stress, poor mucosal defenses, and heredity. Diagnostic tests for ulcers include X-rays, endoscopy, and tests for H. pylori infection. The brochure then outlines lifestyle changes that may help an ulcer heal, including avoiding certain foods and drugs, and stopping smoking. The brochure next reviews the medicines that can be used to treat ulcers, including antibiotics for fighting H. pylori infections, proton pump inhibitors, H2 blockers, and antacids. The brochure concludes with a summary of the information covered and space for readers to take notes. (AA-M).

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Helicobacter Pylori Source: Bethesda, MD: American Gastroenterological Association. 1996. 2 p. Contact: Available from GIDH-AGA Patient Education Center. P.O. Box 1274, West Caldwell, NJ 07007-9562. PRICE: 25 copies free to health care professionals for distribution to patients.

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Summary: This brochure provides patients with basic information about Helicobacter pylori, a bacteria that can cause inflammation of the stomach lining (gastritis) that can lead to ulcers in the stomach and duodenum. An ulcer is a sore or wound in the lining of the stomach or the duodenum that may cause pain or bleeding. Topics include diagnostic tests used to confirm H. pylori infection, treatment options, and the results of eradicating H. pylori infections. Doctors do not know for certain how H. pylori is spread, although it is usually acquired in childhood. For most people with H. pylori infection, elimination of the infection may have no noticeable effect on their health or sense of well-being. However, for those patients who have or have had a duodenal ulcer in the past, successful elimination of the bacteria can reduce the risk of ulcer recurrence. The brochure concludes with a glossary of terms. 3 figures. (AA-M). •

Helicobacter Pylori Infection (Gastritis) Source: in Sodeman, W.A., Jr. Instructions for Geriatric Patients. Philadelphia, PA: W.B. Saunders Company. 1995. p. 110-111. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. PRICE: $38.95. ISBN: 0721643353. Summary: This chapter, from a book of instructions for geriatric patients, provides a basic information sheet on Helicobacter pylori infection (gastritis). H. pylori infections tend to become chronic or long lasting, although they usually cause no complaints or symptoms. But in some people, this chronic infection can lead to the development of stomach and duodenal ulcers. H. pylori infections are not difficult to eradicate, but they do require the use of two or three drugs. The fact sheet outlines the drugs commonly used, including omeprazole (Prilosec), amoxicillin, metronidazole (Flagyl), and bismuth (Pepto-Bismol). The author notes that the timing of treatment for H. pylori infections will take into consideration other health care problems that may need more urgent or immediate treatment. The information sheet concludes by reminding readers to contact their health care provider if they miss more than a single dose of a drug regimen to eradicate H. pylori. The instructions are designed to supplement and reinforce physician instructions to their patients. (AA-M).

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Ulcer Healing Starts Here! Source: Philadelphia, PA: SmithKline Beecham Pharmaceuticals. 1993. 15 p. Contact: Available from SmithKline Beecham Pharmaceuticals. 1 Franklin Plaza, FP1320, Philadelphia, PA 19101. (800) 366-8900, ext. 5722 or (215) 751-5722. Fax (215) 751-7133. PRICE: Single copy free. Summary: This patient education booklet is designed for people who are beginning ulcer treatment. The booklet provides a definition of ulcers and discusses causes, treatment, and prevention of recurrence. Specific topics addressed include the role of gastric acid in digestion; how the mucosal lining protects the stomach; gastric and duodenal ulcers; common ulcer symptoms; the role of antacids; problems with excessive gastric acid overnight; the use of cimetidine (Tagamet) to treat ulcers and to prevent recurrence; medicines that can aggravate ulcers, including aspirin and other nonsteroidal anti-inflammatory drugs; and the role of lifestyle factors, including alcohol consumption, smoking, diet and nutrition, and stress. The last page of the booklet is perforated for removal and provides a chart of prescription and over-the-counter (OTC) medications that can be harmful to the stomach.

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Coping with Ulcers Source: Physician Assistant. p. 29. December 1999. Contact: Available from Springhouse Corporation. Physician Assistant, P.O. Box 908, Springhouse, PA 19477. (215) 646-8700. Fax (215) 646-4399. Summary: This patient handout reviews peptic ulcer disease (PUD), commonly referred to as ulcers, and defined as sores or craters in the lining of the stomach (gastric ulcers) or in the first part of the small intestine called the duodenum (duodenal ulcers). The handout offers information about the causes of ulcers, risk factors that make it more likely to get ulcers, treatment options, and the possible complications of ulcers. Gastric ulcers are caused when the lining of the stomach is injured. Risk factors for gastric ulcers include regular use of aspirin or nonsteroidal antiinflammatory drugs (NSAIDs), excess amounts of bile in the stomach, Helicobacter pylori infection, type O blood, and uncommon tumors called gastrinomas (usually found in the pancreas). Duodenal ulcers develop when an overproduction of enzymes, such as stomach acid, bile or other enzymes, overwhelms the layer of mucus protecting the surface of the duodenum. Risk factors for duodenal ulcers include regular use of aspirin or NSAIDs, smoking, chronic kidney failure, liver damage from alcohol, infection with Helicobacter pylori bacteria, and type O blood. Lifestyle modifications, including smoking cessation, avoidance of NSAIDs, and weight loss, are usually the first line of defense against ulcers. Complications of untreated ulcers can include significant blood loss, intestinal blockage, perforation of the stomach lining or small intestine with spillage of acid, bile, and other substances into the abdominal cavity, and stomach cancer. The handout concludes with the contact information for two resource organizations: American Gastroenterology Association and the International Foundation for Functional Gastrointestinal Disorders. The National Guideline Clearinghouse™

The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “duodenal ulcer” (or synonyms). The following was recently posted: •

Peptic ulcer disease Source: University of Michigan Health System - Academic Institution; 1996 October (revised 1999 May); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2286&nbr=1512&a mp;string=duodenal+AND+ulcer Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:

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H. pylori and Peptic Ulcer Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1454 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 duodenal ulcer. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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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 “duodenal ulcer” (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 “duodenal ulcer”. 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 “duodenal ulcer” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “duodenal ulcer” (or a synonym) into the search box, and click “Submit Query.”

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

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

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

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

25

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

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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)26: •

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

•

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

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

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

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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

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California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

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

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

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

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

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

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

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

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

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

•

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

26

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

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

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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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

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

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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

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

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

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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/

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

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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

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

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

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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

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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

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

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

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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

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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

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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 duodenal ulcer: •

Basic Guidelines for Duodenal Ulcer Duodenal ulcer Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000206.htm Helicobacter pylori Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000229.htm

•

Signs & Symptoms for Duodenal Ulcer Abdominal indigestion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003260.htm Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Belching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003080.htm

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Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Heartburn Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm Indigestion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003260.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Stools, bloody Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003130.htm Tarry stools Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003130.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Vomiting blood Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for Duodenal Ulcer ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Amylase, urine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003607.htm CEA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003574.htm Erosion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm Esophagogastroduodenoscopy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003888.htm GI series Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003816.htm Haptoglobin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003634.htm

Online Glossaries 175

Schilling test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003572.htm Stool guaiac Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003393.htm Ulcer Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm Upper GI series Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003816.htm •

Nutrition for Duodenal Ulcer Caffeine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm Coffee Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm

•

Background Topics for Duodenal Ulcer Cigarette smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm Duodenum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002347.htm Enzyme Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002353.htm Helicobacter pylori Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000229.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.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

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•

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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DUODENAL ULCER DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] 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] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Abscess: A localized, circumscribed collection of pus. [NIH] Absolute risk: The observed or calculated probability of an event in a population under study, as contrasted with the relative risk. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Actin: Essential component of the cell skeleton. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adduct: Complex formed when a carcinogen combines with DNA or a protein. [NIH] Adduction: The rotation of an eye toward the midline (nasally). [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH]

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Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adsorption: The condensation of gases, liquids, or dissolved substances on the surfaces of solids. It includes adsorptive phenomena of bacteria and viruses as well as of tissues treated with exogenous drugs and chemicals. [NIH] Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkalinization: The process by which a substance becomes an alkali. An alkali is the opposite of an acid. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as

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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] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Aluminum Hydroxide: Hydrated aluminum. A compound with many biomedical applications: as a gastric antacid, an antiperspirant, in dentifrices, as an emulsifier, as an adjuvant in bacterins and vaccines, in water purification, etc. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [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] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amylopectin: A highly branched glucan in starch. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a,

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C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiosarcoma: A type of cancer that begins in the lining of blood vessels. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

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

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substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antispasmodic: An agent that relieves spasm. [EU] Anti-Ulcer Agents: Various agents with different action mechanisms used to treat or ameliorate ulcers or irritation of the gastrointestinal tract. [NIH] Antrectomy: An operation to remove the upper portion of the stomach, called the antrum. This operation helps reduce the amount of stomach acid. It is used when a person has complications from ulcers. [NIH] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Appendectomy: An operation to remove the appendix. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal

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phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginase: A ureahydrolase that catalyzes the hydrolysis of arginine or canavanine to yield L-ORNITHINE and urea. Deficiency of this enzyme causes hyperargininemia. EC 3.5.3.1. [NIH]

Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthralgia: Pain in the joint. [NIH] Articular: Of or pertaining to a joint. [EU] Aspiration: The act of inhaling. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophic Gastritis: Chronic irritation of the stomach lining. Causes the stomach lining and glands to wither away. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU]

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Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] 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] Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Bender-Gestalt Test: A psychological test consisting of nine geometric designs on cards. The subject is asked to redraw them from memory after each one is presented individually. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta carotene: A vitamin A precursor. Beta carotene belongs to the family of fat-soluble vitamins called carotenoids. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] 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] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the

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digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] 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] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH]

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Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breath Tests: Any tests done on exhaled air. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Carbonate: Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement. [NIH] Campylobacter: A genus of bacteria found in the reproductive organs, intestinal tract, and oral cavity of animals and man. Some species are pathogenic. [NIH] Campylobacter pylori: The original name for the bacterium that causes ulcers. The new name is Helicobacter pylori. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbenoxolone: An agent derived from licorice root. It is used for the treatment of digestive

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tract ulcers, especially in the stomach. Antidiuretic side effects are frequent, but otherwise the drug is low in toxicity. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotenoids: Substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. May reduce the risk of developing cancer. [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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell Lineage: The developmental history of cells as traced from the first division of the original cell or cells in the embryo. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and

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adaptability. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorates: Inorganic salts of chloric acid that contain the ClO3- ion. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Choriocarcinoma: A malignant tumor of trophoblastic epithelium characterized by secretion of large amounts of chorionic gonadotropin. It usually originates from chorionic products of conception (i.e., hydatidiform mole, normal pregnancy, or following abortion), but can originate in a teratoma of the testis, mediastinum, or pineal gland. [NIH]

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Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [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] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in

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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] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices 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] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or

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bladder. Compliance is expressed as a change in volume per unit change in pressure. [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] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] 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] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [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] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [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] Corpus: The body of the uterus. [NIH] Corpus Striatum: Striped gray and white matter consisting of the neostriatum and paleostriatum (globus pallidus). It is located in front of and lateral to the thalamus in each cerebral hemisphere. The gray substance is made up of the caudate nucleus and the lentiform nucleus (the latter consisting of the globus pallidus and putamen). The white matter is the internal capsule. [NIH] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services.

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Savings may be incurred by the provider or the consumer. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystamine: A radiation-protective agent that interferes with sulfhydryl enzymes. It may also protect against carbon tetrachloride liver damage. [NIH] Cysteamine: A radiation-protective agent that oxidizes in air to form cystamine. It can be given intravenously or orally to treat radiation sickness. The bitartrate has been used for the oral treatment of nephropathic cystinosis. [NIH] Cystic Duct: The tube that carries bile from the gallbladder into the common bile duct and the small intestine. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [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] Cytoplasmic Vesicles: Membrane-limited structures derived from the plasma membrane or various intracellular membranes which function in storage, transport or metabolism. [NIH] Cytotoxic: Cell-killing. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling

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it rapidly causes the two complementary strands to separate. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH] Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dipeptides: Peptides composed of two amino acid units. [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]

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Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] 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] Dumping Syndrome: Gastrointestinal nonfunctioning pylorus. [NIH]

symptoms

resulting

from

an

absent

or

Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenitis: An irritation of the first part of the small intestine (duodenum). [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH]

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Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] 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] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]

Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the

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entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Enterocytes: Terminally differentiated cells comprising the majority of the external surface of the intestinal epithelium (see intestinal mucosa). Unlike goblet cells, they do not produce or secrete mucins, nor do they secrete cryptdins as do the paneth cells. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [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] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [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] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [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] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi

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and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagogastroduodenoscopy: Exam of the upper digestive tract using an endoscope. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Ethanolamine: A viscous, hygroscopic amino alcohol with an ammoniacal odor. It is widely distributed in biological tissue and is a component of lecithin. It is used as a surfactant, fluorimetric reagent, and to remove CO2 and H2S from natural gas and other gases. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excrete: To get rid of waste from the body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU]

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Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Famotidine: A competitive histamine H2-receptor antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Firearms: Small-arms weapons, including handguns, pistols, revolvers, rifles, shotguns, etc. [NIH]

Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process

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whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexor: Muscles which flex a joint. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [NIH] Free Radical Scavengers: Substances that influence the course of a chemical reaction by ready combination with free radicals. Among other effects, this combining activity protects pancreatic islets against damage by cytokines and prevents myocardial and pulmonary perfusion injuries. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Freeze Drying: Method of tissue preparation in which the tissue specimen is frozen and then dehydrated at low temperature in a high vacuum. This method is also used for dehydrating pharmaceutical and food products. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [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] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric atrophy: A condition in which the stomach muscles shrink and become weak. The digestive (peptic) glands may also shrink, resulting in a lack of digestive juices. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria,

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forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroenterostomy: Surgical construction of a channel between the stomach and intestines. [NIH]

Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [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]

Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetic transcription: The process by which the genetic information encoded in the gene, represented as a linear sequence of deoxyribonucleotides, is copied into an exactly complementary sequence of ribonucleotides known as messenger RNA. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia

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lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [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] Globus Pallidus: The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. [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] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [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] Glucuronides: Glycosides of glucuronic acid formed by the reaction of uridine diphosphate glucuronic acid with certain endogenous and exogenous substances. Their formation is important for the detoxification of drugs, steroid excretion and bilirubin metabolism to a more water-soluble compound that can be eliminated in the urine and bile. [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] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosyltransferases: Enzymes that catalyze the transfer of glycosyl groups to an acceptor. Most often another carbohydrate molecule acts as an acceptor, but inorganic phosphate can also act as an acceptor, such as in the case of phosphorylases. Some of the enzymes in this group also catalyze hydrolysis, which can be regarded as transfer of a glycosyl group from the donor to water. Subclasses include the hexosyltransferases, pentosyltransferases, sialyltransferases, and those transferring other glycosyl groups. EC 2.4. [NIH] Goblet Cells: Cells of the epithelial lining that produce and secrete mucins. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU]

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Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] 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] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Harmony: Attribute of a product which gives rise to an overall pleasant sensation. This sensation is produced by the perception of the product components as olfactory, gustatory, tactile and kinaesthetic stimuli because they are present in suitable concentration ratios. [NIH]

Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helicobacter: A genus of gram-negative, spiral-shaped bacteria that is pathogenic and has been isolated from the intestinal tract of mammals, including humans. [NIH] Helicobacter pylori: A spiral bacterium active as a human gastric pathogen. It is a gramnegative, urease-positive, curved or slightly spiral organism initially isolated in 1982 from patients with lesions of gastritis or peptic ulcers in Western Australia. Helicobacter pylori was originally classified in the genus Campylobacter, but RNA sequencing, cellular fatty acid profiles, growth patterns, and other taxonomic characteristics indicate that the microorganism should be included in the genus Helicobacter. It has been officially transferred to Helicobacter gen. nov. (see Int J Syst Bacteriol 1989 Oct;39(4):297-405). [NIH]

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Hematemesis: Vomiting of blood. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] 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] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

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] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Hexosyltransferases: Enzymes that catalyze the transfer of hexose groups. EC 2.4.1.-. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [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] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH]

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Homotypic: Adhesion between neutrophils. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] 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] Hospital Charges: The prices a hospital sets for its services. Hospital costs (the direct and indirect expenses incurred by the hospital in providing the services) are one factor in the determination of hospital charges. Other factors may include, for example, profits, competition, and the necessity of recouping the costs of uncompensated care. [NIH] Hospital Costs: The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine hospital charges (the price the hospital sets for its services). [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydatidiform Mole: A trophoblastic disease characterized by hydrops of the mesenchymal portion of the villus. Its karyotype is paternal and usually homozygotic. The tumor is indistinguishable from chorioadenoma destruens or invasive mole ( = hydatidiform mole, invasive) except by karyotype. There is no apparent relation by karyotype to choriocarcinoma. Hydatidiform refers to the presence of the hydropic state of some or all of the villi (Greek hydatis, a drop of water). [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypersecretion: Excessive secretion. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to

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damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypnotherapy: Sleeping-cure. [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]

Hypoglycemic Agents: Agents which lower the blood glucose level. [NIH] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxic: Having too little oxygen. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileum: The lower end of the small intestine. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immersion: The placing of a body or a part thereof into a liquid. [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] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [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 vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH]

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Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [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] 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]

Infectious Diarrhea: Diarrhea caused by infection from bacteria, viruses, or parasites. [NIH] 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] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inguinal Hernia: A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol

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phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, Tlymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Capsule: White matter pathway, flanked by nuclear masses, consisting of both afferent and efferent fibers projecting between the cerebral cortex and the brainstem. It consists of three distinct parts: an anterior limb, posterior limb, and genu. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal contents toward the anus. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH]

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Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [NIH]

Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [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] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in

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blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lectins: Protein or glycoprotein substances, usually of plant origin, that bind to sugar moieties in cell walls or membranes and thereby change the physiology of the membrane to cause agglutination, mitosis, or other biochemical changes in the cell. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [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]

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] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [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] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together

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from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] 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] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lumen: The cavity or channel within a tube or tubular organ. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] 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]

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] 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] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [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] Lysosome: A sac-like compartment inside a cell that has enzymes that can break down

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cellular components that need to be destroyed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] 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] Magnesium Hydroxide: Magnesium hydroxide (Mg(OH)2). An inorganic compound that occurs in nature as the mineral brucite. It acts as an antacid with cathartic effects. [NIH] Magnesium Oxide: Magnesium oxide (MgO). An inorganic compound that occurs in nature as the mineral periclase. In aqueous media combines quickly with water to form magnesium hydroxide. It is used as an antacid and mild laxative and has many nonmedicinal uses. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH]

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Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [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] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Misoprostol: A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH]

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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] Mononuclear: A cell with one nucleus. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Cortex: Area of the frontal lobe concerned with primary motor control. It lies anterior to the central sulcus. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucosal Lining: The lining of GI tract organs that makes mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source

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including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] 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] Neostriatum: The phylogenetically newer part of the corpus striatum consisting of the caudate nucleus and putamen. It is often called simply the striatum. [NIH] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]

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] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis,

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as the neutral arch. [EU] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [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] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]

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] Neutralization: An act or process of neutralizing. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Neutrophil Infiltration: The diffusion or accumulation of neutrophils in tissues or cells in response to a wide variety of substances released at the sites of inflammatory reactions. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nizatidine: A histamine H2 receptor antagonist with low toxicity that inhibits gastric acid secretion. The drug is used for the treatment of duodenal ulcers. [NIH] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used

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pharmacologically as a sympathomimetic. [NIH] NSAIDs: Nonsteroidal anti-inflammatory drugs. A group of drugs that decrease fever, swelling, pain, and redness. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [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] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor

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molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxytocic: 1. Pertaining to, characterized by, or promoting oxytocia (= rapid labor). 2. An agent that hastens evacuation of the uterus by stimulating contractions of the myometrium. [EU]

Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Paneth Cells: Epithelial cells found in the basal part of the intestinal glands (crypts of Lieberkuhn). Paneth cells synthesize and secrete lysozyme and cryptdins. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parasitic Diseases: Infections or infestations with parasitic organisms. They are often contracted through contact with an intermediate vector, but may occur as the result of direct exposure. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Cells: Cells in the stomach wall that make hydrochloric acid. [NIH] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH]

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Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentagastrin: A synthetic polypeptide that has effects like gastrin when given parenterally. It stimulates the secretion of gastric acid, pepsin, and intrinsic factor, and has been used as a diagnostic aid. [NIH] Pentosyltransferases: Enzymes of the transferase class that catalyze the transfer of a pentose group from one compound to another. (Dorland, 28th ed) EC 2.4.2. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptic Ulcer Hemorrhage: Bleeding from a peptic ulcer. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforated Ulcer: An ulcer that breaks through the wall of the stomach or the duodenum. Causes stomach contents to leak into the abdominal cavity. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU]

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Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [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] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Phagosomes: Membrane-bound cytoplasmic vesicles formed by invagination of phagocytized material. They fuse with lysosomes to form phagolysosomes in which the hydrolytic enzymes of the lysosome digest the phagocytized material. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] 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] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] 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] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or

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glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pineal gland: A tiny organ located in the cerebrum that produces melatonin. Also called pineal body or pineal organ. [NIH] Pirenzepine: An antimuscarinic agent that inhibits gastric secretion at lower doses than are required to affect gastrointestinal motility, salivary, central nervous system, cardiovascular, ocular, and urinary function. It promotes the healing of duodenal ulcers and due to its cytoprotective action is beneficial in the prevention of duodenal ulcer recurrence. It also potentiates the effect of other antiulcer agents such as cimetidine and ranitidine. It is generally well tolerated by patients. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [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] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form.

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Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [NIH] 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] Postgastrectomy Syndrome: A condition that occurs after an operation to remove the stomach (gastrectomy). [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH]

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Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [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] Proctitis: Inflammation of the rectum. [EU] Proglumide: 4-Benzamido-N,N-dipropylglutaramic acid. A drug that exerts an inhibitory effect on gastric secretion and reduces gastrointestinal motility. It is used clinically in the drug therapy of gastrointestinal ulcers. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Prone: Having the front portion of the body downwards. [NIH] Propantheline: A muscarinic antagonist used as an antispasmodic, in rhinitis, in urinary incontinence, and in the treatment of ulcers. At high doses it has nicotinic effects resulting in neuromuscular blocking. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the

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level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostaglandins D: Physiologically active prostaglandins found in many tissues and organs. They show pressor activity, are mediators of inflammation, and have potential antithrombotic effects. [NIH] Prostanoic Acids: 2-Octylcyclopentaneheptanoic acids. The family of saturated carbon-20 cyclic fatty acids that represent the parent compounds of the prostaglandins. [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] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [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 Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [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] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH]

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Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosomatic Medicine: A system of medicine which aims at discovering the exact nature of the relationship between the emotions and bodily function, affirming the principle that the mind and body are one. [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] Pulmonary: Relating to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Putamen: The largest and most lateral of the basal ganglia lying between the lateral medullary lamina of the globus pallidus and the external capsule. It is part of the neostriatum and forms part of the lentiform nucleus along with the globus pallidus. [NIH] Pyloric Stenosis: Obstruction of the pyloric canal. [NIH] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Quercetin: Aglucon of quercetrin, rutin, and other glycosides. It is widely distributed in the plant kingdom, especially in rinds and barks, clover blossoms, and ragweed pollen. [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] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body.

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Also called radiotherapy. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [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] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Ranitidine Bismuth Citrate: Drug used to eradicate Helicobacter pylori. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] 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] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [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 Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reinfection: A second infection by the same pathogenic agent, or a second infection of an organ such as the kidney by a different pathogenic agent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a

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specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [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] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restitution: The restoration to a normal state. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] 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] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of

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developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rod: A reception for vision, located in the retina. [NIH] Rutin: 3-((6-O-(6-Deoxy-alpha-L-mannopyranosyl)-beta-D-glucopyranosyl)oxy)-2-(3,4dihydroxyphenyl)-5,7-dihydroxy-4H-1-benzopyran-4-one. Found in many plants, including buckwheat, tobacco, forsythia, hydrangea, pansies, etc. It has been used therapeutically to decrease capillary fragility. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Sclerotherapy: Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Secretin: A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] 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] Seminal vesicles: Glands that help produce semen. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the

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broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Sialyltransferases: A group of enzymes with the general formula CMP-Nacetylneuraminate:acceptor N-acetylneuraminyl transferase. They catalyze the transfer of Nacetylneuraminic acid from CMP-N-acetylneuraminic acid to an acceptor, which is usually the terminal sugar residue of an oligosaccharide, a glycoprotein, or a glycolipid. EC 2.4.99.-. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicic: A mixture of gelatinous substances obtained by treating silicates with acids. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

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Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [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] Sperm: The fecundating fluid of the male. [NIH] Sphincters: Any annular muscle closing an orifice. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spirillum: A genus of gram-negative, curved and spiral-shaped bacteria found in stagnant, freshwater environments. These organisms are motile by bipolar tufts of flagella having a long wavelength and about one helical turn. [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] Splenic Vein: Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Statistically significant: Describes a mathematical measure of difference between groups.

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The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steatorrhea: A condition in which the body cannot absorb fat. Causes a buildup of fat in the stool and loose, greasy, and foul bowel movements. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress Ulcer: An upper GI ulcer from physical injury such as surgery, major burns, or critical head injury. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [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] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [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]

Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective, pepsinostatic, antacid, and bile acid-binding properties. The drug is only slightly absorbed

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by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Systemic: Affecting the entire body. [NIH] Talc: A native magnesium silicate. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratoma: A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant. [NIH] Testicle: The male gonad where, in adult life, spermatozoa develop; the testis. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include

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cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]

Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thiourea: A photographic fixative used also in the manufacture of resins. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance may reasonably be anticipated to be a carcinogen (Merck Index, 9th ed). Many of its derivatives are antithryoid agents and/or free radical scavengers. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] 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] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] 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 toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case

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of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transforming Growth Factor alpha: Factor isolated in a variety of tissues including epithelium, and maternal decidua. It is closely related to epidermal growth factor and binds to the EGF receptor. TGF-alpha acts synergistically with TGF-beta in inducing phenotypic transformation, but its physiological role is unknown. [NIH] Transforming Growth Factor beta: A factor synthesized in a wide variety of tissues. It acts synergistically with TGF-alpha in inducing phenotypic transformation and can also act as a negative autocrine growth factor. TGF-beta has a potential role in embryonal development, cellular differentiation, hormone secretion, and immune function. TGF-beta is found mostly as homodimer forms of separate gene products TGF-beta1, TGF-beta2 or TGF-beta3. Heterodimers composed of TGF-beta1 and 2 (TGF-beta1.2) or of TGF-beta2 and 3 (TGFbeta2.3) have been isolated. The TGF-beta proteins are synthesized as precursor proteins. [NIH]

Transforming Growth Factors: Hormonally active polypeptides that can induce the transformed phenotype when added to normal, non-transformed cells. They have been found in culture fluids from retrovirally transformed cells and in tumor-derived cells as well as in non-neoplastic sources. Their transforming activities are due to the simultaneous action of two otherwise unrelated factors, transforming growth factor alpha and transforming growth factor beta. [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] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [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] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Truncal: The bilateral dissection of the abdominal branches of the vagus nerve. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor-derived: Taken from an individual's own tumor tissue; may be used in the development of a vaccine that enhances the body's ability to build an immune response to the tumor. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU]

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Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Umbilical Arteries: Either of a pair of arteries originating from the internal iliac artery and passing through the umbilical cord to carry blood from the fetus to the placenta. [NIH] Umbilical Cord: The flexible structure, giving passage to the umbilical arteries and vein, which connects the embryo or fetus to the placenta. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urease: An enzyme that catalyzes the conversion of urea and water to carbon dioxide and ammonia. EC 3.5.1.5. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [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] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital System: All the organs involved in reproduction and the formation and release of urine. It includes the kidneys, ureters, bladder, urethra, and the organs of reproduction ovaries, uterus, fallopian tubes, vagina, and clitoris in women and the testes, seminal vesicles, prostate, seminal ducts, and penis in men. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH]

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Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Varicocele: A complex of dilated veins which surround the testicle, usually on the left side. [NIH]

Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villus: Cell found in the lining of the small intestine. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH]

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Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [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] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [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]

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INDEX A Abdomen, 84, 114, 177, 184, 195, 201, 206, 208, 209, 216, 217, 218, 228, 229, 231, 234 Abdominal, 41, 126, 127, 130, 163, 173, 177, 188, 192, 199, 210, 211, 216, 217, 218, 232, 233 Abdominal Pain, 127, 130, 177, 199, 210, 233 Abortion, 177, 187 Abscess, 25, 177 Absolute risk, 4, 177 Acceptor, 177, 200, 209, 215, 227 Acetylcholine, 105, 177, 214 Acidity, 38, 39, 51, 89, 105, 113, 177 Actin, 177, 213 Acyl, 61, 177 Adaptability, 177, 186, 187 Adduct, 16, 177 Adduction, 16, 177 Adenocarcinoma, 6, 14, 21, 48, 131, 177 Adenosine, 27, 177, 185, 219 Adenylate Cyclase, 105, 177 Adjuvant, 177, 179, 199 Adrenal Medulla, 177, 186, 195, 214 Adrenergic, 178, 181, 193, 195, 230 Adsorption, 104, 178 Adsorptive, 178 Adverse Effect, 12, 132, 178, 227 Affinity, 178, 228 Agonist, 178, 193 Albumin, 178, 230 Alertness, 178, 185 Algorithms, 127, 178, 184 Alkaline, 131, 133, 178, 179, 183, 185 Alkalinization, 67, 178 Alkaloid, 178, 182 Alpha Particles, 178, 223 Alpha-1, 34, 178 Alternative medicine, 139, 178 Aluminum, 12, 92, 120, 179, 229 Aluminum Hydroxide, 92, 120, 179 Amebiasis, 179, 211 Amine, 179, 202 Amino Acid Sequence, 20, 118, 179, 180, 199 Ammonia, 179, 233 Amoxicillin, 5, 9, 10, 11, 13, 30, 31, 33, 39, 42, 73, 75, 110, 162, 179

Ampicillin, 179 Ampulla, 179, 194 Amylopectin, 81, 82, 83, 86, 179 Anal, 179, 197 Analgesic, 114, 179, 192, 194 Analog, 111, 179, 211 Analytes, 158, 179 Anaphylatoxins, 179, 189 Anatomical, 180, 182, 184, 187, 192, 204, 226 Anemia, 155, 180, 207 Anesthesia, 126, 180 Anesthetics, 180, 196 Aneurysm, 56, 180, 234 Angiosarcoma, 34, 180 Animal model, 14, 180 Annealing, 180, 220 Anorectal, 127, 180 Anorexia, 180, 199, 233 Antagonism, 180, 185 Antibacterial, 12, 180 Antibiotic, 5, 8, 10, 48, 110, 122, 138, 140, 160, 179, 180, 185, 188, 196, 230 Antibodies, 14, 23, 24, 48, 109, 122, 180, 204, 209, 219 Antibody, 20, 178, 180, 181, 189, 204, 205, 207, 210, 212, 223, 224, 226, 228, 235 Anticholinergic, 88, 113, 133, 180 Anticoagulants, 138, 180 Antigen, 14, 23, 24, 178, 180, 181, 189, 203, 204, 205, 210, 226 Antigen-Antibody Complex, 181, 189 Anti-inflammatory, 12, 22, 46, 112, 120, 127, 130, 161, 162, 181, 182, 192, 215 Anti-Inflammatory Agents, 120, 181, 182 Antimicrobial, 9, 11, 12, 109, 181 Antioxidant, 16, 104, 181, 216 Antipsychotic, 181, 214 Antipyretic, 181, 192 Antispasmodic, 181, 221 Anti-Ulcer Agents, 105, 181 Antrectomy, 54, 181 Anuria, 181, 207 Anus, 179, 180, 181, 184, 189, 198, 206 Anxiety, 114, 181 Apathy, 181, 214 Appendectomy, 126, 181 Appendicitis, 127, 181

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Aqueous, 181, 183, 194, 208, 210 Arachidonic Acid, 111, 181, 208, 221 Arginase, 20, 182 Arginine, 179, 182, 214 Arterial, 182, 203, 222 Arteries, 182, 184, 190, 211, 231, 233 Arteriovenous, 35, 60, 182 Artery, 56, 180, 182, 184, 190, 194, 213, 225, 233, 234 Arthralgia, 121, 122, 182 Articular, 110, 111, 182 Aspiration, 41, 182 Aspirin, 22, 112, 133, 162, 163, 182 Assay, 18, 182 Asymptomatic, 6, 13, 23, 34, 179, 182, 216 Ataxia, 155, 182, 230 Atrioventricular, 41, 75, 182 Atrium, 182, 234 Atrophic Gastritis, 17, 20, 51, 182 Atrophy, 121, 154, 155, 182 Atropine, 113, 120, 182, 183 Attenuation, 38, 182 Atypical, 126, 182 Autodigestion, 182, 216 Autoimmune disease, 182, 212 Autonomic, 28, 177, 181, 182, 183, 214, 218 B Bacteriophage, 183, 232, 235 Bacterium, 13, 21, 110, 122, 161, 183, 185, 201 Barium, 65, 183 Basal Ganglia, 181, 182, 183, 223 Basal Ganglia Diseases, 182, 183 Base, 30, 53, 183, 192, 199, 207, 208, 230, 233 Basophils, 183, 201, 208 Belladonna, 182, 183 Bender-Gestalt Test, 89, 183 Benign, 114, 127, 131, 183, 201, 213, 224 Beta carotene, 18, 183 Beta-Thromboglobulin, 183, 206 Bilateral, 183, 232 Bile, 42, 46, 131, 163, 183, 184, 191, 198, 199, 200, 203, 204, 209, 226, 229 Bile Acids, 183, 199 Bile Acids and Salts, 183 Bile duct, 42, 184, 204 Biliary, 65, 131, 132, 184, 189, 216 Biliary Tract, 65, 184, 216 Biochemical, 106, 116, 119, 184, 207, 208, 226 Biological therapy, 184, 201

Biopsy, 41, 69, 122, 184 Biopsy specimen, 69, 122, 184 Biotechnology, 22, 25, 139, 151, 153, 154, 155, 156, 184 Biotransformation, 184 Bismuth, 4, 8, 9, 10, 11, 30, 42, 55, 56, 72, 73, 76, 84, 109, 110, 162, 184 Bladder, 121, 122, 184, 190, 205, 212, 222, 233 Bloating, 126, 184, 205, 210, 214 Blood Coagulation, 184, 185 Blood Glucose, 184, 202, 204, 206 Blood pressure, 184, 203, 218, 228 Body Fluids, 184, 193, 228 Body Regions, 184, 188 Bowel, 119, 121, 122, 127, 160, 179, 184, 192, 195, 205, 206, 208, 218, 227, 229, 233 Bowel Movement, 184, 192, 229 Brachytherapy, 42, 185, 206, 207, 223, 235 Bradykinin, 185, 214 Branch, 171, 185, 209, 217, 228, 231 Breakdown, 30, 109, 185, 192, 198 Breath Tests, 140, 185 Broad-spectrum, 179, 185 Bronchi, 185, 195 Bronchial, 185, 202 Bronchitis, 185, 188 Bulbar, 32, 40, 185 Burns, 185, 229 C Caffeine, 72, 133, 144, 175, 185 Calcium, 113, 185, 189, 213, 222, 227 Calcium Carbonate, 113, 185 Campylobacter, 23, 46, 75, 83, 108, 110, 128, 135, 185, 201 Campylobacter pylori, 23, 46, 75, 83, 108, 110, 135, 185 Cannula, 126, 185 Capsules, 82, 86, 104, 113, 185, 199 Carbenoxolone, 82, 83, 84, 86, 129, 185 Carbohydrate, 83, 116, 186, 200, 220 Carbon Dioxide, 186, 191, 198, 219, 225, 233 Carcinogen, 17, 177, 186, 211, 231 Carcinogenesis, 17, 186 Carcinoma, 23, 28, 35, 45, 186 Cardiac, 185, 186, 196, 199, 213, 225 Cardiovascular, 186, 208, 219, 226 Carotene, 183, 186 Carotenoids, 183, 186 Case report, 24, 31, 43, 45, 61, 186, 188 Catecholamine, 186, 193, 218

Index

Caudal, 186, 204, 220 Caudate Nucleus, 183, 186, 190, 213 Causal, 11, 12, 16, 110, 186 Cell, 14, 16, 20, 31, 40, 42, 43, 44, 68, 105, 106, 111, 116, 118, 154, 155, 177, 178, 179, 182, 183, 184, 186, 188, 189, 191, 192, 194, 195, 196, 200, 201, 205, 206, 207, 208, 209, 211, 212, 213, 214, 215, 219, 221, 224, 225, 227, 230, 231, 232, 234, 235 Cell Death, 15, 186 Cell Differentiation, 186, 227 Cell Division, 118, 154, 183, 186, 201, 211, 219 Cell Lineage, 118, 186 Cell proliferation, 42, 186, 227 Cell Survival, 186, 201 Cellulose, 187, 219 Central Nervous System, 106, 177, 185, 187, 198, 201, 208, 212, 219, 226 Central Nervous System Infections, 187, 201 Cerebellar, 182, 187, 224 Cerebral, 182, 183, 187, 190, 196, 197, 198, 206, 216, 223 Cerebral Cortex, 182, 187, 197, 206 Cerebrum, 187, 219, 232 Chemoprevention, 17, 187 Chemotactic Factors, 187, 189 Chemotherapeutic agent, 110, 187 Chest Pain, 126, 187 Chin, 73, 187, 211 Chlorates, 116, 187 Cholecystectomy, 126, 187 Cholecystokinin, 66, 83, 187 Cholesterol, 91, 159, 183, 187, 209 Chondrocytes, 187, 197 Choriocarcinoma, 56, 187, 203 Chromosome, 188, 201, 208 Chronic Obstructive Pulmonary Disease, 121, 122, 188 Chronic renal, 188, 220, 233 Cimetidine, 69, 88, 105, 109, 120, 162, 188, 219 Circulatory system, 119, 188 Cirrhosis, 120, 188 Clarithromycin, 5, 8, 9, 10, 13, 27, 30, 31, 72, 76, 144, 188 Clinical Medicine, 49, 188, 221 Clinical study, 83, 188, 190 Clinical trial, 14, 29, 99, 100, 151, 188, 190, 193, 212, 217, 222, 224

239

Cloning, 184, 188 Coagulation, 22, 184, 188, 202, 231 Cofactor, 188, 222 Cognition, 188, 214 Colic, 112, 188 Colitis, 127, 158, 188 Collagen, 179, 188, 197, 199, 219 Collapse, 185, 189 Colloidal, 55, 73, 76, 84, 178, 189 Colon, 67, 88, 119, 127, 154, 188, 189, 204, 205, 208, 233 Combination Therapy, 5, 10, 22, 189 Common Bile Duct, 126, 189, 191 Complement, 23, 179, 189 Complementary and alternative medicine, 81, 97, 189 Complementary medicine, 81, 189 Compliance, 10, 12, 189 Computational Biology, 151, 153, 190 Conception, 177, 187, 190, 197 Concomitant, 12, 190 Connective Tissue, 117, 189, 190, 197, 198, 199, 209, 211, 225 Connective Tissue Cells, 190 Consciousness, 179, 190, 225 Constipation, 127, 181, 190 Constriction, 190, 207, 234 Consumption, 162, 190, 192, 199, 225 Contraindications, ii, 190 Control group, 8, 190 Controlled clinical trial, 82, 190 Controlled study, 29, 32, 38, 55, 81, 85, 190 Coordination, 19, 190, 212 Coronary, 190, 211 Coronary Thrombosis, 190, 211 Corpus, 11, 27, 44, 107, 190, 200, 213, 217, 235 Corpus Striatum, 107, 190, 200, 213 Corticosteroids, 12, 190 Cost Savings, 10, 190 Cranial, 191, 201, 218, 234 Craniocerebral Trauma, 183, 191, 201, 231 Curative, 114, 191, 231 Cutaneous, 116, 191 Cyclic, 177, 185, 191, 201, 214, 222 Cystamine, 191 Cysteamine, 74, 76, 77, 87, 191 Cystic Duct, 189, 191 Cytochrome, 188, 191 Cytokine, 23, 34, 52, 59, 191, 206 Cytomegalovirus, 132, 191 Cytoplasmic Vesicles, 191, 218

240

Duodenal Ulcer

Cytotoxic, 20, 23, 191, 224, 227 D Decarboxylation, 191, 202 Defense Mechanisms, 15, 191 Deletion, 20, 191 Denaturation, 191, 220 Density, 9, 28, 29, 34, 110, 192, 209, 215, 228 Dentifrices, 179, 192 Depolarization, 192, 227 Deuterium, 192, 203 Developing Countries, 36, 192 Diabetes Mellitus, 8, 192, 200, 202 Diagnostic procedure, 103, 139, 192 Diaphragm, 45, 192, 202 Diarrhea, 5, 112, 114, 120, 127, 133, 179, 192, 205, 210 Diarrhoea, 192, 199 Diathermy, 126, 192 Diclofenac, 16, 192 Diclofenac Sodium, 192 Digestion, 39, 57, 69, 109, 128, 162, 178, 183, 184, 192, 193, 205, 206, 209, 217, 229, 234 Digestive system, 101, 192, 199 Digestive tract, 120, 161, 186, 192, 196, 227 Dilatation, 177, 180, 192, 234 Dilatation, Pathologic, 192, 234 Dilation, 185, 192, 234 Dipeptides, 106, 192 Diploid, 192, 219 Direct, iii, 116, 121, 130, 143, 188, 192, 193, 200, 203, 216, 224 Dissection, 21, 126, 193, 232 Distal, 119, 193, 199, 223 Diuresis, 185, 193 Diverticula, 193 Diverticulitis, 127, 193 Diverticulum, 65, 193 Dopamine, 73, 181, 193, 214, 218 Dorsal, 193, 220 Double-blind, 22, 26, 32, 33, 36, 40, 67, 72, 76, 82, 84, 86, 193 Drug Interactions, 12, 145, 193 Drug Tolerance, 193, 231 Duct, 179, 185, 189, 193, 196, 226, 229 Dumping Syndrome, 133, 193 Duodenitis, 193 Dura mater, 193, 211, 216 Dyskinesia, 181, 193 Dyspepsia, 9, 11, 27, 33, 39, 110, 112, 125, 127, 193, 205

Dysplasia, 17, 20, 155, 193 Dystrophy, 24, 154, 193 E Effector, 177, 189, 193 Efficacy, 3, 6, 8, 12, 29, 34, 75, 100, 108, 119, 122, 194 Elective, 4, 133, 194 Electrocoagulation, 188, 194 Electrolyte, 132, 194, 208, 228, 233 Emboli, 36, 194 Embolization, 36, 194 Embryo, 177, 186, 194, 205, 220, 233 Emphysema, 188, 194 Emulsion, 194, 198 Endemic, 17, 36, 194, 228 Endogenous, 106, 116, 193, 194, 200 Endorphin, 30, 194 Endoscope, 194, 196 Endoscopic, 22, 32, 39, 40, 41, 43, 55, 82, 85, 86, 87, 89, 99, 100, 127, 194 Endoscopy, 6, 11, 13, 18, 28, 29, 32, 33, 40, 43, 53, 56, 66, 69, 132, 140, 158, 161, 194 Endothelial cell, 194, 197, 206 Endothelium, 116, 194, 195, 214 Endothelium, Lymphatic, 194 Endothelium, Vascular, 194 Endothelium-derived, 195, 214 Endotoxins, 189, 195, 207 End-stage renal, 188, 195, 220 Enhancers, 120, 195 Enteritis, 120, 195 Enterocolitis, 195 Enterocytes, 16, 195 Environmental Exposure, 7, 195, 215 Environmental Health, 150, 152, 195 Enzymatic, 107, 179, 185, 186, 189, 195, 197, 202, 220 Enzyme, 20, 112, 116, 175, 177, 182, 193, 195, 201, 213, 217, 220, 222, 227, 231, 233, 235 Eosinophilic, 132, 195 Eosinophils, 195, 201, 208 Epidemiological, 13, 73, 195 Epidermal, 57, 73, 195, 207, 210, 232 Epidermal Growth Factor, 73, 195, 232 Epidermis, 195, 207, 223 Epigastric, 108, 130, 195, 216 Epinephrine, 22, 178, 193, 195, 214, 232 Epithelial, 14, 15, 16, 19, 20, 23, 34, 52, 132, 177, 195, 196, 200, 216 Epithelial Cells, 15, 19, 52, 195, 196

Index

Epithelium, 14, 15, 21, 22, 105, 114, 187, 194, 195, 196, 198, 232 Erythrocytes, 180, 196 Erythromycin, 188, 196 Esophageal, 126, 127, 196, 226 Esophageal Varices, 196, 226 Esophagitis, 62, 126, 127, 196, 229 Esophagogastroduodenoscopy, 130, 174, 196 Esophagus, 127, 192, 196, 199, 201, 209, 218, 224, 229 Essential Tremor, 154, 196 Ethanolamine, 39, 196 Eukaryotic Cells, 196, 204 Evacuation, 190, 196, 198, 208, 216 Excrete, 181, 196, 207 Exocrine, 187, 196, 216 Exogenous, 178, 184, 194, 196, 200 Extensor, 196, 223 External-beam radiation, 196, 207, 223, 235 Extracellular, 15, 190, 196, 197, 228 Extracellular Matrix, 190, 196, 197 Extraction, 113, 126, 196 Extrapyramidal, 181, 193, 196 F Fallopian tube, 197, 233 Family Planning, 151, 197 Famotidine, 32, 41, 59, 94, 105, 120, 128, 139, 197 Fat, 181, 183, 184, 186, 194, 197, 209, 212, 225, 229, 230 Fatty acids, 72, 111, 178, 197, 221, 222, 231 Fecal Incontinence, 127, 197, 205 Feces, 190, 197, 229 Fetus, 177, 197, 219, 233 Fibrin, 184, 197, 231 Fibrinogen, 197, 231 Fibrinolysis, 49, 197 Fibroblast Growth Factor, 118, 197 Fibroblasts, 190, 197, 206 Fibrosis, 15, 155, 197, 226 Firearms, 110, 111, 197 Fissure, 68, 197 Fistula, 31, 42, 68, 197, 199 Fixation, 23, 197 Flatulence, 127, 198 Flatus, 197, 198 Flexor, 84, 196, 198 Fold, 5, 197, 198, 211 Foramen, 187, 198, 218 Fovea, 198

241

Fractionation, 21, 198 Free Radical Scavengers, 198, 231 Free Radicals, 181, 198, 213 Freeze Drying, 113, 198 Frontal Lobe, 198, 212 Fungi, 119, 198, 211, 235 G Gallbladder, 43, 126, 177, 184, 187, 191, 192, 198, 199 Ganglia, 177, 183, 198, 213, 218 Gas, 68, 127, 179, 186, 196, 198, 203, 205, 210, 214, 234 Gastrectomy, 198, 220 Gastric atrophy, 121, 198 Gastric Emptying, 29, 37, 77, 109, 131, 133, 198 Gastric Juices, 198, 217 Gastric Mucosa, 6, 18, 20, 27, 38, 68, 87, 106, 109, 122, 125, 198, 217 Gastrin, 7, 29, 43, 44, 45, 55, 63, 64, 65, 69, 83, 105, 120, 121, 188, 199, 203, 217 Gastroduodenal, 9, 12, 41, 73, 76, 77, 83, 127, 132, 137, 199 Gastroenteritis, 127, 199 Gastroenterostomy, 126, 199 Gastroesophageal Reflux, 33, 91, 125, 127, 140, 199 Gastrointestinal tract, 107, 111, 119, 131, 132, 181, 198, 199, 208, 226, 228 Gelatin, 199, 200 Gene, 15, 23, 24, 28, 30, 41, 116, 155, 156, 184, 199, 215, 232 Genetic Code, 199, 215 Genetic testing, 199, 220 Genetic transcription, 199, 221 Genetics, 132, 199 Genital, 199, 233 Genitourinary, 199, 233 Genotype, 199, 218 Giardiasis, 199, 211 Gland, 177, 200, 209, 213, 216, 219, 222, 226, 229 Globus Pallidus, 183, 190, 200, 223 Glucose, 154, 184, 187, 192, 200, 202, 205, 206 Glucose Intolerance, 192, 200 Glucuronic Acid, 117, 200, 202 Glucuronides, 200 Glycine, 121, 179, 183, 200, 214 Glycoprotein, 197, 200, 207, 208, 227 Glycosyltransferases, 116, 200 Goblet Cells, 195, 200

242

Duodenal Ulcer

Gonadotropin, 187, 200 Governing Board, 200, 220 Grade, 56, 200 Graft, 132, 200, 203, 213 Gram-negative, 122, 200, 201, 228 Granulocytes, 201, 208, 227, 235 Groin, 201, 205 Group Practice, 10, 201 Growth factors, 45, 118, 201 Guanylate Cyclase, 201, 214 H Haematoma, 201 Haemorrhage, 63, 67, 177, 201 Haploid, 201, 219 Harmony, 108, 201 Headache, 6, 185, 201 Headache Disorders, 201 Heartburn, 49, 125, 127, 133, 174, 201, 202, 205 Hematemesis, 50, 202 Hemodialysis, 185, 202, 207, 208 Hemoglobin, 180, 196, 202, 208 Hemoglobinuria, 154, 202 Hemophilia, 50, 155, 202 Hemorrhage, 9, 22, 30, 36, 40, 63, 74, 76, 127, 131, 132, 133, 138, 191, 194, 201, 202, 213, 223, 229 Hemorrhoids, 202, 226 Hemostasis, 22, 126, 202, 226 Heparin, 118, 202 Hepatic, 178, 189, 202 Hereditary, 202, 212, 225 Heredity, 161, 199, 202 Heterotrophic, 198, 202 Hexosyltransferases, 200, 202 Hiatal Hernia, 61, 132, 202 Histamine, 55, 76, 105, 109, 114, 144, 179, 181, 188, 197, 202, 214, 224 Histidine, 202 Histology, 44, 127, 202 Homeostasis, 132, 202 Homotypic, 21, 203 Hormonal, 182, 203 Hormone, 107, 120, 121, 190, 195, 199, 203, 206, 210, 225, 226, 227, 228, 232 Hospital Charges, 203 Hospital Costs, 22, 203 Host, 14, 18, 20, 21, 118, 120, 132, 183, 203, 208, 234 Humoral, 24, 49, 203 Humour, 203 Hybrid, 20, 203

Hydatidiform Mole, 187, 203 Hydrochloric Acid, 106, 203, 216 Hydrogen, 106, 177, 179, 183, 186, 191, 192, 203, 209, 212, 214, 215, 223 Hydrolysis, 182, 184, 200, 203, 218, 222 Hydroxyproline, 179, 189, 203 Hypersecretion, 8, 30, 203 Hypersensitivity, 203, 208, 225 Hypertension, 201, 203, 233 Hyperthermia, 192, 203 Hypnotherapy, 84, 204 Hypoglycemic, 120, 204 Hypoglycemic Agents, 120, 204 Hypothalamus, 204, 219, 228 Hypoxic, 204, 211 I Id, 78, 90, 154, 159, 163, 164, 170, 172, 204 Idiopathic, 8, 204 Ileum, 204, 207 Imidazole, 73, 202, 204, 224 Immersion, 109, 204 Immune response, 14, 18, 20, 49, 66, 120, 177, 180, 182, 204, 229, 232, 235 Immune system, 21, 119, 184, 204, 208, 209, 210, 212, 233, 235 Immunity, 204 Immunodeficiency, 154, 204 Immunofluorescence, 21, 204 Immunogenic, 109, 204 Immunohistochemistry, 16, 20, 204 Immunologic, 17, 127, 187, 204, 224 Impaction, 127, 204 Impairment, 50, 182, 193, 204, 206, 211 Implant radiation, 204, 206, 207, 223, 235 In situ, 18, 20, 204 In Situ Hybridization, 20, 204 In vitro, 18, 19, 110, 204, 220, 226 In vivo, 110, 202, 204, 231 Incision, 205, 207 Incompetence, 199, 205 Incontinence, 205, 221 Indicative, 128, 205, 217, 234 Indigestion, 133, 173, 174, 205 Induction, 181, 192, 205 Infarction, 183, 190, 205, 211, 225 Infectious Diarrhea, 127, 205 Infiltration, 20, 205 Inflammatory bowel disease, 121, 122, 205 Infusion, 16, 74, 205, 213, 226 Ingestion, 22, 205, 220 Inguinal, 126, 205 Inguinal Hernia, 126, 205

Index

Initiation, 205, 221 Inlay, 205, 225 Inorganic, 187, 200, 205, 210, 212 Inositol, 105, 205 Inotropic, 193, 206 Insight, 15, 206 Insulator, 206, 212 Insulin, 116, 206 Insulin-dependent diabetes mellitus, 206 Interleukin-1, 52, 206 Interleukin-2, 206 Interleukin-8, 44, 206 Intermittent, 10, 206 Internal Capsule, 190, 206 Internal Medicine, 7, 10, 21, 38, 72, 74, 76, 77, 108, 199, 206 Internal radiation, 206, 207, 223, 235 Interstitial, 185, 206, 207, 235 Intestinal, 13, 16, 27, 45, 66, 108, 109, 110, 112, 114, 127, 133, 163, 185, 186, 187, 195, 201, 206, 210, 216 Intestinal Mucosa, 187, 195, 206 Intestinal Obstruction, 127, 206 Intestine, 16, 127, 133, 163, 183, 184, 195, 206, 208, 223 Intracellular, 15, 19, 105, 185, 191, 205, 206, 210, 214, 222, 227 Intramuscular, 206, 216 Intravenous, 3, 26, 38, 67, 74, 99, 100, 205, 206, 216 Intrinsic, 178, 207, 217 Intrinsic Factor, 207, 217 Invasive, 19, 203, 204, 207 Involuntary, 183, 196, 197, 207, 213 Ionizing, 178, 195, 207, 224 Ions, 177, 183, 194, 203, 207, 222 Irradiation, 111, 128, 207, 235 Ischemia, 118, 182, 207, 213, 225 J Jejunum, 16, 207 Joint, 182, 198, 207, 230 K Kb, 150, 207 Keratinocytes, 206, 207 Keto, 115, 207 Kidney Disease, 101, 150, 155, 160, 164, 207 Kidney Failure, 163, 195, 207, 208 Kidney Failure, Acute, 207 Kidney Failure, Chronic, 207, 208 Kinetic, 207, 208

243

L Labile, 189, 208 Laparoscopy, 32, 66, 126, 208 Large Intestine, 192, 206, 208, 224, 227 Latent, 208, 221 Laxative, 208, 210 Lectins, 116, 208 Lens, 208, 235 Leucine, 208, 217 Leucocyte, 178, 208 Leukemia, 154, 208 Leukocytes, 18, 116, 183, 187, 195, 201, 208, 212 Leukotrienes, 182, 208 Library Services, 170, 208 Life cycle, 198, 208 Ligament, 197, 208, 222 Ligands, 116, 208 Ligation, 126, 208 Linkage, 16, 208, 217 Lipid, 16, 206, 207, 209, 212, 216 Lipid Peroxidation, 209, 216 Lipopolysaccharide, 200, 209 Lipoprotein, 200, 209 Liver Transplantation, 26, 209 Localization, 204, 209 Localized, 133, 177, 198, 201, 205, 209, 219, 226, 232 Locomotion, 209, 219 Lower Esophageal Sphincter, 199, 209 Lumen, 119, 185, 195, 209 Lymph, 188, 194, 203, 209, 213, 229 Lymph node, 209, 213 Lymphatic, 194, 205, 209, 211, 228 Lymphatic system, 209, 228 Lymphocyte, 15, 181, 209, 210 Lymphocytic, 116, 209 Lymphoid, 180, 190, 208, 209 Lymphoma, 6, 114, 119, 154, 209 Lysosome, 209, 218 Lytic, 210, 226, 235 M Macrophage, 21, 206, 210 Magnesium Hydroxide, 210 Magnesium Oxide, 120, 210 Maintenance therapy, 12, 29, 51, 54, 55, 74, 114, 130, 132, 138, 210 Malabsorption, 127, 154, 210, 227 Malabsorption syndrome, 210, 227 Malformation, 35, 60, 210 Malignancy, 11, 20, 210

244

Duodenal Ulcer

Malignant, 114, 127, 154, 177, 187, 210, 213, 224, 230 Malignant tumor, 127, 187, 210 Malnutrition, 178, 182, 210, 212 Mediate, 8, 193, 210, 224 Mediator, 187, 206, 210, 227 MEDLINE, 151, 153, 155, 210 Melanocytes, 210 Melanoma, 154, 210 Membrane Proteins, 210, 222 Memory, 107, 180, 183, 210 Meninges, 187, 191, 193, 211 Meningitis, 36, 211 Mental, iv, 14, 101, 150, 152, 156, 187, 188, 205, 210, 211, 223, 233 Mental Disorders, 101, 211, 223 Mesenchymal, 195, 203, 211 Mesenteric, 76, 211, 220 Mesentery, 211, 218, 228 Meta-Analysis, 3, 4, 26, 55, 211 Metaplasia, 5, 12, 15, 27, 35, 44, 45, 63, 211 Metronidazole, 8, 9, 10, 11, 18, 30, 39, 42, 43, 75, 110, 162, 211 MI, 44, 176, 211 Microbe, 211, 231 Microbiology, 28, 31, 34, 35, 49, 57, 61, 69, 74, 182, 211 Microorganism, 109, 188, 211, 217, 235 Micro-organism, 119, 201, 211 Microscopy, 16, 21, 211 Millimeter, 110, 111, 211 Misoprostol, 12, 72, 76, 211 Mitosis, 118, 208, 211 Modification, 179, 212 Molecular, 16, 17, 21, 24, 57, 117, 151, 153, 184, 190, 197, 202, 212, 231 Molecule, 116, 181, 183, 189, 193, 195, 200, 203, 212, 215, 224, 227, 234 Monoclonal, 207, 212, 223, 235 Monocytes, 206, 208, 212 Mononuclear, 14, 212 Motility, 127, 132, 212, 219, 221, 226 Motion Sickness, 212, 213 Motor Cortex, 84, 212, 224 Movement Disorders, 181, 212, 230 Mucins, 195, 200, 212, 226 Mucosa, 4, 11, 15, 20, 23, 34, 49, 54, 66, 74, 76, 104, 114, 120, 131, 199, 212, 230 Mucosal Lining, 162, 212 Mucus, 15, 110, 120, 163, 212, 233 Multicenter study, 6, 26, 53, 212 Multiple sclerosis, 116, 212

Muscle Fibers, 212, 213 Muscular Atrophy, 154, 212 Muscular Dystrophies, 193, 212 Myelin, 212 Myocardial Reperfusion, 212, 213, 225 Myocardial Reperfusion Injury, 213, 225 Myocardium, 211, 213 Myosin, 105, 213 Myotonic Dystrophy, 154, 213 N Nausea, 112, 127, 140, 174, 181, 199, 205, 213, 214, 233 NCI, 1, 100, 149, 213 Need, 3, 4, 125, 130, 135, 140, 159, 162, 165, 188, 210, 213, 231 Neoplasia, 154, 213 Neoplasm, 41, 213 Neoplastic, 17, 209, 213, 232 Neostriatum, 186, 190, 213, 223 Nephrectomy, 126, 213 Nephropathy, 207, 213 Nerve, 121, 122, 178, 180, 182, 187, 210, 212, 213, 216, 220, 225, 226, 229, 232, 234 Nervous System, 107, 154, 183, 187, 210, 213, 214, 218, 230, 234 Neural, 118, 203, 213 Neuroleptic, 107, 181, 214 Neuromuscular, 177, 214, 221, 233 Neuromuscular Junction, 177, 214 Neuropathy, 121, 122, 214 Neurosis, 214 Neurotic, 121, 122, 214 Neurotransmitter, 177, 179, 185, 193, 200, 202, 214, 227, 228, 229 Neutralization, 114, 214 Neutrons, 178, 207, 214, 223 Neutrophil, 44, 214 Neutrophil Infiltration, 44, 214 Nitric Oxide, 30, 214 Nitrogen, 178, 179, 198, 208, 214 Nizatidine, 58, 96, 120, 214 Nonulcer Dyspepsia, 8, 214 Norepinephrine, 178, 193, 214 NSAIDs, 12, 16, 125, 132, 139, 159, 161, 163, 215 Nuclei, 178, 211, 214, 215, 223 Nucleic acid, 118, 199, 204, 214, 215 Nucleus, 183, 190, 191, 192, 195, 196, 200, 212, 214, 215, 223, 229, 230 O Observational study, 33, 215 Ocular, 215, 219

Index

Odds Ratio, 4, 215, 225 Oliguria, 207, 215 Oncogene, 154, 215 Opacity, 192, 215 Operon, 215, 221 Ophthalmology, 198, 215 Ovaries, 215, 230, 233 Oxidation, 177, 181, 184, 191, 209, 215, 216 Oxidative Stress, 16, 216 Oxytocic, 211, 216 P Pachymeningitis, 211, 216 Palliative, 114, 216, 231 Pancreas, 131, 132, 163, 177, 192, 199, 206, 216, 226, 228 Pancreatic, 35, 60, 112, 154, 187, 198, 199, 216 Pancreatic cancer, 154, 216 Pancreatic Juice, 199, 216 Pancreatitis, 8, 35, 61, 216 Paneth Cells, 195, 216 Paralysis, 185, 216 Parasite, 216, 232 Parasitic, 127, 216 Parasitic Diseases, 127, 216 Parenteral, 89, 106, 216 Parietal, 14, 31, 40, 43, 68, 105, 121, 215, 216, 218 Parietal Cells, 31, 68, 105, 121, 216 Parietal Lobe, 216 Paroxysmal, 154, 201, 216 Patch, 40, 53, 216 Pathogen, 6, 14, 119, 201, 217 Pathogenesis, 6, 7, 8, 12, 15, 16, 17, 46, 61, 64, 74, 105, 112, 128, 131, 217 Pathologic, 75, 184, 190, 203, 217, 223, 234 Pathophysiology, 127, 130, 131, 132, 217 Patient Education, 160, 161, 162, 168, 170, 176, 217 Patient Selection, 12, 217 Pelvic, 217, 222 Pelvis, 177, 215, 217, 233 Penis, 217, 218, 233 Pentagastrin, 29, 35, 89, 217 Pentosyltransferases, 200, 217 Pepsin, 15, 69, 83, 109, 112, 114, 120, 132, 133, 188, 211, 217, 226 Pepsin A, 109, 112, 188, 217 Peptic Ulcer Hemorrhage, 99, 217, 226 Peptide, 45, 65, 106, 109, 113, 121, 179, 187, 188, 197, 217, 222 Peptide Chain Elongation, 188, 217

245

Perception, 13, 201, 217 Perforated Ulcer, 9, 217 Perforation, 4, 9, 16, 32, 34, 36, 39, 40, 47, 56, 64, 65, 132, 133, 163, 198, 217 Peripheral blood, 20, 218 Peripheral Nervous System, 214, 218, 228, 229 Peripheral Vascular Disease, 118, 218 Peritoneal, 119, 131, 132, 218 Peritoneal Cavity, 119, 218 Peritoneum, 211, 218 Peroxide, 16, 209, 218 Petechiae, 201, 218 Phagocytosis, 21, 218 Phagosomes, 21, 218 Phallic, 197, 218 Pharmacokinetic, 218 Pharmacologic, 180, 218, 231 Pharmacotherapy, 63, 64, 218 Pharynx, 199, 218, 234 Phenotype, 20, 121, 218, 232 Phenylalanine, 217, 218, 232 Phospholipases, 218, 227 Phospholipids, 197, 206, 209, 219 Phosphorus, 185, 219 Photocoagulation, 188, 219 Physiologic, 132, 178, 219, 221, 224 Physiology, 39, 45, 66, 73, 75, 77, 82, 83, 125, 127, 130, 132, 199, 208, 219 Pilot study, 50, 68, 90, 219 Pineal gland, 187, 219 Pirenzepine, 76, 120, 219 Pituitary Gland, 197, 219 Placenta, 219, 233 Plants, 114, 119, 178, 182, 183, 186, 200, 214, 219, 220, 226, 231, 234 Plasma, 19, 43, 44, 83, 178, 180, 183, 191, 194, 197, 199, 200, 202, 207, 219, 222, 226 Plasma cells, 180, 219 Platelet Activation, 219, 227 Platelet Aggregation, 115, 179, 214, 219, 231 Platelets, 183, 214, 219, 226, 231 Pneumonia, 190, 220 Poisoning, 199, 213, 220 Pollen, 220, 223 Polycystic, 155, 220 Polymerase, 34, 220, 221 Polymerase Chain Reaction, 34, 220 Polymorphism, 24, 30, 220 Polyposis, 127, 220 Polysaccharide, 181, 187, 220

246

Duodenal Ulcer

Portal Vein, 42, 220 Posterior, 27, 179, 182, 193, 206, 216, 220 Postgastrectomy Syndrome, 133, 220 Postoperative, 126, 131, 220 Postsynaptic, 220, 227 Potentiates, 206, 219, 220 Potentiation, 220, 227 Practice Guidelines, 152, 163, 220 Precancerous, 18, 221 Precursor, 182, 183, 193, 195, 214, 218, 221, 222, 232 Predisposition, 49, 221 Premalignant, 221 Prevalence, 5, 7, 8, 9, 13, 24, 46, 48, 51, 61, 62, 86, 87, 131, 138, 215, 221 Proctitis, 116, 221 Proglumide, 120, 221 Progression, 18, 20, 180, 221 Progressive, 186, 188, 193, 201, 208, 212, 213, 219, 221 Projection, 191, 214, 221, 224 Promotor, 13, 221 Prone, 16, 221 Propantheline, 81, 82, 83, 221 Prophylaxis, 12, 114, 221 Prospective study, 68, 75, 83, 87, 221 Prostaglandin, 43, 74, 77, 111, 115, 211, 221, 231 Prostaglandins A, 111, 221, 222 Prostaglandins D, 222 Prostanoic Acids, 115, 222 Prostate, 154, 222, 233 Protease, 49, 189, 222 Protective Agents, 4, 112, 222 Protein C, 178, 179, 183, 209, 222, 233 Protein Conformation, 179, 222 Protein S, 155, 184, 188, 196, 199, 222, 230 Proteolytic, 178, 189, 197, 222 Prothrombin, 222, 231 Protocol, 22, 222 Proton Pump, 4, 6, 8, 9, 11, 50, 105, 114, 120, 132, 138, 140, 161, 215, 222, 223 Proton Pump Inhibitors, 4, 6, 9, 120, 132, 140, 161, 223 Protons, 178, 203, 207, 222, 223 Protozoa, 211, 223 Proximal, 4, 193, 223 Psoriasis, 116, 223 Psychiatry, 197, 223 Psychic, 211, 214, 223, 226 Psychomotor, 214, 223 Psychosomatic Medicine, 33, 86, 89, 223

Public Policy, 151, 223 Pulmonary, 184, 190, 195, 198, 207, 208, 223, 230, 234 Pulmonary Edema, 207, 223 Purpura, 201, 223 Putamen, 183, 190, 213, 223 Pyloric Stenosis, 61, 223 Pylorus, 193, 223 Q Quercetin, 79, 223 R Radiation, 110, 111, 119, 191, 195, 196, 198, 204, 206, 207, 211, 223, 224, 235 Radiation therapy, 196, 198, 206, 207, 223, 235 Radio Waves, 192, 224 Radioactive, 203, 204, 206, 207, 223, 224, 235 Radiography, 132, 224 Radiolabeled, 207, 223, 224, 235 Radiotherapy, 185, 207, 224, 235 Randomized, 4, 6, 11, 22, 26, 27, 30, 32, 37, 38, 41, 49, 52, 53, 72, 75, 128, 194, 224 Ranitidine Bismuth Citrate, 8, 36, 46, 53, 73, 74, 224 Reagent, 196, 203, 224 Recombinant, 20, 224, 234 Rectum, 180, 181, 184, 189, 192, 198, 205, 208, 221, 222, 224 Red Nucleus, 182, 224 Refer, 1, 189, 197, 198, 209, 214, 224, 231 Reflux, 37, 48, 62, 65, 126, 131, 133, 138, 199, 224, 229 Refractory, 33, 38, 132, 194, 224 Regeneration, 197, 224 Regimen, 8, 10, 18, 48, 60, 73, 76, 88, 162, 194, 218, 224 Regurgitation, 199, 201, 224 Reinfection, 17, 39, 117, 224 Relapse, 10, 11, 25, 26, 42, 52, 54, 55, 59, 62, 63, 65, 74, 77, 84, 108, 114, 224 Relative risk, 4, 177, 224 Remission, 210, 224, 225 Reperfusion, 116, 213, 225 Reperfusion Injury, 116, 225 Resection, 30, 42, 225, 227 Respiration, 186, 225 Restitution, 16, 225 Restoration, 67, 212, 225, 235 Resuscitation, 132, 225 Retina, 208, 225, 226, 235 Retinoblastoma, 154, 225

Index

Retrospective, 37, 85, 225 Rheumatism, 225 Rheumatoid, 116, 225 Rheumatoid arthritis, 116, 225 Rhinitis, 221, 225 Rigidity, 219, 225 Risk factor, 6, 7, 19, 27, 30, 31, 52, 53, 57, 64, 77, 88, 126, 133, 140, 163, 221, 225 Risk patient, 4, 226 Rod, 122, 183, 226 Rutin, 223, 226 S Saliva, 226 Salivary, 29, 59, 191, 192, 216, 219, 226, 229 Salivary glands, 191, 192, 226 Sclerosis, 154, 212, 226 Sclerotherapy, 41, 226 Screening, 20, 64, 119, 160, 188, 226 Scrotum, 226 Secretin, 74, 120, 226 Secretory, 30, 35, 36, 43, 127, 215, 226 Seizures, 216, 226 Semen, 222, 226 Seminal vesicles, 226, 233 Semisynthetic, 179, 188, 226 Sensor, 111, 226 Sequencing, 201, 220, 226 Serologic, 54, 226 Serology, 66, 226 Serotonin, 181, 214, 218, 226 Serous, 194, 227 Serum, 7, 21, 29, 55, 64, 69, 75, 178, 179, 189, 200, 208, 226, 227 Sex Determination, 155, 227 Shock, 34, 116, 227, 232 Short Bowel Syndrome, 127, 227 Sialyltransferases, 200, 227 Side effect, 10, 12, 108, 112, 113, 114, 115, 120, 135, 143, 178, 181, 184, 186, 227, 231 Signal Transduction, 20, 206, 227 Signs and Symptoms, 224, 225, 227, 233 Silicic, 104, 227 Skeleton, 177, 207, 221, 227 Skull, 191, 227, 230 Small intestine, 16, 127, 163, 191, 193, 195, 199, 203, 204, 205, 206, 207, 227, 234 Smoking Cessation, 163, 227 Smooth muscle, 179, 185, 190, 202, 227, 229 Sodium, 6, 82, 86, 117, 120, 145, 192, 228 Sodium Bicarbonate, 120, 145, 228 Somatic, 203, 211, 218, 228, 234

247

Somatic cells, 211, 228 Somatostatin, 65, 83, 228 Sound wave, 192, 228 Specialist, 164, 192, 228 Species, 118, 183, 185, 195, 199, 203, 211, 212, 216, 228, 229, 232, 234, 235 Specificity, 14, 178, 228 Sperm, 188, 220, 228 Sphincters, 197, 228 Spinal cord, 187, 193, 211, 213, 214, 216, 218, 228 Spirillum, 107, 228 Spleen, 108, 191, 209, 228 Splenectomy, 126, 228 Splenic Vein, 220, 228 Sporadic, 225, 228 Stasis, 108, 131, 228 Statistically significant, 5, 8, 14, 228 Steatorrhea, 8, 229 Stenosis, 9, 40, 229 Sterilization, 126, 229 Steroids, 190, 229 Stimulant, 144, 185, 202, 229 Stimulus, 206, 229 Stool, 175, 189, 204, 205, 208, 229 Strand, 220, 229 Stress Ulcer, 12, 229 Stricture, 30, 229 Stroke, 101, 121, 122, 150, 229 Subacute, 205, 229 Subarachnoid, 201, 229 Subclinical, 17, 205, 226, 229 Subcutaneous, 107, 216, 229 Submaxillary, 195, 229 Subspecies, 228, 229 Substance P, 196, 226, 229 Sucralfate, 4, 12, 25, 27, 41, 65, 72, 73, 75, 76, 77, 120, 127, 132, 139, 145, 229 Supplementation, 85, 89, 230 Suppression, 52, 65, 138, 230 Surfactant, 196, 230 Sympathomimetic, 193, 195, 215, 230 Symphysis, 187, 222, 230 Symptomatic, 9, 10, 11, 62, 216, 230 Synaptic, 214, 227, 230 Synovial, 117, 230 Synovial Fluid, 117, 230 Synovial Membrane, 230 Systemic, 12, 66, 144, 145, 184, 195, 205, 207, 223, 228, 230, 235 T Talc, 113, 230

248

Duodenal Ulcer

Tardive, 107, 181, 230 Telangiectasia, 155, 230 Temporal, 5, 16, 201, 230 Teratoma, 187, 230 Testicle, 230, 234 Testis, 187, 230 Tetracycline, 9, 11, 30, 39, 75, 110, 230 Thalamic, 182, 230 Thalamic Diseases, 182, 230 Thalamus, 190, 230, 231 Thermal, 22, 214, 220, 231 Thiourea, 121, 122, 231 Thoracic, 192, 231 Thorax, 177, 231, 234 Thrombin, 39, 197, 219, 222, 231 Thrombosis, 183, 222, 226, 229, 231 Thromboxanes, 182, 231 Thrombus, 190, 205, 213, 219, 231 Tissue, 16, 18, 104, 107, 110, 111, 117, 119, 120, 161, 181, 182, 183, 184, 187, 188, 190, 193, 194, 195, 196, 197, 198, 200, 201, 203, 205, 206, 208, 209, 210, 211, 212, 213, 216, 217, 218, 219, 220, 224, 225, 227, 229, 230, 231, 232, 235 Tolerance, 8, 107, 114, 177, 200, 231 Topical, 12, 106, 111, 228, 231 Toxic, iv, 106, 114, 116, 182, 195, 204, 214, 231 Toxicity, 106, 186, 193, 214, 230, 231 Toxicokinetics, 231 Toxicology, 152, 231 Toxin, 20, 231 Transduction, 21, 227, 231 Transfection, 184, 232 Transforming Growth Factor alpha, 232 Transforming Growth Factor beta, 232 Transforming Growth Factors, 57, 232 Translation, 179, 196, 232 Translocation, 188, 196, 232 Transmitter, 177, 193, 210, 214, 232 Transplantation, 26, 116, 188, 208, 232 Trauma, 116, 127, 196, 216, 232 Trichomoniasis, 211, 232 Truncal, 27, 43, 126, 232 Tuberous Sclerosis, 155, 232 Tumor-derived, 232 Tunica, 212, 232 Tyrosine, 24, 193, 232 U Ulceration, 4, 7, 12, 15, 16, 24, 109, 110, 132, 133, 232 Ulcerative colitis, 119, 127, 205, 233

Ultrasonography, 126, 233 Umbilical Arteries, 233 Umbilical Cord, 117, 233 Unconscious, 180, 191, 204, 233 Uraemia, 216, 233 Urea, 182, 208, 233 Urease, 10, 11, 21, 31, 122, 201, 233 Uremia, 207, 233 Ureters, 233 Urethra, 217, 222, 233 Urinary, 119, 121, 122, 199, 205, 215, 219, 221, 233 Urinary tract, 119, 233 Urine, 174, 181, 184, 193, 195, 200, 202, 205, 207, 215, 233 Urogenital, 119, 199, 233 Urogenital System, 119, 233 Uterus, 177, 190, 215, 216, 233, 234 V Vaccine, 177, 222, 232, 233 Vacuoles, 19, 234 Vagina, 233, 234 Vagotomy, 4, 27, 40, 43, 53, 54, 57, 68, 69, 126, 130, 234 Vagus Nerve, 232, 234 Varicocele, 126, 234 Varicose, 226, 234 Varicose vein, 226, 234 Vascular, 116, 194, 195, 201, 205, 214, 219, 231, 234 Vasculitis, 216, 234 Vasoconstriction, 195, 234 Vasodilation, 115, 234 Vasodilator, 185, 193, 202, 213, 234 VE, 63, 89, 234 Vector, 216, 232, 234 Vegetative, 110, 111, 234 Vein, 180, 182, 206, 220, 228, 233, 234 Venous, 182, 183, 202, 222, 234 Ventricle, 182, 186, 204, 231, 234 Veterinary Medicine, 151, 234 Villi, 16, 203, 234 Villus, 15, 203, 234 Viral, 231, 234 Virulence, 18, 19, 23, 34, 231, 234 Virulent, 18, 235 Virus, 183, 187, 195, 232, 234, 235 Vitamin A, 79, 138, 205, 235 Vitreous, 117, 208, 225, 235 Vitreous Body, 117, 225, 235 Vitro, 110, 202, 235 Vivo, 110, 235

Index

W White blood cell, 180, 208, 209, 210, 212, 214, 219, 235 Wound Healing, 197, 235 X Xenograft, 180, 235

X-ray, 161, 207, 223, 224, 235 X-ray therapy, 207, 235 Y Yeasts, 198, 218, 235

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250

Duodenal Ulcer

Index

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252

Duodenal Ulcer