IDNEY ANCER A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Kidney Cancer: 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: 0-597-84474-7 1. Kidney Cancer-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.
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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 kidney cancer. 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 KIDNEY CANCER ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Kidney Cancer............................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 18 The National Library of Medicine: PubMed ................................................................................ 19 CHAPTER 2. NUTRITION AND KIDNEY CANCER............................................................................. 35 Overview...................................................................................................................................... 35 Finding Nutrition Studies on Kidney Cancer ............................................................................. 35 Federal Resources on Nutrition ................................................................................................... 36 Additional Web Resources ........................................................................................................... 37 CHAPTER 3. CLINICAL TRIALS AND KIDNEY CANCER ................................................................... 39 Overview...................................................................................................................................... 39 Recent Trials on Kidney Cancer .................................................................................................. 39 Keeping Current on Clinical Trials ............................................................................................. 53 CHAPTER 4. PATENTS ON KIDNEY CANCER ................................................................................... 55 Overview...................................................................................................................................... 55 Patent Applications on Kidney Cancer........................................................................................ 55 Keeping Current .......................................................................................................................... 59 CHAPTER 5. BOOKS ON KIDNEY CANCER ....................................................................................... 61 Overview...................................................................................................................................... 61 Book Summaries: Federal Agencies.............................................................................................. 61 Book Summaries: Online Booksellers........................................................................................... 63 Chapters on Kidney Cancer ......................................................................................................... 63 CHAPTER 6. MULTIMEDIA ON KIDNEY CANCER ............................................................................ 67 Overview...................................................................................................................................... 67 Video Recordings ......................................................................................................................... 67 CHAPTER 7. PERIODICALS AND NEWS ON KIDNEY CANCER ......................................................... 69 Overview...................................................................................................................................... 69 News Services and Press Releases................................................................................................ 69 Academic Periodicals covering Kidney Cancer ............................................................................ 73 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 75 Overview...................................................................................................................................... 75 U.S. Pharmacopeia....................................................................................................................... 75 Commercial Databases ................................................................................................................. 76 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 79 Overview...................................................................................................................................... 79 NIH Guidelines............................................................................................................................ 79 NIH Databases............................................................................................................................. 81 Other Commercial Databases....................................................................................................... 83 APPENDIX B. PATIENT RESOURCES ................................................................................................. 85 Overview...................................................................................................................................... 85 Patient Guideline Sources............................................................................................................ 85 Associations and Kidney Cancer.................................................................................................. 90 Finding Associations.................................................................................................................... 91 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 93 Overview...................................................................................................................................... 93 Preparation................................................................................................................................... 93 Finding a Local Medical Library.................................................................................................. 93 Medical Libraries in the U.S. and Canada ................................................................................... 93
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ONLINE GLOSSARIES.................................................................................................................. 99 Online Dictionary Directories ..................................................................................................... 99 KIDNEY CANCER DICTIONARY............................................................................................. 101 INDEX .............................................................................................................................................. 149
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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 kidney cancer 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 kidney cancer, 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 kidney cancer, 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 kidney cancer. 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 kidney cancer, 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 kidney cancer. 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 KIDNEY CANCER Overview In this chapter, we will show you how to locate peer-reviewed references and studies on kidney cancer.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and kidney cancer, 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 “kidney cancer” (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: •
Laparoscopic Radical Nephrectomy for Advanced Kidney Cancer Source: Current Urology Reports. 3(1): 21-24. February 2002. Contact: Current Science, Inc. 400 Market Street, Suite 700, Philadelphia, PA 19106 (800) 427-1796. Fax (215) 574-2225. E-mail:
[email protected]. Website: http://www.current-reports.com. Summary: The management of advanced renal cell carcinoma (RCC) continues to evolve. With the advent of laparoscopic radical nephrectomy (LRN), minimally invasive approaches to kidney cancer have developed. Laparoscopic resection of locally advanced RCC yields a similar cancer-control rate with the advantage of decreased morbidity (complications and associated illness). With respect to cytoreductive nephrectomy in asymptomatic patients being considered for systemic therapies
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Kidney Cancer
(chemotherapy or immunotherapy), the timing of nephrectomy is somewhat controversial. However, several practical points support initial cytoreductive nephrectomy prior to systemic therapy. Although cytoreductive LRN is a technically challenging procedure, it may be completed safely in selected patients. Further prospective study of the role of LRN for advanced RCC is warranted. 3 figures. 1 table. 24 references.
Federally Funded Research on Kidney Cancer The U.S. Government supports a variety of research studies relating to kidney cancer. 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 kidney cancer. 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 kidney cancer. The following is typical of the type of information found when searching the CRISP database for kidney cancer: •
Project Title: CANCER SUSCEPTIBILITY IN AN ANIMAL MODEL Principal Investigator & Institution: Yeung, Raymond; Associate Professor; Surgery; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-JAN-1994; Project End 31-DEC-2004 Summary: For any given cancer, there exists a wide spectrum of clinical behavior. Understanding the factors that influence tumors approach to risk assessment and the design of therapy. Inherited variation of certain genes and their interaction with the environment are thought to govern, to a large extent, tumor heterogeneity, both in terms of susceptibility and progression. This proposal makes use of hereditary cancer model in the Eker rat and a transgenic TSC2-mutant mouse model to identify post- initiation events that modulate kidney cancer phenotype. Both strains carry a germline mutation of the TSC2 gene that in humans, also predisposes the carriers to renal cell carcinoma as part of the tuberous sclerosis complex (TSC). The clinical features of the latter disease are highly variable even among family members sharing the same mutation. Those with mild forms of TSC live a normal life whereas those severely affected die prematurely of brain and kidney complications. Similarly, patients with low tumor burden fare better than those with heavy tumor load. In an attempt to understand the genetic determinants of phenotypic variation, observations in the Eker rat suggested a strain-dependent difference in renal tumor size at 18 months of age. Using the tools of quantitative biology, the investigators have demonstrated evidence for genetic factors governing tumor size that are unlinked to the TSC2 gene. The aims of this proposal are to
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).
Studies
5
determine the molecular identity of a dominant modifier of tumor burden and to detect and map other genetic elements that affect its phenotype (e.g., size, multiplicity, metastasis) in the two rodent models. Appreciation of these 'modifier' genes will impart new knowledge about the interplay between genes and environment during the development of complex diseases such as cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIFFERENTIAL GENE EXPRESSION IN RENAL CANCERS Principal Investigator & Institution: Parker, Alexander S.; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2003; Project Start 03-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Incidence and mortality rates for renal cell carcinoma (RCC) have increased steadily over the past three decades, and these trends are largely unexplained. While it is widely acknowledged that a history of obesity increases the risk of developing RCC, little is known regarding the actual biologic mechanisms that underlie this association. Indeed, the Kidney Cancer Progress Review Group recently recommended that investigators focus efforts on illuminating the "biological mechanisms underlying the known risk factors for kidney cancers". A logical first approach to identifying specific molecular alterations that link obesity and RCC would be to compare the somatic gene expression profiles in tumors from RCC patients with and without a history of obesity. In this application, we propose to employ the high throughput capabilities of commercially available DNA microarray technology in order to scan the genome for genes that are differentially expressed in RCC tumors that develop in obese and non-obese individuals. To do this, we will use the Mayo Nephrectomy Registry to identify all patients treated surgically for stage I, clear cell RCC at the Mayo Clinic Rochester during a one year period who report no history of smoking. From this list, we will sample 10 individuals with and 10 individuals without a history of obesity. We will then request fresh-frozen tissue samples (both tumor and normal) on each individual and use laser capture microdissection to obtain samples for RNA extraction. The Mayo Clinic DNA Microarray Core Facility will conduct measurements of gene expression in the sampled tissues using the Affymetrix U133 GeneChip platform. Members of our investigative team with experience in microarray analysis and bioinformatics will then conduct analysis to determine differential gene expression patterns between the two study groups. Explicitly, we wish to test the hypothesis that specific gene expression profiles can be identified that will distinguish between RCC tumors that develop in obese and nonobese individuals. Results from this study will provide direction and support for larger, more candidate-specific investigations of the biologic mechanisms behind the obesity/RCC association. In summary, this application represents an effort to harness an innovative, high throughput laboratory technology in order to improve our understanding of RCC etiology by broadening the search for risk-factor-specific molecular heterogeneity in human RCC. The long-term goal of the proposed study is to potentially inform novel prevention and treatment strategies for RCC at both the individual and population level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: EFFECTS OF ARSENIC ON CYTOCHROME P450 Principal Investigator & Institution: Sinclair, Jacqueline A.; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2003
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Kidney Cancer
Summary: Arsenic is found at high levels in almost half of all Superfund sites as well as many public and private water supplies in the northeastern and western regions of the United States. High levels of arsenic in drinking water are associated with an increased risk of skin, bladder, lung, and kidney cancer. Previous work in this and other laboratories has demonstrated that arsenic can have substantial effects on specific cytochrome P450s (CYPs) that are principally responsible for metabolism of drugs and other xenobiotics by the liver, lung and other organs. In particular, arsenic exposure decreases the induction of CYPs by chemicals that are subsequently metabolized by these CYPs. We hypothesize that arsenic-induced alterations in CYP mediated xenobiotic metabolism may have a significant impact on the response of humans and other organisms to other toxic chemicals, which might occur in Superfund sites containing arsenic in combination with other metals and organic contaminants. This is postulated to increase the bioaccumulation of other toxic chemicals, and therefore these effects may contribute to arsenic- induced cancer and vascular disease and/or enhance the toxicity of other chemicals. The overall goal of this project is to determine the effects of arsenic (III) and other selected metals on specific liver CYPs. Our previous studies have demonstrated in hepatocytes in culture that low concentrations of arsenic significantly decrease induction of several major CYPs. These arsenic mediated decreases are not due to the induction of heme oxygenase, depletion of heme, or oxidative damage as had been previously postulated. We hypothesize that these effects occur mainly at the post-transcriptional level. Our specific aims will be to: 1) determine in intact rodents the effects of acute and chronic exposure to arsenic (III) on induction of CYPs, and the ability of arsenic to modulate accumulation and elimination of polychlorinated biphenyls and drugs; and 2) determine, in cultured hepatocytes, the post-transcriptional mechanisms by which arsenite specifically decreases synthesis of rat CYPA23 and chick CYP2H1. These studies may provide insight into effects of arsenic and other toxic metals, in combination with exposures to other toxic agents, that have not previously been appreciated. Since most Superfund sites and other waste sites contain complex mixtures of toxins, and over 60% of these sites contain toxic metals, understanding their effects when present in combinations will be important for our overall evaluation of the health effects of these agents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTS OF CARCINOGENIC METALS ON GENE EXPRESSION Principal Investigator & Institution: Hamilton, Joshua W.; Associate Professor; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002 Summary: Arsenic (III) and chromium (VI) are considered human lung carcinogens, and arsenic is also associated with increased risk of skin, bladder and kidney cancer. The overall goal of the proposed research is to determine the mechanism by which these toxic metals act as human carcinogens. The specific goal of the project is to determine the mechanistic basis for the preferential effects of these carcinogenic metals on inducible gene expression. Our previous studies have demonstrated that arsenic and chromium have strong preferential effects on the expression of several model inducible that arsenic and chromium have strong preferential effects on the expression of whereas most other genes are refractory to these treatments. These gene-specific effects appear to be mediated, at least in part, by the ability of these metals to modulate specific transcription factors and cell signaling pathways that regulate the expression of these targeted genes. In particular, we observed profound effects of arsenic and chromium on the function of the glucocorticoid receptor, leading to alterations in glucocorticoid
Studies
7
receptor-dependent gene expression. These results suggest that arsenic and chromium, and perhaps other toxic metals, may represent a new class of "endocrine disrupters" that are capable of altering cell phenotype through direct interactions with steroid receptors. The specific objectives of this research are to determine the molecular basis for these effects, genetic and biochemical approaches to investigate these effects in model cell systems. Our specific aims will be to: 1) determine the mechanism by which arsenic (III) and chromium (VI) specifically alter glucocorticoid receptor function and receptormediated gene expression as well as other steroid receptors; 2) determine whether other trans acting transcription factors and/or their cis acting DNA regulatory elements contribute to mediating the specific effects of arsenic (III) and chromium (VI) on inducible gene expression; and 3) determine the sub set of eukaryotic genes whose expression is specifically altered by low dose arsenic (III) or chromium (VI) exposures. We hypothesize that these selective gene effects may contribute to the carcinogenic process by altering cell phenotype in a tissue-specific manner. Some of these interactions, such as alterations in steroid receptor function, may also lead to more global organ and systemic effects of these metals. This may also result in synergy with other metal effects, such as the ability of chromium (VI) to directly cause DNA damage and mutations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL PROPERTIES OF THE WILM'S TUMOR GENE WT1 Principal Investigator & Institution: Haber, Daniel A.; Director, Cancer Center; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 01-JAN-1993; Project End 31-DEC-2007 Summary: (provided by applicant): The genetic pathways that underlie the development of the pediatric kidney cancer Wilms tumor provide unique insight into the link between normal development of the kidney and its deregulation during malignant transformation. Inactivating mutations in the WT1 tumor suppressor, a zinc finger transcription factor encoded by multiple alternative splicing variants, underlie a subset of Wilms tumors, pointing to critical transcriptional targets that contribute to kidney development and tumorigenesis. We have used cells with inducible expression of the transcription allyactive isoform, WT1 (-KTS), combined with expression profile analysis to identify physiologically regulated target genes, and we have established a model for WT1-directed cellular differentiation using hematopoietic precursors. Here, we propose to focus on the functional properties of the most abundant isoform, WT1 (+KTS), whose function is unknown. In Aim I, we will search for endogenous genes whose expression is regulated by WT1 (+KTS), using both hybridization to microarrays and subtractivePCR approaches. The mechanisms by which this WT1 isoform regulates expression of its target genes (transcriptional as well as postulated post-transcriptional mechanisms) will be studied. The functional properties of these downstream effectors and their potential contribution to renal differentiation and Wilms tumorigenesis will be addressed. In Aim II, we will pursue protein-protein interactions that have been implicated in WT1 (+KTS) function, as well as in its characteristic subnuclear localization within "speckles". A combination of yeast-two hybrid assays and mass spectrometry sequencing of coprecipitated proteins will be employed, and the functional significance of confirmed interactors will be addressed. In Aim III, we will study another recently isolated transcription factor, BF2, which is also essential for kidney development, but through a distinct mechanism. Remarkably, BF2 is expressed only in stromal cells of the fetal kidney, yet its inactivation in the mouse suppresses epithelial differentiation without affecting stromal cells themselves. Using inducible
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Kidney Cancer
expression of BF2 and expression profile analysis, we have identified downstream targets, including secreted growth factors, whose contribution to renal differentiation and to stromal-epithelial interactions will be explored. Taken together, this proposal aims at identifying downstream targets of two transcription factors that are essential to kidney development, defining the mechanism by which these targets are regulated, and studying their potential contribution to Wilms tumorigenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETIC AND MOLECULAR CHARACTERIZATION OF KIDNEY CANCER Principal Investigator & Institution: Pantuck, Allan J.; Urology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 23-SEP-2002; Project End 31-AUG-2006 Summary: (provided by applicant): Financial support and protected time is requested to support a career development program comprised of mentored clinical research and formal course work leading to a Masters in Clinical Research from a Graduate Training Program in Translational Investigation (K30). The long-term career objective of this grant application is to become a successful, independent clinical investigator in urological oncology focussing on patient-oriented research, ultimately leading to a tenured faculty position. The proposed research project will serve as a tool from which to gain mentored research experience. The overall goal of the proposed research is to combine the extensive clinical and experimental resources in kidney cancer at UCLA School of Medicine to identify the genetic and molecular signature of response to immunotherapy for patients with metastatic renal cell carcinoma (RCC). Although some aspects of the molecular genetics of RCC have begun to be appreciated, little is known about the genes and proteins underlying its unpredictable clinical course and whether or not an individual patient will or will not respond to immunotherapy. The resources at UCLA provide a unique opportunity to take advantage of new genome wide discovery tools (e.g., expression arrays, genomic databases) which will provide new strategies to tackle tumor classification and tumor biology. The combination of a strong clinical database, mRNA expression array studies from fresh tumor samples, comparative genomics and gene sequencing, and large archived tissue sample resources organized in a tissue array format may provide new tools to uncover novel aspects of RCC biology. I propose to use chromosomal analysis (aim 1), VHL mutation analysis (aim 2), as well as molecular profiling of global gene expression patterns (aim 3) to identify genetic and molecular markers for kidney cancer progression, metastasis, and response to immunotherapy. Lastly, human tissue arrays and an extensive clinical database will be used to externally validate the experimental markers (aim 4). Ultimately, this proposal is a platform from which I seek training to further a career in cancer research at the clinical/translational interface of oncologic care with a special interest in gene and immune-based therapies for renal cell carcinoma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: APPROACH
GENETICS
OF
CANCER
SUSCEPTIBILITY--MULTISYSTEM
Principal Investigator & Institution: Ostrander, Elaine A.; Member; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109 Timing: Fiscal Year 2002; Project Start 01-JUL-2001; Project End 30-JUN-2006
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Summary: (provided by applicant): We are interested in the identification and analysis of genes which increase susceptibility to cancer and are taking a three-pronged approach to addressing the problem. We have used linkage analysis to look for highlypenetrant Plostate cancer susceptibility loci by performing a ganomc-wide scan in 266 high-riskI prostate cancer families, preliminary results from this scan implicate multiple lociof interest, and ongoing efforts focus on fine mapping of the regions identified and positional cloning of the affected genes. We have used population-based case/control studies to determine the role played in sporadic breast cancer of mutations in the highly-penetrant genes BRCA1 and BRCA2. Work to date has focused on a population of women in Western Washington State, and ongoing efforts center around 2 much larger studies, 1 in the U.S. and 1 in Shanghai, China, and also on understanding the effects of non-genetic factors on panetrance of BRCA1 and 2 mutations. Our human work has underscored the difficulties of studying a genetically complex disease in human families. We have therefore developed the domestic dog as a uniquely powerful system for advancing cancer genetics, taking advantage of both the large family size as well as the closed breeding populations (breeds) that characterize purebred dogs. To date, we have developed a map of the dog genome and demonstrated the utility of the canine system for simplifying the locus heterogeneity associated with mapping complex traits. In the process we have mapped several disease genes, including a kidney cancer locus, of interest to the human genetics community. The next key step is to integrate our throe approaches. Cloning prostate cancer susceptibility loci identified in high risk families and analysis of mutation frequency and distribution will allow us to determine the significance of these genes in the general population, much as we have done in our studies of breast cancer. Mapping and cloning of canine cancer loci will accelerate identification both of highly penetrant genes and of less penerrant genetic modifier loci, and will permit us to test the hypothesis that genes we identify in dogs are equally relevant in human disease, as suggested by a variety of prior studies. This K05 will provide the resources, and particularly the time, necessary to provide guidance and mentoring to students and postdocs in my lab as they pursue the new avenues of research that will achieve the integration of our efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOXIA VHL NAD HIF IN RENAL TUMOR DEVELOPMENT Principal Investigator & Institution: Haase, Volker H.; Medicine; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2009 Summary: (provided by applicant): Clear cell carcinoma of the kidney (RCC), the most common form of kidney cancer, is associated with the inactivation of the von HippeILindau (VHL) tumor suppressor. Mutations in the VHL gene can be found in approximately 70% of sporadic RCCs. One of the major functions of the VHL gene product, pVHL, is the targeting of the oxygen sensitive alpha-subunit of hypoxiainducible factor (HIF) for ubiquitination and subsequent proteasomal degradation. Inactivation of VHL is felt to be an early event during RCC tumorigenesis and results in constitutive expression of two major HIF isoforms, HIF-1 and HIF-2. This results in increased transcription of genes that regulate glycolysis, angiogenesis and erythropoiesis. HIF-1 has furthermore been shown to up-regulate factors that promote growth arrest and apoptosis. The role of increased HIF expression in VHL associated tumorigenesis remains controversial. The hypothesis that the ratio of HIF-1 to HIF-2 levels is important for VHL associated renal tumor development will be investigated. Conditional gene targeting technology based on Cre-loxP mediated recombination as
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well as targeted transgenesis will be used to manipulate the expression levels of both pVHL and HIF in vivo and in vitro. This system enables the study of the functional relationship between VHL deficiency and HIF activation in regard to renal cell growth and viability in primary renal epithelial cells of different histogenetic origin. Specifically, the proposed investigations will examine the effects of increased or absent HIF-1 and increased HIF-2 expression in VHL deficient and wild type backgrounds. Studies will be performed in primary cell culture and in vivo with kidney specific conditional knock out mice. Gene expression studies will provide information regarding differential HIF-1 and HIF-2 target gene expression in different nephron segments with a special emphasis on genes involved in the regulation of cell survival. Taken all together, the proposed in vivo and in vitro studies will not only provide novel insights into the early events of renal oncogenesis and the histogenetic origin of RCC, but also examine fundamental aspects of HIF-1 and HIF-2 function in different nephron segments. Ultimately they have the potential to create a murine model of VHL associated renal tumors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPACT OF ARSENIC ON MORTALITY IN CHILE FROM 1950-2000 Principal Investigator & Institution: Smith, Allan H.; Professor; Environmental Health Sciences; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2002; Project Start 15-AUG-2000; Project End 31-JUL-2004 Summary: (Adapted from applicant's abstract): The purpose of the proposed study is to investigate mortality in Region 11 of Chile from 1950 to 2000. This' region, currently with a population of close to a half million people, experienced a peak exposure to arsenic with a population-weighted average drinking water concentration of 580 micrograms/L, from 1955 to 1970. In contrast, water supplies for the rest of the country mostly contained less than 10 4g/L. Following the installation of arsenic treatment plants, concentrations have gradually been reduced, so that by 1990 the average was less than 50 @ig/l-, the current drinking water standard in much of the world. An investigation of mortality in Region 11 during 1989-1993 indicated that rates for bladder, skin, lung, and kidney cancer were increased compared to the rest of Chile. Bladder cancer mortality was markedly elevated [men, SMR = 6.0, 95 percent confidence interval (CI), 4.8-7.4; women, SMR = 8.2, 95 percent CI, 6.3-10.5] as was lung cancer mortality [men, SMR = 3.8, 95 percent CI, 3.5-4.1; women, SMR = 3.1, 95 percent CI, 2.7-3.7]. It was estimated that arsenic might account for 7 percent of all deaths among those aged 30 years and over. If so, the impact of arsenic on the population mortality in Region 11 of Chile would be greater than that reported anywhere to date from environmental exposure to a carcinogen in a major population. Moreover, the impact may have been even greater in previous years, particularly from arsenic-caused diseases with shorter latencies than cancer. The proposed study will therefore collect and analyze 0 available measurements of arsenic in water, and investigate all causes of mortality from 1950 to 2000, in Region 11. As well as cancer, increased mortality might be expected from noncancer outcomes including cardiovascular, peripheral vascular and cerebrovascular diseases. The impact of arsenic exposure during childhood on pulmonary disease mortality in young adults, and on childhood cancer mortality, will also be assessed. This study will provide a unique opportunity to investigate arsenic-caused mortality, including latency patterns, in one of the world's most significant environmental toxic exposures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMPACT OF RENOX ON HIF-ALPHA IN RENAL CANCER Principal Investigator & Institution: Maranchie, Jodi; Surgery; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Renal cell carcinoma (RCC) takes 12,000 American lives each year. Existing systemic therapies are curative in fewer than 10% of patients, and targeted therapeutic approaches are needed. Loss of the von Hippel Lindau (VHL) tumor suppressor is an early event in the development of most clear cell RCC, and preliminary studies have indicated that a critical function of VHL is ubiquitin-mediated degradation of hypoxia inducible factor alpha (HIF-alpha). HIF-alpha stability and transactivation are regulated by hypoxia and redox signaling by two independent mechanisms that involve binding of VHL and the transcriptional co-activator CBP/p300. A novel kidney-specific, superoxide-producing NAD(P)H oxidase, Renox, was recently described and implicated in oxygen sensing for maintenance of oxygen homeostasis via secretion of erythropoeitin. This exclusive renal function is known to require HIF transcriptional activation. The hypothesis of this proposal is that Renoxmediated accumulation of reactive oxygen species (ROS) within the renal cell influences activation of HIF-( leading to malignant transformation in the absence of functional VHL. There are three major aims of this work. The first is to determine the effect of Renox and ROS upon HIF-alpha regulation and activity. A second aim is to determine the effect of redox signaling upon HIF-alpha post-translational modification. The final aim is to specifically inhibit Renox function to determine its effects on the tumorigenic phenotype of renal cell carcinoma. Although this work is of high relevance to renal carcinogenesis, its has broader implications in the areas of renal microenvironment, oxidative stress in disease states, and general renal physiology. The candidate is a urologist with expertise in the area of molecular genetics of kidney cancer. She recently completed a research fellowship in urologic oncology at the National Cancer Institute. The candidate seeks to establish a career as an independent physician-scientist in an academic setting where 75% of her time is devoted to the laboratory and 25% to teaching and.clinical work. This will be achieved by a comprehensive program to acquire both technical and intellectual skills under the guidance of two distinguished and outstanding mentors, Shuk Mei Ho and Gary Stein, and to draw upon the scientific strengths of a number of investigators within the UMass Medical School community. This will provide an excellent environment for completion of this project and a basis for transition to independent investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISM OF CHAPERONE-MEDIATED TUMOR REJECTION Principal Investigator & Institution: Nicchitta, Christopher V.; Professor; Cell Biology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2009 Summary: (provided by applicant): Vaccination with tumor-derived GRP94/gp96, the endoplasmic reticulum Hsp90 molecular chaperone, can elicit suppression of tumor growth and metastasis. The substantial therapeutic efficacy of GRP94/gp96 in prophylactic and therapeutic vaccination of mice has prompted its clinical evaluation as an immunotherapeutic for treatment of cancer in humans. Currently, GRP94/gp96 is undergoing Phase III trials for kidney cancer and melanoma. Although GRP94/gp96 has generated substantial interest as a novel immunotherapeutic, its mechanism of action remains unknown. The broad, long-term objective of the proposed research is to
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identify the mechanism of GRP94/gp96-mediated anti-tumor immune responses. This objective will be accomplished in the following specific aims: 1. Define the immunological basis for a gp96-secreting, cell-based tumor vaccine strategy; 2. Determine the role of gp96 and gp96 NTD in the regulation of innate immune responses. 3. Examine the role of gp96 and gp96 NTD in early immune modulation of retrovirusinduced disease. 4. Identify the effector cells and effector cell receptor(s) functioning in gp96/gp96NTD recognition and cell activation. The proposed studies will utilize a recently developed novel immunization strategy wherein animals are vaccinated with cells expressing a secretory form of GRP94/gp96. Using this experimental approach, we have demonstrated that GRP94/gp96-mediated tumor rejection is independent of the tissue of origin and thusGRP94/gp96-elicited anti-tumor immune responses can be elicited using GRP94/gp96 of non-tumor origin. Given the absence of tumor-restriction identified in these experiments, we hypothesize that GRP94/gp96functions through activation of innate immune responses. Such responses are a necessary prerequisite to robust anti-cancer adaptive immune responses. In executing the Specific Aims presented above, we will define the efficacy of the gp96-secreting, cell-based tumor vaccine strategy in multiple tumor models, using prophylactic and therapeutic immunization strategies. Detailed studies of the interactions of GRP94/gp96 with effector cells of the innate immune system will be performed. These studies will emphasize in vivo models and analyses of in vivo cellular responses. To better define the mechanism of GRP94/gp96 interaction with the innate immune system, we propose to extend analyses to the study of retrovirus-induced disease, in a neonate model, and to identification of signaling pathways accessed by GRP94/gp96. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS IN WILMS TUMORIGENESIS Principal Investigator & Institution: Williams, Bryan R G.; Professor and Chairman; Cleveland Clinic Foundation 9500 Euclid Ave Cleveland, Oh 44195 Timing: Fiscal Year 2002; Project Start 23-AUG-2001; Project End 30-JUN-2004 Summary: Wilms tumor is an embryonal kidney cancer of children that has been linked to molecular genetic abnormalities on the short arm of chromosome 11. This tumor is associated with anomalies in the urogenitary system and a shared genetic origin has become evident from the cloning and characterization of the WT1 locus by ourselves and others. WT1 is restricted in expression to the condensing metanephric mesenchyme or developing glomeruli. Thus it must respond to induction signals following interaction of the metanephric mesenchyme and the epithelial ureteric bud and likely regulate the expression of other genes involved in differentiation and morphogenesis. The long term objective of this project is to determine how the WT1 regulates this process by identifying WT1-target genes and defining their role in nephrogenesis and tumorigenesis. These objectives will be achieved by pursuing the following specific aims. To test the hypothesis that WT1 both activates and represses target genes to regulate nephrogenesis in Aim one we will characterize genes identified as potential WT1 targets from GeneChip analyses by studying their promoters, examining their expression in Wilms tumors and during nephrogenesis in vitro and in vivo. In aim two we will use chromatin precipitation to identify genes that are direct transcriptional targets for WT1. In aim three we will modulate WT1 and p53 expression in a Wilms tumor cell line and determine effects on transcript profiles. We will also develop kidney specific cDNA arrays and methods for specifically ablating selective transcripts. The proposed studies promise to provide new insights into the role of WT1 as a
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transcriptional regulator and to lead to the identification of novel genes involved in nephrogenesis and Wilms tumorigenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MODULATION OF PROSTAGLANDINS BY ARSENIC Principal Investigator & Institution: Vaillancourt, Richard R.; Associate Professor; Pharmacology and Toxicology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 10-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant) Arsenic (As) is an inorganic environmental contaminant of major concern due to its ubiquitous presence. Chronic exposure to arsenic frequently results in peripheral vascular disease, as well as skin, lung, bladder, and kidney cancer. Recent evidence demonstrates that arsenite stimulates cyclooxygenase (COX-II) expression suggesting that arsenite affects prostaglandin synthesis. The investigator's published studies with arsenic have demonstrated that the serine/threonine kinase, MEKK4, is involved in arsenic signal transduction. To further understand the molecular mechanism by which arsenic causes its deleterious effects and how the activity of MEKK4 contributes to arsenic toxicity, efforts by the investigators have focused on characterizing the activity of MEKK4 in vascular smooth muscle cells since it appears to function upstream of COX-II. The hvpothesis of this proposal is that the prostaglandin biosynthetic pathway is regulated by MEKK4 and that arsenic affects the vascular system by modulating prostaglandin homeostasis through MEKK4. The Specific Aims are to: 1. To identify and characterize tyrosine phosphorylation of MEKK4. Our data indicate that Pyk2 phosphorylates MEKK4. This site is not known and will be identified by LC-MS. Then, the site will be mutated and MEKK4 catalytic activity will be characterized to assess the significance of the phosphorylation site. 2. To characterize the mechanism by which SHP-2 interacts with MEKK4 and how arsenite inhibits SHP-2 activity. SHP-2 associates with MEKK4 in a stimulus-dependent manner. Intracellular calcium promotes dephosphorylation of MEKK4, while arsenite inhibits the tyrosine dephosphorylation of MEKK4. 3. To identify and characterize the MEKK4 substrate. Candidate proteins include members of the MAP kinase family or novel proteins that will be identified using a modification of the "tethered" MEKK4 approach and LC-MS. It is possible that MEKK4 phosphorylates and regulates cytosolic phospholipase A2 (cPLA2), a key enzyme involved in prostaglandin biosynthesis that is regulated by phosphorylation. 4. To characterize the mechanism by which MEKK4 regulates prostaglandin synthesis. The kinase-inactive mutant of MEKK4 functions as a dominant-negative protein, and the investigators have shown that expression of this protein inhibits transcription of a Cox-II promoter/luciferase chimeric plasmid. This result suggests that endogenous MEKK4 functions upstream of pathways that regulate prostaglandin synthesis. The proposed research will provide a further understanding of the importance of the arsenic-induced signaling processes and how it adversely affects the peripheral vascular system and promotes tissue injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MODULATION OF RETINOIC ACID ACTION IN RENAL CANCER Principal Investigator & Institution: Nanus, David M.; Associate Professor; Medicine; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 03-AUG-2001; Project End 31-JUL-2006
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Summary: (Provided by applicant) Renal cell carcinoma is the most common primary cancer arising from the kidney in adults, and is a frequent cause of cancer morbidity and mortality in the U.S., with over 12,000 deaths per year. Currently, there are no consistently effective chemotherapeutic or biologic treatment modalities for patients with advanced disease. Recent results of clinical trials in patients with advanced renal cancer (RC), and of pre-clinical studies using cell culture and human RC tissue specimens, suggest that natural and synthetic derivatives of vitamin A (retinol), a group of compounds called retinoids, play a role in the therapy of RC. We have preliminary data that intracellular levels of retinoic acid (RA) are significantly diminished in human RC cells and that retinol metabolism is aberrant in RC cells as compared to normal human kidney proximal tubule cells. Furthermore, our data indicate that combining retinoids with agents which augment retinoid actions, such as IFN (IFN) or histone deacetylase (HDAC) inhibitors, significantly increases the anti-tumor effect of RA. In this grant application, we propose to study the effects of modulating retinoid anti-tumor action by combining RA with other therapies. The specific aims are: 1) to perform a series of Phase I-II clinical trials designed to evaluate the safety and efficacy of combining liposomal all trans RA (ATRA) with modulators of RA such as interferon and HDAC inhibitors in patients with metastatic RC; 2) to collect peripheral blood samples and tumor tissues to allow laboratory analysis in order to monitor the presence and magnitude of specific therapies on retinoid metabolites and retinoid related genes; and 3) to analyze modulators of RA such as interferon and HDAC inhibitors at a molecular level in RC cell lines and xenograft models to delineate mechanisms of action, and to use this information to design strategies to test specific drugs in combination with RA in preparation for future clinical trials. These aims will allow us to perform clinical trials and laboratory studies aimed at gaining a better understanding of the involvement of retinoids in the development, progression and therapy of RC. Moreover, the experiments proposed in this application will help to clarify the potential use of retinoids as a therapeutic strategy to treat patients with RC, and may lead to the identification of new therapeutic agents which result in increased retinol actions for the treatment of various stages of renal cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR EFFECTS OF LOW LEVEL EXPOSURE TO ARSENIC Principal Investigator & Institution: Gandolfi, a J.; Asst. Dean of Research; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002 Summary: Arsenic (As) is an inorganic environmental contaminant of major concern in the desert Southwest due to its ubiquitous presence and its occurrence in drinking waters due to wells penetrating arsenic layers in the earth along with standards under consideration. Chronic exposure to arsenic frequently results in skin, lung, bladder, and kidney cancer. The hypothesis of this proposal is that inorganic arsenicals regulate specific genes and therefore specific proteins, and it target tissues are being studied to demonstrate the uniformity or specificity of the signaling and gene responses to arsenic exposure. These investigations will only utilize low level arsenic exposures to more closely mimic to the concentrations observed from environmental exposures and to better reflect the current proposal of lowering the drinking water standard from its current 50 ppb level. To address our hypothesis , we propose 4 independent and nonoverlapping specific aims. 1.) Identify proteins that associate with a serine/threonine kinase involved in arsenic signaling. 2.) Characterize the activity of proteins that are regulated by arsenic and correlate protein activity with cellular toxicity. Once a specific
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protein involved in arsenic signal transduction is identified, we need to determine how arsenic affects the activity of that protein and whether the activity of that protein correlates with cytotoxicity. 3) Identify specific genes whose expression pattern changes after low level exposure to inorganic arsenic. We have already shown that nanomolar levels of arsenate and arsenite increase the binding of specific transcription factors and induce gene expression in renal tissue. Acute, repeated, and chronic exposures of arsenic will be investigated and differential expression of specific genes is predicted. 4) Examine the expression of key genes induced by inorganic arsenic exposure and correlate gene expression with cellular injury. Specific gene expression by the chemical species of arsenic will be correlated with the subsequent response of the target cells to the toxicant. If there is any production of proteins or other biochemical markers that are the result of the specific genes induced, these genes and proteins may potentially serve as early indicators of biomarkers for low-level exposure of this tissue to arsenic. The study of these two tissues will provide a further understanding of the importance of the arsenicinduced signaling processes and gene expression that are responsible for tissue injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF THE TUMOR SUPPRESSOR PTEN Principal Investigator & Institution: Mustelin, Tomas M.; Professor; Burnham Institute 10901 N Torrey Pines Rd La Jolla, Ca 920371005 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2006 Summary: (provided by applicant): Malignant transformation and tumor progression are frequently accompanied by the loss of genes with antitumor activity. One such tumor suppressor gene, PTEN, is located on chromosome 10 at q22-23, a locus that is altered in almost half of all endometrial cancers, in a third of glioblastomas, and in a wide range of other human neoplasms, such as prostate, brain, breast, kidney cancers, and leukemias. In addition, PTEN is mutated in three human inherited cancerpredisposing syndromes. Thus, PTEN appears to play an important role in a pathway the loss of which sensitizes cells to malignant transformation. It has recently become clear that the PTEN protein is a specific phosphatidylinositol 3-phosphatase (PI3Pase) that directly counteracts the versatile effects of phosphatidylinositol 3-kinase (PI3K) in cell growth, survival, motility, cytoskeletal architecture and differentiation. The regulation of PTEN is currently poorly known. This grant will address a novel hypothesis for the regulation of the biological function of PTEN. Specific aim 1 (Transcriptional regulation of PTEN) represents the continuation of our recent finding that the transcription of the PTEN gene is regulated by the Egr-1 transcription factor. Egr-1 is also a tumor suppressor and mediates the upregulation of PTEN in response to UV and g-irradiation and other proapoptotic stimuli. Our work will address our hypothesis that PTEN transcription is influenced by D3-phosphoinositides (the substrates for PTEN) as part of a feedback loop that may include Egr-1 and/or other Egr family members, particularly in lymphoid cells and tumors. The scenarios present in tumors will be addressed. Specific aim 2 (Post-translational regulation of PTEN) will explore a similar model for the regulation of PTEN degradation. Our hypothesis predicts that D3-phosphoinositides influence the turnover of PTEN by a mechanism that involves phosphorylation at S380 (plus adjacent sites), which protects the protein from degradation. We will study this mechanism, identify the responsible kinase (could well be PKB), and the route of proteolysis. We will also evaluate the effects of S380 phosphorylation on other aspects of PTEN function. Taken together, our results are expected to improve our understanding of the molecular mechanisms by which PTEN participates in carcinogenesis and may open new avenues for rational drug design. The
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possible crosstalk between two pathways of programmed cell death (PTEN and Egr-1) may be highly relevant for the understanding and eventual treatment of a large number of human cancers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RENAL ENVIRONMENTAL RISK
CANCER
GENOMIC
ALTERATIONS
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Principal Investigator & Institution: Waldman, Frederic M.; Professor; Laboratory Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-MAY-2008 Summary: (provided by applicant): A number of environmental, occupational and life style factors have been associated with renal cell cancer (RCC) incidence. However, the mechanism by which these risk factors cause RCC, presumably acting through alteration of specific genes, is unknown. We hypothesize that specific genomic alterations detected in renal cancers (DNA gain or loss) are associated with renal cancer risk factors. We propose to analyze associations between risk factors and genomic alterations in renal tumors collected as part of the Eastern European Renal Cell Cancer Study (EERCC), being carried out by the National Cancer Institute and the International Association for Research on Cancer (IARC). We hypothesize that specific qenomic alterations in renal cancers (DNA gain or loss) are associated with renal cancer risk factors and with tumor proqression. Our Aims are: The overall design of this study is to characterize over 700 renal tumors by array CGH to define genomic alterations and their associations with clinical variables, and with exposure, and genetic risk factors. 1. Identify genomic alterations associated with tumor stage in conventional (clear cell) renal cancer. Array based CGH will be used to define copy number gains and losses, including DNA amplifications and homozygous deletions, in DNA from 200 conventional RCC grouped according to stage (I-IV). 2. Identify associations of genomic alterations with statistically significant exposure, occupational, and genetic risk factors defined using this IARC case-control cohort of renal cancer patients. 500 additional tumors will be characterized by array CGH beyond those studied in Aim 1. Patients will be selected based on their exposure history, to generate the most power for analysis (enriching for highest exposure groups). Risk factors to be considered include smoking, occupational, and environmental exposures (trichloroethylene, polycyclic aromatic hydrocarbons, petroleum products, asbestos, and heavy metals) and factors that alter renal function (obesity and hypertension). 3. Validate genes identified in Aims 1 and 2 using immunohistochemical analysis of renal tumor tissue microarrays containing the entire cohort of tumors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF BETA SUBUNIT OF SODIUM PUMP IN CELL ADHESION Principal Investigator & Institution: Rajasekaran, Ayyappan K.; Pathology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 15-APR-2001; Project End 31-MAR-2005 Summary: (Adapted from the investigator's abstract) The sodium pump (Na,K-ATPase), a heterodimer consisting of an a- and a 13-subunit, plays a central role in kidney functions. We showed that the b-subunit of this enzyme was drastically reduced in the most common and aggressive form of kidney cancer, the clear-cell renal cell carcinoma. We now provide evidences that the 13-subunit of Na,K-ATPase play a key role in the
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cell adhesion mechanisms leading to the polarization of kidney epithelial cells and suppression of invasion and motility of carcinoma cells. E-cadherin is a cell adhesion molecule implicated in cell adhesion, maintenance of the polarized epithelial phenotype, and invasion suppression of carcinoma cells. Over-expression of E-cadherin in Moloney Sarcoma Virus-transformed Madin-Darby Canine Kidney (MSV-MDCK) cells did not alter their fibroblast-like phenotype and invasiveness. However, co-expression of the 13subunit of Na,K-ATPase and E-cadherin in MSV-MDCK cells resulted in the reversion of the fibroblast-like phenotype to a well-differentiated epithelial phenotype including formation of tight junctions and loss of invasiveness. These studies strongly indicate that E-cadherins' cell adhesion function alone is not sufficient to regulate polarity and invasion suppression of kidney epithelial cells and that the 13-subunit of Na,K-ATPase play a crucial role in these functions. In this proposal, we shall test the hypothesis that like E-cadherin, the b-subunit of Na,K-ATPase functions as a cell adhesion molecule to regulate epithelial polarity and to suppress invasion and motility of carcinoma cells. We shall assess whether b-subunit expression in renal clear-cell carcinoma cell lines reduces their invasiveness and tumorigenicity by both in vitro and in vivo assays. These studies will ultimately elucidate novel roles of the b-subunit of Na,K-ATPase in normal and disease states. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VHL, JADE-1 AND PROTEIN STABILITY IN RENAL CANCER Principal Investigator & Institution: Cohen, Herbert Tod.; Boston Medical Center Gambro Bldg, 2Nd Fl, 660 Harrison Ave, Ste a Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 01-APR-1999; Project End 30-JUN-2008 Summary: Revised Abstract: Renal cancer is a devastating malignancy that is highly resistant to medical therapy. The VHL tumor suppressor is mutated in most adult renal cancers. Yet, the mechanism of VHL tumor suppression is not known. Using a directed approach to find VHL-interacting proteins important in renal cancer, our laboratory has identified Jade-1 (gene for Apoptosis and Differentiation in Epithelia) as a particularly strong VHL interactor. Jade-1, a novel,kidney-enriched, PEST and plant homeodomain protein, is a member of a new protein family. VHL stabilizes Jade-1 protein, which is a new VHL function. Moreover, we have now shown that Jade-1 stabilization is VHL mutation-dependent, with non-renal cancer-causing VHL missense mutations able to stabilize Jade-1 like wild-type VHL. Jade-1 stabilization is therefore the first VHL activity to show substantial correlation with renal cancer risk, suggesting it has a disease relationship. Moreover, stabilization of Jade-1 by VHL is highly specific, as it has not been observed with known or potential VHL partners. We have established convincing evidence of the VHL-Jade-1 relationship's authenticity as well as Jade-1's compelling biological significance. We propose the following Aims: 1. The VHL-Jade-1 protein-protein interaction, and Jade-1 expression in renal cancer tissue 2. VHLdependent Jade-1 stabilization and modification 3. Examination of the role of Jade-1 in apoptosis and modulation by VHL Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “kidney cancer” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for kidney cancer in the PubMed Central database: •
Carbonic anhydrase inhibitor suppresses invasion of renal cancer cells in vitro. by Parkkila S, Rajaniemi H, Parkkila AK, Kivela J, Waheed A, Pastorekova S, Pastorek J, Sly WS.; 2000 Feb 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=15781
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Cell surface antigens of human renal cancer defined by mouse monoclonal antibodies: identification of tissue-specific kidney glycoproteins. by Ueda R, Ogata S, Morrissey DM, Finstad CL, Szkudlarek J, Whitmore WF, Oettgen HF, Lloyd KO, Old LJ.; 1981 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=320345
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Comparison of [3H]glucosamine-labeled glycoproteins from human renal cancer and normal kidney epithelial cell cultures by two-dimensional polyacrylamide gel electrophoresis. by Ogata S, Ueda R, Lloyd KO.; 1981 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=319884
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Genetic mapping of a naturally occurring hereditary renal cancer syndrome in dogs. by Jonasdottir TJ, Mellersh CS, Moe L, Heggebo R, Gamlem H, Ostrander EA, Lingaas F.; 2000 Apr 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=18172
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Immunohistochemical Detection of JC Virus in Nontumorous Renal Tissue of a Patient with Renal Cancer but without Progressive Multifocal Leukoencephalopathy. by Aoki N, Kitamura T, Tominaga T, Fukumori N, Sakamoto Y, Kato K, Mori M.; 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=88666
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Predicting survival in patients with metastatic kidney cancer by gene-expression profiling in the primary tumor. by Vasselli JR, Shih JH, Iyengar SR, Maranchie J, Riss J, Worrell R, Torres-Cabala C, Tabios R, Mariotti A, Stearman R, Merino M, Walther MM, Simon R, Klausner RD, Linehan WM.; 2003 Jun 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=165812
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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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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 kidney cancer, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “kidney cancer” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for kidney cancer (hyperlinks lead to article summaries): •
A 39-year follow-up of the U.K. oil refinery and distribution center studies: results for kidney cancer and leukemia. Author(s): Rushton L. Source: Environmental Health Perspectives. 1993 December; 101 Suppl 6: 77-84. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8020451
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A nested case-control study of kidney cancer among refinery/petrochemical workers. Author(s): Gamble JF, Pearlman ED, Nicolich MJ. Source: Environmental Health Perspectives. 1996 June; 104(6): 642-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8793353
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A phase II trial of weekly intravenous ranpirnase (Onconase), a novel ribonuclease in patients with metastatic kidney cancer. Author(s): Vogelzang NJ, Aklilu M, Stadler WM, Dumas MC, Mikulski SM. Source: Investigational New Drugs. 2001; 19(3): 255-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11561684
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Are deaths from liver cancer, kidney cancer, and leukemia clustered in San Antonio? Author(s): Zhan FB. Source: Tex Med. 2002 October; 98(10): 51-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12391737
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Are lumpectomies for kidney cancer shifting towards acceptance? Author(s): McCann J. Source: Journal of the National Cancer Institute. 1998 October 7; 90(19): 1426-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9776406
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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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Arsenic concentrations in well water and risk of bladder and kidney cancer in Finland. Author(s): Kurttio P, Pukkala E, Kahelin H, Auvinen A, Pekkanen J. Source: Environmental Health Perspectives. 1999 September; 107(9): 705-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10464069
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Asbestos and kidney cancer: the evidence supports a causal association. Author(s): Smith AH, Shearn VI, Wood R. Source: American Journal of Industrial Medicine. 1989; 16(2): 159-66. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2672801
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Attributable risks for kidney cancer in northern Italy. Author(s): Tavani A, Pregnolato A, Violante A, La Vecchia C, Negri E. Source: European Journal of Cancer Prevention : the Official Journal of the European Cancer Prevention Organisation (Ecp). 1997 April; 6(2): 195-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9237070
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Bladder and kidney cancer following cyclophosphamide therapy for non-Hodgkin's lymphoma. Author(s): Travis LB, Curtis RE, Glimelius B, Holowaty EJ, Van Leeuwen FE, Lynch CF, Hagenbeek A, Stovall M, Banks PM, Adami J, et al. Source: Journal of the National Cancer Institute. 1995 April 5; 87(7): 524-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7707439
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CXCR4/CXCL12 expression and signalling in kidney cancer. Author(s): Schrader AJ, Lechner O, Templin M, Dittmar KE, Machtens S, Mengel M, Probst-Kepper M, Franzke A, Wollensak T, Gatzlaff P, Atzpodien J, Buer J, Lauber J. Source: British Journal of Cancer. 2002 April 22; 86(8): 1250-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11953881
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Editorial: Kidney cancer--a unique opportunity for the development of disease specific therapy. Author(s): Linehan WM. Source: The Journal of Urology. 2002 December; 168(6): 2411-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12441928
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Effects of high-energy shock waves combined with biological response modifiers in different human kidney cancer xenografts. Author(s): Oosterhof GO, Smits GA, de Ruyter AE, Schalken JA, Debruyne FM. Source: Ultrasound in Medicine & Biology. 1991; 17(4): 391-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1949350
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Effects of high-energy shock waves combined with biological response modifiers or Adriamycin on a human kidney cancer xenograft. Author(s): Oosterhof GO, Smiths GA, deRuyter JE, Schalken JA, Debruyne FM. Source: Urological Research. 1990; 18(6): 419-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2100419
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Epidemiologic evidence for an association between gasoline and kidney cancer. Author(s): Enterline PE, Viren J. Source: Environmental Health Perspectives. 1985 October; 62: 303-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4085434
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Epidemiology of kidney cancer in Australia. Author(s): McCredie M. Source: The Medical Journal of Australia. 1992 October 19; 157(8): 508-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1479966
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Epidemiology of kidney cancer in Oklahoma. Author(s): Asal NR, Ferguson SW. Source: J Okla State Med Assoc. 1974 February; 67(2): 40-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4820105
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Epidemiology of kidney cancer. Author(s): Dayal H, Kinman J. Source: Seminars in Oncology. 1983 December; 10(4): 366-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6320449
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Evaluation of dietary, medical and lifestyle risk factors for incident kidney cancer in postmenopausal women. Author(s): Nicodemus KK, Sweeney C, Folsom AR. Source: International Journal of Cancer. Journal International Du Cancer. 2004 January 1; 108(1): 115-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14618625
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Evaluation of organ sparing operation results from planned indications in patients with kidney cancer. Author(s): Fryczkowski M, Potyka A, Huk J. Source: International Urology and Nephrology. 2001; 32(4): 621-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11989552
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Evaluation of organ sparing surgery results in patients with kidney cancer in scheduled operations. Author(s): Fryczkowski M, Potyka A, Huk J. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2000 November-December; 6(6): 1098-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11208462
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Expression of NAD(P)H:quinone oxidoreductase and glutathione S-transferases alpha and pi in human renal cell carcinoma and in kidney cancer-derived cell lines. Author(s): Eickelmann P, Ebert T, Warskulat U, Schulz WA, Sies H. Source: Carcinogenesis. 1994 February; 15(2): 219-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8313512
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Expression of the plasminogen activation system in kidney cancer correlates with its aggressive phenotype. Author(s): Swiercz R, Wolfe JD, Zaher A, Jankun J. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 1998 April; 4(4): 869-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9563880
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Gasoline exposure, smoking, and kidney cancer. Author(s): Domiano SF, Vena JE, Swanson MK. Source: J Occup Med. 1985 June; 27(6): 398-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4020495
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Germline and somatic mutations in von Hippel-Lindau disease gene and its significance in the development of kidney cancer. Author(s): Shuin T, Kondo K, Ashida S, Okuda H, Yoshida M, Kanno H, Yao M. Source: Contrib Nephrol. 1999; 128: 1-10. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10597373
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Global increases in kidney cancer incidence, 1973-1992. Author(s): Mathew A, Devesa SS, Fraumeni JF Jr, Chow WH. Source: European Journal of Cancer Prevention : the Official Journal of the European Cancer Prevention Organisation (Ecp). 2002 April; 11(2): 171-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11984136
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Health related quality of life outcomes in patients treated for metastatic kidney cancer: a pilot study. Author(s): Litwin MS, Fine JT, Dorey F, Figlin RA, Belldegrun AS. Source: The Journal of Urology. 1997 May; 157(5): 1608-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9112487
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Hereditary kidney cancer. Author(s): Hwang JJ, Uchio EM, Linehan WM, Walther MM. Source: The Urologic Clinics of North America. 2003 November; 30(4): 831-42. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14680318
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Immune gene therapy for kidney cancer: the search for a magic trigger. Author(s): Kim HL, Belldegrun AS, Figlin RA. Source: Molecular Therapy : the Journal of the American Society of Gene Therapy. 2003 February; 7(2): 153-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12597902
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Immunotherapy of metastatic kidney cancer. Author(s): Pizza G, De Vinci C, Lo Conte G, Maver P, Dragoni E, Aiello E, Fornarola V, Bergami T, Busutti L, Boriani S, Palareti A, Capanna R. Source: International Journal of Cancer. Journal International Du Cancer. 2001 October 1; 94(1): 109-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11668485
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Increased levels of fibroblast growth factor-like activity in urine from patients with bladder or kidney cancer. Author(s): Chodak GW, Hospelhorn V, Judge SM, Mayforth R, Koeppen H, Sasse J. Source: Cancer Research. 1988 April 15; 48(8): 2083-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3349479
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Increasing incidence of all stages of kidney cancer in the last 2 decades in the United States: an analysis of surveillance, epidemiology and end results program data. Author(s): Hock LM, Lynch J, Balaji KC. Source: The Journal of Urology. 2002 January; 167(1): 57-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11743275
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Influence of tumor site on the therapy of murine kidney cancer. Author(s): Chakrabarty A, Hillman GG, Maughan RL, Visscher DW, Ali E, Pontes JE, Haas GP. Source: Anticancer Res. 1994 March-April; 14(2A): 373-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8017836
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Interferon and kidney cancer: a promise unfulfilled? Author(s): Naitoh J, Belldegrun AS. Source: Cancer J Sci Am. 1998 May-June; 4(3): 155-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9612594
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Intrinsic drug resistance in human kidney cancer is associated with expression of a human multidrug-resistance gene. Author(s): Fojo AT, Shen DW, Mickley LA, Pastan I, Gottesman MM. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1987 December; 5(12): 1922-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3681376
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Kidney cancer among leather workers. Author(s): Cartwright RA, Boyko RW. Source: Lancet. 1984 April 14; 1(8381): 850-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6143161
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Kidney cancer among leather workers. Author(s): Acheson ED, Pippard EC. Source: Lancet. 1984 March 10; 1(8376): 563. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6142275
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Kidney cancer among leather workers. Author(s): Malker HR, Malker BK, McLaughlin JK, Blot WJ. Source: Lancet. 1984 January 7; 1(8367): 56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6140388
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Kidney cancer and hydrocarbon exposures among petroleum refinery workers. Author(s): Poole C, Dreyer NA, Satterfield MH, Levin L, Rothman KJ. Source: Environmental Health Perspectives. 1993 December; 101 Suppl 6: 53-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8020449
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Kidney cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies. Author(s): Sali D, Boffetta P. Source: Cancer Causes & Control : Ccc. 2000 January; 11(1): 37-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10680728
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Kidney cancer in Canada: the rapidly increasing incidence of adenocarcinoma in adults and seniors. Author(s): Liu S, Semenciw R, Morrison H, Schanzer D, Mao Y. Source: Canadian Journal of Public Health. Revue Canadienne De Sante Publique. 1997 March-April; 88(2): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9170688
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Kidney cancer in the Swedish Family Cancer Database: familial risks and second primary malignancies. Author(s): Czene K, Hemminki K. Source: Kidney International. 2002 May; 61(5): 1806-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11967031
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Kidney cancer in utility workers exposed to polychlorinated biphenyls (PCBs) Author(s): Lees RE. Source: Br J Ind Med. 1990 May; 47(5): 358. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2113404
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Kidney cancer in utility workers exposed to polychlorinated biphenyls (PCBs) Author(s): Shalat SL, True LD, Fleming LE, Pace PE. Source: Br J Ind Med. 1989 November; 46(11): 823-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2511925
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Kidney cancer mortality in The Netherlands, 1950-94: prediction of a decreasing trend. Author(s): Kiemeney L, Van Berkel H, Witjes JA, Sonke GS, Debruyne FM, Straatman H. Source: Journal of Epidemiology and Biostatistics. 1999; 4(4): 303-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10764244
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Kidney cancer, leukemia, and liver cancer. Part 3. Author(s): Kemp C. Source: Am J Hosp Palliat Care. 1999 March-April; 16(2): 479-86. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10232125
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Kidney cancer. Author(s): Halperin EC. Source: Lancet. 1999 February 13; 353(9152): 594. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10029013
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Kidney cancer. Author(s): Vogelzang NJ, Stadler WM. Source: Lancet. 1998 November 21; 352(9141): 1691-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9853456
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Kidney cancer. Author(s): Libertino JA. Source: The Journal of Urology. 1996 February; 155(2): 466-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8558636
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Kidney cancer. An overview of the disease, treatment. Author(s): LaFollette SS. Source: Aorn Journal. 1992 July; 56(1): 31; 34-48. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1622196
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Kidney cancer: current management guidelines. Author(s): Lee F, Patel HR. Source: Hosp Med. 2002 April; 63(4): 214-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11995271
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Kidney cancer: the Cytokine Working Group experience (1986-2001): part I. IL-2-based clinical trials. Author(s): Atkins MB, Dutcher J, Weiss G, Margolin K, Clark J, Sosman J, Logan T, Aronson F, Mier J; Cytokine Working Group. Source: Medical Oncology (Northwood, London, England). 2001; 18(3): 197-207. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11917944
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Kidney cancer: the Cytokine Working Group experience (1986-2001): part II. Management of IL-2 toxicity and studies with other cytokines. Author(s): Dutcher J, Atkins MB, Margolin K, Weiss G, Clark J, Sosman J, Logan T, Aronson F, Mier J; Cytokine Working Group. Source: Medical Oncology (Northwood, London, England). 2001; 18(3): 209-19. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11917945
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Laparoscopic radical nephrectomy for advanced kidney cancer. Author(s): Pautler SE, Walther MM. Source: Curr Urol Rep. 2002 February; 3(1): 21-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12084215
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Letter: Metastatic kidney cancer treated with multiple drug therapy at the Rotterdam Radiotherapy Institute. Author(s): van der Werf-Messing B, Mulder J. Source: British Journal of Cancer. 1974 June; 29(6): 491-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4546853
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Local progression after operative treatment of metastatic kidney cancer. Author(s): Les KA, Nicholas RW, Rougraff B, Wurtz D, Vogelzang NJ, Simon MA, Peabody TD. Source: Clinical Orthopaedics and Related Research. 2001 September; (390): 206-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11550867
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Lung and kidney cancer mortality associated with arsenic in drinking water in Cordoba, Argentina. Author(s): Hopenhayn-Rich C, Biggs ML, Smith AH. Source: International Journal of Epidemiology. 1998 August; 27(4): 561-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9758107
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Management of disseminated kidney cancer. Author(s): Taneja SS, Pierce W, Figlin R, Belldegrun A. Source: The Urologic Clinics of North America. 1994 November; 21(4): 625-37. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7974894
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Mitochondrial targeting of human 8-oxoguanine DNA glycosylase hOGG1 is impaired by a somatic mutation found in kidney cancer. Author(s): Audebert M, Charbonnier JB, Boiteux S, Radicella JP. Source: Dna Repair. 2002 July 17; 1(7): 497-505. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12509224
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Modulation of IgG and complement receptor expression of phagocytes in kidney cancer patients during treatment with interferon-alpha. Author(s): Salminen E, Kankuri M, Nuutila J, Lilius EM, Pellimiemi TT. Source: Anticancer Res. 2001 May-June; 21(3B): 2049-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11497297
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Molecular targeting of VHL gene pathway in clear cell kidney cancer. Author(s): Linehan WM. Source: The Journal of Urology. 2003 August; 170(2 Pt 1): 593-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12853837
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Neoplastic thrombosis of the inferior vena cava and right atrium due to kidney cancer. Three surgically treated cases. Author(s): Odero A, Giorgetti PL, Cugnasca M, Rampoldi V, Bortolani EM, Ruberti U. Source: Panminerva Medica. 1989 July-September; 31(3): 140-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2601979
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Nephrectomy with prior intraluminal balloon occlusion of the renal artery in kidney cancer. Author(s): Lopatkin NA, Mazo EB, Nabiev YN. Source: European Urology. 1979; 5(4): 255-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=436873
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Nested case-control study of leukaemia, multiple myeloma, and kidney cancer in a cohort of petroleum workers exposed to gasoline. Author(s): Wong O, Trent L, Harris F. Source: Occupational and Environmental Medicine. 1999 April; 56(4): 217-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10450237
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Novel kidney cancer immunotherapy based on the granulocyte-macrophage colonystimulating factor and carbonic anhydrase IX fusion gene. Author(s): Hernandez JM, Bui MH, Han KR, Mukouyama H, Freitas DG, Nguyen D, Caliliw R, Shintaku PI, Paik SH, Tso CL, Figlin RA, Belldegrun AS. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 2003 May; 9(5): 1906-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12738749
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Obesity, hypertension, and the risk of kidney cancer in men. Author(s): Chow WH, Gridley G, Fraumeni JF Jr, Jarvholm B. Source: The New England Journal of Medicine. 2000 November 2; 343(18): 1305-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11058675
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Obesity, interrelated mechanisms, and exposures and kidney cancer. Author(s): Moyad MA. Source: Semin Urol Oncol. 2001 November; 19(4): 270-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11769879
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Orthotopic neobladder after kidney transplantation in a male patient with recurring urothelial carcinoma and renal cancer. Author(s): Giessing M, Turk I, Schoenberger B, Loening SA. Source: The Journal of Urology. 2001 October; 166(4): 1383. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11547081
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Outpatient experience with moderate dose bolus interleukin-2 in metastatic malignant melanoma and kidney cancer. Author(s): Quan WD Jr, Quan FM. Source: Journal of Immunotherapy (Hagerstown, Md. : 1997). 2003 May-June; 26(3): 28690. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12806282
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Paternal employment in agriculture and childhood kidney cancer. Author(s): Pearce MS, Parker L. Source: Pediatric Hematology and Oncology. 2000 April-May; 17(3): 223-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10779988
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Phase II trial of tetrathiomolybdate in patients with advanced kidney cancer. Author(s): Redman BG, Esper P, Pan Q, Dunn RL, Hussain HK, Chenevert T, Brewer GJ, Merajver SD. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 2003 May; 9(5): 1666-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12738719
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Point mutations of c-ras genes in human bladder cancer and kidney cancer. Author(s): Nagata Y, Abe M, Kobayashi K, Saiki S, Kotake T, Yoshikawa K, Ueda R, Nakayama E, Shiku H. Source: Japanese Journal of Cancer Research : Gann. 1990 January; 81(1): 22-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2108944
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Predicting survival in patients with metastatic kidney cancer by gene-expression profiling in the primary tumor. Author(s): Vasselli JR, Shih JH, Iyengar SR, Maranchie J, Riss J, Worrell R, Torres-Cabala C, Tabios R, Mariotti A, Stearman R, Merino M, Walther MM, Simon R, Klausner RD, Linehan WM. Source: Proceedings of the National Academy of Sciences of the United States of America. 2003 June 10; 100(12): 6958-63. Epub 2003 May 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12777628
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Predictors of mortality from kidney cancer in 332,547 men screened for the Multiple Risk Factor Intervention Trial. Author(s): Coughlin SS, Neaton JD, Randall B, Sengupta A. Source: Cancer. 1997 June 1; 79(11): 2171-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9179064
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Presentation of renal tumor antigens by human dendritic cells activates tumorinfiltrating lymphocytes against autologous tumor: implications for live kidney cancer vaccines. Author(s): Mulders P, Tso CL, Gitlitz B, Kaboo R, Hinkel A, Frand S, Kiertscher S, Roth MD, deKernion J, Figlin R, Belldegrun A. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 1999 February; 5(2): 445-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10037196
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Prognostic factors for biologic therapy in kidney cancer. Author(s): Drucker BJ. Source: Curr Urol Rep. 2002 February; 3(1): 31-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12084217
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Prognostic implications of cytogenetic findings in kidney cancer. Author(s): Elfving P, Mandahl N, Lundgren R, Limon J, Bak-Jensen E, Ferno M, Olsson H, Mitelman F. Source: British Journal of Urology. 1997 November; 80(5): 698-706. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9393289
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Promoter hypermethylation of tumor suppressor genes in urine from kidney cancer patients. Author(s): Battagli C, Uzzo RG, Dulaimi E, Ibanez de Caceres I, Krassenstein R, AlSaleem T, Greenberg RE, Cairns P. Source: Cancer Research. 2003 December 15; 63(24): 8695-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14695183
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Pseudouridine and uridine in normal kidney and kidney cancer tissues. Author(s): Koshida K, Harmenberg J, Borgstrom E, Wahren B, Andersson L. Source: Urological Research. 1985; 13(5): 219-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4060365
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Racial disparity in incidence patterns and outcome of kidney cancer. Author(s): Vaishampayan UN, Do H, Hussain M, Schwartz K. Source: Urology. 2003 December; 62(6): 1012-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665346
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Recent advances in kidney cancer and metastatic disease. Author(s): Kirkali Z, Tuzel E, Mungan MU. Source: Bju International. 2001 November; 88(8): 818-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11736854
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Researching the experience of kidney cancer patients. Author(s): Taylor K. Source: European Journal of Cancer Care. 2002 September; 11(3): 200-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12296838
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Results of surgical treatment of kidney cancer with solitary metastasis to contralateral adrenal. Author(s): Plawner J. Source: Urology. 1991 March; 37(3): 233-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2000680
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Review of new evidence regarding the relationship of gasoline exposure to kidney cancer and leukemia. Author(s): Enterline PE. Source: Environmental Health Perspectives. 1993 December; 101 Suppl 6: 101-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8020432
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Risk factors for kidney cancer in New South Wales, Australia. II. Urologic disease, hypertension, obesity, and hormonal factors. Author(s): McCredie M, Stewart JH. Source: Cancer Causes & Control : Ccc. 1992 July; 3(4): 323-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1617119
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Risk factors for kidney cancer in New South Wales. IV. Occupation. Author(s): McCredie M, Stewart JH. Source: Br J Ind Med. 1993 April; 50(4): 349-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8494775
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Risk factors for kidney cancer in New South Wales--I. Cigarette smoking. Author(s): McCredie M, Stewart JH. Source: European Journal of Cancer (Oxford, England : 1990). 1992; 28A(12): 2050-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1419302
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Risk of kidney cancer among patients using analgesics and diuretics: a populationbased cohort study. Author(s): Lindblad P, McLaughlin JK, Mellemgaard A, Adami HO. Source: International Journal of Cancer. Journal International Du Cancer. 1993 August 19; 55(1): 5-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8344752
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Risk of kidney cancer and other second solid malignancies in patients with chronic lymphocytic leukemia. Author(s): Mellemgaard A, Geisler CH, Storm HH. Source: European Journal of Haematology. 1994 October; 53(4): 218-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7957806
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Risk of kidney cancer in analgesics users. Author(s): Mellemgaard A, Moller H, Jensen OM, Halberg P, Olsen JH. Source: Journal of Clinical Epidemiology. 1992 September; 45(9): 1021-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1432016
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Selling cells. Is a kidney cancer treatment a therapy or an experiment? Author(s): Rennie J. Source: Scientific American. 1991 June; 264(6): 120. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1857954
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Short-term tumor cell lines from renal cell carcinoma for use as autologous tumor cell vaccines in the treatment of kidney cancer. Author(s): Dillman RO, Beutel LD, Cornforth AN, Nayak SK. Source: Cancer Biotherapy & Radiopharmaceuticals. 2000 April; 15(2): 161-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10803321
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Smoking and health, with a note on kidney cancer. Author(s): Tavani A, La Vecchia C. Source: Contrib Nephrol. 2000; 130: 11-20. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10892546
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Study of the normal human kidney and kidney cancer with monoclonal antibodies. Author(s): Bander NH. Source: Uremia Invest. 1984-85; 8(3-4): 263-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6400157
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Studying cancer families to identify kidney cancer genes. Author(s): Zbar B, Klausner R, Linehan WM. Source: Annual Review of Medicine. 2003; 54: 217-33. Epub 2001 December 03. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12525673
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Surgical treatment of spinal cord compression in kidney cancer. Author(s): Sundaresan N, Scher H, DiGiacinto GV, Yagoda A, Whitmore W, Choi IS. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1986 December; 4(12): 1851-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2431111
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The a posteriori probability of a kidney cancer cluster attributed to trichloroethylene exposure. Author(s): Rhomberg L. Source: Environmental Health Perspectives. 2002 May; 110(5): A232. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12008739
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The association of oral contraception with kidney cancer, colon cancer, gallbladder cancer (including extrahepatic bile duct cancer) and pituitary tumours. Author(s): Milne R, Vessey M. Source: Contraception. 1991 June; 43(6): 667-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1868737
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The enhanced 32P labeling of CDP-diacylglycerol in c-myc gene expressed human kidney cancer cells. Author(s): Kubota Y, Shuin T, Yao M, Inoue H, Yoshioka T. Source: Febs Letters. 1987 February 9; 212(1): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3803604
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The importance of reliable exposure estimates in deciding whether trichloroethylene can cause kidney cancer. Author(s): Cherrie JW, Kromhout H, Semple S. Source: Journal of Cancer Research and Clinical Oncology. 2001; 127(6): 400-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11414201
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The lack of effect of a prophylactic dose of enoxaparin on thrombin generation in patients subjected to nephrectomy because of kidney cancer. Author(s): Szczepanski M, Szostek P, Pypno W, Borowka A. Source: Thrombosis Research. 2001 December 15; 104(6): 427-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11755953
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The National Cancer Data Base: report on kidney cancers. The American College of Surgeons Commission on Cancer and the American Cancer Society. Author(s): Marshall FF, Stewart AK, Menck HR. Source: Cancer. 1997 December 1; 80(11): 2167-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9392341
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The TRC8 hereditary kidney cancer gene suppresses growth and functions with VHL in a common pathway. Author(s): Gemmill RM, Bemis LT, Lee JP, Sozen MA, Baron A, Zeng C, Erickson PF, Hooper JE, Drabkin HA. Source: Oncogene. 2002 May 16; 21(22): 3507-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12032852
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The von Hippel-Lindau protein, vascular endothelial growth factor, and kidney cancer. Author(s): George DJ, Kaelin WG Jr. Source: The New England Journal of Medicine. 2003 July 31; 349(5): 419-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890838
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This month in investigative urology. Kidney cancer: novel model for cancer genetics and therapy. Author(s): Linehan WM. Source: The Journal of Urology. 1999 August; 162(2): 291-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10411024
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Towards kidney cancer crystal ball. Better prognostication of patients with renal cell carcinoma. Author(s): Freedland SJ, Belldegrun AS. Source: The Journal of Urology. 2001 July; 166(1): 73-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11435826
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Treatment of kidney cancer with autologous tumor cell vaccines of short-term cell lines derived from renal cell carcinoma. Author(s): Dillman RO, Barth NM, VanderMolen LA, Garfield DH, De Leon C, O'Connor AA, Mahdavi K, Nayak SK. Source: Cancer Biotherapy & Radiopharmaceuticals. 2001 February; 16(1): 47-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11279797
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Treatment of spinal metastases from kidney cancer by presurgical embolization and resection. Author(s): Sundaresan N, Choi IS, Hughes JE, Sachdev VP, Berenstein A. Source: Journal of Neurosurgery. 1990 October; 73(4): 548-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2398386
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Treatment with tumor necrosis factor alpha and interferon alpha of a human kidney cancer xenograft in nude mice: evidence for an anticachectic effect of interferon alpha. Author(s): Bassukas ID, Hofmockel G, Maurer-Schultze B. Source: Anticancer Res. 1994 January-February; 14(1A): 237-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8166454
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VHL and kidney cancer. Author(s): Ohh M, Kaelin WG Jr. Source: Methods in Molecular Biology (Clifton, N.J.). 2003; 222: 167-83. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12710686
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CHAPTER 2. NUTRITION AND KIDNEY CANCER Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and kidney cancer.
Finding Nutrition Studies on Kidney Cancer 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 “kidney cancer” (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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Kidney Cancer
The following information is typical of that found when using the “Full IBIDS Database” to search for “kidney cancer” (or a synonym): •
Flavopiridol, a novel cyclin-dependent kinase inhibitor, in metastatic renal cancer: a University of Chicago Phase II Consortium study. Author(s): University of Chicago and University of Illinois, Chicago, IL, USA.
[email protected] Source: Stadler, W M Vogelzang, N J Amato, R Sosman, J Taber, D Liebowitz, D Vokes, E E J-Clin-Oncol. 2000 January; 18(2): 371-5 0732-183X
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Palliative and adjuvant chemotherapy of metastatic renal cancer. Author(s): II. Medical Department, University of Vienna, Austria. Source: Kuhbock, J Potzi, P Madaras, T Semin-Surg-Oncol. 1988; 4(2): 116-23 8756-0437
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T cell lysis of murine renal cancer: multiple signaling pathways for cell death via Fas. Author(s): Intramural Research Support Program, SAIC-Frederick, DBS, NCI-FCRDC, Maryland 21702-1201, USA.
[email protected] Source: Sayers, T J Brooks, A D Seki, N Smyth, M J Yagita, H Blazar, B R Malyguine, A M J-Leukoc-Biol. 2000 July; 68(1): 81-6 0741-5400
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Vinblastine fails to improve response of renal cancer to interferon alfa-n1: high response rate in patients with pulmonary metastases. Author(s): University of New Mexico, Albuquerque. Source: Neidhart, J A Anderson, S A Harris, J E Rinehart, J J Laszlo, J Dexeus, F H Einhorn, L H Trump, D L Benedetto, P W Tuttle, R L et al. J-Clin-Oncol. 1991 May; 9(5): 832-6 0732-183X
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/
Nutrition
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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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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. CLINICAL TRIALS AND KIDNEY CANCER Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning kidney cancer.
Recent Trials on Kidney Cancer The following is a list of recent trials dedicated to kidney cancer.8 Further information on a trial is available at the Web site indicated. •
A research study in patients with renal cancer to determine the safety and effectiveness of a new investigational drug called ABX-EGF. Condition(s): Renal Cell Carcinoma Study Status: This study is currently recruiting patients. Sponsor(s): Abgenix; Immunex Corporation Purpose - Excerpt: Part 1: To determine the safety and effectiveness of up to 4 different doses of ABX-EGF in patients with renal cancer. Part 1: Closed, no longer recruiting (Completed December 2003) Part 2: To determine the safety and effectiveness of a defined dose of ABX-EGF in renal cancer patients, who had nephrectomy and either failed one biotherapy or received no prior therapy. (Currently Recruiting) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00036530
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Antineoplaston Therapy in Treating Patients With Stage IV Kidney Cancer Condition(s): stage IV renal cell cancer; recurrent renal cell cancer; Renal Cell Adenocarcinoma; metastatic transitional cell cancer of the renal pelvis and ureter; recurrent transitional cell cancer of the renal pelvis and ureter
8
These are listed at www.ClinicalTrials.gov.
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Kidney Cancer
Study Status: This study is currently recruiting patients. Sponsor(s): Burzynski Research Institute Purpose - Excerpt: RATIONALE: Antineoplastons are naturally-occurring substances found in urine, but they may also be made in the laboratory. Antineoplastons may inhibit the growth of cancer cells. PURPOSE: Phase II trial to study the effectiveness of antineoplaston therapy in treating patients who have stage IV kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003520 •
Atrasentan in Treating Patients With Locally Recurrent or Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Eastern Cooperative Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase II trial to study the effectiveness of atrasentan in treating patients who have locallyrecurrent or metastaticrenal cell (kidney) cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00039429
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Biological Therapy and Chemotherapy in Treating Patients With Metastatic Kidney Cancer or Colorectal Cancer Condition(s): stage IV colon cancer; Stage IV rectal cancer; recurrent colon cancer; recurrent rectal cancer; stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): St. Luke's Medical Center Purpose - Excerpt: RATIONALE: Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining biological therapy with chemotherapy may kill more tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of biological therapy combined with chemotherapy in treating patients who have metastatic kidney cancer or colorectal cancer. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00030342
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BMS 247550 to Treat Kidney Cancer Condition(s): Renal Cell Carcinoma
Clinical Trials 41
Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This study will examine whether the experimental drug BMS 247550 is an effective treatment for kidney cancer. BMS 247550 belongs to a class of drugs that prevent cancer cells from replicating. Patients 18 years of age or older with kidney cancer that has not spread to the central nervous system may be eligible for this study. Pregnant or nursing women may not participate. Candidates will be screened with various tests that may include blood and urine tests, electrocardiogram (EKG), and chest X-ray. Computerized tomography (CT) scans or X-rays, and possibly nuclear medicine studies may be done to determine the extent of disease. Participants will receive BMS 247550 intravenously (by vein) in treatment cycles of 5 consecutive days every 21 days. The drug will be given through a central venous catheter-a tube placed under the skin of the chest or neck into a major vein. The catheter is placed in the operating room under local anesthesia. Patients must stay in the NIH area near Bethesda, Maryland for 7 to 8 days during the first treatment cycle and for the 5 days of treatment in subsequent cycles. The total number of cycles will vary among patients, depending on their individual clinical situation. The drug dose may be increased gradually in subsequent cycles in patients who can tolerate such increases. In addition, participants will undergo the following tests and procedures: - Periodic physical examinations and frequent blood tests - X-ray and other imaging studies to determine if the tumor is responding to the treatment. - Tumor biopsies to confirm the diagnosis or spread of tumor and to examine the reaction of certain proteins in cancer cells to BMS 247550. Two biopsies will be done. For this procedure, a small piece of tumor tissue is withdrawn through a needle under local anesthetic. Treatment will be stopped in patients whose tumor grows while receiving BMS 247550. Patients whose tumor disappears completely will be followed at NIH periodically for examinations and tests. Patients whose disease does not completely resolve or whose disease recurs may be advised of other appropriate research protocols at NIH or, if none are available, will be returned to the care of their local doctor. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00030992 •
Chemotherapy Followed by Peripheral Stem Cell Transplantation in Treating Patients With Metastatic or Unresectable Kidney Cancer Condition(s): stage IV renal cell cancer; recurrent renal cell cancer; renal clear cell carcinoma; renal granular cell carcinoma Study Status: This study is currently recruiting patients. Sponsor(s): Cancer and Leukemia Group B; National Cancer Institute (NCI); Southwest Oncology Group; Eastern Cooperative Oncology Group Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy used to kill tumor cells. PURPOSE: Phase II trial to study the effectiveness of chemotherapy followed by donor peripheral stem cell transplantation in treating patients who have metastatic or unresectable kidney cancer. Phase(s): Phase II
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Kidney Cancer
Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027573 •
Combination Chemotherapy in Treating Patients With Advanced Bladder or Kidney Cancer Condition(s): stage III bladder cancer; stage IV bladder cancer; transitional cell carcinoma of the bladder; metastatic transitional cell cancer of the renal pelvis and ureter; localized transitional cell cancer of the renal pelvis and ureter; regional transitional cell cancer of the renal pelvis and ureter Study Status: This study is currently recruiting patients. Sponsor(s): Memorial Sloan-Kettering Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. PURPOSE: Phase I trial to study the effectiveness of combination chemotherapy consisting of gemcitabine, doxorubicin, paclitaxel, and carboplatin in treating patients with advanced bladder or kidney cancer and impaired kidney function. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003342
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CTLA-4 Antibody (MDX-010) to Treat Advanced Kidney Cancer Condition(s): Kidney Neoplasm Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This study will evaluate the safety and effectiveness of the experimental drug MDX-010 in treating patients with stage IV kidney cancer. MDX-010 is an antibody to the CTLA-4protein found on certain lymphocytes (a type of white blood cell) that helps stop an immune response. When lymphocytes recognize a foreign substance, such as a virus or bacteria, they initiate an immune response to fight and control the infection. Once this is achieved, CTLA-4 protein help stop the immune response, decreasing the number of immune cells against the specific virus or bacteria. When an immune response is mounted against tumor cells, however, it may be beneficial not to stop the immune response, but instead, to keep a large number of lymphocytes available to recognize and fight tumor cells. In this study, MDX-010 will be used to block CTLA-4 and maintain immune activity. Patients 16 years of age and older who have kidney cancer that has spread to the lymph nodes or other sites and who have either not benefited from standard treatment with interleukin-2 or cannot receive interleukin-2 for medical reasons may be eligible for this study. Candidates will be screened with a history, physical examination, eye examination, blood and urine tests, electrocardiogram (EKG), lung function tests, and computed tomography (CT) or magnetic resonance imaging (MRI) scans to evaluate the size and extent of their tumor. Participants will receive up to four MDX-010 treatments 28 days apart. Each treatment consists of a dose of MDX-010 given intravenously (through a vein) via a catheter (thin
Clinical Trials 43
plastic tube) over 90 minutes. In addition to the drug treatment, patients will have the following tests and procedures: - Blood tests every 28 days (every treatment visit) to look for side effects and the body's reaction to he treatment. - Leukapheresis to study the effects of treatment on the immune system. For this procedure, blood is drawn through a needle in an arm vein and circulated through a machine that separates the blood into its components (red cells, white cells, platelets, and plasma). The lymphocytes are extracted and the rest of the blood is returned to the patient through a needle in the other arm. - Biopsy of normal skin and tumor or lymph node to examine the effects of antibody on the immune cells in the tumor. For this procedure, a needle is put into the skin or tumor and a small amount of tissue is pulled out with the needle. Biopsies are optional; they are not required for participation in the study. - Follow-up visits 4 weeks after the second and fourth treatments for checkup examination, scans and X-rays, and blood tests. Patients will be watched closely for treatment side effects. Those who develop severe drug side effects, whose body develops an immune reaction against the MDX-010 antibody, or whose condition worsens during treatment may be taken off the study. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00053729 •
Doxorubicin and Gemcitabine in Treating Patients With Locally Recurrent or Metastatic Unresectable Renal Cell Carcinoma (Kidney Cancer) Condition(s): stage III renal cell cancer; stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Eastern Cooperative Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy such as doxorubicin and gemcitabine use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining doxorubicin with gemcitabine in treating patients who have locallyrecurrent or metastaticunresectablerenal cellcarcinoma(kidney cancer). Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068393
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Electrocautery for Kidney Cancer Condition(s): Kidney Neoplasm Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This study will examine the safety and effectiveness of electrocautery in treating kidney cancer. Electrocautery is a non-surgical procedure that uses heat to kill the tumor. Some patients are not good surgery candidates because of age, health
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Kidney Cancer
reasons, or the need for dialysis following surgery. Patients whose tumor cells are destroyed by electrocautery may not need surgery, or may have their surgery delayed. Patients with kidney tumors from 0.5 to 3.0 cm in size will be screened for eligibility in the study with a history and physical examination, CT scan, chest X-ray and blood tests. Study patients will then have their tumors cauterized using a needle device approved by the Food and Drug Administration for treating soft tissues. The patient first receives a local anesthetic in the area of the back where the needle, or needles, are inserted through the skin into the tumor. (A separate needle stick may be used for each tumor treated.) After insertion, the needles are heated to 85 to 105 degrees centigrade (185 to 221 degrees Fahrenheit) for 10 minutes. A thermometer then measures the temperature of the tumor tissue. If the tumor has not been heated to 60 degrees centigrade (140 degrees Fahrenheit), it may be reheated up to two more times to reach that temperature. Patients will be evaluated after the treatment for any complications, similar to those that may occur after surgery. From 1 to 6 months after the procedure, patients will have a CT scan of the abdomen, nuclear medicine kidney scan, and blood or urine tests to evaluate kidney function and tumor growth, if any. These tests will be repeated a year after treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001834 •
Erlotinib in Treating Patients With Advanced Kidney Cancer Condition(s): recurrent renal cell cancer; stage III renal cell cancer; stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Institute for Drug Development; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Erlotinib may stop the growth of tumor cells by blocking the enzymes necessary for tumor cell growth. PURPOSE: Phase II trial to study the effectiveness of erlotinib in treating patients who have advanced kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00045487
•
Fludarabine, Cyclophosphamide, and Alemtuzumab in Treating Patients With Recurrent or Metastatic Renal Cell Carcinoma (Kidney Cancer) Undergoing Allogeneic Stem Cell Transplantation Condition(s): stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Baylor College of Medicine Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy, such as fludarabine and cyclophosphamide, use different ways to stop cancer cells from dividing so they stop growing or die. Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy. Sometimes the transplanted cells can reject the
Clinical Trials 45
body's normal tissues. Alemtuzumab and tacrolimus may prevent this from happening. PURPOSE: Phase II trial to study the effectiveness of combining fludarabine and cyclophosphamide with alemtuzumab in treating patients who are undergoing allogeneic stem cell transplantation for recurrent or metastaticrenal cell carcinoma (kidney cancer). Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00073879 •
Gemcitabine Plus Cisplatin in Treating Patients With Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Ireland Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase II trial to study the effectiveness of gemcitabine plus cisplatin in treating patients who have metastatic kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003928
•
Genetic Analysis of Birt Hogg-Dube Predisposition to Kidney Cancer
Syndrome
and
Characterization
of
Condition(s): Syndrome; MedlinePlus consumer health information Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This study will investigate the genetic cause of Birt Hogg-Dube (BHD) syndrome and the relationship of this disorder to kidney cancer. BHD is a rare inherited condition characterized by papules, or bumps-benign tumors involving hair follicles-on the head and neck. People with BHD are at increased risk of developing kidney cancer. Scientists have identified the chromosome (strand of genetic material in the cell nucleus) that contains the BHD gene and the region of the gene on the chromosome. This study will try to learn more about: - The characteristics and type of kidney tumors associated with BHD - The risk of kidney cancer in people with BHD Whether more than one gene causes BHD - The genetic mutations (changes) responsible for BHD Patients with known or suspected Birt Hogg-Dube syndrome, and their family members, may be eligible for this study. Candidates will be screened with a family history and review of medical records, including pathology reports for tumors, and films of computed tomography (CT) and magnetic resonance imaging (MRI) scans. Participants may undergo various tests and procedures, including the following: Physical examination - Review of personal and family history with a cancer doctor, cancer nurses, kidney surgeon, and genetic counselor - Chest and other x-rays Ultrasound (imaging study using sound waves) - MRI (imaging study using radiowaves
46
Kidney Cancer
and a magnetic field) - CT scans of the chest and abdomen (imaging studies using radiation) - Blood tests for blood chemistries and genetic testing - Skin evaluation, including a skin biopsy (surgical removal of a small skin tissue sample for microscopic evaluation) - Cheek swab or mouthwash to collect cells for genetic analysis - Lung function studies - Medical photography of skin lesions These tests will be done on an outpatient basis in either one day or over 3 to 4 days. When the studies are complete, participants will receive counseling about the findings and recommendations. Patients with kidney lesions may be asked to return periodically, such as every 3 to 36 months, based on their individual condition, to document the rate of progression of the lesions. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033137 •
Hereditary Leiomyomatosis Renal Cell Cancer - Study of the Genetic Cause and the Predisposition to Renal Cancer Condition(s): Leiomyomatosis; Kidney Neoplasms Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: This study will investigate what causes hereditary leiomyomatosis renal (kidney) cell cancer, or HLRCC, and how the disease is related to the development of kidney tumors. Leiomyomas are benign (non-cancerous) tumors arising from smooth muscle. HLRCC can cause various health problems. Some people develop red bumps on their skin that can be painful at times. Some women with HLRCC can develop leiomyomas of the uterus. In some families, people with HLRCC develop kidney tumors. This study will try to determine: - What gene changes (mutations) cause HLRCC; - What kind of kidney tumors develop in HLRCC and how they grow; - What the chance is that a person with HLRCC will develop a kidney tumor. People with known or suspected HLRCC and their family members of any age may be eligible for this study. This includes people in families in which one or more members has skin leiomyoma and kidney cancer; skin leiomyoma and uterine leiomyoma; multiple skin leiomyomas; or kidney cancer and uterine leiomyomas. Candidates will be screened with a physical examination, family history, and, for affected family members, a review of medical records, including pathology slides and computed tomography (CT) or magnetic resonance imaging (MRI) scans. Participants will undergo tests and procedures that may include the following: - Interviews with a cancer doctor, cancer nurses, genetic counselor and kidney surgeon; - Blood tests for: - Genetic research to identify the gene responsible for HLRCC; - Evaluation of liver, kidney, heart, pancreas, and thyroid function; - Complete blood count and clotting profile; - Pregnancy test for pre-menopausal women; - PSA test for prostate cancer in men over age 40. - CT or MRI scans; - Skin examination; - Skin biopsy (surgical removal of a small sample of skin tissue); - Cheek swab to collect cells for genetic analysis; - Medical photographs of lesions. When the tests are completed, participants will discuss the results with a doctor and possibly a genetic nurse or genetic counselor. The genetic findings will not be revealed to participants because their meaning and implications may not yet be understood. Participants may be asked to return to NIH from every 3 months to every 3 years, depending on their condition, for follow-up examinations and tests. Study Type: Observational Contact(s): see Web site below
Clinical Trials 47
Web Site: http://clinicaltrials.gov/ct/show/NCT00050752 •
High-Dose Combination Chemotherapy Plus Peripheral Stem Cell Transplantation in Treating Patients With Advanced Cancer Condition(s): Breast Cancer; Gastrointestinal Cancer; Kidney Cancer; Musculoskeletal Cancer; Reproductive Cancer; Skin Cancer Study Status: This study is currently recruiting patients. Sponsor(s): Beckman Research Institute; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. PURPOSE: Phase I trial to study the effectiveness of combination chemotherapy plus peripheral stem cell transplantation in treating patients who have advanced cancer. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002854
•
Interferon alfa With or Without Interleukin-2 and Fluorouracil in Treating Patients With Advanced Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Medical Cooperative Group
Research
Council;
EORTC
Genito-Urinary
Tract
Cancer
Purpose - Excerpt: RATIONALE: Interferon alfa may interfere with the growth of tumor cells. Interleukin-2 may stimulate a person's white blood cells to kill tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining interferon alfa with interleukin-2 and fluorouracil may kill more tumor cells. It is not yet known whether interferon alfa is more effective with or without interleukin-2 and fluorouracil in treating metastatic kidney cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of interferon alfa combined with interleukin-2 and fluorouracil to that of interferon alfa alone in treating patients who have advanced metastatic kidney cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00053820 •
Interferon alfa With or Without Thalidomide in Treating Patients With Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Cancer Research UK
48
Kidney Cancer
Purpose - Excerpt: RATIONALE: Interferon alfa may interfere with the growth of cancer cells. Thalidomide may stop the growth of cancer by stopping blood flow to the tumor. It is not yet known if interferon alfa is more effective with or without thalidomide in treating metastatic kidney cancer. PURPOSE: Randomizedphase II trial to compare the effectiveness of interferon alfa with or without thalidomide in treating patients who have metastatic kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027664 •
Interferon alfa-2b With or Without Bevacizumab in Treating Patients With Advanced Renal Cell Carcinoma (Kidney Cancer) Condition(s): stage III renal cell cancer; stage IV renal cell cancer; renal clear cell carcinoma; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Cancer and Leukemia Group B; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Biological therapies, such as interferon alfa-2b, may interfere with the growth of tumor cells. Bevacizumab may stop the growth of tumor cells by stopping blood flow to the tumor. It is not yet known whether interferon alfa-2b is more effective with or without bevacizumab in treating advanced renal cellcarcinoma (kidney cancer). PURPOSE: Randomizedphase III trial to compare the effectiveness of interferon alfa-2b with or without bevacizumab in treating patients who have advanced renal cell carcinoma. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00072046
•
Interferon alfa-2b With or Without Thalidomide in Treating Patients With Metastatic or Unresectable Kidney Cancer Condition(s): stage III renal cell cancer; stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Eastern Cooperative Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Interferon alfa-2b may interfere with the growth of the cancer cells. Thalidomide may stop the growth of cancer by stopping blood flow to the tumor. It is not yet known if interferon alfa-2b is more effective with or without thalidomide in treating kidney cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of interferon alfa-2b with or without thalidomide in treating patients who have previously untreated metastatic or unresectable kidney cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005966
Clinical Trials 49
•
Interleukin-12 and Interferon alfa in Treating Patients With Metastatic Kidney Cancer or Malignant Melanoma Condition(s): stage IV renal cell cancer; recurrent renal cell cancer; Stage IV Melanoma; Recurrent Melanoma Study Status: This study is currently recruiting patients. Sponsor(s): Cleveland Clinic Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Interleukin-12 may kill tumor cells by stopping blood flow to the tumor and by stimulating a person's white blood cells to kill cancer cells. Interferon alfa may interfere with the growth of cancer cells. Combining interleukin-12 and interferon alfa may kill more cancer cells. PURPOSE: Phase I trial to study the effectiveness of interleukin-12 and interferon alfa in treating patients who have metastatic kidney cancer or malignantmelanoma. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004244
•
Lymphocyte Therapy in Treating Patients With Kidney Cancer Condition(s): stage III renal cell cancer; stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): St. Luke's Medical Center Purpose - Excerpt: RATIONALE: Treating a person's lymphocytes with interleukin-2 and monoclonal antibody may help them kill more cancer cells when they are put back in the body. PURPOSE: Phase II trial to study the effectiveness of lymphocyte therapy in treating patients who have stage III or stage IV kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002589
•
Magnetic-Resonance-Guided Radiofrequency Ablation in Treating Patients With Primary Kidney Cancer, Liver Metastases, or Other Solid Tumors Condition(s): stage III renal cell cancer; stage IV renal cell cancer; recurrent renal cell cancer; unspecified adult solid tumor, protocol specific; liver metastases Study Status: This study is currently recruiting patients. Sponsor(s): Ireland Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiofrequency ablation uses high-frequency electric current to heat and kill tumor cells. Magnetic resonance imaging-guided radiofrequency ablation may an effective treatment for primary kidney cancer, liver metastases, or other solid tumors. PURPOSE: Phase II trial to study the effectiveness of magnetic-resonanceguided radiofrequency ablation in treating patients who have primary kidney cancer, liver metastases, or other solid tumors. Phase(s): Phase II
50
Kidney Cancer
Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006255 •
PEG-Interferon alfa-2b in Treating Patients With Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Memorial Sloan-Kettering Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: PEG-interferon alfa-2b may stop the growth of kidney cancer by stopping blood flow to the tumor. PURPOSE: Phase II trial to study the effectiveness of PEG-interferon alfa-2b in treating patients who have metastatic kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00045279
•
Peripheral Stem Cell Transplantation in Treating Patients With Metastatic or Recurrent Kidney Cancer Condition(s): stage IV renal cell cancer; recurrent renal cell cancer; renal clear cell carcinoma Study Status: This study is currently recruiting patients. Sponsor(s): Fox Chase Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy and radiation therapy used to kill cancer cells. Sometimes the transplanted cells can be rejected by the body's tissues. Mycophenolate mofetil, tacrolimus, and donor white blood cells may prevent this from happening. PURPOSE: Phase II trial to study the effectiveness of chemotherapy followed by peripheral stem cell transplantation in treating patients who have metastatic or recurrentkidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00025519
•
Peripheral Stem Cell Transplantation Plus Monoclonal Antibody Therapy in Treating Patients With High-Risk Hematologic Cancer, Refractory Breast or Kidney Cancer, or Melanoma Condition(s): Breast Cancer; hematopoietic and lymphoid cancer; kidney and urinary cancer; skin tumor Study Status: This study is currently recruiting patients. Sponsor(s): Duke Comprehensive Cancer Center; National Cancer Institute (NCI)
Clinical Trials 51
Purpose - Excerpt: RATIONALE: Peripheral stem cell transplantation replaces immune cells that were destroyed by chemotherapy used to kill tumor cells. Sometimes the transplanted cells can make an immune response against the body's normal tissues. Treatment of the cells with a monoclonal antibody may prevent this from happening. PURPOSE: Phase II trial to study the effectiveness of peripheral stem cell transplantation plus monoclonal antibody therapy in treating patients who have high-risk hematologic cancer, refractory breast or kidney cancer, or melanoma. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004143 •
Phase II Evaluation of Denileukin Diftotox in Patients with Metastatic Melanoma or Metastatic Kidney Cancer Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: Patients with metastatic melanoma or metastatic kidney cancer will be entered into separate cohorts using a two stage optimal design. All patients will receive intravenous denileukin diftitix at a dose of 9 mcg/kg/day for five days every three weeks for four cycles. Patients will be evaluated for clinical response approximately three weeks after completion of each course. In addition, patients will be evaluated for change in the phenotype of circulating lymphocytes using FACS analysis. Toxicity profile of patients treated on this protocol will be established. Patients who are stable or who have mixed, partial or complete response after one course may be offered additional courses of therapy. Phase(s): Phase II; MedlinePlus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00078702
•
Study of Peripheral Stem Cell Transplantation After Chemotherapy and Radiation Therapy in Treating Patients With Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Fred Hutchinson Cancer Research Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy or radiation therapy used to kill tumor cells. Donor white blood cellinfusions may decrease the body's immune response to transplanted peripheral stem cells. PURPOSE: Phase I/II trial to study the effectiveness of combining chemotherapy, radiation therapy, peripheral stem cell transplantation, and donor white blood cells in treating patients who have metastatickidney cancer. Phase(s): Phase I; Phase II
52
Kidney Cancer
Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005851 •
Survival Study Of Oncophage(r) vs. Observation In Patients with Kidney Cancer Condition(s): Renal Cell Carcinoma Study Status: This study is currently recruiting patients. Sponsor(s): Antigenics Purpose - Excerpt: Determine whether patients receiving adjuvant HSPPC-96 treatment after surgically resected, locally advanced renal cell carcinoma have improved recurrence-free survival as compared to subjects with no adjuvant treatment. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033904
•
Tretinoin Plus Interferon alfa in Treating Patients With Metastatic Kidney Cancer Condition(s): stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Cornell University Medical College Purpose - Excerpt: RATIONALE: Tretinoin may help kidney cancer cells develop into normal cells. Interferon alfa may interfere with the growth of cancer cells. PURPOSE: Phase II trial to study the effectiveness of liposomal tretinoin plus interferon alfa in treating patients who have metastatic kidney cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003656
•
Vaccine Therapy and Interleukin-2 in Treating Patients With Stage IV Kidney Cancer Condition(s): stage IV renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): H. Lee Moffitt Cancer Center and Research Institute; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Vaccines made by inserting a laboratory-treated gene into a person's tumor cells may make the body build an immune response to kill tumor cells. Interleukin-2 may stimulate a person's white blood cells to kill cancer cells. Combining vaccine therapy with interleukin-2 may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining vaccine therapy with interleukin-2 in treating patients who have stage IV kidney cancer. Phase(s): Phase II Study Type: Interventional
Clinical Trials 53
Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031564 •
Vaccine Therapy Following Surgery in Treating Patients With Locally Advanced Kidney Cancer Condition(s): stage II renal cell cancer; stage III renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Antigenics Purpose - Excerpt: RATIONALE: Vaccines made from a patient's white blood cells and tumor cells may make the body build an immune response to kill tumor cells. It is not yet known if surgery plus vaccine therapy is more effective than surgery alone for advanced kidney cancer. PURPOSE: Randomizedphase III trial to determine the effectiveness of vaccine therapy following surgery in treating patients who have locally advanced kidney cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00017420
•
Vaccine Therapy in Treating Patients With Kidney Cancer Condition(s): stage III renal cell cancer; stage IV renal cell cancer; recurrent renal cell cancer Study Status: This study is currently recruiting patients. Sponsor(s): Hoag Memorial Hospital Presbyterian Purpose - Excerpt: RATIONALE: Vaccines made from a patient's white blood cells and tumor cells may make the body build an immune response to kill tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy in treating patients who have recurrent or stage III or stage IV kidney cancer. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00014131
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
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Kidney Cancer
5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “kidney cancer” (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
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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
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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
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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
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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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
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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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
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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
55
CHAPTER 4. PATENTS ON KIDNEY CANCER 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 “kidney cancer” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on kidney cancer, we have not necessarily excluded non-medical patents in this bibliography.
Patent Applications on Kidney Cancer 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 kidney cancer:
9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 10 This has been a common practice outside the United States prior to December 2000.
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•
Kidney Cancer
COMPOSITION, FORMULATIONS & METHOD FOR PREVENTION & TREATMENT OF DISEASES AND CONDITIONS ASSOCIATED WITH BRONCHOCONSTRICTION, ALLERGY(IES) & INFLAMMATION Inventor(s): NYCE, JONATHAN W.; (PRINCETON, NJ) Correspondence: Viviana Amzel, PH.D.; Epigenesis Pharmaceuticals, INC.; 7 Clarke Drive; Cranbury; NJ; 05812; US Patent Application Number: 20030087845 Date filed: June 9, 1998 Abstract: A pharmaceutical composition effective for preventing and alleviating bronchoconstriction, allergy(ies) and/or inflammation comprises a surfactant and a nucleic acid comprising an oligonucleotide anti-sense to an adenosine A1, A2a, A2b or A3 receptor gene, mRNA, flanking regions or regions bridging the intro/exon borders, analogues which bind thymidine but have low adenosine content or exhibit lower or no adenosine receptor agonist activity, combinations thereof, physiologically acceptable salts thereof or mixtures thereof, and optionally a carrier and other agents such as therapeutic agents and formulation products known in the art. The composition is formulated for administration by a multiplicity of routes for the prevention or alleviation of diseases and conditions associated with breathing difficulties, impeded and obstructed airways, bronchoconstriction, allergy and/or inflammation. Among the appplications of this technology are the prevention and treatment of diseases and conditions such as asthma, kidney damage or failure, ARDS, pulmonary vasoconstriction, inflammation, allergies, impeded respiration, respiratory distress syndrome, pain, cystic fibrosis, pulmonary hypertension, pulmonary vasoconstriction, emphysema, chronic obstructive pulmonary disease (COPD), and cancers such as leukemias, lymphomas, carcinomas, and the like, e.g. colon cancer, breast cancer, lung cancer, pancreatic cancer, hepatocellular carcinoma, kidney cancer, melanoma, hepatic, lung, breast, and prostate metastases, etc., to counter the renal damage and failure associated with ischemic conditions and the administration of certain drugs and radio active diagnostic and therapeutic agents, as well as a joint therapy with the administration of adenosine and adenosine-like agents in the treatment of arrhythmias such as SVT and in cardiovascular function tests (stress tests). The present agent(s) is (are) also suitable for administration before, during and after other treatments, including radiation, chemotherapy, antibody therapy, phototherapy and cancer, and other types of surgery. Alternatively, the present agent may be effectively administered preventatively, prophylactically or therapeutically, and in conjunction with other therapies, or by itself for conditions without known therapies or as a substitute for therapies that have significant negative side effects. Excerpt(s): This invention relates to compositions and formulations of oligonucleotides and surfactants, which are highly effective for the prevention and treatment of diseases and conditions associated with difficult breathing, bronchoconstriction, impeded airways, allergy(ies) and inflammation of the lungs. Adenosine A.sub.1-mediated diseases and conditions, such as asthma and Acute Respiratory Distress Syndrome (ARDS), among others, are common diseases in industrialized countries, and in the United States alone account for extremely high health care costs. These diseases or conditions have recently been increasing at an alarming rate, both in terms of prevalence and mortality. Occupational asthma is predicted to be the preeminent occupational lung disease in the next decade. In many of these, the underlying causes remain poorly understood. Adenosine, a natural nucleoside, may constitute an important natural mediator of bronchial asthma and ARDS. The potential role of adenosine in these
Patents 57
diseases or conditions is supported by experimental findings that, for example and in contrast to normal individuals, asthmatics respond to aerosolized adenosine with marked bronchoconstriction. Similarly, asthmatic rabbits produced using the dust mite allergic rabbit model of human asthma also were shown to respond to aerosolized adenosine with marked bronchoconstriction, while non-asthmatic rabbits showed no response. Recent work using this model system has suggested that adenosine-mediated bronchoconstriction in asthma is mediated through the stimulation of the adenosine A.sub.1 receptor. Other experimental data suggest the possibility that adenosine receptors may also be involved in allergic and inflammatory responses. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Compositions and methods for the therapy and diagnosis of kidney cancer Inventor(s): Algate, Paul A.; (Issaquah, WA), Gaiger, Alexander; (Seattle, WA), Gordon, Brian; (Seattle, WA), Harlocker, Susan L.; (Seattle, WA), Mannion, Jane; (Edmonds, WA) Correspondence: Seed Intellectual Property Law Group Pllc; 701 Fifth Ave; Suite 6300; Seattle; WA; 98104-7092; US Patent Application Number: 20030109434 Date filed: March 19, 2002 Abstract: Compositions and methods for the therapy and diagnosis of cancer, particularly kidney cancer, are disclosed. Illustrative compositions comprise one or more kidney tumor polypeptides, immunogenic portions thereof, polynucleotides that encode such polypeptides, antigen presenting cell that expresses such polypeptides, and T cells that are specific for cells expressing such polypeptides. The disclosed compositions are useful, for example, in the diagnosis, prevention and/or treatment of diseases, particularly kidney cancer. Excerpt(s): The Sequence Listing associated with this application is provided on CDROM in lieu of a paper copy, and is hereby incorporated by reference into the specification. Three CD-ROMs are provided, containing identical copies of the sequence listing: CD-ROM No. 1 is labeled COPY 1, contains the file 572.app which is 1.4 MB and created on Mar. 19, 2002; CD-ROM No.2 is labeled COPY 2, contains the file 572.app which is 1.4 MB and created on Mar. 19, 2002; CD-ROM No. 3 is labeled CRF, contains the file 572.app which is 1.4 MB and created on Mar. 19, 2002. The present invention relates generally to therapy and diagnosis of cancer, such as kidney cancer. The invention is more specifically related to polypeptides, comprising at least a portion of a kidney tumor protein, and to polynucleotides encoding such polypeptides. Such polypeptides and polynucleotides are useful in pharmaceutical compositions, e.g., vaccines, and other compositions for the diagnosis and treatment of kidney cancer. Cancer is a significant health problem throughout the world. Although advances have been made in detection and therapy of cancer, no vaccine or other universally successful method for prevention and/or treatment is currently available. Current therapies, which are generally based on a combination of chemotherapy or surgery and radiation, continue to prove inadequate in many patients. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Kidney-specific tumor vaccine directed against kidney tumor antigen G-250 Inventor(s): Belldegrun, Arie; (Los Angeles, CA), Tso, Cho-Lea; (Torrance, CA) Correspondence: Law Offices OF Jonathan Alan Quine; P O Box 458; Alameda; CA; 94501 Patent Application Number: 20020058041 Date filed: February 13, 2001 Abstract: This invention provides an anti-cancer immunogenic agent(s) (e.g. vaccines) that elicit an immune response specifically directed against renal cell cancers expressing a G250 antigenic marker. Preferred immunogenic agents comprise a chimeric molecule comprising a kidney cancer specific antigen (G250) attached to a granulocytemacrophage colony stimulating factor (GM-CSF). The agents are useful in a wide variety of treatment modalities including, but not limited to protein vaccination, DNA vaccination, and adoptive immunotherapy. Excerpt(s): This application claims priority to and benefit of U.S. provisional applications U.S. Ser. No. 60/182,429, filed on Feb. 14, 2000, and U.S. Ser. No. 60/182,636, filed on Feb. 15, 2000, both of which are incorporated herein by reference in their entirety for all purposes. This invention relates to the field of oncology. In particular this invention provides novel vaccines for use in the treatment of renal cell cancers. Renal cell carcinoma (RCC), also often identified as renal cancer, "hypemephroma", or adenocarcinoma of the kidney accounts for about 85 percent of all primary renal neoplasms. Approximately 25,000 new cases are diagnosed annually with 10,000 deaths in the United States. Unfortunately, the prognosis of patients with recurrent or metastatic renal cell carcinoma remains poor. Chemotherapy and radiotherapy have little or no activity in this disease and there is no standard chemotherapeutic, hormonal, or immunologic program for recurrent or metastatic renal cancer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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TIMM8b-related protein Inventor(s): Hillman, Jennifer L.; (Mountain View, CA) Correspondence: Incyte Corporation (formerly Known AS Incyte; Genomics, INC.); 3160 Porter Drive; Palo Alto; CA; 94304; US Patent Application Number: 20030166041 Date filed: February 8, 2001 Abstract: The invention provides a cDNA which encodes TIMM8 b-related protein. It also provides for the use of the cDNA, fragments, complements, and variants thereof and of the encoded protein, portions thereof and antibodies thereto for diagnosis and treatment of cancer, particularly breast cancer, ovarian cancer, and kidney cancer; and neurodegenerative disorders, particularly Mohr-Tranebjaerg syndrome, epilepsy, spasticity, and dystonia. The invention additionally provides expression vectors and host cells for the production of the protein and a transgenic model system. Excerpt(s): This invention relates to a cDNA which encodes TIMM8b-related protein and to the use of the cDNA and the encoded protein in the diagnosis and treatment of cancer and neurodegenerative disorders. Phylogenetic relationships among organisms have been demonstrated many times, and studies from a diversity of prokaryotic and
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eukaryotic organisms suggest a more or less gradual evolution of molecules, biochemical and physiological mechanisms, and metabolic pathways. Despite different evolutionary pressures, the proteins of nematode, fly, rat, and man have common chemical and structural features and generally perform the same cellular function. Comparisons of the nucleic acid and protein sequences from organisms where structure and/or function are known accelerate the investigation of human sequences and allow the development of model systems for testing diagnostic and therapeutic agents for human conditions, diseases, and disorders. The neurodegenerative disorder DFN-1, which is also known as Mohr-Tranebjaerg syndrome is caused by defects in a gene that encodes deafness/dystonia peptide (DDP) (Wallace and Murdock (1999) Proc Natl Acad Sci 96:1817-1819). Human deafness dystonia syndrome is associated with progressive sensorineural deafness, cortical blindness, dystonia, dysphagia, and paranoia. Human DDP shows sequence similarity to a family of zinc-binding proteins in yeast, referred to as TIM proteins, that are involved in mitochondrial import. This family of proteins is characterized by the presence of a zinc-binding motif, CX.sub.3CX.sub.1117CX.sub.3C(Jin et al. (1999) Genomics 61:259-267). Mitochondrial import, in yeast, involves cytosolic chaperones, a TOM complex (translocase of the outer membrane), and a TIM complex (translocase of the inner membrane). Mitochondrial proteins with an Nterminal signal sequence are targeted to the TOM complex. The TOM complex interacts with TIM complexes to transport proteins across the intermembrane space. Two TIM complexes are present in the inner mitochondrial membrane, TIM23 and TIM22, which import different substrates. TIM23 imports molecules with a matrix targeting signal into the matrix space and into the inner membrane. TIM22 imports members of the mitochondrial carrier family and other integral inner membrane proteins that lack a matrix targeting signal. 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 kidney cancer, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “kidney cancer” (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 kidney cancer. You can also use this procedure to view pending patent applications concerning kidney cancer. 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 5. BOOKS ON KIDNEY CANCER Overview This chapter provides bibliographic book references relating to kidney cancer. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on kidney cancer 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 “kidney cancer” (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 kidney cancer: •
Medical Advisor Home Edition: The Complete Guide to Alternative and Conventional Treatments Source: Alexandria, VA: Time-Life Books. 1997. 960 p. Contact: Available from Time-Life Books. 400 Keystone Industrial Park, Dunsmore, PA 18512. PRICE: $20.00. ISBN: 0783552505. Summary: This book offers information about 300 health problems, ranging from relatively benign conditions to the most serious diseases. The book provides symptom charts that name several related problems and help readers decide which ailment entry to look up. Ailment entries provide a more complete list of symptoms, plus guidelines to discern whether the condition is potentially serious or requires a doctor's attention. Each entry describes the ailment and how it affects the body. Next, the entry outlines the underlying causes of the ailment and tests and procedures a doctor may use to confirm the diagnosis. The treatment segment presents conventional and alternative
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recommendations for curing the problem or alleviating the symptoms. Most ailment entries conclude with advice on preventive measures that can be used to maintain health. Alternative treatments described include bodywork, acupuncture and acupressure, herbal therapies, homeopathy, lifestyle changes, and nutrition and diet. The book begins with a section on emergency medicine. Also included is a visual diagnostic guide, an atlas to the body, a medicine chest section (describing herbs, homeopathic remedies, and over the counter drugs), a glossary, a subject index, a bibliography, and a list of health associations and organizations. Topics related to kidney and urologic diseases include AIDS, anemia, bedwetting, bladder cancer, bladder infections, diabetes, drug abuse, fluid retention, groin strain, impotence, incontinence, infertility, kidney cancer, kidney disease, kidney infections, kidney stones, penile pain, prostate cancer, prostate problems, sexual dysfunction, sexually transmitted diseases, testicle problems, testicular cancer, and urinary problems. The book is illustrated with line drawings and full color photographs. •
Kidney and Urinary Tract Diseases and Disorders Sourcebook Source: Detroit, MI: Omnigraphics, Inc. 1997. 602 p. Contact: Available from Omnigraphics, Inc. Penobscot Building, Detroit, MI 48226. (800) 234-1340 or (313) 961-1340. Fax (313) 961-1383. PRICE: $75.00. ISBN: 0780800796. Summary: This sourcebook provides nontechnical information to address the concerns of those who live with kidney and urinary tract diseases and disorders. The book provides research, diagnostic, and treatment information; demographic and statistical data; and lists of resources. The book's 43 chapters are presented in 10 sections. General Information on Kidney and Urinary Tract Disease Resources provides general information on and contacts for organizations that support patients with kidney disease. In addition, a glossary provides definitions of terms associated with kidney disease. Introduction to the Kidneys explains normal kidney function and the complications that result from a nonfunctioning organ. Also included in this section is information about kidney disease among African Americans, a population in which the incidence of various kidney diseases is disproportionately high. Kidney Disorders in Children discusses the diagnosis, treatment, and followup care for those with Wilms' Tumor (a form of kidney cancer that most often appears in children) and childhood nephrotic syndrome. Understanding Adult Kidney Disorders describes the symptoms, diagnosis, and treatment options available to those with common and rare kidney problems. Cancer and the Kidney contains recent information about the diagnosis and treatment of kidney cancer, including an online service for kidney cancer patients. End-stage Renal Disease (ESRD), Dialysis, and Amyloidosis presents material on the differences between the various treatments of ESRD, the nutritional needs of ESRD patients, and related health concerns such as the risk of AIDS and amyloidosis in dialysis patients. General Information on Urinary Tract Disorders gives basic facts about urologic diseases and disorders, including when to be concerned about blood in the urine, and explains the information that is gained from a urinalysis. Children and Urinary Tract Disorders addresses common problems including bedwetting, frequent urination, and urinary reflux in children. Understanding Adult Urinary Tract Disorders supplies information about incontinence, interstitial cystitis, and urinary tract infections. The resources in this section are designed to help the reader and concerned loved ones to gain basic information about the causes and treatment of these problems and can provide a basis of discussion with a health professional. Finally, Cancer of the Urinary Tract delineates diagnosis, treatment, and coping strategies for those faced with cancer of the bladder and urethra. Throughout the guidebook, readers are provided with suggestions for
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additional resources, including supporting organizations. A detailed subject index concludes the volume. (AA-M).
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “kidney cancer” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “kidney cancer” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “kidney cancer” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
21st Century Complete Medical Guide to Kidney Cancer (Renal Cell, Transitional Cell, Wilm's Tumor) - Authoritative Government Documents and Clinical References for Patients and Physicians with Practical Information on Diagnosis and Treatment Options by PM Medical Health News; ISBN: 1592480179; http://www.amazon.com/exec/obidos/ASIN/1592480179/icongroupinterna
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Kidney Cancer (Cancer Treatment and Research, 116) by Robert A. Figlin (Editor); ISBN: 1402074573; http://www.amazon.com/exec/obidos/ASIN/1402074573/icongroupinterna
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Kidney Cancer: Recent Results of Basic and Clinical Research (Contributions to Nephrology) by O. Hino (Editor); ISBN: 380556919X; http://www.amazon.com/exec/obidos/ASIN/380556919X/icongroupinterna
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Prostate and Renal Cancer, Benign Prostatic Hyperplasia, Erectile Dysfunction and Basic Research: An Update by Ch. H. Bangma (Editor), et al; ISBN: 1842141961; http://www.amazon.com/exec/obidos/ASIN/1842141961/icongroupinterna
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Recent Progress in Bladder and Kidney Cancer: Based on the Proceedings of the First International Congress of the Dutch Urological Association "Prog by Fritz H. Schroder (Editor), Dutch Urological Association; ISBN: 0471588210; http://www.amazon.com/exec/obidos/ASIN/0471588210/icongroupinterna
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Renal Cancer: Methods and Protocols by Jack H. Mydlo (Editor); ISBN: 0896038289; http://www.amazon.com/exec/obidos/ASIN/0896038289/icongroupinterna
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What you need to know about kidney cancer (SuDoc HE 20.3152:K 54/990) by U.S. Dept of Health and Human Services; ISBN: B000105G9E; http://www.amazon.com/exec/obidos/ASIN/B000105G9E/icongroupinterna
Chapters on Kidney Cancer In order to find chapters that specifically relate to kidney cancer, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and kidney cancer 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
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and language you prefer, and the format option “Book Chapter.” Type “kidney cancer” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on kidney cancer: •
Urological Issues for the Nephrologist Source: in Johnson, R.J. and Feehally, J. Comprehensive Clinical Nephrology. 2nd ed. Orlando, FL: Mosby, Inc. 2003. p. 759-767. Contact: Available from Mosby, Inc. Order Fulfillment Department, 6277 Sea Harbor Drive, Orlando FL 32887. (800) 321-5068. Fax (800)874-6418. E-mail:
[email protected] Website: www.elsevierhealth.com. PRICE: $199.00. ISBN: 723432589. Summary: Close working between nephrologists (kidney specialists) and urologists is crucial to the optimal management of a number of common clinical problems. A proper understanding of urological strategies helps the nephrologist to ensure that patients presenting with these problems are given clear information and are optimally managed. This chapter on urological issues for the nephrologist is from a comprehensive textbook that covers every clinical condition encountered in nephrology (the study of kidney disease). The authors of this chapter discuss the areas where such coordinated work is most important, including the management of stone disease, the surgical approach to urinary tract obstruction, the investigation of hematuria (blood in the urine), and the management of renal tract malignancy (kidney cancer). The chapter is clinically focused and extensively illustrated in full color. 5 figures. 6 tables. 22 references.
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Partial Nephrectomy Source: in Graham, S.D., Jr., et al., eds. Glenn's Urologic Surgery. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins. 1998. p. 51-60. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Fax (301) 824-7390. Website: lww.com. PRICE: $199.00 plus shipping and handling. ISBN: 0397587376. Summary: Recent interest in partial nephrectomy or nephron sparing surgery for renal cell carcinoma has been stimulated by advances in renal imaging, improved surgical techniques, the increasing number of incidentally discovered low stage renal cell carcinomas, and good long term survival in patients undergoing this form of treatment. Partial nephrectomy entails complete local resection of a renal tumor while leaving the largest possible amount of normal functioning parenchyma in the involved kidney. This chapter on partial nephrectomy is from an exhaustive textbook on urologic surgery. Evaluation of patients with renal cell carcinoma (kidney cancer) for partial nephrectomy should include preoperative testing to rule out locally extensive or metastatic disease. Accepted indications for partial nephrectomy in malignancies include situations in which radical nephrectomy would render the patient anephric (without kidney function) with subsequent need for dialysis. Partial nephrectomy is also indicated in selected patients with localized benign pathology of the kidney. The author reviews the surgical technique, including anatomic considerations, the timing of surgery in bilateral tumors, general operative considerations, segmental polar nephrectomy, wedge resection, transverse resection, simple enucleation, extracorporeal partial nephrectomy and autotransplantation, postoperative followup, and complications. Complications of partial nephrectomy include hemorrhage, urinary fistula formation, ureteral obstruction, renal insufficiency, and infection. The need for early control and ready access to the renal artery is emphasized, as significant intraoperative bleeding can occur
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in patients who are undergoing partial nephrectomy. The technical success rate with partial nephrectomy for renal cell carcinoma is excellent, as several large studies have reported 5 year survival rates of 87 to 90 percent. 7 figures. 2 tables. 10 references. •
Radical Nephrectomy Source: in Graham, S.D., Jr., et al., eds. Glenn's Urologic Surgery. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins. 1998. p. 61-72. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Fax (301) 824-7390. Website: lww.com. PRICE: $199.00 plus shipping and handling. ISBN: 0397587376. Summary: Renal cell carcinoma (RCC, kidney cancer) is the most common malignancy of the kidney and accounts for about 3 percent of all adult neoplasms. Because RCC is relatively resistant to chemotherapy and radiation therapy, surgery in general and radical nephrectomy in particular has evolved as the primary treatment in patients with clinically localized and locally advanced disease. This chapter on radical nephrectomy is from an exhaustive textbook on urologic surgery. Radical nephrectomy is defined as resection of Gerota fascia and its entire contents including the kidney, perinephric fat and lymphatics, and ipsilateral adrenal gland. A renal mass detected on either intravenous pyelography or ultrasound is usually confirmed by computer tomography (CT scan); between 85 percent and 90 percent of all solid renal masses are RCC. The indication for radical nephrectomy is a clinically localized solid renal mass in a patient with a normal contralateral kidney. In contrast, patients with solitary kidneys, renal insufficiency, and bilateral renal masses should be considered candidates for nephron sparing surgery. The author reviews surgical techniques, including flank incision, thoracoabdominal incision, transabdominal (Chevron or anterior subcostal), general techniques for radical nephrectomy, complications, and results. The author cautions that the potential for bleeding during radical nephrectomy necessitates careful patient preparation and preoperative planning to significantly reduce the chances of bleeding. 7 figures. 10 references.
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CHAPTER 6. MULTIMEDIA ON KIDNEY CANCER Overview In this chapter, we show you how to keep current on multimedia sources of information on kidney cancer. 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 kidney cancer is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “kidney cancer” 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 “kidney cancer” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on kidney cancer: •
Radiofrequency Assisted Laparoscopic Partial Nephrectomy Source: Houston, TX: American Urological Association (AUA) Office of Education. 2000. (videocassette). Contact: Available from AUA Office of Education. 2425 West Loop South, Suite 333, Houston, Texas 77027. (800) 282-7077. Fax: (713) 622-2898. PRICE: $20.00. Item number HV2247. Summary: This videotape program demonstrates the step by step technique of using laparoscopic radiofrequency (thermal or heat) coagulation of a cancerous mass followed by laparoscopic excision of the mass (removal of a tumor, done with a laparoscope, an illuminated tube that permits transcutaneous, or through the skin, surgery). The program first reviews the patient preparation and trocar placement (how and where on the abdomen the laparoscopes are placed), then details the operative technique used. Each step of the surgery is shown in an actual patient, a 48 year old female with a 1.5 centimeter by 1.5 centimeter Grade II renal cell carcinoma (kidney cancer tumor).
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Graphics are interspersed and overlaid to help visualize the steps of each part of the procedure. The program concludes by offering statistics and information about the benefits of this procedure (including a decrease in peri and postoperative bleeding and the ability to perform precise pathologic staging and grading of the cancer). •
Kidney Failure: Are You At Risk? Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1998. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 051498B. Summary: This videotape program, moderated by Mary Lee, discusses end stage renal disease and the prevention or delay of kidney failure. The program features Dr. Bryan Becker, a nephrologist (kidney specialist). Dr. Becker explores the epidemiology of the recent trend of increasing levels of kidney failure, discussing the aging population, better diagnostics, and better rates of survival. Dr. Becker then reviews the physiology of the kidneys, noting that kidneys control fluids and electrolytes (sodium, potassium, chloride) in the body, regulate the acid base balance, help metabolize proteins and carbohydrates, and remove creatinine (a muscle breakdown product). Different kidney diseases have a varying impact on kidney function. More than 50 percent of kidney failure is caused by two diseases: diabetes mellitus and hypertension; other causes include heredity, illnesses, inflammation, toxicity, kidney cancer, and trauma to the kidney (e.g., automobile accidents). The symptoms of kidney disease (which can be largely silent) can include protein in the urine, hypertension, elevated creatinine levels, decrease in urine output, swelling in the feet (edema, or fluid accumulation), and an increase in nocturia (urinating at night). End stage renal disease (ESRD) is defined as loss of 90 percent or more of kidney function. Dr. Becker discusses screening and identifying patients who may be at risk of kidney disease, then debunks various myths about kidney disease, on the topics of one kidney versus two kidneys, dialysis, and transplantation. Dr. Becker emphasizes that kidney disease, while treatable, has a great impact on lifestyle, diet, caretaking, finances, family and support systems, and heart disease. Prevention strategies include identifying high risk patients, avoiding nephrotoxic medications (including ibuprofen), monitoring the diet, controlling blood pressure, controlling blood glucose levels (for people with diabetes), and educating oneself about kidney disease. The program concludes by referring viewers to the National Kidney and Urologic Diseases Information Clearinghouse (www.niddk.nih.gov).
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CHAPTER 7. PERIODICALS AND NEWS ON KIDNEY CANCER Overview In this chapter, we suggest a number of news sources and present various periodicals that cover kidney cancer.
News Services and Press Releases One of the simplest ways of tracking press releases on kidney cancer 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 “kidney cancer” (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 kidney cancer. 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 “kidney cancer” (or synonyms). The following was recently listed in this archive for kidney cancer: •
Kidney cancer vaccine shows promise in trial Source: Reuters Health eLine Date: February 20, 2004
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Aeterna stops kidney cancer study, cuts staff Source: Reuters Industry Breifing Date: December 17, 2003
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Focused ultrasound promising for kidney cancer Source: Reuters Health eLine Date: December 15, 2003
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Bayer, Onyx expand kidney cancer drug trials Source: Reuters Industry Breifing Date: October 27, 2003
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Aeterna's kidney cancer drug trial did not meet goals Source: Reuters Industry Breifing Date: September 24, 2003
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Aeterna kidney cancer drug trial did not meet goals Source: Reuters Medical News Date: September 24, 2003
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New drug delays kidney cancer progression Source: Reuters Health eLine Date: July 30, 2003
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Shark cartilage extract to treat kidney cancer given US orphan drug status Source: Reuters Medical News Date: October 29, 2002
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AEterna gets US orphan drug status for kidney cancer drug Source: Reuters Industry Breifing Date: October 29, 2002
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Kidney cancer rate rising rapidly in British women Source: Reuters Medical News Date: September 23, 2002
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Kidney cancer growing fastest in British women Source: Reuters Health eLine Date: September 23, 2002
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FDA grants Antigenics vaccine orphan status for kidney cancer Source: Reuters Industry Breifing Date: May 29, 2002
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Abgenix compound shows promise in phase II kidney cancer study Source: Reuters Industry Breifing Date: May 22, 2002
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Angiogenesis inhibitor appears to delay kidney cancer progression Source: Reuters Medical News Date: May 21, 2002
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Genentech's Avastin delays kidney cancer progression in phase II trial Source: Reuters Industry Breifing Date: May 20, 2002
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Drug may delay kidney cancer progression Source: Reuters Health eLine Date: May 20, 2002
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Kidney cancer cases have risen dramatically in UK Source: Reuters Health eLine Date: February 21, 2002
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Kidney cancer detection on the rise in US Source: Reuters Health eLine Date: January 14, 2002
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Surgery still useful after kidney cancer spreads Source: Reuters Health eLine Date: December 05, 2001
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Obesity ups kidney cancer risk in men and women Source: Reuters Health eLine Date: November 12, 2001
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Chinese herb associated with kidney cancer Source: Reuters Health eLine Date: November 02, 2001
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Genentech kidney cancer drug reaches phase II trial endpoint early Source: Reuters Industry Breifing Date: October 25, 2001
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ZD 1839 shows promise in phase II renal cancer trial Source: Reuters Industry Breifing Date: June 11, 2001
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Abgenix, Immunex move ABX-EGF into phase II kidney cancer trials Source: Reuters Industry Breifing Date: April 18, 2001
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Phase I/II data show shark cartilage extract effective against kidney cancer Source: Reuters Medical News Date: March 26, 2001
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Aeterna moves shark cartilage drug into phase III kidney cancer study Source: Reuters Industry Breifing Date: March 26, 2001
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Laparoscopic nephrectomy for kidney cancer works well Source: Reuters Medical News Date: December 06, 2000
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Obesity, high blood pressure raise kidney cancer risk Source: Reuters Health eLine Date: November 01, 2000
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Obesity and hypertension independently linked to risk of kidney cancer in men Source: Reuters Medical News Date: November 01, 2000
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Stem-cell transplant shrinks tumors in kidney cancer patients Source: Reuters Health eLine Date: September 13, 2000
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New kidney cancer treatment proposed Source: Reuters Health eLine Date: June 07, 2000
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Removal of kidney substantially increases survival of patients with renal cancer Source: Reuters Medical News Date: May 23, 2000
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Surgery, drug treatment prolongs kidney cancer survival Source: Reuters Health eLine Date: May 22, 2000
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Vaccine approach offers hope for kidney cancer Source: Reuters Health eLine Date: March 01, 2000
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Molecular urinalysis detects renal cancer Source: Reuters Medical News Date: December 09, 1999
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Trichloroethylene exposure linked to "unique" kidney cancer mutations Source: Reuters Medical News Date: May 19, 1999
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Blood test detects kidney cancer Source: Reuters Health eLine Date: May 19, 1999
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Chemical linked to gene mutation in kidney cancer Source: Reuters Health eLine Date: May 18, 1999
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US kidney cancer cases, deaths rising Source: Reuters Health eLine Date: May 06, 1999
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Oil refinery jobs linked to kidney cancer Source: Reuters Health eLine Date: August 20, 1998
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Smoking, Hypertension Again Emerge As Risk Factors For Kidney Cancer Source: Reuters Medical News Date: June 03, 1997
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Synthetic GH-RH Antagonist Suppresses Kidney Cancer Growth Source: Reuters Medical News Date: May 27, 1997
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Experimental Kidney Cancer Vaccine Source: Reuters Health eLine Date: April 15, 1997
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High Blood Pressure Link to Kidney Cancer Source: Reuters Health eLine Date: April 07, 1997
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Renal Cancer Gene Identified Source: Reuters Medical News Date: May 10, 1996 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date
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at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “kidney cancer” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “kidney cancer” (or synonyms). If you know the name of a company that is relevant to kidney cancer, 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 “kidney cancer” (or synonyms).
Academic Periodicals covering Kidney Cancer Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to kidney cancer. In addition to these sources, you can search for articles covering kidney cancer that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.”
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If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 8. 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 kidney cancer. 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 kidney cancer. 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 kidney cancer: Interferons, Alpha •
Systemic - U.S. Brands: Alferon N; Intron A; Roferon-A http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202299.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 “kidney cancer” (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 35278 175 1064 1 322 36840
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 “kidney cancer” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
14
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
15
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/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
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.
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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 kidney cancer 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 kidney cancer. 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 kidney cancer. 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 “kidney cancer”:
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Guides on kidney cancer Kidney Cancer http://www.nlm.nih.gov/medlineplus/kidneycancer.html
•
Other guides Bladder Cancer http://www.nlm.nih.gov/medlineplus/bladdercancer.html Cancer http://www.nlm.nih.gov/medlineplus/cancer.html Kidney Diseases http://www.nlm.nih.gov/medlineplus/kidneydiseases.html Prostate Cancer http://www.nlm.nih.gov/medlineplus/prostatecancer.html
Within the health topic page dedicated to kidney cancer, the following was listed: •
General/Overviews Kidney Cancer Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00360 What Is Kidney Cancer (Renal Cell Carcinoma)? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_kidney_cancer_ 22.asp?sitearea=cri
•
Diagnosis/Symptoms Cystoscopy and Ureteroscopy Source: National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/cystoscopy/index.htm How Is Kidney Cancer (Renal Cell Carcinoma) Diagnosed? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_3x_how_is_kidney_cancer_d iagnosed_22.asp?sitearea=cri How Is Kidney Cancer (Renal Cell Carcinoma) Staged? Source: American Cancer Society http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_kidney_cance r_staged_22.asp?sitearea=&level= Urine Cytology Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01050
Patient Resources 87 •
Treatment How Is Kidney Cancer (Renal Cell Carcinoma) Treated? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_4x_how_is_kidney_cancer_tr eated_22.asp? Kidney Cancer: Treatment Choices by Stage Source: American Cancer Society http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Treatment_Choices_b y_Stage_22.asp?sitearea=
•
Specific Conditions/Aspects Transitional Cell Cancer of the Renal Pelvis and Ureter (PDQ): Treatment Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/treatment/transitionalcell/patient/ What Should You Ask Your Doctor about Kidney Cancer? Source: American Cancer Society http://www.cancer.org/docroot/CRI/content/CRI_2_4_5X_What_should_you_as k_your_physician_about_kidney_cancer_22.asp
•
From the National Institutes of Health Renal Cell Cancer (PDQ): Treatment Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/treatment/renalcell/patient/ What You Need to Know about Kidney Cancer Source: National Cancer Institute http://www.cancer.gov/cancerinfo/wyntk/kidney
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Latest News Kidney Cancer Vaccine Shows Promise in Trial Source: 02/20/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16186 .html
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Organizations American Cancer Society http://www.cancer.org/ American Foundation for Urologic Disease http://www.afud.org/ National Cancer Institute http://www.cancer.gov/
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Prevention/Screening Kidney Cancer Questionnaire Source: Harvard Center for Cancer Prevention http://www.yourcancerrisk.harvard.edu/hccpquiz.pl?func=d_start&cancer_list=Ki dney What Are the Risk Factors for Kidney Cancer (Renal Cell Carcinoma)? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_2x_what_are_the_risk_factor s_for_kidney_cancer_22.asp?sitearea=cri
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Research Molecularly Targeted Drug Slows Tumor Growth in Patients with Metastatic Kidney Cancer Source: National Cancer Institute http://www.nih.gov/news/pr/may2002/nci-19.htm Therapy Shows Promise for Treating Advanced Renal Cell Cancer Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Therapy_Shows_Pro mise_For_Treating_Advanced_Renal_Cell_Cancer.asp
•
Statistics What Are the Key Statistics for Kidney Cancer (Renal Cell Carcinoma)? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_are_the_key_statist ics_for_kidney_cancer_22.asp?sitearea=cri
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 kidney cancer. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Renal Cell Carcinoma: Basic Facts About Kidney Cancer Source: Baltimore, MD: American Foundation for Urologic Disease. 200x. 15 p.
Patient Resources 89 Contact: Available from American Foundation for Urologic Disease (AFUD). 1128 North Charles Street, Baltimore, MD 21201. (800) 242-2383. Website: www.afud.org. PRICE: $13.00 for pack of 50; plus shipping and handling. Summary: Renal cell carcinoma is the most common type of kidney cancer. This brochure, written for people recently diagnosed with renal cell carcinoma, explains the risk factors for kidney cancer, diagnostic tests used to confirm kidney cancer, staging of renal cell carcinoma, prognosis, and treatment options, including new treatment modalities currently under development. Environmental risk factors potentially related to renal cell carcinoma include smoking, certain pain killers that contain phenacetin, and exposure to some heavy metals; there are also hereditary risk factors. Diagnosis includes physical examination and medical history, urinalysis (to detect the presence of blood in the urine), imaging studies (intravenous pyelogram, ultrasonography, computed tomography, and magnetic resonance imaging), and cystoscopy. Renal cell carcinoma is classified into four stages: stage I, confined to the kidney; stage II, broken through the kidney capsule and spread into adjacent tissues; stage III, may have spread further into lymph nodes and blood vessels; and stage IV, more advanced, spread into other organs. The treatment of renal cell carcinoma depends on the stage and the patient's overall physical health. Surgery is the main treatment and can include radical nephrectomy (removal of the kidney, adrenal gland, and fatty tissue around the kidney), lymphadenectomy (removal of the adjacent lymph nodes), or partial nephrectomy (removal of a portion of the kidney). The brochure concludes with a glossary of terms used in the text. 2 figures. 1 table. •
Kidney Cancer Source: New York, NY: National Kidney Foundation, Inc. 1991. 3 p. Contact: Available from National Kidney Foundation, Inc. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free. Summary: This fact sheet presents a brief overview of kidney cancer. Written in a question-and-answer format, the fact sheet includes a description of renal carcinoma; how kidney cancer is diagnosed; the meaning of blood in the urine; how doctors tell a kidney cyst from a kidney cancer; how kidney cancer is treated; the options for the person with only one kidney that is found to be cancerous; non-surgical options for treating kidney cancer; problems in patients in whom the kidney cancer has spread beyond the kidneys, notably to the lungs; the role of heredity in kidney cancer; and the activities of the National Kidney Foundation. 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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Dealing with Kidney Cancer Summary: healthfinder® — your guide to reliable health information health library just for you health care organizations search: go help | about healthfinder® Dealing with Kidney Source: Kidney Cancer Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7819
•
What You Need To Know About™ Kidney Cancer Summary: The National Cancer Institute (NCI) has written this booklet to help people with kidney cancer and their families and friends better understand this disease. Source: Cancer Information Service, National Cancer Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7132 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 kidney cancer. 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
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Associations and Kidney Cancer The following is a list of associations that provide information on and resources relating to kidney cancer:
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Kidney Cancer Association Telephone: (847) 332-1051 Toll-free: (800) 850-9132 Fax: (847) 332-2978 Email:
[email protected] Web Site: http://curekidneycancer.org Background: The Kidney Cancer Association is a national non-profit organization comprised of people who have been affected by kidney cancer, their families and friends, physicians, and researchers. The Association is dedicated to improving the quality of care and increasing survival of individuals affected by kidney cancer. Established in 1990, the Association works toward three primary goals: to provide information to affected individuals and physicians; to sponsor and conduct research on kidney cancer; and to act as an advocate on a federal level and with insurance companies and employers on behalf of affected individuals and their families. Comprised of more than 15,000 constituents, the organization publishes 'Kidney Cancer News,' an electronic newsletter, as well as several informational brochures including 'We Have Kidney Cancer,' 'Interleukin-2 Therapy: What You Should Know,' and 'Kidney Cancer: Emotional vs. Rational.' The Association holds support group meetings several times a year in various cities so that individuals who have kidney cancer can learn how others have dealt with their disease. In addition, the Association conducts a yearly national convention that brings individuals together with leading physicians and researchers in the field of kidney cancer.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to kidney cancer. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with kidney cancer. 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 kidney cancer. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine.
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To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “kidney cancer” (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 “kidney cancer”. 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 “kidney cancer” (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 “kidney cancer” (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.22
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
22
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)23: •
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
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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)
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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/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
23
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 95
•
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
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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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/
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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
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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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/
Finding Medical Libraries 97
•
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
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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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/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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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
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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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
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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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).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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KIDNEY CANCER 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] Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablation: The removal of an organ by surgery. [NIH] Abscess: A localized, circumscribed collection of pus. [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] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [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] 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 Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [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
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stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airways: Tubes that carry air into and out of the lungs. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Allogeneic: Taken from different individuals of the same species. [NIH] Alopecia: Absence of hair from areas where it is normally present. [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] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alternative Splicing: A process whereby multiple protein isoforms are generated from a single gene. Alternative splicing involves the splicing together of nonconsecutive exons during the processing of some, but not all, transcripts of the gene. Thus a particular exon may be connected to any one of several alternative exons to form messenger RNA. The alternative forms produce proteins in which one part is common while the other part is different. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] 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] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast
Dictionary 103
cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [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] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] 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] Anomalies: Birth defects; abnormalities. [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] Antibody therapy: Treatment with an antibody, a substance that can directly kill specific tumor cells or stimulate the immune system to kill tumor cells. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [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 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] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH]
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Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [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] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] 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 phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arsenicals: Inorganic or organic compounds that contain arsenic. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Asbestos: Fibrous incombustible mineral composed of magnesium and calcium silicates with or without other elements. It is relatively inert chemically and used in thermal insulation and fireproofing. Inhalation of dust causes asbestosis and later lung and gastrointestinal neoplasms. [NIH] Asbestosis: A lung disorder caused by constant inhalation of asbestos particles. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH]
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Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Balloon Occlusion: Use of a balloon catheter to block the flow of blood through an artery or vein. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [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] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Bevacizumab: A monoclonal antibody that may prevent the growth of blood vessels from surrounding tissue to a solid tumor. [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 digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] 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] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived
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constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] 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] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Cells: Cells contained in the bone marrow including fat cells, stromal cells, megakaryocytes, and the immediate precursors of most blood cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] 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] 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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] 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]
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Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Bronchus: A large air passage that leads from the trachea (windpipe) to the lung. [NIH] Cadherins: A group of functionally related glycoproteins responsible for the calciumdependent cell-to-cell adhesion mechanism. They are divided into subclasses E-, P-, and Ncadherins, which are distinct in immunological specificity and tissue distribution. They promote cell adhesion via a homophilic mechanism. These compounds play a role in the construction of tissues and of the whole animal body. [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] Cancer vaccine: A vaccine designed to prevent or treat cancer. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] 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] Carboplatin: An organoplatinum compound that possesses antineoplastic activity. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] 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] Cardiotoxicity: Toxicity that affects the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [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 Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell
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division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [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] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] 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] Checkup: A general physical examination. [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] Chemotherapy: Treatment with anticancer drugs. [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] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by
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calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical 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] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] 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] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [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
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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] Complete response: The disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [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] Contralateral: Having to do with the opposite side of the body. [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
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pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortical Blindness: The inability to understand or interpret what is seen due to a disturbance in the cerebral associational areas, the retina, the sensory pathways, and the striate area being intact. [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] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclin: Molecule that regulates the cell cycle. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cystoscopy: Endoscopic examination, therapy or surgery of the urinary bladder. [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] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of
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special organs. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]
Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]
Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [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] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] 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] 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] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNA-
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binding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dystonia: Disordered tonicity of muscle. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] 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] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] 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] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be
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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] Emergency Medicine: A branch of medicine concerned with an individual's resuscitation, transportation and care from the point of injury or beginning of illness through the hospital or other emergency treatment facility. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometrium: The layer of tissue that lines the uterus. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enoxaparin: A drug used to prevent blood clots. It belongs to the family of drugs called anticoagulants. [NIH] Enucleation: Removal of the nucleus from an eucaryiotic cell. [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]
Environmental Pollutants: Substances which pollute the environment. Use environmental pollutants in general or for which there is no specific heading. [NIH]
for
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophil: A polymorphonuclear leucocyte with large eosinophilic granules in its cytoplasm, which plays a role in hypersensitivity reactions. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [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 and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local
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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] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoiesis: The production of erythrocytes. [EU] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] 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] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] 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] Extracorporeal: Situated or occurring outside the body. [EU] Extraction: The process or act of pulling or drawing out. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] 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] 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] Fibroid: A benign smooth muscle tumor, usually in the uterus or gastrointestinal tract. Also called leiomyoma. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ,
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usually as a consequence of inflammation or other injury. [NIH] Fludarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]
Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Follicles: Shafts through which hair grows. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal Neoplasms: Tumors or cancer of the gastrointestinal system. [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] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]
Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Targeting: The integration of exogenous DNA into the genome of an organism at sites where its expression can be suitably controlled. This integration occurs as a result of homologous recombination. [NIH] Genetic 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 Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]
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Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germline mutation: A gene change in the body's reproductive cells (egg or sperm) that becomes incorporated into the DNA of every cell in the body of offspring; germline mutations are passed on from parents to offspring. Also called hereditary mutation. [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] Glomeruli: Plural of glomerulus. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [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] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] 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] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [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] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Granulocyte-Macrophage Colony-Stimulating Factor: An acidic glycoprotein of MW 23 kDa with internal disulfide bonds. The protein is produced in response to a number of inflammatory mediators by mesenchymal cells present in the hemopoietic environment and at peripheral sites of inflammation. GM-CSF is able to stimulate the production of
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neutrophilic granulocytes, macrophages, and mixed granulocyte-macrophage colonies from bone marrow cells and can stimulate the formation of eosinophil colonies from fetal liver progenitor cells. GM-CSF can also stimulate some functional activities in mature granulocytes and macrophages. [NIH] 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]
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] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Hematuria: Presence of blood in the urine. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] 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] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH]
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Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Hereditary mutation: A gene change in the body's reproductive cells (egg or sperm) that becomes incorporated into the DNA of every cell in the body of offspring; hereditary mutations are passed on from parents to offspring. Also called germline mutation. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterodimer: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histone Deacetylase: Hydrolyzes N-acetyl groups on histones. [NIH] Homeopathic remedies: Small doses of medicines, herbs, or both that are believed to stimulate the immune system. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] 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] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [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] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires
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and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [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
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [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] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [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] Impotence: The inability to perform sexual intercourse. [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] Incision: A cut made in the body during surgery. [NIH] 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] 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
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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]
Inferior vena cava: A large vein that empties into the heart. It carries blood from the legs and feet, and from organs in the abdomen and pelvis. [NIH] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] 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] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] 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] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon Alfa-2b: A recombinant alfa interferon consisting of 165 amino acid residues with arginine in position 23 and histidine in position 34. It is used extensively as an antiviral and antineoplastic agent. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [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-12: A heterodimeric cytokine that stimulates the production of interferon gamma from T-cells and natural killer cells, and also induces differentiation of Th1 helper
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cells. It is an initiator of cell-mediated immunity. [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] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] 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] 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] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intravenous: IV. Into a vein. [NIH] Intravenous pyelogram: IVP. A series of x-rays of the kidneys, ureters, and bladder. The xrays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. [NIH] Intravenous pyelography: IVP. X-ray study of the kidneys, ureters, and bladder. The x-rays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. [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]
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] Ipsilateral: Having to do with the same side of the body. [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] Jealousy: An irrational reaction compounded of grief, loss of self-esteem, enmity against the rival and self criticism. [NIH] 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]
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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 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] Kidney Pelvis: The flattened, funnel-shaped expansion connecting the ureter to the kidney calices. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laparoscopes: Endoscopes for examining the interior of the abdomen. [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] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Leiomyoma: A benign tumor derived from smooth muscle tissue, also known as a fibroid tumor. They rarely occur outside of the uterus and the gastrointestinal tract but can occur in the skin and subcutaneous tissues, probably arising from the smooth muscle of small blood vessels in these tissues. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase
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of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]
Liver metastases: Cancer that has spread from the original (primary) tumor to the liver. [NIH]
Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] 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] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lubricants: Oily or slippery substances. [NIH] Luciferase: Any one of several enzymes that catalyze the bioluminescent reaction in certain marine crustaceans, fish, bacteria, and insects. The enzyme is a flavoprotein; it oxidizes luciferins to an electronically excited compound that emits energy in the form of light. The color of light emitted varies with the organism. The firefly enzyme is a valuable reagent for measurement of ATP concentration. (Dorland, 27th ed) EC 1.13.12.-. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH]
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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]
Lymphadenectomy: A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. Also called lymph node dissection. [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] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] 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] 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] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [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]
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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] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] 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] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [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] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] 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] 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] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [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] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH]
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Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] 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] 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]
Nephrologist: A doctor who treats patients with kidney problems or hypertension. [NIH]
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Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephron: A tiny part of the kidneys. Each kidney is made up of about 1 million nephrons, which are the working units of the kidneys, removing wastes and extra fluids from the blood. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nephrotoxic: Toxic or destructive to kidney cells. [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] 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] 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] Nocturia: Excessive urination at night. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Medicine: A specialty field of radiology concerned with diagnostic, therapeutic, and investigative use of radioactive compounds in a pharmaceutical form. [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] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount
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of urine secreted. [NIH] Oncology: The study of cancer. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [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] Paranoia: A psychotic disorder marked by persistent delusions of persecution or delusional jealousy and behaviour like that of the paranoid personality, such as suspiciousness, mistrust, and combativeness. It differs from paranoid schizophrenia, in which hallucinations or formal thought disorder are present, in that the delusions are logically consistent and that there are no other psychotic features. The designation in DSM III-R is delusional (paranoid) disorders, with five types : persecutory, jealous, erotomanic, somatic, and grandiose. [EU] Parenchyma: The essential elements of an organ; used in anatomical nomenclature as a general term to designate the functional elements of an organ, as distinguished from its framework, or stroma. [EU] Particle: A tiny mass of material. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Patient Education: The teaching or training of patients concerning their own health needs.
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[NIH]
PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pelvic: Pertaining to the pelvis. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral stem cell transplantation: A method of replacing blood-forming cells destroyed by cancer treatment. Immature blood cells (stem cells) in the circulating blood that are similar to those in the bone marrow are given after treatment to help the bone marrow recover and continue producing healthy blood cells. Transplantation may be autologous (an individual's own blood cells saved earlier), allogeneic (blood cells donated by someone else), or syngeneic (blood cells donated by an identical twin). Also called peripheral stem cell support. [NIH] Peripheral stem cells: Immature cells found circulating in the bloodstream. New blood cells develop from peripheral stem cells. [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] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Pharmacokinetics: Dynamic and kinetic mechanisms of exogenous chemical and drug absorption, biotransformation, distribution, release, transport, uptake, and elimination as a function of dosage, and extent and rate of metabolic processes. It includes toxicokinetics, the pharmacokinetic mechanism of the toxic effects of a substance. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived
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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] Phosphorylates: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] 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] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [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] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert
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plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Polychlorinated Biphenyls: Industrial products consisting of a mixture of chlorinated biphenyl congeners and isomers. These compounds are highly lipophilic and tend to accumulate in fat stores of animals. Many of these compounds are considered toxic and potential environmental pollutants. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] 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] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [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] Precipitation: The act or process of precipitating. [EU]
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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] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary tumor: The original tumor. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [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] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Promyelocytic leukemia: A type of acute myeloid leukemia, a quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. [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 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] 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
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lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Isoforms: Different forms of a protein that may be produced from different genes, or from the same gene by alternative splicing. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] 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] 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] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [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] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH]
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Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] 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. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiofrequency ablation: The use of electrical current to destroy tissue. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [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] Ras gene: A gene that has been found to cause cancer when it is altered (mutated). Agents that block its activity may stop the growth of cancer. A ras peptide is a protein fragment produced by the ras gene. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been
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shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] 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] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [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] 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] Renal Artery: A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters. [NIH] Renal cell cancer: Cancer that develops in the lining of the renal tubules, which filter the blood and produce urine. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reproductive cells: Egg and sperm cells. Each mature reproductive cell carries a single set of 23 chromosomes. [NIH] Resected: Surgical removal of part of an organ. [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]
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Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [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] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Reversion: A return to the original condition, e. g. the reappearance of the normal or wild type in previously mutated cells, tissues, or organisms. [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] Ribonuclease: RNA-digesting enzyme. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [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 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] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and
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monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] 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] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU]
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Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] 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] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [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 mutations: Alterations in DNA that occur after conception. Somatic mutations can occur in any of the cells of the body except the germ cells (sperm and egg) and therefore are not passed on to children. These alterations can (but do not always) cause cancer or other diseases. [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] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH]
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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] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Compression: Acute and chronic conditions characterized by external mechanical compression of the spinal cord due to extramedullary neoplasm; epidural abscess; spinal fractures; bony deformities of the vertebral bodies; and other conditions. Clinical manifestations vary with the anatomic site of the lesion and may include localized pain, weakness, sensory loss, incontinence, and impotence. [NIH] Spinal Fractures: Broken bones in the vertebral column. [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] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other
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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] Striate: Recurrent branch of the anterior cerebral artery which supplies the anterior limb of the internal capsule. [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] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] 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]
Substrate: A substance upon which an enzyme acts. [EU] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [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]
Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH]
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Symphysis: A secondary cartilaginous joint. [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] Systemic: Affecting the entire body. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Thalidomide: A pharmaceutical agent originally introduced as a non-barbiturate hypnotic, but withdrawn from the market because of its known tetratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppresive and anti-angiogenic activity. It inhibits release of tumor necrosis factor alpha from monocytes, and modulates other cytokine action. [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] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymidine: A chemical compound found in DNA. Also used as treatment for mucositis.
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[NIH]
Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonicity: The normal state of muscular tension. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case 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] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another
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compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transitional cell carcinoma: A type of cancer that develops in the lining of the bladder, ureter, or renal pelvis. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [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] Tretinoin: An important regulator of gene expression, particularly during growth and development and in neoplasms. Retinoic acid derived from maternal vitamin A is essential for normal gene expression during embryonic development and either a deficiency or an excess can be teratogenic. It is also a topical dermatologic agent which is used in the treatment of psoriasis, acne vulgaris, and several other skin diseases. It has also been approved for use in promyelocytic leukemia. [NIH] Trichloroethylene: A highly volatile inhalation anesthetic used mainly in short surgical procedures where light anesthesia with good analgesia is required. It is also used as an industrial solvent. Prolonged exposure to high concentrations of the vapor can lead to cardiotoxicity and neurological impairment. [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 marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor model: A type of animal model which can be 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] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumor suppressor gene: Genes in the body that can suppress or block the development of cancer. [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] Tumorigenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [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] Ubiquitin: A highly conserved 76 amino acid-protein found in all eukaryotic cells. [NIH]
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Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Unresectable: Unable to be surgically removed. [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] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Fistula: An abnormal passage in any organ of the urinary tract or between urinary organs and other organs. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [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 Diseases: Diseases of the urogenital tract. [NIH] Urologic Diseases: Diseases of the urinary tract in both male and female. It does not include the male genitalia for which urogenital diseases is used for general discussions of diseases of both the urinary tract and the genitalia. [NIH] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [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] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU]
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Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [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] 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] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [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]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenobiotics: Chemical substances that are foreign to the biological system. They include naturally occurring compounds, drugs, environmental agents, carcinogens, insecticides, etc. [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
Dictionary 147
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] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
149
INDEX A Abdomen, 44, 46, 67, 101, 106, 114, 118, 121, 122, 123, 124, 129, 140, 141, 142, 146 Abdominal, 101, 129, 136 Aberrant, 14, 101 Ablation, 49, 101 Abscess, 101, 140 Acceptor, 101, 124, 129, 144 Acne, 101, 144 Acne Vulgaris, 101, 144 Adaptability, 101, 107, 108 Adenine, 101, 135 Adenocarcinoma, 24, 39, 58, 101, 118 Adenosine, 56, 101, 131 Adjuvant, 36, 52, 101, 116 Adrenal Glands, 101, 102, 136 Adverse Effect, 101, 138 Affinity, 101, 124, 139 Agonist, 56, 101 Airways, 56, 102 Algorithms, 102, 106 Alkaline, 102, 107 Allogeneic, 44, 45, 102, 117, 130 Alopecia, 102, 111 Alpha Particles, 102, 135 Alternative medicine, 73, 102 Alternative Splicing, 7, 102, 134 Amino Acid Sequence, 102, 103, 115, 116 Amino Acids, 102, 116, 130, 132, 134, 138 Amyloidosis, 62, 102 Anaesthesia, 102, 120 Analgesic, 102, 119 Analog, 102, 116 Analogous, 102, 113, 143 Anaphylatoxins, 102, 110 Anaplasia, 103 Anatomical, 103, 104, 110, 120, 129 Anemia, 62, 103, 127 Anesthesia, 41, 103, 144 Angiogenesis, 9, 70, 103 Animal model, 103, 144 Anomalies, 12, 103, 142 Antibacterial, 103, 140 Antibiotic, 103, 112, 140 Antibodies, 58, 103, 120, 125, 127, 131, 135 Antibody, 42, 49, 50, 51, 56, 101, 103, 105, 109, 119, 120, 121, 122, 125, 127, 135, 140, 147
Antibody therapy, 51, 56, 103 Anticoagulant, 103, 134 Antigen, 57, 58, 101, 103, 110, 112, 119, 120, 121, 125 Antigen-Antibody Complex, 103, 110 Antigen-presenting cell, 103, 112 Anti-inflammatory, 104, 117, 119 Antimetabolite, 104, 116 Antineoplastic, 104, 107, 111, 112, 116, 121, 129 Antioxidant, 104, 129 Antiviral, 104, 121 Anuria, 104, 123 Anus, 104, 106, 136 Aorta, 104, 136 Apoptosis, 9, 17, 104 Aqueous, 104, 105, 111 Arachidonic Acid, 104, 133 Arginine, 102, 104, 121 Aromatic, 16, 104, 130 Arsenicals, 14, 104 Arterial, 104, 119, 134, 142 Arteries, 104, 106, 110, 126, 135 Arterioles, 104, 106 Asbestos, 16, 20, 24, 104 Asbestosis, 104 Asymptomatic, 3, 104 Atrium, 27, 104 Autologous, 29, 32, 34, 104, 130 B Bacteria, 42, 103, 104, 105, 113, 114, 124, 126, 131, 136, 140, 143, 145 Bacteriuria, 105, 145 Balloon Occlusion, 27, 105 Barbiturate, 105, 142 Base, 33, 68, 101, 105, 112, 116, 122, 123 Benign, 45, 46, 61, 63, 64, 105, 115, 123, 127, 135 Benign tumor, 45, 105, 123 Bevacizumab, 48, 105 Bilateral, 64, 65, 105 Bile, 33, 105, 116, 124, 140 Bile Acids, 105, 140 Bile Acids and Salts, 105 Biochemical, 7, 15, 59, 104, 105, 123 Biological response modifier, 20, 21, 105, 121 Biological therapy, 40, 105, 118
150
Kidney Cancer
Biomarkers, 15, 105 Biopsy, 43, 46, 105 Biosynthesis, 13, 104, 105, 138 Biotechnology, 18, 19, 73, 81, 105 Bladder, 6, 10, 13, 14, 20, 23, 29, 42, 62, 63, 86, 106, 111, 120, 122, 133, 136, 144, 145 Blood Coagulation, 106, 107, 142 Blood Glucose, 68, 106, 118 Blood pressure, 68, 71, 106, 119, 127, 130, 135, 139 Body Fluids, 105, 106, 113, 139, 144 Bolus, 28, 106 Bolus infusion, 106 Bone Marrow, 106, 118, 120, 125, 127, 130, 133, 139, 140, 141 Bone Marrow Cells, 106, 118 Bone scan, 106, 138 Bowel, 106, 112, 122, 141 Bowel Movement, 106, 112, 141 Brachytherapy, 106, 122, 135, 147 Branch, 97, 106, 114, 125, 129, 136, 139, 141, 142 Breakdown, 68, 106, 112 Breeding, 9, 106 Bronchi, 106, 107, 114, 143 Bronchial, 56, 106 Bronchitis, 107, 108 Bronchoconstriction, 56, 107 Bronchus, 107 C Cadherins, 17, 107 Calcium, 13, 104, 107, 109, 134, 139 Cancer vaccine, 29, 69, 107 Carbohydrates, 68, 107 Carbon Dioxide, 107, 136 Carboplatin, 42, 107 Carcinogen, 10, 107 Carcinogenesis, 11, 15, 22, 107 Carcinogenic, 6, 107, 121, 133, 140, 144 Cardiac, 107, 114, 127, 137, 140 Cardiotoxicity, 107, 144 Cardiovascular, 10, 56, 107 Causal, 20, 107 Cell Adhesion, 17, 107 Cell Cycle, 107, 109, 111, 134 Cell Death, 16, 36, 104, 107, 127 Cell Differentiation, 107, 139 Cell Division, 104, 107, 108, 118, 126, 131, 138 Cell proliferation, 107, 139 Cell Respiration, 108, 136 Cell Survival, 10, 108, 118
Cell Transplantation, 41, 44, 47, 50, 51, 108 Cellulose, 107, 108, 131 Central Nervous System, 41, 108 Cerebral, 108, 111, 114, 115, 141 Cerebrovascular, 10, 108 Cerebrum, 108, 144 Checkup, 43, 108 Chemotactic Factors, 108, 110 Chemotherapy, 4, 36, 40, 41, 42, 43, 44, 45, 47, 50, 51, 56, 57, 58, 65, 108 Cholesterol, 105, 108, 140 Chromatin, 12, 104, 108 Chromium, 6, 108 Chromosomal, 8, 108, 131, 137 Chromosome, 12, 15, 45, 108, 118, 124, 138 Chronic, 6, 13, 14, 31, 56, 101, 108, 121, 123, 124, 134, 140, 141 Chronic Disease, 108, 123 Chronic lymphocytic leukemia, 31, 108 Chronic Obstructive Pulmonary Disease, 56, 108 CIS, 7, 108, 137 Cisplatin, 45, 109 Clear cell carcinoma, 9, 41, 48, 50, 109 Clinical trial, 4, 14, 26, 39, 54, 81, 109, 130, 134, 135 Cloning, 9, 12, 106, 109 Coagulation, 67, 106, 109 Cofactor, 109, 134, 142 Cohort Studies, 24, 109 Collapse, 106, 109 Colloidal, 109, 113 Colorectal, 40, 109 Colorectal Cancer, 40, 109 Combination chemotherapy, 42, 47, 109 Complement, 27, 102, 109, 116 Complete response, 51, 110 Computational Biology, 81, 110 Computed tomography, 42, 45, 46, 89, 110, 138 Computerized axial tomography, 110, 138 Computerized tomography, 41, 110 Conception, 110, 115, 139, 140 Conjugated, 105, 110, 111 Connective Tissue, 106, 110, 115, 116, 125, 126, 137, 141 Consciousness, 102, 110, 137 Constriction, 110, 146 Constriction, Pathologic, 110, 146 Contraception, 33, 110 Contraindications, ii, 110 Contralateral, 30, 65, 110
Index 151
Coronary, 110, 111, 126 Coronary Thrombosis, 111, 126 Cortex, 111, 115, 133 Cortical, 59, 111 Cortical Blindness, 59, 111 Corticosteroids, 111, 117 Creatinine, 68, 111, 123 Crossing-over, 111, 136 Curative, 11, 111, 142 Cyclic, 111, 133 Cyclin, 36, 111 Cyclophosphamide, 20, 44, 111 Cyst, 89, 111 Cystitis, 62, 111 Cystoscopy, 86, 89, 111 Cytochrome, 6, 111 Cytokine, 26, 111, 121, 142 Cytoplasm, 104, 111, 114, 118, 127 Cytotoxic, 111, 135, 139 Cytotoxicity, 15, 109, 111 D Databases, Bibliographic, 81, 112 Daunorubicin, 112 Deletion, 104, 112 Delivery of Health Care, 112, 118 Delusions, 112, 129 Dendrites, 112 Dendritic, 29, 112, 125 Dendritic cell, 29, 112 Density, 112, 139 Depolarization, 112, 139 Diabetes Mellitus, 68, 112, 117, 118 Diagnostic procedure, 55, 73, 112 Diastolic, 112, 119 Digestion, 105, 106, 112, 122, 124, 141 Digestive system, 54, 112, 127 Diploid, 112, 131 Direct, iii, 7, 12, 75, 112, 136 Disparity, 30, 112 Dissection, 112, 125 Distal, 112, 134 Doxorubicin, 42, 43, 112 Drug Design, 15, 112 Drug Interactions, 76, 113 Drug Resistance, 24, 113 Drug Tolerance, 113 Duct, 33, 113, 115, 137 Duodenum, 105, 113, 141 Dysphagia, 59, 113 Dystonia, 58, 59, 113 E Edema, 68, 113, 128
Effector, 12, 109, 113 Effector cell, 12, 113 Efficacy, 11, 14, 113 Electrocardiogram, 41, 42, 113 Electrocoagulation, 109, 113 Electrolyte, 113, 123, 132, 139 Electrons, 104, 105, 113, 122, 129, 135 Electrophoresis, 18, 113 Emboli, 34, 113 Embolization, 34, 113 Embryo, 107, 114, 120 Emergency Medicine, 62, 114 Emergency Treatment, 114 Emphysema, 56, 108, 114 Encapsulated, 114, 124 Endemic, 114, 140 Endometrial, 15, 114 Endometrium, 114 Endothelial cell, 114, 115, 142 Endotoxin, 114, 144 Enoxaparin, 33, 114 Enucleation, 64, 114 Environmental Exposure, 10, 14, 16, 114 Environmental Health, 10, 19, 20, 21, 24, 31, 32, 80, 82, 114 Environmental Pollutants, 114, 132 Enzymatic, 107, 110, 114, 137 Enzyme, 13, 16, 113, 114, 124, 129, 131, 134, 137, 139, 141, 142, 143, 144, 146, 147 Eosinophil, 114, 118 Epidemic, 114, 140 Epidural, 114, 140 Epigastric, 114, 129 Epinephrine, 114, 144 Epithelial, 7, 10, 12, 17, 18, 101, 115, 118 Epithelial Cells, 10, 17, 115, 118 Erythrocytes, 103, 106, 115, 136 Erythropoiesis, 9, 115 Esophagus, 112, 115, 136, 141 Eukaryotic Cells, 115, 144 Evoke, 115, 140 Excrete, 104, 115, 123 Exocrine, 115, 129 Exogenous, 115, 116, 130 Exon, 56, 102, 115 Expiration, 115, 136 External-beam radiation, 115, 122, 135, 146 Extracellular, 110, 115, 139 Extracorporeal, 64, 115 Extraction, 5, 115
152
Kidney Cancer
F Family Planning, 81, 115 Fat, 65, 104, 105, 106, 113, 115, 124, 132, 137, 139, 141 Fatty acids, 115, 133 Fetus, 115, 145 Fibrin, 106, 115, 131, 142 Fibrinogen, 115, 131, 142 Fibroblast Growth Factor, 23, 115 Fibroid, 115, 123 Fibrosis, 56, 115 Fludarabine, 44, 116 Fluorouracil, 47, 116 Follicles, 116 Forearm, 106, 116 G Gallbladder, 33, 101, 112, 116 Gamma Rays, 116, 135 Gasoline, 21, 22, 28, 31, 116 Gastrointestinal, 47, 104, 114, 115, 116, 123, 141, 144 Gastrointestinal Neoplasms, 104, 116 Gastrointestinal tract, 115, 116, 123, 144 Gelatin, 116, 117, 142 Gemcitabine, 42, 43, 45, 116 Gene Expression, 5, 6, 8, 10, 15, 116, 144 Gene Targeting, 9, 116 Genetic Code, 116, 128 Genetic Engineering, 106, 109, 116 Genetic testing, 46, 116 Genetics, 8, 9, 11, 34, 116, 130 Genital, 109, 116, 145 Genomics, 8, 59, 116 Genotype, 117, 130 Germline mutation, 4, 117, 119 Gland, 65, 89, 117, 125, 127, 129, 131, 133, 138, 140, 143 Glomeruli, 12, 117 Glomerulus, 117 Glucocorticoid, 6, 117 Glucose, 106, 108, 112, 117, 118, 137 Glucose Intolerance, 112, 117 Glycine, 105, 117, 138 Glycolysis, 9, 117 Glycoprotein, 115, 117, 142, 144 Gonadal, 117, 140 Governing Board, 117, 132 Grade, 67, 117 Grading, 68, 117 Graft, 117, 119, 120 Graft Rejection, 117, 120
Granulocyte-Macrophage ColonyStimulating Factor, 28, 117 Granulocytes, 118, 123, 139, 146 Groin, 62, 118 Growth factors, 8, 118 H Hair follicles, 45, 118 Haploid, 118, 131 Health Care Costs, 56, 118 Health Expenditures, 118 Hematuria, 64, 118 Heme, 6, 111, 118, 129 Hemodialysis, 118, 123 Hemoglobin, 103, 115, 118 Hemorrhage, 64, 113, 118, 141 Hepatic, 56, 118 Hepatocellular, 56, 118 Hepatocellular carcinoma, 56, 118 Hepatocytes, 6, 118 Hereditary, 4, 18, 23, 33, 46, 89, 117, 119 Hereditary mutation, 117, 119 Heredity, 68, 89, 101, 116, 119 Heterodimer, 16, 119 Heterogeneity, 4, 5, 9, 101, 119 Histidine, 119, 121 Histone Deacetylase, 14, 119 Homeopathic remedies, 62, 119 Homeostasis, 11, 13, 119 Homologous, 111, 116, 119, 138, 142 Hormonal, 31, 58, 119 Hormone, 111, 114, 119, 126, 133, 139, 143 Host, 58, 119, 120, 137, 145, 146 Hybrid, 7, 119 Hybridization, 7, 119 Hydrogen, 101, 105, 107, 119, 124, 126, 128, 129, 134 Hydrolysis, 109, 119, 130, 132, 134 Hypertension, 16, 28, 31, 68, 71, 72, 119, 127 Hypnotic, 105, 119, 142 Hypoxia, 9, 11, 119 I Ibuprofen, 68, 119 Id, 37, 86, 90, 96, 98, 119 Immune response, 12, 42, 51, 52, 53, 58, 101, 103, 117, 120, 141, 144, 145, 146 Immune Sera, 120 Immune system, 12, 40, 43, 103, 105, 113, 119, 120, 125, 145, 146 Immunity, 120, 122, 143 Immunization, 12, 120 Immunogenic, 57, 58, 120
Index 153
Immunoglobulin, 103, 120, 127 Immunologic, 58, 108, 120, 135 Immunology, 101, 120 Immunosuppressant, 116, 120 Immunosuppressive, 111, 117, 120, 142 Immunosuppressive therapy, 120 Immunotherapy, 4, 8, 23, 28, 58, 105, 120 Impairment, 120, 126, 144 Implant radiation, 120, 122, 135, 146 Impotence, 62, 120, 140 In vitro, 10, 12, 17, 18, 120, 142 In vivo, 10, 12, 17, 120, 142 Incision, 65, 120, 122 Incontinence, 62, 120, 140 Indicative, 63, 120, 129, 145 Induction, 6, 12, 120 Infarction, 111, 120, 126 Infection, 42, 64, 105, 108, 120, 121, 124, 125, 141, 146 Inferior vena cava, 27, 121 Infertility, 62, 121, 145 Inflammation, 56, 68, 101, 104, 107, 111, 116, 117, 121, 137 Inhalation, 104, 121, 144 Initiation, 4, 121, 143 Initiator, 121, 122 Inorganic, 13, 14, 104, 109, 121 Insecticides, 121, 146 Insight, 6, 7, 121 Interferon, 14, 23, 27, 34, 36, 47, 48, 49, 50, 52, 121 Interferon Alfa-2b, 48, 50, 121 Interferon-alpha, 27, 121 Interleukin-1, 49, 121 Interleukin-12, 49, 121 Interleukin-2, 28, 42, 47, 49, 52, 91, 121, 122 Intermittent, 122, 124 Internal Medicine, 122, 128 Internal radiation, 122, 135, 146 Interstitial, 62, 106, 122, 146 Intestine, 105, 106, 109, 113, 119, 122, 123 Intracellular, 13, 14, 121, 122, 126, 132, 133, 139 Intracellular Membranes, 122, 126 Intravenous, 19, 51, 65, 89, 122 Intravenous pyelogram, 89, 122 Intravenous pyelography, 65, 122 Invasive, 3, 120, 122, 125 Ionizing, 102, 114, 122, 135 Ions, 105, 113, 119, 122, 134 Ipsilateral, 65, 122
Irradiation, 15, 122, 147 J Jealousy, 122, 129 Joint, 56, 122, 142 K Kb, 80, 122 Kidney Disease, 54, 62, 64, 68, 80, 86, 123 Kidney Failure, 68, 123 Kidney Failure, Acute, 123 Kidney Failure, Chronic, 123 Kidney Pelvis, 123, 145 Kidney stone, 62, 123 Kidney Transplantation, 28, 123 L Labile, 109, 123 Laparoscopes, 67, 123 Large Intestine, 109, 112, 122, 123, 136 Latency, 10, 123 Lectin, 123, 126 Leiomyoma, 46, 115, 123 Lesion, 123, 124, 140 Leucocyte, 114, 123, 124 Leukaemia, 28, 123 Leukemia, 19, 25, 31, 41, 48, 112, 124, 133 Leukocytes, 106, 108, 118, 121, 124, 127, 144 Library Services, 96, 124 Ligament, 124, 134 Linkage, 9, 124 Lipid, 124, 129 Lipid Peroxidation, 124, 129 Lipophilic, 124, 132 Liposomal, 14, 52, 124 Liver, 6, 19, 25, 46, 49, 101, 102, 104, 105, 111, 112, 116, 118, 124, 138 Liver cancer, 19, 25, 124 Liver metastases, 49, 124 Liver scan, 124, 138 Localization, 7, 124 Localized, 42, 64, 65, 101, 102, 114, 121, 124, 131, 140 Locomotion, 124, 131 Long-Term Care, 8, 124 Loop, 15, 67, 124 Lubricants, 124, 130 Luciferase, 13, 124 Lymph, 42, 89, 114, 124, 125, 127 Lymph node, 42, 89, 125, 127 Lymphadenectomy, 89, 125 Lymphatic, 121, 124, 125, 126, 139, 140, 143 Lymphatic system, 124, 125, 139, 140, 143
154
Kidney Cancer
Lymphocyte, 49, 103, 125 Lymphocytic, 125 Lymphoid, 15, 50, 103, 111, 123, 125 Lymphoma, 20, 125 M Macrophage, 58, 118, 121, 125 Magnetic Resonance Imaging, 42, 45, 46, 89, 125, 138 Malignancy, 17, 64, 65, 125 Malignant, 7, 11, 15, 28, 49, 101, 104, 124, 125, 127, 135 Malignant tumor, 125, 127 Mediator, 56, 122, 125 Medical Records, 45, 46, 125 MEDLINE, 81, 125 Melanin, 125, 130, 144 Melanocytes, 125 Melanoma, 11, 28, 49, 50, 51, 56, 125 Membrane, 59, 110, 112, 115, 126, 127, 131, 132, 137, 139, 144 Membrane Proteins, 59, 126 Meninges, 108, 126 Menopause, 126, 132 Mental Disorders, 54, 126 Mentors, 11, 126 Mesenchymal, 117, 126 Meta-Analysis, 24, 126 Metastasis, 5, 8, 11, 30, 126 MI, 62, 99, 126 Microbe, 126, 143 Microorganism, 109, 126, 146 Microtubules, 126, 129 Mitosis, 104, 126 Modeling, 113, 126 Modification, 11, 13, 17, 116, 126, 135 Molecular, 5, 7, 8, 11, 12, 13, 14, 15, 23, 27, 34, 72, 81, 83, 106, 110, 112, 115, 126, 131, 141, 144 Molecule, 17, 58, 103, 105, 110, 111, 113, 119, 123, 126, 128, 129, 131, 135, 136, 139, 143 Monitor, 14, 22, 111, 127, 128 Monoclonal, 18, 32, 49, 50, 51, 105, 122, 127, 135, 147 Monoclonal antibodies, 18, 32, 127 Monocytes, 121, 124, 127, 142 Mononuclear, 127, 144 Morphogenesis, 12, 127 Motility, 15, 17, 127 Mucosa, 127, 141 Mucositis, 127, 142 Multiple Myeloma, 28, 127
Myocardium, 126, 127 N Natural killer cells, 121, 127 NCI, 1, 36, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 54, 79, 88, 90, 109, 127, 130 Necrosis, 104, 121, 126, 127 Need, 3, 15, 44, 61, 63, 64, 67, 87, 90, 92, 127 Neoplasm, 42, 43, 127, 140 Neoplastic, 27, 103, 125, 127 Nephrectomy, 3, 5, 26, 27, 33, 39, 64, 65, 67, 71, 89, 127 Nephrologist, 64, 68, 127 Nephrology, 21, 63, 64, 128 Nephron, 10, 64, 65, 117, 128 Nephropathy, 123, 128 Nephrosis, 128 Nephrotic, 62, 128 Nephrotic Syndrome, 62, 128 Nephrotoxic, 68, 128 Nerve, 103, 112, 125, 128, 132, 137, 140, 144 Nervous System, 108, 125, 128, 141 Neutrons, 102, 122, 128, 135 Nitrogen, 111, 123, 128 Nocturia, 68, 128 Nuclear, 41, 44, 113, 115, 116, 127, 128 Nuclear Medicine, 41, 44, 128 Nuclei, 102, 113, 116, 125, 126, 128, 134 Nucleic acid, 56, 59, 116, 119, 128, 135 Nucleic Acid Hybridization, 119, 128 Nucleus, 45, 104, 108, 111, 114, 115, 116, 127, 128, 134, 141 O Occupational Exposure, 24, 128 Odour, 104, 128 Oliguria, 123, 128 Oncology, 8, 11, 21, 24, 26, 28, 32, 33, 40, 41, 43, 48, 58, 129 Outpatient, 28, 46, 129 Ovary, 129, 141 Oxidation, 101, 104, 111, 124, 129 Oxidative Stress, 11, 129 Oxygen Consumption, 129, 136 Oxygenase, 6, 129 P Paclitaxel, 42, 129 Palliative, 36, 129, 142 Pancreas, 46, 101, 105, 112, 129, 144 Pancreatic, 56, 129 Pancreatic cancer, 56, 129 Paranoia, 59, 129
Index 155
Parenchyma, 64, 129 Particle, 129, 139, 143 Pathologic, 68, 104, 105, 111, 129, 134 Pathologic Processes, 104, 129 Patient Education, 88, 94, 96, 99, 129 PDQ, 87, 130 Pelvic, 130, 133 Peptide, 59, 115, 130, 132, 134, 135 Perfusion, 119, 130, 143 Peripheral blood, 14, 121, 130 Peripheral stem cell transplantation, 41, 44, 47, 50, 51, 130 Peripheral stem cells, 51, 130 Peripheral Vascular Disease, 13, 130 Petroleum, 16, 24, 28, 116, 130 Pharmacokinetics, 113, 130 Pharmacologic, 103, 130, 143 Phenotype, 4, 7, 11, 17, 22, 51, 130 Phenylalanine, 130, 144 Phospholipases, 130, 139 Phospholipids, 115, 130 Phosphorus, 107, 131 Phosphorylates, 13, 131 Phosphorylation, 13, 15, 131 Photocoagulation, 109, 131 Phototherapy, 56, 131 Physical Examination, 41, 42, 44, 46, 89, 108, 131 Physiologic, 102, 105, 131, 133, 136 Physiology, 11, 68, 128, 131 Pigment, 125, 131 Pilot study, 22, 131 Pituitary Gland, 115, 131 Plants, 10, 106, 107, 117, 123, 131, 137, 143 Plasma, 43, 103, 115, 116, 117, 118, 123, 127, 131, 134, 138, 143 Plasma cells, 103, 127, 131 Plasmid, 13, 131 Plasmin, 131, 132 Plasminogen, 22, 131 Plasminogen Activators, 131 Platelet Activation, 132, 139 Platelets, 43, 132, 142 Platinum, 109, 124, 132 Polychlorinated Biphenyls, 6, 25, 132 Polypeptide, 102, 115, 119, 131, 132, 147 Polyposis, 109, 132 Polysaccharide, 103, 108, 132 Posterior, 129, 132 Postmenopausal, 21, 132 Postoperative, 64, 68, 132 Postsynaptic, 132, 139
Post-translational, 11, 15, 132 Potassium, 68, 132 Potentiates, 121, 132 Potentiation, 132, 139 Practice Guidelines, 82, 132 Precipitation, 12, 132 Precursor, 104, 111, 113, 114, 130, 131, 133, 134, 144 Prevalence, 56, 133 Primary tumor, 18, 29, 133 Progesterone, 133, 140 Progression, 4, 8, 14, 15, 26, 46, 70, 103, 133, 144 Progressive, 18, 59, 107, 113, 118, 123, 127, 132, 133 Promoter, 13, 30, 133 Promyelocytic leukemia, 133, 144 Prophylaxis, 133, 145 Prospective study, 4, 133 Prostaglandin, 13, 133 Prostaglandins A, 133 Prostate, 9, 15, 46, 56, 62, 63, 86, 105, 133, 144 Protein C, 15, 102, 134 Protein Isoforms, 102, 134 Protein S, 59, 106, 116, 134 Proteinuria, 127, 128, 134 Proteolytic, 109, 115, 131, 134 Prothrombin, 134, 142 Protocol, 49, 51, 134 Protons, 102, 119, 122, 134, 135 Proto-Oncogene Proteins, 129, 134 Proto-Oncogene Proteins c-mos, 129, 134 Proximal, 14, 112, 134 Psoriasis, 134, 144 Public Policy, 81, 134 Publishing, 18, 134 Pulmonary, 10, 36, 56, 106, 123, 134, 135, 141 Pulmonary Artery, 106, 135 Pulmonary Edema, 123, 135 Pulmonary hypertension, 56, 135 Pulse, 127, 135 Purines, 135, 138 Q Quality of Life, 22, 135, 141 R Radiation, 46, 50, 51, 56, 57, 65, 114, 115, 116, 122, 135, 138, 146 Radiation therapy, 50, 51, 65, 115, 122, 135, 147
156
Kidney Cancer
Radioactive, 106, 119, 120, 122, 124, 127, 128, 135, 138, 144, 147 Radiofrequency ablation, 49, 135 Radioimmunotherapy, 135 Radiolabeled, 122, 135, 147 Radiology, 128, 135 Radiotherapy, 26, 58, 106, 122, 135, 147 Randomized, 113, 135 Ras gene, 29, 135 Reactive Oxygen Species, 11, 135 Reagent, 124, 136 Receptor, 6, 12, 27, 56, 57, 103, 136, 139 Recombinant, 121, 136 Recombination, 9, 116, 136 Rectal, 40, 136 Rectum, 104, 106, 109, 112, 120, 123, 134, 136 Recurrence, 52, 136 Red blood cells, 115, 129, 136, 137 Refer, 1, 109, 124, 128, 135, 136 Reflux, 62, 136 Refraction, 136, 140 Refractory, 6, 50, 51, 113, 136 Regeneration, 115, 136 Regimen, 113, 136 Remission, 136 Renal Artery, 27, 64, 136 Renal cell cancer, 16, 39, 40, 41, 43, 44, 45, 47, 48, 49, 50, 51, 52, 53, 58, 136 Renal pelvis, 39, 42, 123, 136, 144 Reproductive cells, 117, 119, 136 Resected, 52, 136 Resection, 3, 34, 64, 65, 136 Respiration, 56, 107, 127, 136, 137 Respiratory distress syndrome, 56, 137 Response rate, 36, 137 Resuscitation, 114, 137 Retina, 111, 137 Retinal, 112, 137 Retinoid, 14, 137 Retinol, 14, 137 Retrovirus, 12, 137 Reversion, 17, 137 Rheumatism, 119, 137 Ribonuclease, 19, 137 Ribose, 101, 137 Rigidity, 131, 137 Risk factor, 5, 16, 21, 31, 89, 133, 137 Risk patient, 68, 137 S Salivary, 112, 129, 137 Salivary glands, 112, 137
Saponins, 137, 140 Scans, 41, 42, 45, 46, 137 Schizophrenia, 129, 138 Screening, 68, 88, 109, 130, 138, 145 Secondary tumor, 126, 138 Secretion, 11, 101, 138 Secretory, 12, 138 Sediment, 138, 145 Segmental, 64, 138 Segmentation, 138 Segregation, 105, 136, 138 Semen, 133, 138 Sensory loss, 138, 140 Sequencing, 7, 8, 138 Serine, 13, 14, 134, 138 Serum, 102, 109, 120, 123, 138, 144 Sexually Transmitted Diseases, 62, 138 Shock, 20, 21, 138, 144 Side effect, 43, 56, 75, 101, 105, 111, 138, 141, 143 Signal Transduction, 13, 15, 139 Skeletal, 127, 139 Skeleton, 122, 133, 139 Smooth muscle, 13, 46, 102, 115, 123, 139, 141 Social Environment, 135, 139 Sodium, 16, 68, 139 Soft tissue, 44, 106, 139 Solid tumor, 49, 103, 105, 112, 139 Solvent, 139, 144 Soma, 139 Somatic, 5, 22, 27, 126, 129, 139 Somatic mutations, 22, 139 Sound wave, 45, 139 Spasticity, 58, 139 Specialist, 68, 91, 139 Species, 15, 102, 108, 114, 119, 126, 127, 135, 140, 141, 144, 146 Specificity, 14, 101, 107, 140, 143 Spectrum, 4, 140 Sperm, 108, 117, 119, 136, 139, 140 Spinal cord, 32, 108, 114, 126, 128, 140 Spinal Cord Compression, 32, 140 Spinal Fractures, 140 Spleen, 102, 125, 140 Sporadic, 9, 140 Stabilization, 17, 140 Staging, 68, 89, 137, 140 Statistically significant, 16, 140 Stem cell transplantation, 41, 45, 47, 50, 51, 140 Stem Cells, 130, 140
Index 157
Sterility, 111, 121, 140 Steroid, 7, 105, 137, 140 Stimulus, 13, 113, 123, 140, 142 Stomach, 101, 112, 115, 116, 119, 136, 140, 141 Stool, 120, 123, 141 Strand, 45, 141 Stress, 56, 129, 141 Striate, 111, 141 Stroke, 54, 80, 141 Stroma, 129, 141 Stromal, 7, 106, 141 Stromal Cells, 7, 106, 141 Subacute, 121, 141 Subclinical, 121, 141 Subcutaneous, 113, 123, 141 Subspecies, 140, 141 Substance P, 138, 141 Substrate, 13, 141 Superoxide, 11, 141 Support group, 91, 141 Supportive care, 130, 141 Suppression, 11, 17, 141 Surfactant, 56, 141 Survival Rate, 65, 141 Symphysis, 134, 142 Synaptic, 139, 142 Systemic, 3, 7, 11, 76, 102, 104, 106, 114, 121, 122, 135, 142, 143, 147 Systemic therapy, 4, 142 Systolic, 119, 142 T Tacrolimus, 45, 50, 142 Teratogenic, 142, 144 Testicular, 62, 142 Testis, 142 Thalidomide, 47, 48, 142 Therapeutics, 76, 142 Thermal, 67, 104, 128, 142 Thigh, 118, 142 Thorax, 101, 142 Threonine, 13, 14, 134, 138, 142 Threshold, 119, 142 Thrombin, 33, 115, 134, 142 Thrombocytes, 132, 142 Thrombolytic, 131, 142 Thrombomodulin, 134, 142 Thrombosis, 27, 33, 134, 141, 142 Thymidine, 56, 142 Thymus, 120, 125, 143 Thyroid, 46, 143, 144 Tissue Distribution, 107, 143
Tomography, 65, 143 Tonicity, 113, 143 Topical, 143, 144 Toxic, iv, 6, 10, 111, 112, 114, 120, 128, 130, 132, 143 Toxicity, 6, 13, 14, 26, 51, 68, 107, 113, 143 Toxicology, 13, 82, 143 Toxins, 6, 103, 121, 127, 135, 143 Trace element, 108, 143 Trachea, 106, 107, 143 Transcriptase, 137, 143 Transcription Factors, 6, 8, 15, 143 Transcutaneous, 67, 143 Transduction, 139, 143 Transfection, 106, 143 Transfer Factor, 120, 143 Transferases, 22, 143 Transitional cell carcinoma, 42, 144 Translational, 8, 144 Transmitter, 125, 144 Transplantation, 68, 120, 130, 144 Trauma, 68, 127, 144 Tretinoin, 52, 144 Trichloroethylene, 16, 32, 33, 72, 144 Tuberous Sclerosis, 4, 144 Tumor marker, 105, 144 Tumor model, 12, 144 Tumor Necrosis Factor, 34, 142, 144 Tumor suppressor gene, 15, 30, 144 Tumor-derived, 11, 144 Tumorigenic, 11, 144 Tyrosine, 13, 144 U Ubiquitin, 11, 144 Ultrasonography, 89, 145 Unconscious, 119, 145 Unresectable, 41, 43, 48, 145 Uremia, 32, 123, 145 Ureter, 39, 42, 87, 123, 136, 144, 145 Urethra, 62, 133, 145 Urinalysis, 62, 72, 89, 145 Urinary, 47, 50, 62, 64, 105, 111, 120, 128, 145 Urinary Fistula, 64, 145 Urinary tract, 62, 64, 105, 145 Urinary tract infection, 62, 105, 145 Urogenital, 145 Urogenital Diseases, 145 Urologic Diseases, 62, 68, 86, 145 Urologist, 11, 145 Urology, 3, 8, 20, 21, 22, 23, 25, 27, 28, 30, 34, 145
158
Kidney Cancer
Uterus, 46, 114, 115, 123, 133, 145 V Vaccination, 11, 58, 145 Vaccine, 12, 52, 53, 57, 58, 70, 72, 87, 101, 107, 134, 144, 145 Vascular, 6, 10, 13, 33, 121, 132, 145, 146 Vascular endothelial growth factor, 33, 146 Vasoconstriction, 56, 114, 146 Vein, 41, 42, 105, 121, 122, 128, 146 Vena, 22, 146 Venous, 41, 134, 146 Venules, 106, 146 Vertebrae, 140, 146 Vertebral, 140, 146 Veterinary Medicine, 81, 146 Viral, 137, 143, 144, 146 Virulence, 143, 146 Virus, 17, 18, 42, 116, 121, 143, 146
Viscera, 139, 146 Vitro, 10, 146 Vivo, 10, 12, 146 W White blood cell, 42, 47, 49, 50, 51, 52, 53, 103, 108, 124, 125, 127, 131, 146 Windpipe, 107, 143, 146 Womb, 145, 146 Wound Healing, 115, 146 X Xenobiotics, 6, 146 Xenograft, 14, 21, 34, 103, 144, 146 X-ray, 41, 43, 44, 45, 51, 110, 116, 122, 128, 135, 138, 146 X-ray therapy, 122, 146 Y Yeasts, 130, 147 Z Zymogen, 134, 147
Index 159
160
Kidney Cancer
