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

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

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OSTEOMALACIA 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., 1960Osteomalacia: 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: 0-597-84539-5 1. Osteomalacia-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on osteomalacia. 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 OSTEOMALACIA ........................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Osteomalacia ................................................................................. 4 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND OSTEOMALACIA .............................................................................. 55 Overview...................................................................................................................................... 55 Finding Nutrition Studies on Osteomalacia................................................................................ 55 Federal Resources on Nutrition ................................................................................................... 57 Additional Web Resources ........................................................................................................... 58 CHAPTER 3. ALTERNATIVE MEDICINE AND OSTEOMALACIA........................................................ 59 Overview...................................................................................................................................... 59 National Center for Complementary and Alternative Medicine.................................................. 59 Additional Web Resources ........................................................................................................... 65 General References ....................................................................................................................... 67 CHAPTER 4. CLINICAL TRIALS AND OSTEOMALACIA .................................................................... 69 Overview...................................................................................................................................... 69 Recent Trials on Osteomalacia..................................................................................................... 69 Keeping Current on Clinical Trials ............................................................................................. 70 CHAPTER 5. PATENTS ON OSTEOMALACIA .................................................................................... 73 Overview...................................................................................................................................... 73 Patents on Osteomalacia .............................................................................................................. 73 Patent Applications on Osteomalacia .......................................................................................... 76 Keeping Current .......................................................................................................................... 79 CHAPTER 6. BOOKS ON OSTEOMALACIA ........................................................................................ 81 Overview...................................................................................................................................... 81 Book Summaries: Federal Agencies.............................................................................................. 81 Book Summaries: Online Booksellers........................................................................................... 82 The National Library of Medicine Book Index ............................................................................. 83 Chapters on Osteomalacia............................................................................................................ 83 CHAPTER 7. MULTIMEDIA ON OSTEOMALACIA ............................................................................. 85 Overview...................................................................................................................................... 85 Video Recordings ......................................................................................................................... 85 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 89 Overview...................................................................................................................................... 89 NIH Guidelines............................................................................................................................ 89 NIH Databases............................................................................................................................. 91 Other Commercial Databases....................................................................................................... 93 The Genome Project and Osteomalacia........................................................................................ 93 APPENDIX B. PATIENT RESOURCES ................................................................................................. 97 Overview...................................................................................................................................... 97 Patient Guideline Sources............................................................................................................ 97 Finding Associations.................................................................................................................... 99 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 101 Overview.................................................................................................................................... 101 Preparation................................................................................................................................. 101 Finding a Local Medical Library................................................................................................ 101 Medical Libraries in the U.S. and Canada ................................................................................. 101

Contents

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ONLINE GLOSSARIES................................................................................................................ 107 Online Dictionary Directories ................................................................................................... 109 OSTEOMALACIA DICTIONARY ............................................................................................. 111 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 osteomalacia 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 osteomalacia, 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 osteomalacia, 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 osteomalacia. 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 osteomalacia, 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 osteomalacia. The Editors

1

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

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

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

Musculoskeletal Manifestations of Osteomalacia: Report of 26 Cases and Literature Review Source: Seminars in Arthritis and Rheumatism. 28(5): 287-304. April 1999. Summary: This journal article provides health professionals with information on a study that investigated the muscle manifestations in a selected population of 26 patients with biopsy proven osteomalacia (OM). The 26 patients with biopsy proven OM were selected from a total number of 79 patients who underwent anterior iliac crest biopsy. The diagnosis of OM was confirmed by the presence of an osteoid volume greater than 10 percent, osteoid width greater than 15 um, and delayed mineralization assessed by double tetracycline labeling. The study found that OM was caused by intestinal malabsorption in 13 patients, whereas six other patients presented with hypophosphatemia of different causes. Five elderly patients presented with

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hypovitaminosis D, and, in two patients, the OM was part of renal osteodystrophy. Twenty-three patients presented with bone pain and diffuse demineralization, whereas three other patients had normal or increased bone density. Characteristic pseudofractures were seen in only seven patients. Six of the 23 patients with diffuse demineralization had an osteoporotic like pattern, without pseudofractures. Prominent articular manifestations were seen in seven patients, including a rheumatoid arthritis like picture in three, osteogenic synovitis in three, and ankylosing spondylitis like in one. Two other patients were referred with the diagnosis of possible metastatic bone disease attributable to polyostotic areas on increased ratio nuclide uptake caused by pseudofractures. Six patients also had proximal myopathy, two elderly patients were diagnosed as having polymyalgia rheumatica, and two young patients were diagnosed as having fibromyalgia. One of the patients who presented with increased bone density was misdiagnosed as possible fluorosis. The article concludes that OM is usually neglected when compared with other metabolic bone diseases and may present with various clinical and radiographic manifestations mimicking other musculoskeletal disorders. 8 figures, 4 tables, and 75 references. (AA-M).

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

Project Title: BONE WATER & MINERALIZATION: NUCLEAR MAGNETIC RESONANCE Principal Investigator & Institution: Wehrli, Felix W.; Professor; Radiology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 09-SEP-2003; Project End 31-AUG-2007 Summary: (provided by applicant): The mechanical competence of bone is determined by the amount of bone per unit volume (also referred to as apparent density), its structural arrangement and its chemical make-up. Age and osteoporosis-related deterioration of the bone has typically been attributed to a net loss of bone mass and architectural impairment but it has been widely assumed that the bone's intrinsic material properties remain invariant. This notion is in conflict with a substantial body of

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

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literature indicating significant decreases in the degree of mineralization of bone (DMB) following ovariectomy and increased DMB in response to antiresorptive treatment. Such a behavior is plausible since the bone turnover rate determines the average age of the bone and younger bone is known to be hypomineralized. Paralleling changes in DMB are the bone's biomechanical properties in that decreased DMB is associated with decreased static strength and Young's modulus. The extent to which mechanical failure in the form of fractures is related to changes in the bone's mineral content is not known. Unfortunately, DMB cannot currently be measured noninvasively. However, since DMB is related to the bone's osteoid water content, information on mineral density can be obtained indirectly. There is evidence that during mineralization some of the matrix water is displaced and its space taken by mineral in such a manner that osteoid volume remains constant. In this proposal we advance the hypothesis that there is an inverse relationship between osteoid water and bone mineral volume and that a measure of DMB can be obtained indirectly by quantitative proton magnetic resonance of solid bone. We provide evidence in preliminary work that decreased mineralization is associated with higher water content and that the matrix water can be imaged with appropriate imaging techniques in intact bone. In two disease models in which DMB is expected to be altered (rabbit osteomalacia and rat ovariectomy) we test the hypothesis using proton and 31P NMR that changes in DMB occur at the expense of a commensurate change in bone water and further that increased bone water decreases static strength and elastic modulus. The long-term goal of this project is to provide a noninvasive method for probing the intrinsic properties of bone in laboratory animals and ultimately in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DISORDERS OF MINERAL METABOLISM IN CHILDREN Principal Investigator & Institution: Carpenter, Thomas O.; Associate Professor of Pediatrics; Pediatrics; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-JUL-1999; Project End 30-JUN-2004 Summary: This application describes Dr. Carpenter's career and clinical research accomplishments. His CV and list of ongoing projects describe a candidate strongly invested in the focused direction of clinical investigation in the field of mineral metabolism in children. His commitment to training students and fellows, and his major role at Yale in this regard is emphasized. Dr. Carpenter's immediate career goals focus on two projects: 1) the use of 24,25(OH)2D3 in the treatment of childhood bone disease; and 2) the isolation and purification of a phosphate (Pi) wasting substance from tumors from children with Pi- wasting oncogenic osteomalacia. The first of these projects arose following Dr. Carpenter's initial trial of 24,25(OH)2D3 to improve skeletal disease in hypophosphatemic rickets (XLH). The study identified mild hyperparathyroidism as a frequent feature of XLH, and its correction with 24,25(OH)2D3. A subsequent pilot study indicated successful suppression of autonomous hyperparathyroidism in 4 XLH patients considered for parathyroidectomy. Thus, a controlled trial evaluating efficacy and safety of 24,25(OH)2D3 in the management of autonomous hyperparathyroidism in XLH comprises the primary project in this application. Diurnal profiles of parathyroid hormone (PTH) secretion will be obtained prior to randomization to placebo or 24,25(OH)2D3, given in concert with standard therapy. At 2 month intervals PTH will be sampled, and doses of 24,25(OH)2D3 will be increased if PTH levels have not decreased with initial dose levels. Monitoring of other mineral levels and PTH bioactivity will be performed. After one year, repeat diurnal PTH profiles will be

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obtained. The secondary project, identification of a phosphaturic factor(s) in oncogenic osteomalacia tumors, involves serial chromatography with differential selectivity (e.g., ion exchange, size exclusion, reverse phase HPLC). Source material is conditioned medium from immortalized tumor cells. Bioactivity is assessed by inhibition of Pi transport assay in renal epithelial cells. This project will provide critical new information for understanding normal Pi homeostasis, and pathophysiology of XLH. Other related research projects are also described. Resources at Yale, as described in the application, are ideal for performing clinical research, including the NIH-supported General Clinical Research Centers. Furthermore, the long-standing collaborations with the Departments of Internal Medicine and Orthopaedics provide for a rich intellectual environment, and critical mass of interest. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FGF-23 REGULATION OF PHOSPHATE HOMEOSTASIS Principal Investigator & Institution: White, Kenneth E.; Medicine; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2003; Project Start 27-DEC-2002; Project End 30-NOV-2007 Summary: (provided by applicant): The regulation of serum phosphate concentrations is a complex process and our current models are far from complete. We positionally cloned a novel gene from chromosome 12p13.3, FGF23, that encodes a secreted factor, and demonstrated that, when mutated, the gene is responsible for the renal phosphate wasting disorder autosomal dominant hypophosphatemic rickets (ADHR). We also determined that FGF-23 is overexpressed in tumors causing oncogenic hypophosphatemic osteomalacia (OHO), and in vivo evidence supports the role of FGF23 as a phosphaturic substance. The cellular and molecular mechanisms by which FGF23 causes isolated renal phosphate wasting are currently unknown, however. The longterm goals of the present studies are to understand the molecular physiology and function of genes involved in regulating renal phosphate reabsorption controlled by FGF-23. The study of the phosphate-wasting metabolic syndromes, ADHR and OHO, provides a unique opportunity to discover novel pathways controlling renal phosphate homeostasis. Currently there are no animal models for ADHR, thus limiting the ability to test hypotheses regarding the physiological mechanisms underlying the disease. The hypothesis to be tested within this proposal is: FGF-23 acts through a specific receptor to cause changes in gene transcription and translation in kidney proximal tubule that result in decreased renal absorption of phosphorous. We will test this hypothesis through the following Specific Aims: (1) to test for changes in the expression of renal and skeletal genes in mice that may be regulated by FGF-23 in vivo; (2) to determine the FGF receptor(s) involved in FGF-23 actions on the kidney proximal tubule; and (3) to develop an appropriate mouse model of ADHR and to understand the manifestations of the disorder. The results of the proposed studies will provide insight into the pathogenesis of ADHR and OHO, as well as lead to improved understanding of the mechanisms dictating phosphate homeostasis in the long-term. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: GENETIC REGULATION OF CALCIUM METABOLISM Principal Investigator & Institution: Demay, Marie B.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114

Associate

Timing: Fiscal Year 2002; Project Start 01-AUG-1993; Project End 28-FEB-2006

Professor;

Studies

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Summary: (provided by applicant): The vitamin D receptor (VDR) is thought to mediate the biological effects of 1,25-dihydroxyvitamin D. We have generated VDR knockout mice that develop abnormalities in mineral ion homeostasis, accompanied by osteomalacia, rickets and hyperparathyroidism by 4 weeks of age. Analogous to humans with VDR mutations, these mice have hair perinatally, but develop alopecia. Although VDR null mice with normal mineral ion levels have histologically, histomorphometrically and biomechanically normal long bones, there remains considerable controversy as to whether the VDR and its ligand play a critical role in the skeleton. To address this hypothesis, we propose to isolate primary calvarial osteoblasts from the VDR null mice and examine their ability to form mineralized bone nodules. We will also address whether VDR ablation influences the program of osteoblast differentiation in this system. Because there is increasing evidence that the two major hormones involved in mineral ion homeostasis, PTH and 1,25-dihydroxyvitamin D, have different effects on osteoblasts that give rise to endochondral and intramembranous bone, similar studies will be performed in stromal cells isolated from the long bones of the VDR null mice and control littermates. The effects of VDR status and mineral ion homeostasis on bone morphogenesis will also be examined, using ectopic bone formation assays. Hair reconstitution assays have demonstrated that the VDR null keratinocyte is responsible for the hair cycle defect that causes alopecia. Preliminary studies in VDR null mice that express the human VDR under the keratin 14 promoter support these findings. These mice will be further characterized, as will signaling pathways involved in hair morphogenesis, to determine if a defect in these pathways in the VDR null mice is responsible for the defect in the hair cycle. Keratinocyte stem cells, thought to provide a source of cells for cyclic regeneration of the lower part of the hair follicle, will also be quantitatively and qualitatively assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR HYPOPHOSPHATASIA

PATHOGENESIS

AND

TREATMENT

OF

Principal Investigator & Institution: Millan, Jose L.; Professor; Burnham Institute 10901 N Torrey Pines Rd La Jolla, Ca 920371005 Timing: Fiscal Year 2004; Project Start 01-MAR-1999; Project End 31-DEC-2008 Summary: (provided by applicant): Hypophosphatasia is a heritable, untreatable, bone mineralization disease of variable clinical severity and pattern of inheritance caused by mutations that affect the tissue-nonspecific alkaline phosphatase (TNAP) gene. TNAP's primary function in bone is to hydrolyze inorganic pyrophosphate (PPi), a potent inhibitor of mineralization. The elevated levels of PPi that accumulate in hypophosphatasia cause a secondary increase in the levels of osteopontin (OPN), another mineralization inhibitor, which likely contributes to the resulting rickets/osteomalacia characteristic of this disease. The genetic ablation of the molecules that produce and transport PPi to the extracellular space, i.e., NPP1 and ANK, lead to normalization of the extracellular PPi and OPN levels, resulting in the reversal of rickets/osteomalacia in the Akp2 (TNAP) knockout mice. In Aim 1 we will test the hypothesis that we can use chemical inhibitors to therapeutically target the function of NPP1 and ANK to cause normalization of both PPi and OPN levels and thus, achieve correction of the bone abnormalities of hypophosphatasia. We will also ascertain to what extent increased OPN levels contribute to the rickets/osteomalacia by examining the degree of correction that might be achieved in Akp2/OPN double deficient mice. We will also continue with our ongoing efforts to treat hypophosphatasia by cell/gene therapy. Elucidating the molecular basis of monomer-monomer crosstalk in TNAP

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heterodimers is crucial to our ability to understand and predict the severity of TNAPmutant combinations and the mechanism(s) of pathogenesis, penetrance, expressivity and mode of inheritance for each mutation. In Specific Aim 2, we will clarify how each structural domain in the TNAP subunit contributes to the allosteric behavior of TNAP dimers and how they affect the kinetic properties of TNAP heterodimers towards the physiological substrates PLP, PPi and AMP. Also, since TNAP itself may be a useful therapeutic target to treat hvpermineralization disorders, we will elucidate the precise mechanism of TNAP inhibition to help us design more specific enzyme inhibitors for the clinical management of diseases such as ankylosis and osteoarthritis. Our work will provide fundamental information about the molecular mechanism(s) of pathogenesis of hypophosphatasia and the molecular basis for the different genetic modes of transmission. We also have a unique opportunity to develop successful treatments for hypophosphatasia and other bone diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HORMONE

PHOSPHOTONIN--A

NOVEL

PHOSPHATE

REGULATORY

Principal Investigator & Institution: Jan De Beur, Suzanne M.; Director; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-AUG-1999; Project End 30-JUN-2004 Summary: As a developing Physician Scientist, my career goal is to cultivate and integrate my experience as a clinician and investigator so that I may ultimately translate a basic understanding of normal physiology and the disease process to the bedside. I am committed to a career in academic medicine with the goal of developing an internationally recognized phosphate homeostasis. The studies outlined in this proposal will allow me to apply and extend my clinical and technical training to a new level by broadening my experience in protein biochemistry, transgenic technology and antibody and radioimmunoassay development. Intensive laboratory investigation will be complimented by course work in the program of Cellular and Molecular Medicine. The Johns Hopkins Medical Institute provides a rich environment for collaboration and technical support both at an institutional level and within the Levine laboratory. Dr. Michael Levine is an internationally recognized expert in bone and mineral metabolism with a strong mentorship track record. He is the previous Director of the Johns Hopkins Institutional Physician Scientist Award and he is the current Director of the Training Program in Cellular and Molecular Endocrinology. Additional mentored laboratory based work and the specific career development plan Dr. Levine and I have devised will provide me with the skills I need to launch an independent research career. The research proposal I have prepared is an extension of my clinical interest in the molecular basis of hormone action, ectopic hormonal production and the regulation of phosphate homeostasis. Oncogenic osteomalacia (OOM) is a paraneoplastic syndrome characterized by hypophosphatemia, hypophosphaturia and osteomalacia. Tumors associated with OOM secrete a factor, termed phosphatonin (PTN) that inhibits renal proximal tubular reabsorption of phosphate. X-linked hypophosphatemic rickets (XLH) is a genetic syndrome with clinical manifestations similar to OOM. The defective gene in XLH encodes PEX, a membrane bound metallopeptidase. Other enzymes in this class have important roles in hormonal processing and degradation. The discovery of the defective PE enzyme paired with evidence for a circulating phosphaturic factor in both XLH and OOM, has led to speculation about the relationship of PEX and PTN. We hypothesize that phosphatonin is important for phosphate homeostasis in the bone and once phospatonin is related into the circulation, it exerts a phosphaturic effect on the

Studies

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proximal renal tubule. Phosphatonin is released into the circulation by either being produced ectopically as in OOM or by failing to be inactivated as in XLH. We propose to: 1) Isolate phosphatonin 2) Determine the role of PEX in phosphate homeostasis and its interaction with phosphatonin 3) Define the role of phosphatonin in normal physiology and in disorders of phosphate homeostasis. Identifying and characterizing phosphatonin will contribute substantially to the understanding of phosphate homeostasis, further define the genetic defect in X-linked hypophosphatemic rickets, and identify a novel hormone produced ectopically in oncogenic osteomalacia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STUDIES OF METABOLIC BONE DISEASE Principal Investigator & Institution: Avioli, Louis V.; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002 Summary: Adults and children with generalized skeletal abnormalities or abnormalities in mineral metabolism have been studied. Included were metabolic, radiographic, genetic and pathological studies to define the pathogenesis of a variety of disorders of bone and mineral metabolism, particularly osteoporosis, osteomalacia and Paget's disease. Several new disorders have been characterized. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ULTRAVIOLET LIGHT DEVICES FOR VITAMIN D Principal Investigator & Institution: Savage, Henry C.; Apollo Light Systems, Inc. 352 West 1060 South Orem, Ut 84058 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): Vitamin D deficiency is now recognized as a significant health problem for middle-aged and older adults. Vitamin D deficiency exacerbates osteoporosis and causes the bone disease, osteomalacia. Vitamin D deficiency increases risk of skeletal fractures. It is well known that the ultraviolet B portion of the solar spectrum is responsible for the cutaneous production if vitamin D3. It has been estimated that approximately 90 to 95% of most people's vitamin D requirement comes from their casual exposure to sunlight. However, people above the age of 50 years do not get adequate exposure to sunlight placing them at risk for vitamin D deficiency. The goal of this program is to determine the feasibility of developing ultraviolet B light sources that can be used in a nursing home setting or in an individual home for promoting the cutaneous production of vitamin D3. This will be accomplished by using a whole body ultraviolet B light source and a portable partial body ultraviolet B home device unit. The goal will be to test the effect of exposure to varying doses of whole body and partial body ultraviolet B radiation from these prototype commercial devices to determine their effect on raising the blood level of vitamin D and 25hydroxyvitamin D, the major circulating form of vitamin D that is used to determine the vitamin D status. This study addresses an issue crucial to the successful commercial development of ultraviolet B radiation sources that can be placed in nursing homes or in an individual home for the therapeutic purpose of producing vitamin D3. 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 “osteomalacia” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for osteomalacia in the PubMed Central database: •

Cloning and characterization of FGF23 as a causative factor of tumor-induced osteomalacia. by Shimada T, Mizutani S, Muto T, Yoneya T, Hino R, Takeda S, Takeuchi Y, Fujita T, Fukumoto S, Yamashita T.; 2001 May 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33497

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

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A case of neuroendocrine oncogenic osteomalacia associated with a PHEX and fibroblast growth factor-23 expressing sinusidal malignant schwannoma. Author(s): John MR, Wickert H, Zaar K, Jonsson KB, Grauer A, Ruppersberger P, Schmidt-Gayk H, Murer H, Ziegler R, Blind E. Source: Bone. 2001 October; 29(4): 393-402. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11595624

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

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

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A case of osteomalacia mimicking ankylosing spondylitis. Author(s): Akkus S, Tamer MN, Yorgancigil H. Source: Rheumatology International. 2001 August; 20(6): 239-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11563583

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A neuroendocrine cause of oncogenic osteomalacia. Author(s): Stone MD, Quincey C, Hosking DJ. Source: The Journal of Pathology. 1992 June; 167(2): 181-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1378890

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A patient with osteomalacia as single presenting symptom of gluten-sensitive enteropathy. Author(s): De Boer WA, Tytgat GN. Source: Journal of Internal Medicine. 1992 July; 232(1): 81-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1365870

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A patient with primary hyperparathyroidism associated with osteomalacia: markedly increased serum levels of intact PTH and 1,25-dihydroxyvitamin D with normo- and hypercalcemia. Author(s): Takemia T, Sato K, Miyata M, Imaki T, Shibasaki T, Tsushima T, Demura H, Tanaka R, Obara T, Oguchi S. Source: Endocrine Journal. 1993 February; 40(1): 121-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7951485

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A PHEX gene mutation is responsible for adult-onset vitamin D-resistant hypophosphatemic osteomalacia: evidence that the disorder is not a distinct entity from X-linked hypophosphatemic rickets. Author(s): Econs MJ, Friedman NE, Rowe PS, Speer MC, Francis F, Strom TM, Oudet C, Smith JA, Ninomiya JT, Lee BE, Bergen H. Source: The Journal of Clinical Endocrinology and Metabolism. 1998 October; 83(10): 3459-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9768646

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A potential risk for osteomalacia due to sociocultural lifestyle in Turkish women. Author(s): Gullu S, Erdogan MF, Uysal AR, Baskal N, Kamel AN, Erdogan G. Source: Endocrine Journal. 1998 October; 45(5): 675-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10395248

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Osteomalacia

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A prospective study to evaluate the dose of vitamin D required to correct low 25hydroxyvitamin D levels, calcium, and alkaline phosphatase in patients at risk of developing antiepileptic drug-induced osteomalacia. Author(s): Collins N, Maher J, Cole M, Baker M, Callaghan N. Source: The Quarterly Journal of Medicine. 1991 February; 78(286): 113-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1851568

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A rare cause of osteomalacia: osteosarcoma. Author(s): Crognier L, Bon E, Rolland Y, Cantagrel A, Laroche M, Mazieres B. Source: Rev Rhum Engl Ed. 1996 October; 63(9): 630-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8938876

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A severe case of acquired hypophosphataemic osteomalacia: the perils of a missed diagnosis. Author(s): MacGowan JR, Pringle J, Stamp TC. Source: Rheumatology (Oxford, England). 2001 June; 40(6): 707-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11426035

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A unique case of adult hypophosphatemic osteomalacia. Author(s): Edelson GW, Shih MS, Parfitt AM. Source: Bone. 1993 September-October; 14(5): 707-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8268043

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Acquired osteomalacia. Author(s): Bell NH, Key LL Jr. Source: Curr Ther Endocrinol Metab. 1994; 5: 495-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7704780

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Acquired osteomalacia. Author(s): Bell NH, Key LL Jr. Source: Curr Ther Endocrinol Metab. 1997; 6: 530-3. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174801

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Acute epidemic aluminium osteomalacia secondary to water supply contamination. Author(s): O'Brien AA, Moore DP, Keogh JA. Source: Ir J Med Sci. 1990 March; 159(3): 71-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2361822

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Acute tetany in the Crohn's patient with osteomalacia. Author(s): Talabiska DG, Seidner DL, Jensen GL. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1993 March-April; 9(2): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8485330

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Adult Fanconi syndrome with proximal muscle weakness and hypophosphatemic osteomalacia: report of a case. Author(s): Lian LM, Chang YC, Yang CC, Yang JC, Kao KP, Chung MY. Source: J Formos Med Assoc. 1994 August; 93(8): 709-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7858457

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Adult-onset vitamin D-resistant osteomalacia. A case with seventeen-year follow-up. Author(s): Itoi E, Sakurai M, Honma T, Sato K, Kasama F. Source: The Journal of Bone and Joint Surgery. American Volume. 1991 July; 73(6): 9327. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2071626

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Aetiology and clinical profile of osteomalacia in adolescent girls in northern India. Author(s): Rajeswari J, Balasubramanian K, Bhatia V, Sharma VP, Agarwal AK. Source: Natl Med J India. 2003 May-June; 16(3): 139-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12929856

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Aluminium osteomalacia in chronic renal failure patients neither on dialysis nor taking aluminium containing phosphate binders. Author(s): O'Brien AA, Moore DP, Keogh JA. Source: Ir J Med Sci. 1990 March; 159(3): 74-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2361823

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An epidemiological model of privational rickets and osteomalacia. Author(s): Dunnigan MG, Henderson JB. Source: The Proceedings of the Nutrition Society. 1997 November; 56(3): 939-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9483661

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An interesting case of osteomalacia due to antacid use associated with stainable bone aluminum in a patient with normal renal function. Author(s): Woodson GC. Source: Bone. 1998 June; 22(6): 695-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9626411

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Antacid and sucralfate-induced hypophosphatemic osteomalacia: a case report and review of the literature. Author(s): Chines A, Pacifici R. Source: Calcified Tissue International. 1990 November; 47(5): 291-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2257522

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Osteomalacia

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Antacid-induced osteomalacia: a case report with a histomorphometric analysis. Author(s): Kassem M, Eriksen EF, Melsen F, Mosekilde L. Source: Journal of Internal Medicine. 1991 March; 229(3): 275-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2007845

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Anticonvulsant agents and osteomalacia. Author(s): Nair BR. Source: The Medical Journal of Australia. 1990 March 5; 152(5): 279-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2255294

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Anticonvulsant induced osteomalacia. Author(s): Goraya JS, Gupta PN, Gupta RK, Bahadur R, Parmar VR. Source: Indian Pediatrics. 2000 March; 37(3): 325-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10750079

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Are elderly Asians in Britain at a high risk of vitamin D deficiency and osteomalacia? Author(s): Solanki T, Hyatt RH, Kemm JR, Hughes EA, Cowan RA. Source: Age and Ageing. 1995 March; 24(2): 103-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7793330

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Asian osteomalacia is determined by dietary factors when exposure to ultraviolet radiation is restricted: a risk factor model. Author(s): Henderson JB, Dunnigan MG, McIntosh WB, Abdul Motaal A, Hole D. Source: The Quarterly Journal of Medicine. 1990 September; 76(281): 923-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2173012

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Asian rickets and osteomalacia. Author(s): Smith R. Source: The Quarterly Journal of Medicine. 1990 September; 76(281): 899-901. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2236475

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Autosomal dominant hypophosphatemic rickets/osteomalacia: clinical characterization of a novel renal phosphate-wasting disorder. Author(s): Econs MJ, McEnery PT. Source: The Journal of Clinical Endocrinology and Metabolism. 1997 February; 82(2): 674-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9024275

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Axial osteomalacia with sacroiliitis and moderate phosphate diabetes: report of a case. Author(s): Cortet B, Berniere L, Solau-Gervais E, Hacene A, Cotten A, Delcambre B. Source: Clin Exp Rheumatol. 2000 September-October; 18(5): 625-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11072608

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Bilateral atraumatic avulsion fracture of the calcaneal tubercle in osteomalacia during fluoride therapy--a case report. Author(s): Martini F, Kremling E, Sell S. Source: Acta Orthopaedica Scandinavica. 1999 February; 70(1): 91-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10191759

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Bilateral sequential tibial and fibular fatigue fractures associated with aluminum intoxication osteomalacia. A case report. Author(s): Skinner HB, Harris JR, Cook SD, O'Neill WM Jr. Source: The Journal of Bone and Joint Surgery. American Volume. 1983 July; 65(6): 8437. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6863369

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Bilateral simultaneous combined intra- and extracapsular femoral neck fracture secondary to nutritional osteomalacia: a case report. Author(s): Faraj AA. Source: Acta Orthop Belg. 2003 April; 69(2): 201-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12769024

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Biomarkers and imaging in non-malignant and malignant osteomalacia. Author(s): Luftner D, Bollow M, Sturzenbecher A, Kaufmann, Priem F, Richter A, Gunther S, Geppert R, Petrides PE, Wernecke KD, Possinger K. Source: Int J Biol Markers. 2001 April-June; 16(2): 136-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11471897

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Blunted seasonal variation in serum 25-hydroxy vitamin D and increased risk of osteomalacia in vegetarian London Asians. Author(s): Finch PJ, Ang L, Colston KW, Nisbet J, Maxwell JD. Source: European Journal of Clinical Nutrition. 1992 July; 46(7): 509-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1623855

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Bone and In-111 octreotide imaging in oncogenic osteomalacia: a case report. Author(s): Garcia CA, Spencer RP. Source: Clinical Nuclear Medicine. 2002 August; 27(8): 582-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12170004

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Bone disease in primary biliary cirrhosis: increased bone resorption and turnover in the absence of osteoporosis or osteomalacia. Author(s): Cuthbert JA, Pak CY, Zerwekh JE, Glass KD, Combes B. Source: Hepatology (Baltimore, Md.). 1984 January-February; 4(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6693061

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Bone histomorphometry in children and adolescents with beta-thalassemia disease: iron-associated focal osteomalacia. Author(s): Mahachoklertwattana P, Sirikulchayanonta V, Chuansumrit A, Karnsombat P, Choubtum L, Sriphrapradang A, Domrongkitchaiporn S, Sirisriro R, Rajatanavin R. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 August; 88(8): 3966-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12915694

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Bone mineral density and bone scintigraphy in children and adolescents with osteomalacia. Author(s): El-Desouki M, Al-Jurayyan N. Source: European Journal of Nuclear Medicine. 1997 February; 24(2): 202-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9021119

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Bone scan in tumor-induced osteomalacia. Author(s): Lee HK, Sung WW, Solodnik P, Shimshi M. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1995 February; 36(2): 247-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7830124

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Bone scintigraphy in a case of oncogenous osteomalacia. Author(s): Ohta H, Nakaishi S, Oki S, Simizu M, Watanabe H, Fujikawa S, Nakade M, Watanabe H, Kohno K, Shintaku M. Source: Clinical Nuclear Medicine. 1998 July; 23(7): 467-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9676956

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Bone-scan-like pattern with 99Tcm(V)-DMSA scintigraphy in patients with osteomalacia and primary hyperparathyroidism. Author(s): Akbunar AT, Orhan B, Alper E. Source: Nuclear Medicine Communications. 2000 February; 21(2): 181-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10758614

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Brief report: inhibition of renal phosphate transport by a tumor product in a patient with oncogenic osteomalacia. Author(s): Cai Q, Hodgson SF, Kao PC, Lennon VA, Klee GG, Zinsmiester AR, Kumar R. Source: The New England Journal of Medicine. 1994 June 9; 330(23): 1645-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8177270

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Cadmium induces osteomalacia mediated by proximal tubular atrophy and disturbances of phosphate reabsorption. A study of 11 autopsies. Author(s): Takebayashi S, Jimi S, Segawa M, Kiyoshi Y. Source: Pathology, Research and Practice. 2000; 196(9): 653-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10997741

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Calcification of entheses associated with X-linked hypophosphatemic osteomalacia. Author(s): Polisson RP, Martinez S, Khoury M, Harrell RM, Lyles KW, Friedman N, Harrelson JM, Reisner E, Drezner MK. Source: The New England Journal of Medicine. 1985 July 4; 313(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4000222

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Candidate 56 and 58 kDa protein(s) responsible for mediating the renal defects in oncogenic hypophosphatemic osteomalacia. Author(s): Rowe PS, Ong AC, Cockerill FJ, Goulding JN, Hewison M. Source: Bone. 1996 February; 18(2): 159-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8833210

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Carboxyterminal propeptide of type I procollagen in osteomalacia. Author(s): Li F, Iqbal J, Wassif W, Kaddam I, Moniz C. Source: Calcified Tissue International. 1994 August; 55(2): 90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7953986

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Cardiac failure secondary to hypocalcaemia of nutritional osteomalacia. Author(s): Csanady M. Source: European Heart Journal. 1992 September; 13(9): 1299. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1396844

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Cardiac failure secondary to hypocalcaemia of nutritional osteomalacia. Author(s): Avery PG, Arnold IR, Hubner PJ, Iqbal SJ. Source: European Heart Journal. 1992 March; 13(3): 426-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1597235

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Case 29-2001: oncogenic hypophosphatemic osteomalacia. Author(s): White KE, Waguespack SG, Econs MJ. Source: The New England Journal of Medicine. 2002 January 31; 346(5): 381-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11821524

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Case of the winter season. Hypophosphatemic osteomalacia secondary to hemangiopericytoma of the right femur. Author(s): Robertson A. Source: Semin Roentgenol. 1983 January; 18(1): 5-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6836336

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Case report 285. Diagnosis: osteomalacia (rickets) and cerebellar atrophy secondary to the effects of diphenylhydantoin (dilantin). Author(s): Moskowitz H, Milikow E. Source: Skeletal Radiology. 1984; 12(4): 281-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6505733

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Case report 288: osteomalacia and secondary hyperparathyroidism (dialysis-induced), with aluminum deposition. Author(s): Llewellyn CH, Resnik CS, Brower AC. Source: Skeletal Radiology. 1984; 12(3): 223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6494942

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Case report 294. Diagnosis: dialysis osteomalacia with response to desferrioxamine therapy. Author(s): Xipell JM, Ham KN, Brown DJ, Dawborn JK. Source: Skeletal Radiology. 1984; 12(4): 298-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6505735

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Case report. Tumour-induced osteomalacia in a patient with osseous haemangioma. Author(s): Lui CY, Khoo R, Law TC, Chong SF. Source: Clinical Radiology. 2002 December; 57(12): 1125-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12475540

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Central and peripheral bone biopsy in a patient with axial osteomalacia. Author(s): van Erpecum KJ, Kroon HM, van Groningen K, Harinck HI. Source: The Netherlands Journal of Medicine. 1985; 28(11): 505-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4080052

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Changing prevalence of osteomalacia in hip fractures in southeast Scotland over a 20year period. Author(s): Robinson CM, McQueen MM, Wheelwright EF, Gardner DL, Salter DM. Source: Injury. 1992; 23(5): 300-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1644456

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Characteristics of tumor cell bioactivity in oncogenic osteomalacia. Author(s): Nelson AE, Namkung HJ, Patava J, Wilkinson MR, Chang AC, Reddel RR, Robinson BG, Mason RS. Source: Molecular and Cellular Endocrinology. 1996 November 29; 124(1-2): 17-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9027320

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Chronic calcific pancreatitis associated with osteomalacia and secondary hyperparathyroidism. Author(s): Kaur N, Gupta S, Minocha VR. Source: Indian J Gastroenterol. 1996 October; 15(4): 147-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8916580

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Clinical and histological spectrum of osteomalacia among Asians in south London. Author(s): Finch PJ, Ang L, Eastwood JB, Maxwell JD. Source: The Quarterly Journal of Medicine. 1992 June; 83(302): 439-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1448545

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Clinical case seminar: Fibroblast growth factor 23: a new clinical marker for oncogenic osteomalacia. Author(s): Nelson AE, Bligh RC, Mirams M, Gill A, Au A, Clarkson A, Juppner H, Ruff S, Stalley P, Scolyer RA, Robinson BG, Mason RS, Bligh PC. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 September; 88(9): 4088-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12970268

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Cloning and characterization of FGF23 as a causative factor of tumor-induced osteomalacia. Author(s): Shimada T, Mizutani S, Muto T, Yoneya T, Hino R, Takeda S, Takeuchi Y, Fujita T, Fukumoto S, Yamashita T. Source: Proceedings of the National Academy of Sciences of the United States of America. 2001 May 22; 98(11): 6500-5. Epub 2001 May 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344269

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Coeliac disease and osteomalacia: an association still present in Western countries. Author(s): Garcia-Porrua C, Gonzalez-Gay MA, Avila-Alvarenga S, Rivas MJ, Soilan J, Penedo M. Source: Rheumatology (Oxford, England). 2000 December; 39(12): 1435. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11136897

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Coeliac disease as a cause of osteomalacia and rickets in the Asian immigrant population. Author(s): Thalayasingam B. Source: British Medical Journal (Clinical Research Ed.). 1985 April 13; 290(6475): 1146-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3921135

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Coeliac disease can still present with osteomalacia! Author(s): Basu RA, Elmer K, Babu A, Kelly CA. Source: Rheumatology (Oxford, England). 2000 March; 39(3): 335-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10788547

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Combined hemofiltration and desferrioxamine treatment for aluminum induced osteomalacia. Author(s): Barre PE, Prichard S. Source: Int J Artif Organs. 1986 May; 9(3): 167-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3733242

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Common bone features in osteomalacia, secondary hyperparathyroidism, and renal osteodystrophy. Author(s): Verlooy H, De Roo M, Mortelmans L, Dequeker J. Source: Clinical Nuclear Medicine. 1991 May; 16(5): 372-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2054996

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Comparison of aluminum related with vitamin D related osteomalacia by tetracycline based bone histomorphometry. Author(s): Parfitt AM, Rao D, Stanciu J, Villanueva AR. Source: Advances in Experimental Medicine and Biology. 1986; 208: 283-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3565152

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Craniofacial hemangiopericytoma associated with oncogenic osteomalacia: case report. Author(s): Sandhu FA, Martuza RL. Source: Journal of Neuro-Oncology. 2000; 46(3): 241-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10902855

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Daily intermittent decreases in serum levels of parathyroid hormone have an anabolic-like action on the bones of uremic rats with low-turnover bone and osteomalacia. Author(s): Ishii H, Wada M, Furuya Y, Nagano N, Nemeth EF, Fox J. Source: Bone. 2000 February; 26(2): 175-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10678413

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Detection of osteomalacia in British Asians: a comparison of clinical score with biochemical measurements. Author(s): Nisbet JA, Eastwood JB, Colston KW, Ang L, Flanagan AM, Chambers TJ, Maxwell JD. Source: Clinical Science (London, England : 1979). 1990 April; 78(4): 383-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2160356

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Development of hypercalcemic hyperparathyroidism after long-term phosphate supplementation in hypophosphatemic osteomalacia. Report of two cases. Author(s): Firth RG, Grant CS, Riggs BL. Source: The American Journal of Medicine. 1985 April; 78(4): 669-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2984933

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Development of tertiary hyperparathyroidism after phosphate supplementation in oncogenic osteomalacia. Author(s): Huang QL, Feig DS, Blackstein ME. Source: J Endocrinol Invest. 2000 April; 23(4): 263-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10853715

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Diagnosis of a patient with oncogenic osteomalacia using a phosphate uptake bioassay of serum and magnetic resonance imaging. Author(s): Nelson AE, Mason RS, Robinson BG, Hogan JJ, Martin EA, Ahlstrom H, Astrom G, Larsson T, Jonsson K, Wibell L, Ljunggren O. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 October; 145(4): 469-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11581007

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Diagnosis of osteomalacia in the elderly. Author(s): Rai GS, Wright G. Source: Br J Hosp Med. 1987 October; 38(4): 384. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3676562

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Diagnostic utility of magnetic resonance imaging skeletal survey in a patient with oncogenic osteomalacia. Author(s): Fukumoto S, Takeuchi Y, Nagano A, Fujita T. Source: Bone. 1999 September; 25(3): 375-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10495143

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Dialysis osteomalacia and aluminum toxicity: a form of renal osteodystrophy. Author(s): Felsenfeld AJ. Source: Anna J. 1985 June; 12(3): 189-91. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3848318

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Dialysis osteomalacia: a possible role for zirconium as well as aluminium. Author(s): Ham KN, Brown DJ, Dawborn JK, Johnson CI, Nelson S, Xipell JM. Source: Pathology. 1985 July; 17(3): 458-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4069764

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Dialysis osteomalacia: clinical aspects and physiopathological mechanisms. Author(s): Drueke T, Cournot-Witmer G. Source: Clinical Nephrology. 1985; 24 Suppl 1: S26-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3915957

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Distinction between focally accelerated bone formation and osteomalacia in carcinoma of prostate metastasised to bone. Author(s): Taube T, Beneton MN, Williams JL, McCloskey EV, Kanis JA. Source: British Journal of Urology. 1993 July; 72(1): 98-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8149187

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Does osteomalacia contribute to development of oral complications of oxalosis? Author(s): Boyce BF, Prime SS, Halls D, Johnston E, Critchlow H, MacDonald DG, Junor BJ. Source: Oral Surg Oral Med Oral Pathol. 1986 March; 61(3): 272-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3458131

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Does strict phosphorus control precipitate renal osteomalacia? Author(s): Delmez JA, Fallon MD, Harter HR, Hruska KA, Slatopolsky E, Teitelbaum SL. Source: The Journal of Clinical Endocrinology and Metabolism. 1986 April; 62(4): 747-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3949954

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Dystocia due to osteomalacia. Author(s): Dutta D, Chakraborty S. Source: J Indian Med Assoc. 1985 August; 83(8): 288, 292. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3841359

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Electrocochleographic changes in the hearing loss associated with X-linked hypophosphataemic osteomalacia. Author(s): O'Malley S, Ramsden RT, Latif A, Kane R, Davies M. Source: Acta Oto-Laryngologica. 1985 July-August; 100(1-2): 13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4040696

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Elevated bone aluminum content in dialysis patients without osteomalacia. Author(s): McCarthy JT, Kurtz SB, McCall JT. Source: Mayo Clinic Proceedings. 1985 May; 60(5): 315-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3990380

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Evaluation of the parathyroid function in six patients with hypophosphatemic osteomalacia, including a case of tertiary hyperparathyroidism developing during combined oral phosphate and vitamin D therapy. Author(s): Jeon HJ, Kwon SH, Kim SW, Shin CS, Park KS, Kim SY, Cho BY, Lee HK. Source: Hormone Research. 2003; 60(3): 127-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12931040

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Extensive reflex sympathetic dystrophy syndrome of the lower limbs leading to a diagnosis of osteomalacia due to Fanconi syndrome. Author(s): Dumolard A, Gaudin P, Juvin R, Asquier C, Phelip X. Source: Rev Rhum Engl Ed. 1997 July-September; 64(7-9): 519-20. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9338939

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Extracts from tumors causing oncogenic osteomalacia inhibit phosphate uptake in opossum kidney cells. Author(s): Jonsson KB, Mannstadt M, Miyauchi A, Yang IM, Stein G, Ljunggren O, Juppner H. Source: The Journal of Endocrinology. 2001 June; 169(3): 613-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11375132

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False-positive magnetic resonance imaging skeletal survey in a patient with sporadic hypophosphatemic osteomalacia. Author(s): Imanishi Y, Nakatsuka K, Nakayama T, Okamura T, Kobayashi K, Nakayama K, Ishimura E, Inaba M, Nishizawa Y. Source: Journal of Bone and Mineral Metabolism. 2003; 21(1): 57-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12491095

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Familial adult onset X-linked hypophosphataemic osteomalacia (report of a family; clinical and experimental studies). Author(s): Rado JP, Haris A, Szebenyi B. Source: Acta Physiol Hung. 1997-98; 85(3): 199-214. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10101535

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Familial osteomalacia. Report of two families with various unusual features. Author(s): Zhu XY, Zhu DM, Gao YQ, Wang JC. Source: Chinese Medical Journal. 1986 July; 99(7): 592-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3100207

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Fanconi syndrome and osteomalacia without hyperparathyroidism. Author(s): Khoury S, Tucci JR. Source: R I Med J. 1986 January; 69(1): 33-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3006213

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Fibroblast growth factor (FGF)-23 and hypophosphatemic rickets/osteomalacia. Author(s): Fukumoto S, Yamashita T. Source: Endocrine Journal. 2001 December; 48(6): 603-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11873859

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Fibroblast growth factor 23 in oncogenic osteomalacia and X-linked hypophosphatemia. Author(s): Fukumoto S, Yamashita T. Source: The New England Journal of Medicine. 2003 July 31; 349(5): 505-6; Author Reply 505-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12892105

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Fibroblast growth factor 23 in oncogenic osteomalacia and X-linked hypophosphatemia. Author(s): Kida Y. Source: The New England Journal of Medicine. 2003 July 31; 349(5): 505-6; Author Reply 505-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890852

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Fibroblast growth factor 23 in oncogenic osteomalacia and X-linked hypophosphatemia. Author(s): Jonsson KB, Zahradnik R, Larsson T, White KE, Sugimoto T, Imanishi Y, Yamamoto T, Hampson G, Koshiyama H, Ljunggren O, Oba K, Yang IM, Miyauchi A, Econs MJ, Lavigne J, Juppner H. Source: The New England Journal of Medicine. 2003 April 24; 348(17): 1656-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12711740

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Fibroblast growth factor-23 is the phosphaturic factor in tumor-induced osteomalacia and may be phosphatonin. Author(s): Fukumoto S, Yamashita T. Source: Current Opinion in Nephrology and Hypertension. 2002 July; 11(4): 385-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12105387

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Flare response seen in therapy for osteomalacia. Author(s): Akaki S, Ida K, Kanazawa S, Takeda Y, Hiraki Y, Endo T. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1998 December; 39(12): 2095-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9867149

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Fluorosis and osteomalacia. Author(s): Kiely PD, Chow J, Eastwood JB, Bourke BE. Source: Arthritis and Rheumatism. 1999 September; 42(9): 2012-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10513821

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Fluorosis, osteomalacia and pseudohyperparathyroidism in a patient with renal failure. Author(s): Porcar C, Bronsoms J, Lopez-Bonet E, Valles M. Source: Nephron. 1998; 79(2): 234-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9647513

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Focal osteomalacia due to low-dose diphosphonate therapy in Paget's disease. Author(s): Boyce BF, Smith L, Fogelman I, Johnston E, Ralston S, Boyle IT. Source: Lancet. 1984 April 14; 1(8381): 821-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6143140

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Four cases of acquired hypophosphataemic ('oncogenic') osteomalacia. Problems of diagnosis, treatment and long-term management. Author(s): Clunie GP, Fox PE, Stamp TC. Source: Rheumatology (Oxford, England). 2000 December; 39(12): 1415-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11136887

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Fracture healing with deferoxamine therapy in a patient with aluminum-associated osteomalacia. Author(s): Phelps KR, Einhorn TA, Vigorita VJ, Lundin AP, Friedman EA. Source: Asaio Trans. 1986 July-September; 32(1): 198-200. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3778712

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Fracture of the neck of the femur and osteomalacia in pregnancy. Author(s): Henry A, Bowyer L. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 March; 110(3): 329-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12628279

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Fractures caused by epileptic seizures and epileptic osteomalacia. Author(s): Duus BR. Source: Injury. 1986 January; 17(1): 31-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3095234

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Gastrectomy and osteomalacia: an association not to be forgotten. Author(s): Efstathiadou Z, Bitsis S, Tsatsoulis A. Source: Hormone Research. 1999; 52(6): 295-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965211

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Genetic rickets and osteomalacia. Author(s): Weisman Y, Hochberg Z. Source: Curr Ther Endocrinol Metab. 1994; 5: 492-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7704779

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Genetic rickets and osteomalacia. Author(s): Weisman Y, Hochberg Z. Source: Curr Ther Endocrinol Metab. 1997; 6: 527-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174800

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Glomangiopericytoma causing oncogenic osteomalacia. A case report with immunohistochemical analysis. Author(s): Sakamoto A, Oda Y, Nagayoshi Y, Iwakiri K, Tamiya S, Iwamoto Y, Tsuneyoshi M. Source: Archives of Orthopaedic and Trauma Surgery. 2001; 121(1-2): 104-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11195105

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Growth retardation and osteomalacia as a result of ifosfamide nephrotoxicity in a 3year-old boy whose genotype reveals the genes encoding glutathione S-transferases GSTM1 and GSTT1. Author(s): Zielinska E, Bodalski J. Source: Cytobios. 2001; 106(413): 193-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11523744

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H.I. CHU: pioneer clinical investigator of vitamin D deficiency and osteomalacia in China. A scientific and personal tribute. Author(s): Parfitt AM. Source: Chinese Medical Journal. 1986 May; 99(5): 361-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3100167

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H.-I. Chu: pioneer clinical investigator of vitamin D deficiency and osteomalacia in China. A scientific and personal tribute. Author(s): Parfitt AM. Source: Calcified Tissue International. 1985 July; 37(4): 335-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3930027

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Healing of bone disease in X-linked hypophosphatemic rickets/osteomalacia. Induction and maintenance with phosphorus and calcitriol. Author(s): Harrell RM, Lyles KW, Harrelson JM, Friedman NE, Drezner MK. Source: The Journal of Clinical Investigation. 1985 June; 75(6): 1858-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3839245

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Hemangiopericytoma-induced osteomalacia: tumor transplantation in nude mice causes hypophosphatemia and tumor extracts inhibit renal 25-hydroxyvitamin D 1hydroxylase activity. Author(s): Miyauchi A, Fukase M, Tsutsumi M, Fujita T. Source: The Journal of Clinical Endocrinology and Metabolism. 1988 July; 67(1): 46-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2837500

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High prevalence of low bone turnover and occurrence of osteomalacia after kidney transplantation. Author(s): Monier-Faugere MC, Mawad H, Qi Q, Friedler RM, Malluche HH. Source: Journal of the American Society of Nephrology : Jasn. 2000 June; 11(6): 1093-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10820173

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High prevalence of unrecognized osteomalacia in hospital patients with rheumatoid arthritis. Author(s): Ralston SH, Willocks L, Pitkeathly DA, Morton R, Smith GD. Source: British Journal of Rheumatology. 1988 June; 27(3): 202-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3378124

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High-dose phosphate treatment leads to hypokalemia in hypophosphatemic osteomalacia. Author(s): Haris A, Toth A, Rado JP. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 1998; 106(5): 431-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9831311

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Hip pain in a case of hypophosphatemic osteomalacia. Author(s): Esterberg J, Kassim RA, Redmon J, Coad J, Macari GS, Saleh KJ. Source: Am J Orthop. 2003 September; 32(9): 455-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14560828

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Histochemical demonstration of iron but not aluminum in a case of dialysisassociated osteomalacia. Author(s): Phelps KR, Vigorita VJ, Bansal M, Einhorn TA. Source: The American Journal of Medicine. 1988 April; 84(4): 775-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3041812

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Histological and electron microprobe studies of mineralisation in aluminium-related osteomalacia. Author(s): Boyce BF, Byars J, McWilliams S, Mocan MZ, Elder HY, Boyle IT, Junor BJ. Source: Journal of Clinical Pathology. 1992 June; 45(6): 502-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1624597

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Historical overview of rickets, osteomalacia, and vitamin D. Author(s): Hernigou P. Source: Rev Rhum Engl Ed. 1995 April; 62(4): 261-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7606422

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Hypercalcaemic osteomalacia and encephalopathy due to aluminium intoxication in haemodialysis patients. Clinical aspects and treatment with desferrioxamine. Author(s): Mudde AH, Roodvoets AP, Van Groningen K. Source: The Netherlands Journal of Medicine. 1985; 28(1): 6-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3974771

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Hypercalcemic hyperparathyroidism and hypophosphatemic osteomalacia complicating neurofibromatosis. Author(s): Weinstein RS, Harris RL. Source: Calcified Tissue International. 1990 June; 46(6): 361-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2114209

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Hypercalcemic hyperparathyroidism complicating oncogenic osteomalacia. Effect of successful tumor resection on mineral homeostasis. Author(s): Reid IR, Teitelbaum SL, Dusso A, Whyte MP. Source: The American Journal of Medicine. 1987 August; 83(2): 350-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3303928

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Hyperparathyroidism in X-linked hypophosphataemic osteomalacia. Author(s): Davies M. Source: Clinical Endocrinology. 1995 February; 42(2): 205-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7704965

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Hypocalcemia due to spontaneous infarction of parathyroid adenoma and osteomalacia in a patient with primary hyperparathyroidism. Author(s): Otsuka F, Ogura T, Sato T, Hayakawa N, Mimura Y, Kishida M, Yamauchi T, Makino H. Source: Endocrine Journal. 1998 October; 45(5): 617-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10395241

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Hypophosphataemic osteomalacia and alcoholism: a possible link. Author(s): Labib M, Marks V. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1988; 23(2): 111-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3390234

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Hypophosphataemic osteomalacia associated with prostatic carcinoma. Author(s): Murphy P, Wright G, Rai GS. Source: British Medical Journal (Clinical Research Ed.). 1985 June 29; 290(6486): 1945. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3924318

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Hypophosphataemic osteomalacia due to urinary kappa light chain. Author(s): Pope RM, Belchetz PE. Source: Journal of the Royal Society of Medicine. 1993 November; 86(11): 664-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8258805

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Hypophosphataemic osteomalacia misdiagnosed as metastatic carcinoma. A case report. Author(s): O'Donnell D, Meyers AM. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1985 June 8; 67(23): 934-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4002077

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Hypophosphatemia, osteomalacia and proximal muscle weakness treated by surgery. Author(s): Hoogendoorn EH, White KE, Econs MJ, Hermus AR. Source: Clinical Endocrinology. 2003 June; 58(6): 796-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12780759

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Hypophosphatemic oncogenic osteomalacia: report of three new cases. Author(s): Papotti M, Foschini MP, Isaia G, Rizzi G, Betts CM, Eusebi V. Source: Tumori. 1988 October 31; 74(5): 599-607. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3217995

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Hypophosphatemic osteomalacia and adult Fanconi syndrome due to light-chain nephropathy. Another form of oncogenous osteomalacia. Author(s): Rao DS, Parfitt AM, Villanueva AR, Dorman PJ, Kleerekoper M. Source: The American Journal of Medicine. 1987 February; 82(2): 333-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3101497

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Hypophosphatemic osteomalacia complicating von Recklinghausen's neurofibromatosis: increase in spinal density on treatment. Author(s): Hogan DB, Anderson C, MacKenzie RA, Crilly RG. Source: Bone. 1986; 7(1): 9-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3083847

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Hypophosphatemic osteomalacia demonstrated by Tc-99m MDP bone scan: a case report. Author(s): Kim S, Park CH, Chung YS. Source: Clinical Nuclear Medicine. 2000 May; 25(5): 337-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10795690

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Hypophosphatemic osteomalacia in an elderly patient with generalized bone pain. Author(s): Jansen TL, de Vries RA, Verschoor L. Source: Clin Exp Rheumatol. 1996 March-April; 14(2): 225-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8737738

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Hypophosphatemic osteomalacia in von Recklinghausen neurofibromatosis. Author(s): Konishi K, Nakamura M, Yamakawa H, Suzuki H, Saruta T, Hanaoka H, Davatchi F. Source: The American Journal of the Medical Sciences. 1991 May; 301(5): 322-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1902351

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Hypophosphatemic osteomalacia secondary to neoplasia. Author(s): Cotton GE, Van Puffelen P. Source: The Journal of Bone and Joint Surgery. American Volume. 1986 January; 68(1): 129-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3001095

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Hypophosphatemic osteomalacia with plantar neurilemoma. A review of the literature (100 cases). Author(s): Crouzet J, Mimoune H, Beraneck L, Juan LH. Source: Rev Rhum Engl Ed. 1995 June; 62(6): 463-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7552213

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Hypophosphatemic rickets/osteomalacia in linear sebaceous nevus syndrome: a variant of tumor-induced osteomalacia. Author(s): Carey DE, Drezner MK, Hamdan JA, Mange M, Ahmad MS, Mubarak S, Nyhan WL. Source: The Journal of Pediatrics. 1986 December; 109(6): 994-1000. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3023599

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Iatrogenic osteomalacia caused by intravenous administration of saccharated ferric oxide. Author(s): Suzuki A, Ohoike H, Matsuoka Y, Irimajiri S. Source: American Journal of Hematology. 1993 May; 43(1): 75-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8317471

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Immunohistochemical detection of FGF-23 protein in tumors that cause oncogenic osteomalacia. Author(s): Larsson T, Zahradnik R, Lavigne J, Ljunggren O, Juppner H, Jonsson KB. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 February; 148(2): 269-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12590648

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Impaired hearing in X-linked hypophosphataemic (vitamin-D-resistant) osteomalacia. Author(s): Davies M, Kane R, Valentine J. Source: Annals of Internal Medicine. 1984 February; 100(2): 230-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6691666

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In vitro model of aluminum-induced osteomalacia: inhibition of hydroxyapatite formation and growth. Author(s): Blumenthal NC, Posner AS. Source: Calcified Tissue International. 1984 July; 36(4): 439-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6091854

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Incidence of osteomalacia in fractures of the proximal end of femur. Author(s): Tucker GS, Middha VP, Sural A, Sagreiya K. Source: Injury. 1988 March; 19(2): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3198272

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Incipient osteomalacia occurring in chronic actinic dermatitis. Author(s): Kapur N, Creamer D, Hawk J. Source: Clinical and Experimental Dermatology. 2000 July; 25(5): 384-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11012590

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Increased bone strontium levels in hemodialysis patients with osteomalacia. Author(s): D'Haese PC, Schrooten I, Goodman WG, Cabrera WE, Lamberts LV, Elseviers MM, Couttenye MM, De Broe ME. Source: Kidney International. 2000 March; 57(3): 1107-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10720963

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Increased circulatory level of biologically active full-length FGF-23 in patients with hypophosphatemic rickets/osteomalacia. Author(s): Yamazaki Y, Okazaki R, Shibata M, Hasegawa Y, Satoh K, Tajima T, Takeuchi Y, Fujita T, Nakahara K, Yamashita T, Fukumoto S. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 November; 87(11): 4957-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12414858

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Indium-111 pentetreotide scintigraphy of mesenchymal tumor with oncogenic osteomalacia. Author(s): Nguyen BD, Wang EA. Source: Clinical Nuclear Medicine. 1999 February; 24(2): 130-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9988077

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Inflammatory polyenthesopathy in a patient with X-linked osteomalacia. Author(s): Punzi L, Zucchetta P, Stramare R, Podswiadek M, Ramonda R, Todesco S. Source: Clin Exp Rheumatol. 2003 March-April; 21(2): 274. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12747297

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Inherited forms of rickets and osteomalacia. Author(s): Thakker RV, O'Riordan JL. Source: Baillieres Clin Endocrinol Metab. 1988 February; 2(1): 157-91. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2900631

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Inhibitors of renal epithelial phosphate transport in tumor-induced osteomalacia and uremia. Author(s): Kumar R, Haugen JD, Wieben ED, Londowski JM, Cai Q. Source: Proceedings of the Association of American Physicians. 1995 October; 107(3): 296-305. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8608414

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Intractable muscle pain syndrome, osteomalacia, and axonopathy in long-term use of phenytoin. Author(s): Ronin DI, Wu YC, Sahgal V, MacLean IC. Source: Archives of Physical Medicine and Rehabilitation. 1991 September; 72(10): 755-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1929800

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Intra-spinal new bone formation and spinal cord compression in familial hypophosphataemic vitamin D resistant osteomalacia. Author(s): Adams JE, Davies M. Source: The Quarterly Journal of Medicine. 1986 December; 61(236): 1117-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3116593

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Iron and aluminum osteomalacia in hemodialysis patients. Author(s): Pierides AM, Myli MP. Source: The New England Journal of Medicine. 1984 February 2; 310(5): 323. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6690959

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Irreversible bone loss in osteomalacia. Comparison of radial photon absorptiometry with iliac bone histomorphometry during treatment. Author(s): Parfitt AM, Rao DS, Stanciu J, Villanueva AR, Kleerekoper M, Frame B. Source: The Journal of Clinical Investigation. 1985 December; 76(6): 2403-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4077986

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Is a certain degree of osteomalacia involved in femoral neck fractures of the elderly? Histological approach to the problem and practical applications. Author(s): Rapin CH, Lagier R, Boivin G, MacGee W, Jung A. Source: Z Gerontol. 1983 November-December; 16(6): 277-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6666240

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Lack of osteomalacia in chronic cholestatic liver disease. Author(s): Stellon AJ, Webb A, Compston J, Williams R. Source: Bone. 1986; 7(3): 181-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3768195

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Lambda light chain induced nephropathy: a rare cause of the Fanconi syndrome and severe osteomalacia. Author(s): Bate KL, Clouston D, Packham D, Ratnaike S, Ebeling PR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1998 December; 32(6): E3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10074597

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Late onset oncogenic osteomalacia-associated with neurofibromatosis type II. Author(s): Haviv YS, Silver J. Source: Clinical Nephrology. 2000 November; 54(5): 429-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11105809

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Lesson of the week: Danger of stereotyping in suspected osteomalacia. Author(s): Sheikh S, Williamson K, Kearley K, Bassindale S, Lancaster T. Source: Bmj (Clinical Research Ed.). 2001 July 21; 323(7305): 149-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11463688

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Low prevalence of osteomalacia in elderly patients with hip fracture. Author(s): Compston JE, Vedi S, Croucher PI. Source: Age and Ageing. 1991 March; 20(2): 132-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2053503

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Low rate of bone formation with or without histologic appearance of osteomalacia in patients with aluminum intoxication. Author(s): Charhon SA, Chavassieux PM, Chapuy MC, Boivin GY, Meunier PJ. Source: The Journal of Laboratory and Clinical Medicine. 1985 August; 106(2): 123-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2410522

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Medical reversal of acquired hypophosphatemic osteomalacia. Author(s): Silverton SF, Haddad JG. Source: The American Journal of Medicine. 1987 May; 82(5): 1077-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3578346

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MEPE, a new gene expressed in bone marrow and tumors causing osteomalacia. Author(s): Rowe PS, de Zoysa PA, Dong R, Wang HR, White KE, Econs MJ, Oudet CL. Source: Genomics. 2000 July 1; 67(1): 54-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10945470

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Mepe, the gene encoding a tumor-secreted protein in oncogenic hypophosphatemic osteomalacia, is expressed in bone. Author(s): Argiro L, Desbarats M, Glorieux FH, Ecarot B. Source: Genomics. 2001 June 15; 74(3): 342-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11414762

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Metabolic bone disease (anticonvulsant osteomalacia) and renal tubular acidosis in tuberous sclerosis. Author(s): Rado JP, Haris A. Source: Intern Med. 1993 July; 32(7): 574-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8286838

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Metabolic bone disease with and without osteomalacia after intestinal bypass surgery: a bone histomorphometric study. Author(s): Parfitt AM, Podenphant J, Villanueva AR, Frame B. Source: Bone. 1985; 6(4): 211-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3840379

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Metabolic studies in a patient with idiopathic hypophosphatemic osteomalacia. Author(s): Weiss M, Schechter P, Bab I, Mekhmandarov S, Bank H, Eisenstein Z. Source: Isr J Med Sci. 1988 January; 24(1): 46-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3346150

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Model of aluminum-induced osteomalacia: inhibition of apatite formation and growth. Author(s): Posner AS, Blumenthal NC, Boskey AL. Source: Kidney International. Supplement. 1986 February; 18: S17-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3009957

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Molecular biology of hypophosphataemic rickets and oncogenic osteomalacia. Author(s): Rowe PS. Source: Human Genetics. 1994 November; 94(5): 457-67. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7959677

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Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity: an analysis of 32 cases and a comprehensive review of the literature. Author(s): Folpe AL, Fanburg-Smith JC, Billings SD, Bisceglia M, Bertoni F, Cho JY, Econs MJ, Inwards CY, Jan de Beur SM, Mentzel T, Montgomery E, Michal M, Miettinen M, Mills SE, Reith JD, O'Connell JX, Rosenberg AE, Rubin BP, Sweet DE, Vinh TN, Wold LE, Wehrli BM, White KE, Zaino RJ, Weiss SW. Source: The American Journal of Surgical Pathology. 2004 January; 28(1): 1-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14707860

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Muscle pain and wasting in osteomalacia. Author(s): Golding DN. Source: Journal of the Royal Society of Medicine. 1985 June; 78(6): 495-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3999087

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Musculoskeletal case of the day. Oncogenic osteomalacia. Author(s): Kaplan PA, Dussault RG, Buchanan PK, Berardo PV, Gizienski TA, Short JG. Source: Ajr. American Journal of Roentgenology. 1996 July; 167(1): 253, 256-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8659391

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Musculoskeletal manifestations of osteomalacia. Author(s): Reginato AJ. Source: Rev Rhum Engl Ed. 1997 June 30; 64(6 Suppl): 107S-113S. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9273951

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Musculoskeletal manifestations of osteomalacia: report of 26 cases and literature review. Author(s): Reginato AJ, Falasca GF, Pappu R, McKnight B, Agha A. Source: Seminars in Arthritis and Rheumatism. 1999 April; 28(5): 287-304. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10342386

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Nasopharyngeal angiofibroma presenting as adult osteomalacia: case report and review of the literature. Author(s): Linsey M, Smith W, Yamauchi H, Bernstein L. Source: The Laryngoscope. 1983 October; 93(10): 1328-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6312223

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Neoplastic pathology of oncogenic osteomalacia/rickets. Author(s): Weidner N, Bar RS, Weiss D, Strottmann MP. Source: Cancer. 1985 April 15; 55(8): 1691-705. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3978561

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New insights into phosphate homeostasis: fibroblast growth factor 23 and frizzledrelated protein-4 are phosphaturic factors derived from tumors associated with osteomalacia. Author(s): Kumar R. Source: Current Opinion in Nephrology and Hypertension. 2002 September; 11(5): 54753. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12187320

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Newcastle bone disease in Hong Kong: a study of aluminum associated osteomalacia. Author(s): Chan MK, Varghese Z, Li MK, Wong WS, Li CS. Source: Int J Artif Organs. 1990 March; 13(3): 162-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2189835

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Noninvasive testing in the diagnosis of osteomalacia. Author(s): Bingham CT, Fitzpatrick LA. Source: The American Journal of Medicine. 1993 November; 95(5): 519-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7646591

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Noninvasive testing in the diagnosis of osteomalacia. Author(s): McKenna MJ, Freaney R. Source: The American Journal of Medicine. 1995 July; 99(1): 107-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7598132

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Nutritional osteomalacia presenting with plantar fasciitis. Author(s): Paice EW, Hoffbrand BI. Source: The Journal of Bone and Joint Surgery. British Volume. 1987 January; 69(1): 3840. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3818730

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Nutritional osteomalacia: substantial clinical improvement and gain in bone density posttherapy. Author(s): Al-Ali H, Fuleihan GE. Source: Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry. 2000 Spring; 3(1): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10745306

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Nutritional rickets and osteomalacia in school children and adolescents. Author(s): Al-Jurayyan NA, El-Desouki ME, Al-Herbish AS, Al-Mazyad AS, Al-Qhtani MM. Source: Saudi Med J. 2002 February; 23(2): 182-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11938395

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Octreotide for tumor-induced osteomalacia. Author(s): Paglia F, Dionisi S, Minisola S. Source: The New England Journal of Medicine. 2002 May 30; 346(22): 1748-9; Author Reply 1748-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12037159

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Octreotide scanning in the detection of a mesenchymal tumour in the pubic symphysis causing hypophosphataemic osteomalacia. Author(s): Moran M, Paul A. Source: International Orthopaedics. 2002; 26(1): 61-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11954853

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Octreotide therapy for tumor-induced osteomalacia. Author(s): Seufert J, Ebert K, Muller J, Eulert J, Hendrich C, Werner E, Schuuze N, Schulz G, Kenn W, Richtmann H, Palitzsch KD, Jakob F. Source: The New England Journal of Medicine. 2001 December 27; 345(26): 1883-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11756579

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Oncogenic osteomalacia associated with mesenchymal tumour detected by indium111 octreotide scintigraphy. Author(s): Rhee Y, Lee JD, Shin KH, Lee HC, Huh KB, Lim SK. Source: Clinical Endocrinology. 2001 April; 54(4): 551-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11318793

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Oncogenic osteomalacia associated with metastatic prostate carcinoma. Author(s): Rai GS. Source: Journal of the American Geriatrics Society. 1994 June; 42(6): 688. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8043125

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Oncogenic osteomalacia associated with metastatic prostate carcinoma: case report and review of the literature. Author(s): McMurtry CT, Godschalk M, Malluche HH, Geng Z, Adler RA. Source: Journal of the American Geriatrics Society. 1993 September; 41(9): 983-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8409185

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Oncogenic osteomalacia associated with soft tissue chondromyxoid fibroma. Author(s): Park JM, Woo YK, Kang MI, Kang CS, Hahn ST. Source: European Journal of Radiology. 2001 August; 39(2): 69-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11522411

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Oncogenic osteomalacia induced by schwannoma in a patient with neurofibromatosis. Author(s): Ben-Baruch D, Ziv Y, Sandbank J, Wolloch Y. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 1994 February; 20(1): 57-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8131871

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Oncogenic osteomalacia secondary to nasal tumor with decreased urinary excretion of cAMP. Author(s): Kawai Y, Morimoto S, Sakaguchi K, Yoshino H, Yotsui T, Hirota S, Inohara H, Nakagawa T, Hattori K, Kubo T, Yang J, Fujiwara N, Ogihara T. Source: Journal of Bone and Mineral Metabolism. 2001; 19(1): 61-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11156476

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Oncogenic osteomalacia. Author(s): Edmister KA, Sundaram M. Source: Seminars in Musculoskeletal Radiology. 2002 September; 6(3): 191-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12541196

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Oncogenic osteomalacia. Author(s): Rapoport J. Source: Isr Med Assoc J. 2000 December; 2(12): 942-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344782

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Oncogenic osteomalacia. Author(s): Sundaram M, McCarthy EF. Source: Skeletal Radiology. 2000 March; 29(3): 117-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10794548

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Oncogenic osteomalacia--a complex dance of factors. Author(s): Carpenter TO. Source: The New England Journal of Medicine. 2003 April 24; 348(17): 1705-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12711747

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Oncogenous osteomalacia--report of a case. Author(s): Cehreli C, Alakavuklar MN, Cavdar C, Basdemir G, Undar B, Akkoc N, Payzin B, Oztop F. Source: Acta Oncologica (Stockholm, Sweden). 1994; 33(8): 975-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7818934

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Osteoblastoma as a cause of osteomalacia assessed by bone scan. Author(s): Chun KA, Cho IH, Won KJ, Lee HW, Choi JH, Ahn JC, Shin DS. Source: Ann Nucl Med. 2003 July; 17(5): 411-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12971642

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Osteomalacia after pamidronate for Paget's disease. Author(s): Reid IR, Cundy T, Ibbertson HK, King AR. Source: Lancet. 1994 April 2; 343(8901): 855. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7908098

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Osteomalacia and sacroiliitis. Author(s): El Mahou S, Moineuse C, Navaux F, Cantagrel A, Mazieres B, Laroche M. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2003 August; 70(4): 310-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12951319

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Osteomalacia associated with carbamazepine/valproate. Author(s): Karaaslan Y, Haznedaroglu S, Ozturk M. Source: The Annals of Pharmacotherapy. 2000 February; 34(2): 264-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10676838

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Osteomalacia due to vitamin D depletion: a neglected consequence of intestinal malabsorption. Author(s): Basha B, Rao DS, Han ZH, Parfitt AM. Source: The American Journal of Medicine. 2000 March; 108(4): 296-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11014722

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Osteomalacia in a vitamin D-deficient woman with Graves' disease. Author(s): Nagasaka S, Shinohara Y, Kubota K, Murakami T. Source: Endocrine Journal. 2001 August; 48(4): 515-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11603577

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Osteomalacia secondary to renal tubular acidosis masquerading as primary biliary cirrhosis. Author(s): Davidson BK, Haslock I. Source: Rheumatology (Oxford, England). 2000 December; 39(12): 1428-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11136892

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Osteomalacia that became symptomatic 13 years after a total gastrectomy. Author(s): Kikuchi H, Ujiie S, Kanamaru R. Source: Intern Med. 2000 May; 39(5): 394-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10830180

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Parathyroid hormone-like bioactivity in tumours from patients with oncogenic osteomalacia. Author(s): Seshadri MS, Cornish CJ, Mason RS, Posen S. Source: Clinical Endocrinology. 1985 December; 23(6): 689-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3830474

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Pathogenesis of osteomalacia in chronic renal failure and its relationship to vitamin D. Author(s): Kanis JA, Hamdy NA, Cundy T. Source: Annales De Medecine Interne. 1986; 137(3): 193-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3532899

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Pathologic quiz case. A 36-year-old woman with muscle pain and weakness. Phosphaturic mesenchymal tumor (mixed connective tissue variant)/oncogenic osteomalacia. Author(s): Reis-Filho JS, Paiva ME, Lopes JM. Source: Archives of Pathology & Laboratory Medicine. 2002 October; 126(10): 1245-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12385334

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Pathophysiology of X-linked hypophosphatemia, tumor-induced osteomalacia, and autosomal dominant hypophosphatemia: a perPHEXing problem. Author(s): Quarles LD, Drezner MK. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 February; 86(2): 494-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11157997

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Patients with thalassemia develop osteoporosis, osteomalacia, and hypoparathyroidism, all of which are corrected by transfusion. Author(s): Christenson RA, Pootrakul P, Burnell JM, Teubner EJ, Finch CA, Baylink DJ. Source: Birth Defects Orig Artic Ser. 1987; 23(5A): 409-16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3689925

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Pentavalent technetium-99m DMSA uptake in pseudofractures of osteomalacia. Author(s): Sahin M, Basoglu T, Albayrak S, Canbaz F, Yapici O. Source: Clinical Nuclear Medicine. 2001 January; 26(1): 62-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11139060

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Periosteal new bone in patients on intermittent haemodialysis: an early indicator of aluminium-induced osteomalacia? Author(s): Chambers SE, Winney RJ. Source: Clinical Radiology. 1985 March; 36(2): 163-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4064494

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Persistence of dialysis osteomalacia despite treatment with 24R,25dihydroxycholecalciferol. Author(s): Phelps KR, Einhorn TA, Vigorita VJ, Jones G, Lundin AP. Source: Nephron. 1989; 51(2): 197-206. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2783766

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Phenytoin induced osteomalacia and fracture in a young epileptic. Author(s): Mohapatro AK, Behari M, Prasad K, Ahuja GK. Source: J Assoc Physicians India. 1990 September; 38(9): 675-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2266104

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Phosphate wasting in oncogenic osteomalacia: PHEX is normal and the tumor-derived factor has unique properties. Author(s): Nelson AE, Hogan JJ, Holm IA, Robinson BG, Mason RS. Source: Bone. 2001 April; 28(4): 430-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11336925

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Phosphatonin--a new phosphaturetic hormone? (lessons from tumour-induced osteomalacia and X-linked hypophosphataemia) Author(s): Kumar R. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1997 January; 12(1): 11-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9027763

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Phosphaturic mesenchymal tumor, mixed connective tissue variant (oncogenic osteomalacia). Author(s): Tsujimura T, Sakaguchi K, Aozasa K. Source: Pathology International. 1996 March; 46(3): 238-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10846577

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Phosphaturic mesenchymal tumors. A polymorphous group causing osteomalacia or rickets. Author(s): Weidner N, Santa Cruz D. Source: Cancer. 1987 April 15; 59(8): 1442-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3545439

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Plasma creatinine and creatinine clearance in nutritional osteomalacia. Author(s): Fonseca V, Mohiuddin J, Weerakoon J, Boss M, Mikhailidis DP, Dandona P. Source: Lancet. 1984 May 19; 1(8386): 1093-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6144828

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Post-gastrectomy nutrition: methods of outpatient screening for early osteomalacia. Author(s): Tovey FI, Karamanolis DG, Godfrey J, Clark CG. Source: Hum Nutr Clin Nutr. 1985 November; 39(6): 439-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4077579

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Postgastrectomy osteomalacia with pseudofractures assessed by repeated bone scintigraphy. Author(s): Wu YW, Seto H, Shimizu M, Kageyama M, Watanabe N, Kakishita M. Source: Ann Nucl Med. 1995 February; 9(1): 29-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7779527

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Primary hyperparathyroidism complicated by osteomalacia. Author(s): Li JK, Chow CC, Yeung VT, Ko GT, Metreweli C, Cockram CS. Source: Annals of Clinical Biochemistry. 1996 November; 33 ( Pt 6): 571-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8937594

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Primary Sjogren's syndrome presenting as osteomalacia secondary to renal tubular acidosis. Author(s): Pal B, Griffiths ID. Source: Br J Clin Pract. 1988 October; 42(10): 436-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3255423

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Prostate cancer-induced oncogenic hypophosphatemic osteomalacia. Author(s): Nakahama H, Nakanishi T, Uno H, Takaoka T, Taji N, Uyama O, Kitada O, Sugita M, Miyauchi A, Sugishita T, et al. Source: Urologia Internationalis. 1995; 55(1): 38-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7571183

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Proximal renal tubular acidosis associated with osteomalacia. Author(s): Ahmed A, Sims RV. Source: Southern Medical Journal. 2001 May; 94(5): 536-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11372811

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Quantitative bone scanning in the diagnosis of aluminium osteomalacia. Author(s): Worth DP, Smye SW, Robinson PJ, Davison AM, Will EJ. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1989; 4(8): 721-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2510081

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Quiz of the month. Biopsy of the posterior iliac crest after double tetracycline labeling revealed osteomalacia. Author(s): Norris SH. Source: American Journal of Nephrology. 1987; 7(1): 44, 84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3578374

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Radiologic case study. Secondary hyperparathyroidism, osteomalacia with a pseudofracture, and amyloid deposition. Author(s): Kidwai A, Griffiths HJ. Source: Orthopedics. 2003 June; 26(6): 618, 665-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12817725

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Radiology of rickets, osteomalacia and hyperparathyroidism. Author(s): Renton P. Source: Hosp Med. 1998 May; 59(5): 399-403. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9722392

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Rapid improvement of osteomalacia by treatment in a case with Sjogren's syndrome, rheumatoid arthritis and renal tubular acidosis type 1. Author(s): Okada M, Suzuki K, Hidaka T, Shinohara T, Kataharada K, Matsumoto M, Takada K, Ohsuzu F. Source: Intern Med. 2001 August; 40(8): 829-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11518137

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Recurrent malignant variant of phosphaturic mesenchymal tumor with oncogenic osteomalacia. Author(s): Ogose A, Hotta T, Emura I, Hatano H, Inoue Y, Umezu H, Endo N. Source: Skeletal Radiology. 2001 February; 30(2): 99-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11310207

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Reflex sympathetic dystrophy in hypophosphataemic osteomalacia with femoral neck fracture: a case report. Author(s): Roig-Vilaseca D, Moragues-Pastor C, Nolla-Sole JM, Roig-Escofet D. Source: Rheumatology (Oxford, England). 2000 April; 39(4): 439-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10817779

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Reflex sympathetic dystrophy syndrome: an unusual mode of presentation of osteomalacia. Author(s): Huaux JP, Malghem J, Maldague B, Devogelaer JP, Esselinckx W, Withofs H, Nagant de Deuxchaisnes C. Source: Arthritis and Rheumatism. 1986 July; 29(7): 918-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3755603

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Renal failure in adult onset hypophosphatemic osteomalacia with Fanconi syndrome: a family study and review of the literature. Author(s): Harrison NA, Bateman JM, Ledingham JG, Smith R. Source: Clinical Nephrology. 1991 April; 35(4): 148-50. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1649711

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Renal hypophosphatemic osteomalacia unmasked by hyperthyroidism. Author(s): Baranetsky NG, Chertow BS, Sivitz WI, Mullen JO. Source: The American Journal of the Medical Sciences. 1986 October; 292(4): 231-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3019139

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Renal phosphate wasting in fibrous dysplasia of bone is part of a generalized renal tubular dysfunction similar to that seen in tumor-induced osteomalacia. Author(s): Collins MT, Chebli C, Jones J, Kushner H, Consugar M, Rinaldo P, Wientroub S, Bianco P, Robey PG. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 May; 16(5): 806-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11341325

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Review and update: oncogenic osteomalacia-rickets. Author(s): Weidner N. Source: Ultrastructural Pathology. 1991 July-October; 15(4-5): 317-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1755097

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Rickets and osteomalacia are still around. Author(s): Pitt MJ. Source: Radiologic Clinics of North America. 1991 January; 29(1): 97-118. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985332

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Rickets and osteomalacia. Author(s): Lawson DE. Source: The Proceedings of the Nutrition Society. 1984 September; 43(3): 249-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6393133

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Rickets, osteomalacia, and osteopetrosis. Author(s): Balsan S, Garabedian M. Source: Current Opinion in Rheumatology. 1991 June; 3(3): 496-502. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1883705

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Rickets, osteomalacia, and renal osteodystrophy. An update. Author(s): Mankin HJ. Source: The Orthopedic Clinics of North America. 1990 January; 21(1): 81-96. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2404238

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Saccharated ferric oxide (SFO)-induced osteomalacia: in vitro inhibition by SFO of bone formation and 1,25-dihydroxy-vitamin D production in renal tubules. Author(s): Sato K, Nohtomi K, Demura H, Takeuchi A, Kobayashi T, Kazama J, Ozawa H. Source: Bone. 1997 July; 21(1): 57-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9213008

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Saccharated ferric oxide-induced osteomalacia in Japan: iron-induced osteopathy due to nephropathy. Author(s): Sato K, Shiraki M. Source: Endocrine Journal. 1998 August; 45(4): 431-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9881891

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Safety of treatment for subclinical osteomalacia in the elderly. Author(s): Hosking DJ, Campbell GA, Kemm JR, Cotton RE, Boyd RV. Source: British Medical Journal (Clinical Research Ed.). 1984 September 29; 289(6448): 785-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6434081

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Sclerotic bone metastases of prostatic origin and osteomalacia. Importance of a histomorphometry study. Author(s): Burki F, Coindre JM, Mauriac L. Source: Prog Clin Biol Res. 1987; 243A: 569-71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3659014

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Screening for early post-gastrectomy osteomalacia. Author(s): Tovey FI, Karamanolis DG, Godfrey J, Clark CG. Source: The Practitioner. 1987 June; 231(1431): 817, 822. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3330239

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Screening for osteomalacia in elderly patients with femoral neck fractures. Author(s): Wilton TJ, Hosking DJ, Pawley E, Stevens A, Harvey L. Source: The Journal of Bone and Joint Surgery. British Volume. 1987 November; 69(5): 765-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3680338

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Serum osteocalcin is increased in patients with osteomalacia: correlations with biochemical and histomorphometric findings. Author(s): Demiaux B, Arlot ME, Chapuy MC, Meunier PJ, Delmas PD. Source: The Journal of Clinical Endocrinology and Metabolism. 1992 May; 74(5): 1146-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1569162

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Severe hypophosphataemia in a patient with Paget's disease of bone: paraneoplastic osteomalacia? Author(s): D'Amore M, Coluccia F, Cantatore FP, Carrozzo M. Source: Clinical Rheumatology. 1990 September; 9(3): 421. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2261746

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Severe osteomalacia associated with renal tubular acidosis in Crohn's disease. Author(s): Victorino RM, Lucas MB, de Moura MC. Source: Digestive Diseases and Sciences. 1986 March; 31(3): 322-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3004848

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Severe osteomalacia due to gluten-sensitive enteropathy. Author(s): Lupattelli G, Fuscaldo G, Castellucci G, Ciuffetti G, Pelli MA, Mannarino E. Source: Ann Ital Med Int. 1994 January-March; 9(1): 40-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8003392

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Single- and dual-photon absorptiometry in osteoporosis and osteomalacia. Author(s): Wahner HW. Source: Semin Nucl Med. 1987 October; 17(4): 305-15. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3317845

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Single dose vitamin D treatment for osteomalacia in the elderly. Author(s): Burns J, Paterson CR. Source: British Medical Journal (Clinical Research Ed.). 1985 January 26; 290(6464): 281-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3917785

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Somatic mutations of the MEN1 gene and microsatellite instability in a case of tertiary hyperparathyroidism occurring during high phosphate therapy for acquired, hypophosphatemic osteomalacia. Author(s): Sato K, Obara T, Yamazaki K, Kanbe M, Nakajima K, Yamada A, Yanagisawa T, Kato Y, Nishikawa T, Takano K. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 November; 86(11): 5564-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11701736

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Spontaneous bilateral displaced femoral neck fractures in nutritional osteomalacia--a case report. Author(s): Chadha M, Balain B, Maini L, Dhal A. Source: Acta Orthopaedica Scandinavica. 2001 February; 72(1): 94-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11327423

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Spontaneous healing of jejunoileal bypass-induced osteomalacia. Author(s): Halverson JD, Haddad JG, Bergfeld M, Teitelbaum SL. Source: Int J Obes. 1989; 13(4): 497-504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2793302

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Sporadic adult-onset hypophosphatemic osteomalacia--a report of two cases. Author(s): Tan TT, Raymond AA, Cheong I, Khalid BA. Source: Singapore Med J. 1989 August; 30(4): 410-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2814550

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Sporadic aluminum osteomalacia: identification of patients at risk. Author(s): Turner MW, Ardila M, Hutchinson T, Prichard S, Barre PE, Beauvais J, Kaye M. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 1988 January; 11(1): 51-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3337100

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Strontium and osteomalacia in renal failure patients. Author(s): De Broe ME, D'Haese PC. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 January; 18(1): 215-6; Author Reply 216. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12480989

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Studies in a patient with tumor-induced hypophosphatemic osteomalacia. Author(s): Ryan WG, Gitelis S, Charters JR. Source: Calcified Tissue International. 1986 June; 38(6): 358-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3089559

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Successful treatment of dialysis osteomalacia and dementia, using desferrioxamine infusions and oral 1-alpha hydroxycholecalciferol. Author(s): Hood SA, Clark WF, Hodsman AB, Bolton CF, Cordy PE, Anderson C, Leung F. Source: American Journal of Nephrology. 1984; 4(6): 369-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6517116

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Tertiary hyperparathyroidism after high-dose phosphate therapy in adult-onset hypophosphatemic osteomalacia. Author(s): Younis E, Jarrah N, Sroujieh AS, Al Hadidy A, Ajlouni K. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 September-October; 7(5): 375-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11585374

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Tertiary hyperparathyroidism in nutritional osteomalacia. Author(s): Seshadri MS, Qurttom MA, Sivanandan R, Shihab-al-Mohannadi, Samiaman. Source: Postgraduate Medical Journal. 1994 August; 70(826): 595-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7937459

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The association of neurofibromatosis 1 and spinal deformity with primary hyperparathyroidism and osteomalacia: might melatonin have a role? Author(s): Abdel-Wanis ME, Kawahara N, Tomita K. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2001; 6(2): 193-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11484109

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The PEX gene: its role in X-linked rickets, osteomalacia, and bone mineral metabolism. Author(s): Rowe PS. Source: Experimental Nephrology. 1997 September-October; 5(5): 355-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9386970

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The PEX gene: not a simple answer for X-linked hypophosphataemic rickets and oncogenic osteomalacia. Author(s): Nelson AE, Mason RS, Robinson BG. Source: Molecular and Cellular Endocrinology. 1997 September 19; 132(1-2): 1-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9324040

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Thyrotoxicosis with osteomalacia and proximal myopathy. Author(s): Goswami R, Shah P, Ammini AC. Source: Journal of Postgraduate Medicine. 1993 April-June; 39(2): 89-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8169871

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Treatment of vitamin D deficient osteomalacia may unmask autonomous hyperparathyroidism. Author(s): Taylor AV, Wise PH. Source: Postgraduate Medical Journal. 1997 December; 73(866): 813-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9497953

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Tumor expression studies indicate that HEM-1 is unlikely to be the active factor in oncogenic osteomalacia. Author(s): Nelson AE, Mason RS, Hogan JJ, Diamond T, Robinson BG. Source: Bone. 1998 December; 23(6): 549-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9855464

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Tumor induced osteomalacia. Author(s): Ioakimidis DE, Dendrinos GK, Frangia KB, Babiolakis DN, Chilas GI, Lyberopoulos KL, Kontomerkos TK. Source: The Journal of Rheumatology. 1994 June; 21(6): 1162-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7932437

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Tumor-induced osteomalacia and symptomatic looser zones secondary to mesenchymal chondrosarcoma. Author(s): Zura RD, Minasi JS, Kahler DM. Source: Journal of Surgical Oncology. 1999 May; 71(1): 58-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10362094

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Tumor-induced osteomalacia and the regulation of phosphate homeostasis. Author(s): Kumar R. Source: Bone. 2000 September; 27(3): 333-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10962341

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Tumor-induced osteomalacia associated with lesions in the oral and maxillofacial region: report of two cases. Author(s): Kim YG, Choi YS, Lee SC, Ryu DM. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 1996 November; 54(11): 1352-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8941189

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Tumor-induced osteomalacia. Author(s): Hewison M. Source: Current Opinion in Rheumatology. 1994 May; 6(3): 340-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8060772

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Tumor-induced osteomalacia. Author(s): Drezner MK. Source: Reviews in Endocrine & Metabolic Disorders. 2001 April; 2(2): 175-86. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11705323

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Tumor-induced osteomalacia. Author(s): Schapira D, Ben Izhak O, Nachtigal A, Burstein A, Shalom RB, Shagrawi I, Best LA. Source: Seminars in Arthritis and Rheumatism. 1995 August; 25(1): 35-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8525389

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Tumor-induced osteomalacia: clinical and basic studies. Author(s): Shane E, Parisien M, Henderson JE, Dempster DW, Feldman F, Hardy MA, Tohme JF, Karaplis AC, Clemens TL. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1997 September; 12(9): 1502-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9286768

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Tumor-induced osteomalacia--unveiling a new hormone. Author(s): Econs MJ, Drezner MK. Source: The New England Journal of Medicine. 1994 June 9; 330(23): 1679-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8177274

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Tumor-related osteomalacia followed after treatment by hyperparathyroidism. Author(s): Heylen A, Dasnoy D, Hustin J, Pochet JM. Source: Rev Rhum Engl Ed. 1999 January; 66(1): 53-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10036701

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Tumors associated with oncogenic osteomalacia express genes important in bone and mineral metabolism. Author(s): De Beur SM, Finnegan RB, Vassiliadis J, Cook B, Barberio D, Estes S, Manavalan P, Petroziello J, Madden SL, Cho JY, Kumar R, Levine MA, Schiavi SC. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 June; 17(6): 1102-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12054166

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Tumour induced osteomalacia: a report of two cases. A disease of defective matrix synthesis? Author(s): Deshpande RB, Shah NF, Joshi VR. Source: Indian Journal of Cancer. 1992 December; 29(4): 218-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1293009

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Ultrastructural localization of aluminum in patients with dialysis-associated osteomalacia. Author(s): Verbueken AH, Van de Vyver FL, Van Grieken RE, Paulus GJ, Visser WJ, D'Haese P, De Broe ME. Source: Clinical Chemistry. 1984 May; 30(5): 763-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6713639

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Use of long-term intravenous phosphate infusion in the palliative treatment of tumorinduced osteomalacia. Author(s): Yeung SJ, McCutcheon IE, Schultz P, Gagel RF. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 February; 85(2): 549-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10690854

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Use of quantitative ultrasonography in differentiating osteomalacia from osteoporosis: preliminary study. Author(s): Luisetto G, Camozzi V, De Terlizzi F. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 2000 April; 19(4): 251-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10759348

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Value of the history in diagnosis of histological osteomalacia among Asians presenting to the NHS. Author(s): Peach H, Compston JE, Vedi S. Source: Lancet. 1983 December 10; 2(8363): 1347-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6139680

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Vitamin D deficiency and osteomalacia in the elderly. Author(s): Barzel US. Source: Hosp Pract (Off Ed). 1984 October; 19(10): 129-34. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6434554

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Vitamin D deficiency osteomalacia in elderly persons. Author(s): Smith P, Barzel US. Source: Compr Ther. 1984 July; 10(7): 24-32. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6744803

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Vitamin D deficiency rickets and osteomalacia in Israel. Author(s): Weisman Y. Source: Isr Med Assoc J. 2003 April; 5(4): 289-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14509137

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Vitamin D deficiency, osteomalacia, and primary biliary cirrhosis. Response to orally administered vitamin D3. Author(s): Davies M, Mawer EB, Klass HJ, Lumb GA, Berry JL, Warnes TW. Source: Digestive Diseases and Sciences. 1983 February; 28(2): 145-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6297863

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Vitamin D deficiency: a risk factor for osteomalacia in the aged. Author(s): Barzel US. Source: Journal of the American Geriatrics Society. 1983 October; 31(10): 598-601. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6619467

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Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia. Author(s): Williams C, Netzloff M, Folkerts L, Vargas A, Garnica A, Frias J. Source: Southern Medical Journal. 1984 July; 77(7): 834-6, 842. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6740350

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Vitamin D metabolism and bone histomorphometry in a patient with antacidinduced osteomalacia. Author(s): Godsall JW, Baron R, Insogna KL. Source: The American Journal of Medicine. 1984 October; 77(4): 747-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6486152

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Vitamin D metabolism and osteomalacia in cystic fibrosis. Author(s): Friedman HZ, Langman CB, Favus MJ. Source: Gastroenterology. 1985 March; 88(3): 808-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3871414

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Vitamin D metabolism, rickets, and osteomalacia. Author(s): Berry JL, Davies M, Mee AP. Source: Seminars in Musculoskeletal Radiology. 2002 September; 6(3): 173-82. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12541194

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Vitamin D metabolites and osteomalacia in the human Fanconi syndrome. Author(s): Colussi G, De Ferrari ME, Surian M, Malberti F, Rombola G, Pontoriero G, Galvanini G, Minetti L. Source: Proc Eur Dial Transplant Assoc Eur Ren Assoc. 1985; 21: 756-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3991574

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Vitamin D, rickets, and osteomalacia. Author(s): Doppelt SH. Source: The Orthopedic Clinics of North America. 1984 October; 15(4): 671-86. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6387576

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Water content of aluminum, dialysis dementia, and osteomalacia. Author(s): Wills MR, Savory J. Source: Environmental Health Perspectives. 1985 November; 63: 141-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3908086

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When is vitamin D-responsive bone disease not osteomalacia? Author(s): Rosenberg IH. Source: Hepatology (Baltimore, Md.). 1984 January-February; 4(1): 157-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6693066

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CHAPTER 2. NUTRITION AND OSTEOMALACIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and osteomalacia.

Finding Nutrition Studies on Osteomalacia 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 “osteomalacia” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

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

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

A tumour-like bone lesion as a manifestation of vitamin D-resistant hypophosphataemic osteomalacia. Source: Papapoulos, S E Steendijk, R Bijvoet, O L Br-J-Radiol. 1987 March; 60(711): 285-6 0007-1285

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Aluminium induced osteomalacia and encephalopathy--an aberration of the tubulin assembly into microtubules (MTs) by Al3+? Author(s): Anatomical Institute, Martin Luther University, Halle, FRG. Source: Schmidt, R Bohm, K Vater, W Unger, E Prog-Histochem-Cytochem. 1991; 23(14): 355-64 0079-6336

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Effects of systemic aluminum on the resolution of a uremic and dietary phosphorusdependent model of uremic osteomalacia in rats. Author(s): Department of Veterinary Pathobiology, College of Veterinary Medicine, Ohio State University, Columbus. Source: Lieuallen, W G Weisbrode, S E J-Bone-Miner-Res. 1991 July; 6(7): 751-7 08840431

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Favorable effects of low skin pigmentation and lactose tolerance in vitamin D-low nutrition in northern latitudes [Diet, osteomalacia, rickets]. Het gunstige effect van geringe huidpigmentatie en van lactosetolerantie bij vitamine D-arme voeding in noordelijke gebieden. Source: Schaafsma, G. Waard, H. de Voeding. 's-Gravenhage : Stichting tot Wetenschappelijke Voorlichting op Voedingsgebied. December 15, 1982. volume 43 (12) page 401-404. ill. 0042-7926

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Hypophosphatemic osteomalacia in neurofibromatosis 1: hypotheses for pathogenesis and higher incidence of spinal deformity. Author(s): Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Japan. wanis [email protected] Source: Abdel Wanis, M Kawahara, N Med-Hypotheses. 2002 August; 59(2): 183-5 03069877

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Oncogenic osteomalacia presenting as bilateral stress fractures of the tibia. Author(s): Department of Radiology, St. Marianna University Hospital, Kawasaki City, Kanagawa, Japan. Source: Ohashi, K Ohnishi, T Ishikawa, T Tani, H Uesugi, K Takagi, M Skeletal-Radiol. 1999 January; 28(1): 46-8 0364-2348

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Oncogenic vitamin D resistant hypophosphatemic osteomalacia (benign ossifying mesenchymal tumor of bone): case report. Author(s): First Department of Pathology, Medical College of Oita. Source: Uchida, H Yokoyama, S Kashima, K Nakayama, I Shimizu, K Masumi, S Jpn-JClin-Oncol. 1991 June; 21(3): 218-26 0368-2811

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Osteomalacia and rickets. Author(s): Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 294015799. Source: Hutchison, F N Bell, N H Semin-Nephrol. 1992 March; 12(2): 127-45 0270-9295

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Osteomalacia causally related to low phosphorus concentrations: an important geomedical discovery in Norway 100 years ago. Source: Lag, J. Soil-Sci. Baltimore, Md. : Williams & Wilkins. October 1989. volume 148 (4) page 284-285. 0038-075X

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Osteomalacia from Al and Mg antacids. Report of a case of bilateral hip fracture. Author(s): Department of Orthopedics, Svendborg Hospital, Denmark. Source: Neumann, L Jensen, B G Acta-Orthop-Scand. 1989 June; 60(3): 361-2 0001-6470

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Osteomalacia in a patient with severe anorexia nervosa. Author(s): Bone Diseases Unit, Clinicas Hospital, Buenos Aires University, Argentina. [email protected] Source: Oliveri, B Gomez Acotto, C Mautalen, C Rev-Rhum-Engl-Ed. 1999 October; 66(10): 505-8 1169-8446

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Osteomalacia secondary to renal tubular acidosis in a patient with primary Sjogren's syndrome. Author(s): Department of Medicine, Escola Paulista de Medicina, Sao Paulo, Brazil. Source: Monte Neto, J T Sesso, R Kirsztajn, G M Da Silva, L C De Carvalho, A B Pereira, A B Clin-Exp-Rheumatol. 1991 Nov-December; 9(6): 625-7 0392-856X

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Osteomalacia: diagnosis and management. Author(s): Department of Geriatric Medicine, Addenbrooke's Hospital, Cambridge. Source: Campbell, G A Br-J-Hosp-Med. 1990 November; 44(5): 332-3, 336-8 0007-1064

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The osteomalacias. Author(s): Clinica Medica nell'Universita degli Studi di Siena, Italy. Source: Caniggia, A Ann-Ital-Med-Int. 1991 Oct-December; 6(4 Pt 2): 476-82 0393-9340

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Theoretical physical chemical studies of the cause of fluoride-induced osteomalacia. Author(s): Miami Valley Laboratories, Procter and Gamble Co., Cincinnati, OH 452398707. Source: Wiers, B H Francis, M D Hovancik, K Ritchie, C K Baylink, D J J-Bone-MinerRes. 1990 March; 5 Suppl 1S63-70 0884-0431

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Vitamins Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com Vitamin D Alternative names: Calciferol, Calcitrol, Cholecalciferol, Erocalciferol Source: Integrative Medicine Communications; www.drkoop.com

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Minerals Calcium Source: Healthnotes, Inc.; www.healthnotes.com Gabapentin Source: Healthnotes, Inc.; www.healthnotes.com

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Food and Diet Sucralfate Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. OSTEOMALACIA

ALTERNATIVE

MEDICINE

AND

Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to osteomalacia. At the conclusion of this chapter, we will provide additional sources.

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

1alpha-hydroxyvitamin D3 in the treatment of nutritional and metabolic rickets and osteomalacia. Author(s): Gertner JM, Brenton DB, Edwards RH. Source: Clinical Endocrinology. 1977 December; 7 Suppl: 239S-244S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=203419

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24,25 Dihydroxyvitamin D supplementation corrects hyperparathyroidism and improves skeletal abnormalities in X-linked hypophosphatemic rickets--a clinical research center study. Author(s): Carpenter TO, Keller M, Schwartz D, Mitnick M, Smith C, Ellison A, Carey D, Comite F, Horst R, Travers R, Glorieux FH, Gundberg CM, Poole AR, Insogna KL. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 June; 81(6): 2381-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8964881

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A report of 76 cases of chondromalacia patellae treated with an ointment. Author(s): Wang L. Source: J Tradit Chin Med. 1997 March; 17(1): 40-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437243

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Adverse effects of hypolipidaemic drugs. Author(s): Knodel LC, Talbert RL. Source: Med Toxicol. 1987 January-February; 2(1): 10-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3547004

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Albright's syndrome with rickets. Author(s): McArthur RG, Hayles AB, Lambert PW. Source: Mayo Clinic Proceedings. 1979 May; 54(5): 313-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=431133

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Aluminum and renal osteodystrophy. Author(s): Nebeker HG, Coburn JW. Source: Annual Review of Medicine. 1986; 37: 79-95. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3085581

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Aluminum bone disease in children: radiographic features from diagnosis to resolution. Author(s): Andreoli SP, Smith JA, Bergstein JM. Source: Radiology. 1985 September; 156(3): 663-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4023226

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Aluminum-related osteomalacia in renal-failure patients. Author(s): Vick KE, Johnson CA. Source: Clin Pharm. 1985 July-August; 4(4): 434-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3899471

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An epidemiological model of privational rickets and osteomalacia. Author(s): Dunnigan MG, Henderson JB. Source: The Proceedings of the Nutrition Society. 1997 November; 56(3): 939-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9483661

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An unique form of osteomalacia associated with end organ refractoriness to 1,25dihydroxyvitamin D and apparent defective synthesis of 25-hydroxyvitamin D. Author(s): Zerwekh JE, Glass K, Jowsey J, Pak CY.

Alternative Medicine 61

Source: The Journal of Clinical Endocrinology and Metabolism. 1979 August; 49(2): 1715. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=313402 •

Are elderly Asians in Britain at a high risk of vitamin D deficiency and osteomalacia? Author(s): Solanki T, Hyatt RH, Kemm JR, Hughes EA, Cowan RA. Source: Age and Ageing. 1995 March; 24(2): 103-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7793330

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Asian osteomalacia is determined by dietary factors when exposure to ultraviolet radiation is restricted: a risk factor model. Author(s): Henderson JB, Dunnigan MG, McIntosh WB, Abdul Motaal A, Hole D. Source: The Quarterly Journal of Medicine. 1990 September; 76(281): 923-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2173012

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Blunted seasonal variation in serum 25-hydroxy vitamin D and increased risk of osteomalacia in vegetarian London Asians. Author(s): Finch PJ, Ang L, Colston KW, Nisbet J, Maxwell JD. Source: European Journal of Clinical Nutrition. 1992 July; 46(7): 509-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1623855

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Clinical and histological spectrum of osteomalacia among Asians in south London. Author(s): Finch PJ, Ang L, Eastwood JB, Maxwell JD. Source: The Quarterly Journal of Medicine. 1992 June; 83(302): 439-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1448545

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Development of hypercalcemic hyperparathyroidism after long-term phosphate supplementation in hypophosphatemic osteomalacia. Report of two cases. Author(s): Firth RG, Grant CS, Riggs BL. Source: The American Journal of Medicine. 1985 April; 78(4): 669-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2984933

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Development of tertiary hyperparathyroidism after phosphate supplementation in oncogenic osteomalacia. Author(s): Huang QL, Feig DS, Blackstein ME. Source: J Endocrinol Invest. 2000 April; 23(4): 263-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10853715

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Electrocochleographic changes in the hearing loss associated with X-linked hypophosphataemic osteomalacia. Author(s): O'Malley S, Ramsden RT, Latif A, Kane R, Davies M.

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Source: Acta Oto-Laryngologica. 1985 July-August; 100(1-2): 13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4040696 •

High-dosage intravenous calcium therapy for osteoporosis and osteomalacia in anticonvulsant therapy with hypomobilization. Author(s): Latorre H, Kenny FM. Source: Pediatrics. 1974 January; 53(1): 100-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4809184

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High-dose phosphate treatment leads to hypokalemia in hypophosphatemic osteomalacia. Author(s): Haris A, Toth A, Rado JP. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 1998; 106(5): 431-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9831311

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Hypophosphataemic osteomalacia in fibrous dysplasia. Author(s): Dent CE, Gertner JM. Source: The Quarterly Journal of Medicine. 1976 July; 45(179): 411-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=948543

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Hypophosphatemic rickets and osteomalacia in polyostotic fibrous dysplasia. Author(s): Chattopadhyay A, Bhansali A, Mohanty SK, Khandelwal N, Mathur SK, Dash RJ. Source: J Pediatr Endocrinol Metab. 2003 July-August; 16(6): 893-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12948303

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Muscle strength and pre-osteomalacia in vegetarian Asian women. Author(s): Isenberg DA, Newham D, Edwards RH, Wiles CM, Young A. Source: Lancet. 1982 January 2; 1(8262): 55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6119454

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Normal plasma-1,25-(OH)2-vitamin-D concentrations in nutritional osteomalacia. Author(s): Eastwood JB, de Wardener HE, Gray RW, Lemann JL Jr. Source: Lancet. 1979 June 30; 1(8131): 1377-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=87836

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Nutritional osteomalacia presenting with plantar fasciitis. Author(s): Paice EW, Hoffbrand BI.

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Source: The Journal of Bone and Joint Surgery. British Volume. 1987 January; 69(1): 3840. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3818730 •

Nutritional osteomalacia. Author(s): Elinson P, Neustadter LM, Moncman MG. Source: Am J Dis Child. 1980 April; 134(4): 427. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7369211

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Nutritional osteomalacia. Author(s): Dent CE, Smith R. Source: The Quarterly Journal of Medicine. 1969 April; 38(150): 195-209. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5305235

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Osteomalacia and celiac disease: response to 25-hydroxyvitamin D. Author(s): Hepner GW, Jowsey J, Arnaud C, Gordon S, Black J, Roginsky M, Moo HF, Young JF. Source: The American Journal of Medicine. 1978 December; 65(6): 1015-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=742623

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Osteomalacia in Paget's disease treated with short term, high dose sodium etidronate. Author(s): Gibbs CJ, Aaron JE, Peacock M. Source: British Medical Journal (Clinical Research Ed.). 1986 May 10; 292(6530): 1227-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3085789

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Osteomalacia presenting as pathological fractures during pregnancy in Asian women of high socioeconomic class. Author(s): Dandona P, Okonofua F, Clements RV. Source: British Medical Journal (Clinical Research Ed.). 1985 March 16; 290(6471): 837-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3919812

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Osteomalacia secondary to celiac disease, primary hyperparathyroidism, and Graves' disease. Author(s): Gannage MH, Abikaram G, Nasr F, Awada H. Source: The American Journal of the Medical Sciences. 1998 February; 315(2): 136-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9472914

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Osteomalacia, myopathy and basilar impression. Author(s): Chakrabarti AK, Johnson SC, Samantray SK, Reddy ER. Source: Journal of the Neurological Sciences. 1974 October; 23(2): 227-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4427115

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Plasma creatinine and creatinine clearance in nutritional osteomalacia. Author(s): Fonseca V, Mohiuddin J, Weerakoon J, Boss M, Mikhailidis DP, Dandona P. Source: Lancet. 1984 May 19; 1(8386): 1093-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6144828

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Rapid improvement of osteomalacia by treatment in a case with Sjogren's syndrome, rheumatoid arthritis and renal tubular acidosis type 1. Author(s): Okada M, Suzuki K, Hidaka T, Shinohara T, Kataharada K, Matsumoto M, Takada K, Ohsuzu F. Source: Intern Med. 2001 August; 40(8): 829-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11518137

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Serum vitamin-D activity in patients of nutritional osteomalacia requiring high dosage of vitamin-D2 (preliminary report). Author(s): Teotia SP, Kunwar KB, Mukherjee SK, Broach CW, Teotia M. Source: J Assoc Physicians India. 1969 November; 17(11): 635-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5307876

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Tertiary hyperparathyroidism after high-dose phosphate therapy in adult-onset hypophosphatemic osteomalacia. Author(s): Younis E, Jarrah N, Sroujieh AS, Al Hadidy A, Ajlouni K. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 September-October; 7(5): 375-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11585374

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Tertiary hyperparathyroidism after long-term phosphate supplementation in adultonset hypophosphataemic osteomalacia. Author(s): Narvaez J, Rodriguez-Moreno J, Moragues C, Campoy E, Clavaguera T, RoigEscofet D. Source: British Journal of Rheumatology. 1996 June; 35(6): 598-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8670586

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The effect of growth retardation and of osteomalacia on the uptake of albumin by bone. Author(s): Bingham PJ, Melick RA, Mercuri SM. Source: Calcif Tissue Res. 1978 February 28; 25(1): 29-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=647435

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Tumor-induced osteomalacia: long-term follow-up of two patients cured by removal of their tumors. Author(s): Sparagana M.

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Source: Journal of Surgical Oncology. 1987 November; 36(3): 198-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3682838 •

Tumor-induced vitamin D-resistant hypophosphatemic osteomalacia associated with proximal renal tubular dysfunction and 1,25-dihydroxyvitamin D deficiency. Author(s): Fukumoto Y, Tarui S, Tsukiyama K, Ichihara K, Moriwaki K, Nonaka K, Mizushima T, Kobayashi Y, Dokoh S, Fukunaga M, Morita R. Source: The Journal of Clinical Endocrinology and Metabolism. 1979 December; 49(6): 873-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=117020

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Celiac Disease Source: Healthnotes, Inc.; www.healthnotes.com

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Crohn's Disease Source: Healthnotes, Inc.; www.healthnotes.com Osteomalacia Source: Integrative Medicine Communications; www.drkoop.com Rickets/Osteomalacia Source: Healthnotes, Inc.; www.healthnotes.com •

Herbs and Supplements Alendronate Source: Healthnotes, Inc.; www.healthnotes.com Anticonvulsants Source: Healthnotes, Inc.; www.healthnotes.com Antituberculosis Agents Source: Integrative Medicine Communications; www.drkoop.com Barbiturates Source: Integrative Medicine Communications; www.drkoop.com Bile Acid Sequestrants Source: Integrative Medicine Communications; www.drkoop.com Calciferol Source: Integrative Medicine Communications; www.drkoop.com Calcitrol Source: Integrative Medicine Communications; www.drkoop.com Cholecalciferol Source: Integrative Medicine Communications; www.drkoop.com Erocalciferol Source: Integrative Medicine Communications; www.drkoop.com Histamine H2 Antagonists Source: Integrative Medicine Communications; www.drkoop.com Hydantoin Derivatives Source: Integrative Medicine Communications; www.drkoop.com Lubricant Laxatives Source: Integrative Medicine Communications; www.drkoop.com Phenobarbital Source: Healthnotes, Inc.; www.healthnotes.com

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Phenytoin Alternative names: Dilantin Infatab, Dilantin-125 Oral Suspension Source: Prima Communications, Inc.www.personalhealthzone.com Phosphorus Source: Integrative Medicine Communications; www.drkoop.com Valproic Acid Source: Healthnotes, Inc.; www.healthnotes.com

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

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

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

Resistance to Vitamin D or Parathyroid Hormone Condition(s): Hypocalcemia; Osteomalacia; Pseudopseudohypoparathyroidism; Rickets

Pseudohypoparathyroidism;

Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: Patients with confirmed or suspected conditions with a resistance to vitamin D or parathyroid hormone (PTH) will be admitted for diagnosis and treatment, and inclusion in other studies pertaining to similar conditions. This study will provide information about problems relating to calcium in the blood, urine, and bones. Patients in this study will undergo a general evaluation / check-up to give researchers an idea of each person's condition or disease. Patients will receive treatment based on their diagnosis and asked to provide specimen samples for further research studies. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001242

8

These are listed at www.ClinicalTrials.gov.

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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “osteomalacia” (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/

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

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

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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/

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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

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

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CHAPTER 5. PATENTS ON OSTEOMALACIA 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 “osteomalacia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on osteomalacia, we have not necessarily excluded nonmedical patents in this bibliography.

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

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

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

Agent for acting upon bone formation disturbances containing alkaline citrates, lactates and/or malates Inventor(s): Dietl; Hans (Bad Aibling, DE) Assignee(s): Orthomol Pharmazeutische Vertriebs Gmbh (langenfeld, De) Patent Number: 5,985,335 Date filed: November 28, 1997 Abstract: The invention relates to an agent for the prophylaxis and/or therapy of conditions associated with a disorder of bone formation. It contains alkali metal citrates and/or alkali metal lactates and/or alkali metal malates, optionally together with one or more active substances selected from vitamin K, calcium salts and vitamin D. The agent preferably contains potassium citrates and/or sodium citrates or potassium lactates and/or sodium lactates and serves for the prophylaxis and/or therapy of osteoclasis, in particular osteoporosis or osteomalacia. Excerpt(s): The invention relates to an agent for the prophylaxis and/or therapy of conditions associated with a disorder of bone formation. Disorders of bone metabolism, in particular in the form of the occurrence of osteoporosis, are widespread in Western industrial countries. Osteoporosis is a disease which is characterised by disorders of osteogenesis and also by intensified osteoclasis. In the case of a disorder of osteogenesis, reduced synthesis of the bone proteins, eg. collagen, elastin, osteocalcin, occurs. There may also be reduced incorporation of calcium and phosphate. Such a diminution of synthesis and/or of incorporation results in osteoporosis or, in some cases, a more intense osteoporosis. Vitamins D and K, for example, are important for protein synthesis and for the incorporation of calcium and phosphate. In the case of osteoclasis, besides calcium, phosphate is also excreted in increased amounts, and in addition the bone proteins decrease. Consequently osteoporosis constitutes a multi-factor phenomenon, with the catabolism of bone mass and the reduction in bone density in the foreground. In this connection the annual rate of catabolism amounts to 1% to 2%; but it may rise to a multiple of this value and becomes dramatic with regard to osteoporosis if it exceeds 3% to 4%. In the case of osteoclasis, calcium, above all, is removed from the bone, which as a result can easily become brittle. Another disease involving a disorder of bone formation is osteomalacia, which is characterised by deficient incorporation of minerals into the normally or exuberantly formed albumin basic skeleton. This results in broad uncalcified osteoid seams and, accompanied by a general increase in the elastic osteoid substance, greater softness of the bones and a tendency for them to become distorted. Web site: http://www.delphion.com/details?pn=US05985335__

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•

Method of dephosphorylating an endotoxin in vivo with alkaline phosphatase Inventor(s): Bakker; Winston Willem (Woltersum, NL), Hardonk; Machiel Josephus (Groningen, NL), Meijer; Dirk KLaas Fokke (Groningen, NL), Poelstra; Klaas (Buitenpost, NL) Assignee(s): Rijksuniversiteit Groningen (groningen, Nl) Patent Number: 6,290,952 Date filed: April 10, 1996 Abstract: The invention relates to pharmaceutical compositions suitable for treating or curing clinical complications mediated by endotoxin, including sepsis. The compositions contain components suitable for detoxifying endotoxin rendering it less deleterious to mammals such as humans, in particular to patients with reduced host-defence resistance. The invention also relates to pharmaceutical compositions suitable for stimulating bone formation, e.g. for mending broken bone or for prophylaxis or therapy of metabolic bone diseases such as osteoporosis and osteomalacia and pharmaceutical compositions for decreasing or inhibiting undesired bone formation. The pharmaceutical compositions according to the invention are directed at modulating phosphatase activity in vivo. Excerpt(s): The invention relates to pharmaceutical compositions suitable for treating or curing clinical complications induced by infections with Gram-negative bacteria, including sepsis. In particular the invention is directed at systemically applicable compositions. The compositions contain components suitable for detoxifying bacterialwall derived lipopolysaccharides (also known as endotoxins) rendering these products less deleterious to mammals such as humans, in particular to patients with sepsis, optionally in combination with reduced host-defence resistance, i.e. after organ transplantations, during leucopenia (ref. 1) associated with cancer or chemotherapeutic treatment of cancer or during AIDS and AIDS-related diseases (ref. 2). The invention also relates to pharmaceutical compositions suitable for stimulating bone formation, e.g. for mending broken bone or for prophylaxis or therapy of metabolic bone diseases such as osteoporosis and osteomalacia and also pharmaceutical compositions for decreasing or inhibiting undesired bone formation. Endotoxin is a negatively charged lipopolysaccharide present in the capsule of Gram-negative bacteria (ref. 3). Endotoxins are complexes of phospholipid (lipid A) and polysaccharide. The endotoxins produced by different bacteria differ in their antigenicity but they all have the same biological effects which are mainly due to lipid A. For the purposes of this description the term endotoxin also comprises enterotoxins. In addition to the negatively charged sugar moieties, an endotoxin contains two phosphate groups which are essential for its toxicity (ref. 3, 4). Web site: http://www.delphion.com/details?pn=US06290952__

•

Synthesis of 1.alpha.,25-dihydroxy-24R-fluorocholecalciferol dihydroxy-24S-fluorocholecalciferol

and

1.alpha.,25-

Inventor(s): Partridge; John J. (Upper Montclair, NJ), Shiuey; Shian-Jan (Nutley, NJ), Uskokovic; Milan R. (Upper Montclair, NJ) Assignee(s): Hoffmann-la Roche Inc. (nutley, Nj) Patent Number: 4,634,692 Date filed: April 11, 1984

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Abstract: 1.alpha.,25-Dihydroxy-24R-fluorocholecalciferol and 1.alpha.,25-dihydroxy24S-fluorocholecalciferol, analogs of 1.alpha.,25-dihydroxy-cholecalciferol which is physiologically the most active metabolite of vitamin D.sub.3, are synthesized in a multistep process from the known substance 1.alpha.,3.beta.-dihydroxyandrost-5-en-17one. The new analogs are characterized by the ability to increase intestinal calcium transport, increase serum calcium and phosphate concentrations and to increase the deposition of these minerals in bones. These compounds will find a ready application as substitutes for natural 1.alpha.,25-dihydroxycholecalciferol in the treatment of disease states characterized by metabolic calcium and phosphate deficiencies. Exemplary of such disease states are the following: osteomalacia, osteoporosis, rickets, osteitis fibrosa cystica, renal osteodystrophy, osteosclerosis, anti-convulsant treatment, osteopenia, fibrogenesis-imperfecta ossium, secondary hyperparathyrodism, hypoparathyroidism, hyperparathyroidism, cirrhosis, obstructive jaundice, drug induced metabolism, medullary carcinoma, chronic renal disease, hypophosphatemic VDRR, vitamin Ddependent rickets, sarcoidosis, glucocorticoid antagonism, malabsorption syndrome, steatorrhea, tropical sprue, idiopathic hypercalcemia and milk fever. Excerpt(s): This invention relates to 24R- and 24S-fluoro analogs of 1.alpha.,25dihydroxycholecalciferol. Vitamin D.sub.3 is a well-known agent for the control of calcium and phosphorous homeostasis. In the normal animal or human this compound is known to stimulate intestinal calcium transport and bone-calcium mobilization and is effective in preventing rickets. It is also now well known that to be effective, vitamin D.sub.3 must be converted in vivo to its hydroxylated forms. For example, the vitamin is first hydroxylated in the liver to form 25-hydroxy-vitamin D.sub.3 and is further hydroxylated in the kidney to produce 1.alpha.,25-dihydroxy vitamin D.sub.3 or 24,25dihydroxy vitamin D.sub.3. The 1.alpha.-hydroxylated form of the vitamin is generally considered to be the physiologically active or hormonal form of the vitamin and to be responsible for what are termed the vitamin D-like activities, such as increasing intestinal absorption of calcium and phosphate, mobilizing bone mineral, and retaining calcium in the kidneys. Web site: http://www.delphion.com/details?pn=US04634692__

Patent Applications on Osteomalacia 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 osteomalacia: •

Compositions and methods for modulating bone mineral deposition Inventor(s): Millan, Jose Luis; (San Diego, CA), Terkeltaub, Robert; (San Diego, CA) Correspondence: Pillsbury Winthrop Llp; Attention: Docketing Department; 11682 EL Camino Real, Suite 200; San Diego; CA; 92130; US Patent Application Number: 20020183276 Date filed: March 22, 2002

10

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

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Abstract: The key function of TNAP in bone is degradation of PPi to remove this mineralization inhibitor and provide free phosphate for apatite deposition. PC-1 is a direct antagonist of TNAP function. ANK antagonizes TNAP-dependent matrix calcification. Specifically, the activity of PC-1 inhibits initial MV apatite deposition, but ANK inhibits propagation of apatite outside the MVs. Furthermore, loss of function of the two distinct skeletal TNAP antagonists, PC-1 and ANK, ameliorates TNAP deficiency-associated osteomalacia in vivo. Conversely, the hyperossification associated with both PC-1 null mice and ANK-deficient (ank/ank) mice is ameliorated by deficiency of TNAP in vivo. Excerpt(s): This application claims priority to U.S. provisional application serial No. 60/278,197, filed Mar. 23, 2001. This invention relates to the field of modification of bone mineral deposition. Osteoblasts mineralize the pericellular matrix by promoting initial formation of crystalline hydroxyapatite in the sheltered interior of membrane-limited matrix vesicles (MVs) and by modulating matrix composition to further promote propagation of apatite outside of the MVs. Three molecules present in osteoblasts have been identified by means of gene knock-out models as affecting the controlled deposition of bone mineral, i e., alkaline phosphatase (TNAP); PC-1 (or Npps, a nucleoside triphosphate pyrophosphate hydrolase isozyme, NTPPPH) and ANK, a multipass membrane protein that appears to serve as an anion channel. Our inactivation of the mouse TNAP gene led to the development of a model of Infantile Hypophosphatasia characterized by undermineralization of bone (osteomalacia). Inactivation of the PC-1 gene causes systemic hyperossification and skeletal and extraskeletal apatite deposition. Moreover, ANK-deficient ank/ank mutant mice have recently been described as developing a phenotype remarkably similar to that of the PC1 null mice. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for inhibiting bone resorption with an alendronate and vitamin D formulation Inventor(s): Daifotis, Anastasia G.; (Westfield, NJ), Mazel, Sidney; (Basking Ridge, NJ), Yates, John; (Lansdale, PA) Correspondence: Merck And CO Inc; P O Box 2000; Rahway; NJ; 070650907 Patent Application Number: 20030195171 Date filed: April 1, 2003 Abstract: Composition and method for preventing or treating abnormal bone resorption in mammals, the composition characterized as containing, a supplementary effective amount of a non-activated metabolite of vitamin D.sub.2 and/or D.sub.3 and a pharmaceutically effective amount of bisphosphonate to provide vitamin D nutrition during treatment to facilitate normal bone formation and mineralization, while minimizing the occurrence of or potential for the complications associated with vitamin D insufficiency, such as hypocalcemia and osteomalacia. The method of preventing or treating may be further characterized by concomitantly administering the components simultaneously or alternately at dosing intervals selected from once-weekly, twiceweekly, bi-weekly, monthly, and bi-monthly. Excerpt(s): The present invention relates to methods for inhibiting bone resorption in a mammal in need thereof by providing supplemental vitamin D nutrition to facilitate normal bone mineralization and formation while minimizing the occurrence of or

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potential for the complications associated with vitamin D insufficiency and the administration of bisphosphonate resulting from bone resorption. The method of the invention provides adequate vitamin D nutrition, while minimizing the occurrence of or potential for complications of hypocalcemia and osteomalacia associated with excessive amounts of activated vitamin D. The method may be characterized by orally administering, to a mammal, a pharmaceutical composition containing, in combination, a supplementary amount of a non-activated metabolite of vitamin D.sub.2 and/or D.sub.3, and a pharmaceutically effective amount of a bisphosphonate, as a unit dosage, according to a continuous schedule having a dosing interval of once-weekly, twiceweekly, biweekly, monthly, and bimonthly. The present invention also relates to pharmaceutical compositions containing various amounts of the combination of supplemental vitamin D nutrition and bisphosphonates, medicaments and kits useful for carrying out these methods. A variety of disorders in humans and other mammals are associated with abnormal bone resorption. Such disorders include, but are not limited to, osteoporosis, Paget's disease, periprosthetic bone loss or osteolysis, metastatic bone disease, hypercalcemia of malignancy, and arthritides (including but not limited to osteoarthritis and rheumatoid arthritis). One of the most common of these disorders is osteoporosis, which in its most frequent manifestation occurs in postmenopausal women. Osteoporosis is a systemic skeletal disease characterized by a low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Because osteoporosis, as well as other disorders associated with bone loss, are chronic conditions, it is believed that appropriate therapy will generally require chronic treatment. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Oncogenic osteomalacia-related gene 1 Inventor(s): Jan De Beur, Suzanne; (Baltimore, MD), Levine, Michael; (Owings Mills, MD), Madden, Stephen; (Sudbury, MA), Manavalan, Parthasarathy; (Medway, MA), Schia Vi, Susan; (Hopkinton, MA) Correspondence: Genzyme Corporation; Legal Department; 15 Pleasant ST Connector; Framingham; MA; 01701-9322; US Patent Application Number: 20020102641 Date filed: March 22, 2001 Abstract: This invention provides isolated polynucleotides encoding an oncogenic osteomalacia-related factor and polypeptides encoded by this polynucleotide. Expression systems, including gene delivery vehicles such as liposomes and vectors, and host cells containing the polynucleotides are further provided by this invention. The present invention also provides proteins encoded by the polynucleotides and antibodies that specifically recognize and bind to these proteins. In one embodiment the proteins that modulate bone mineralization and phosphate metabolism as characterized by the methods described herein. The present invention also provides methods for modulating bone mineralization activity and phosphate metabolism and for treating diseases related to abnormal bone mineralization and abnormal phosphate metabolism. Excerpt(s): This invention relates to an isolated polynucleotide encoding an oncogenic osteomalacia-related gene and to methods of using this gene to diagnose and treat diseases characterized by abnormal phosphate metabolism or bone mineralization. It is well known that many, but not all genes present in a cell are expressed at any given time. Fundamental questions of biology require knowledge of which genes are

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transcribed and the relative abundance of transcripts in different cells. Typically, when and to what degree a given gene is expressed has been analyzed one gene at a time. Thus, information regarding the identity of all expressed genes in a cell and the level of expression of these genes would facilitate the study of many cellular processes such as activation, differentiation, aging, viral transformation, morphogenesis, and mitosis. A comparison of the expressed genes of a particular cell or the same cell from various individuals or species, under the same or different environmental stimuli, provides valuable insight into the molecular biology of the cell. 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 osteomalacia, 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 “osteomalacia” (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 osteomalacia. You can also use this procedure to view pending patent applications concerning osteomalacia. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON OSTEOMALACIA Overview This chapter provides bibliographic book references relating to osteomalacia. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on osteomalacia 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 “osteomalacia” (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 osteomalacia: •

Endocrinology Source: New York, NY: Elsevier Science, Inc. 2003. 737 p. Contact: Available from Elsevier Science, Inc. Journal Information Center, 655 Avenue of the Americas, New York, NY 10010. (212) 633-3750. Fax (212) 633-3764. Website: www.elsevier.com. PRICE: $39.95. ISBN: 932141170. Summary: This book on endocrinology is from a series that provides the latest on evaluation, diagnosis, management, outcomes and prevention. The book offers concise, action-oriented recommendations for primary care medicine. It includes MediFiles (sections) on acromegaly, Addison's disease (hypoaldosteronism), Cushing's syndrome, diabetes insipidus, type 1 diabetes mellitus, type 2 diabetes mellitus, diabetic ketoacidosis, Gilbert's disease, gynecomastia, hirsutism, hypercalcemia, hyperkalemia, hyperthyroidism, hypocalcemia, hypokalemia, hyponatremia, hypopituitarism, hypothyroidism, Klinefelter's syndrome, osteomalacia and rickets, osteoporosis,

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pheochromocytoma, polycystic ovarian syndrome, precocious puberty, thyroid carcinoma, thyroid nodule, thyroiditis, and Turner's syndrome. Each MediFile covers summary information and background on the condition, and comprehensive information on diagnosis, treatment, outcomes, and prevention. Each section concludes with a list of resources. •

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 3rd ed Source: Hagerstown, MD: Lippincott-Raven Publishers. 1996. 500 p. Contact: Available from Lippincott-Raven Publishers. P.O. Box 1600, Hagerstown, MD 21741-1600. (800) 777-2295. Fax (301) 824-7390. E- mail: [email protected]. Web Site: www.lrpub.com. PRICE: $42.00 plus shipping and handling. ISBN 0397517637. Summary: This book provides health professionals with a comprehensive description of the clinical manifestations, pathophysiology, diagnosis, and treatment of metabolic bone diseases and disorders of mineral metabolism. Section one describes the gross anatomy and ultrastructure, physiology, biochemistry, structural features, and functions of the cellular elements of bone. Section two discusses calcium and other minerals and the biochemistry of calcium-regulating hormones. Section three describes the tests and imaging techniques used to evaluate patients suspected of having bone or mineral disorders. Section four examines the various clinical presentations seen with disordered levels of serum minerals. Sections five presents the genetic and acquired causes of metabolic bone diseases such as rickets, osteomalacia, osteoporosis, and renal osteodystrophy. Section six focuses on genetic, developmental, and dysplastic skeletal disorders, while section seven examines acquired disorders of cartilage and bone. Section eight is devoted to Paget's disease of bone, and section nine describes diseases characterized by pathologic calcification of soft tissue. Section 10 focuses on the nephrolithiasis, while the final section is an appendix containing growth charts, ossification center tables, normal values for commonly used biochemical analyses, recommended daily mineral and vitamin intake, a drug formulary, instructions on how to conduct and interpret dynamic tests, and bone density reference data. The book concludes with a subject index. 1 appendix, numerous figures, tables, and references.

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

Generalized Bone Diseases: Osteoporosis, Osteomalacia, Ostitis Fibrosa by F. Kuhlencordt, et al; ISBN: 0387187898; http://www.amazon.com/exec/obidos/ASIN/0387187898/icongroupinterna

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•

Generalized Bone Diseases: Osteoporosis, Osteomalacia, Ostitis Fibrosa. Proceedings of 2nd Annual Conference of the German Society for Osteology; ISBN: 3540187898; http://www.amazon.com/exec/obidos/ASIN/3540187898/icongroupinterna

•

Osteomalacia, renal osteodystrophy, and osteoporosis by Brian Morgan; ISBN: 0398026025; http://www.amazon.com/exec/obidos/ASIN/0398026025/icongroupinterna

•

Rickets and osteomalacia : report of the Working Party on Fortification of Food with Vitamin D, Committee on Medical Aspects of Food Policy; ISBN: 0113207476; http://www.amazon.com/exec/obidos/ASIN/0113207476/icongroupinterna

•

Vitamin D deficiency and osteomalacia by S. J. Darke; ISBN: 0113202407; http://www.amazon.com/exec/obidos/ASIN/0113202407/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “osteomalacia” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •

Caso classico di osteomalacia maschile. Author: Burani, Carlo; Year: 1887

•

Contributions to the knowledge of osteomalacia, tr. from the German by J. Matthews Duncan. Author: Litzmann, Carl Conrad Theodor, 1815-1890; Year: 1862

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Dissertatio inauguralis medico-chirurgica de osteomalacia. Author: Conradi, Johann Georg Otto Friedrich; Year: 1796

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Generalized bone diseases: osteoporosis, osteomalacia, ostitis fibrosa. Author: F. Kuhlencordt. [et al.], (eds); Year: 1987

•

Osteomalacia nei suoi rapporti con l'ostetricia. Author: Damato, Vincenzo; Year: 1895

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Specimen inaugurale de osteomalacia ejusque casu rariore. Author: Metzger, Johann Daniel, 1739-1805; Year: 1797

Chapters on Osteomalacia In order to find chapters that specifically relate to osteomalacia, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and osteomalacia 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 11

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

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

Osteoporosis and Osteomalacia Source: in Maddison, P.J.; et al., Eds. Oxford Textbook of Rheumatology. Volume 2. New York, NY: Oxford University Press, Inc. 1993. p. 1005-1024. Contact: Available from Oxford University Press, Inc., New York, NY. Summary: This chapter for health professionals presents an overview of osteoporosis and osteomalacia. Epidemiological data on osteoporosis are provided. Types of osteoporosis are described, including postmenopausal, age-related, idiopathic, juvenile, and endocrine- and drug-induced osteoporosis. The clinical features of osteoporosis are highlighted. Its pathogenesis is explained. The use of risk factor assessment, bone mass measurement, bone biopsy, and biochemical markers in the diagnosis of osteoporosis is discussed. The role of calcium and calcitonin supplementation, exercise, and hormone replacement therapy (HRT) in the prevention of osteoporosis is examined. Approaches to treating established osteoporosis are considered, including the use of HRT, calcitonin, bisphosphonates, testosterone and anabolic steroids, vitamin D and metabolites, sodium fluoride, and parathyroid hormone. In addition, the clinical and laboratory features and causes of osteomalacia and rickets are presented. 114 references, 12 figures, and 6 tables.

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CHAPTER 7. MULTIMEDIA ON OSTEOMALACIA Overview In this chapter, we show you how to keep current on multimedia sources of information on osteomalacia. 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 osteomalacia is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “osteomalacia” 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 “osteomalacia” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on osteomalacia: •

Vitamin D: Not Just for Bones Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: In this lecture, Dr. DeLuca discusses the major functions of Vitamin D in the body; studies demonstrating potential therapeutic uses for synthetic Vitamin D compounds; and his own laboratory's progress on developing several such compounds. According to Dr. DeLuca, Vitamin D is, in fact, not a vitamin but a prohormone that remains inactive until metabolized in the liver and the kidney. The principal active metabolite of Vitamin D, calcitrol, acts with parathyroid hormone (PTH) to regulate the blood calcium level. It also plays a role in building up bone and is an important regulator of intestinal calcium absorption. Disturbance of this regulatory mechanism can result in osteoporosis (brittle bones), as well as in several disorders characterized by a deficiency or an oversupply of calcium or PTH in the blood (hypo- and hypercalcemia;

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hypo-and hyperparathyroidism). Vitamin D deficiency results in rickets (soft, weak bones) and osteomalacia in adults. Dr. DeLuca discusses several clinical studies demonstrating an age-related decline in formation of the active Vitamin D metabolite in response to PTH. He describes research he is conducting to develop synthetic Vitamin D compounds that would stimulate bone formation in osteoporotic patients without producing hypercalcemia. He predicts that within a decade these compounds will be important contributors to the treatment of postmenopausal and age-related osteoporosis. Dr. DeLuca goes on to discuss evidence strongly suggesting that Vitamin D influences other biologic processes, including cellular differentiation and regulation of the immune system. Work is ongoing in his laboratory to develop Vitamin D "differentiation compounds" that may have a future role in cancer therapy. The lecture concludes with a discussion of other potential therapeutic uses for Vitamin D, including the treatment of psoriasis, renal osteodystropy (bone disease found with kidney failure), and infertility.

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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 Institute12: •

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

•

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

12

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.13 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:14 •

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

•

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

•

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

•

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

•

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

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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

•

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

13

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). 14 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

The NLM Gateway15 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.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “osteomalacia” (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 5075 46 21 1 111 5254

HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “osteomalacia” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

15

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

16

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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19

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 Biologists20 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.21 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.22 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/.

The Genome Project and Osteomalacia In the following section, we will discuss databases and references which relate to the Genome Project and osteomalacia. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).23 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 20 Adapted 21

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. 22 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. 23 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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

Axial Osteomalacia Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=109130

•

Osteomalacia, Sclerosing, with Cerebral Calcification Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=259660 Genes and Disease (NCBI - Map)

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

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

•

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

•

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

•

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

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease,

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Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html •

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “osteomalacia” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database25 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “osteomalacia” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

24

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on osteomalacia 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 osteomalacia. 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 osteomalacia. 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.

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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 National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “osteomalacia” (or synonyms). 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 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 osteomalacia. 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. NORD (The National Organization of Rare Disorders, Inc.) NORD provides an invaluable service to the public by publishing short yet comprehensive guidelines on over 1,000 diseases. NORD primarily focuses on rare diseases that might not be covered by the previously listed sources. NORD’s Web address is http://www.rarediseases.org/. A complete guide on osteomalacia can be purchased from NORD for a nominal fee. PEDBASE Similar to NORD, PEDBASE covers relatively rare disorders, limited mainly to pediatric conditions. PEDBASE was designed by Dr. Alan Gandy. To access the database, which is more oriented to researchers than patients, you can view the current list of health topics covered at the following Web site: http://www.icondata.com/health/pedbase/pedlynx.htm.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to osteomalacia. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with osteomalacia. 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 osteomalacia. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “osteomalacia” (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

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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 “osteomalacia”. 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 “osteomalacia” (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 “osteomalacia” (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.26

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

26

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)27: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

27

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Osteomalacia Osteomalacia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000376.htm

•

Signs & Symptoms for Osteomalacia Bone pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003180.htm Muscle weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Numbness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm

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Spasms of hands or feet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003194.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •

Diagnostics and Tests for Osteomalacia ALP (alkaline phosphatase) isoenzyme Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003497.htm Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Bone biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003923.htm Bone X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003808.htm Bone X-rays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003808.htm Calcium (ionized) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003486.htm PTH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003690.htm Serum calcium Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003477.htm Serum phosphate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003478.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm

•

Nutrition for Osteomalacia Vitamin D Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002405.htm

•

Background Topics for Osteomalacia Kidney disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000457.htm Metabolism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002257.htm

Online Glossaries 109

Renal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002289.htm

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

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

•

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

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

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

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OSTEOMALACIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] 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] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Adenoma: A benign 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] 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] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alendronate: A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps

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to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [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] Alpha-helix: One of the secondary element of protein. [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] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [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] Amino-terminal: The end of a protein or polypeptide chain that contains a free amino group (-NH2). [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anabolic Steroids: Chemical derivatives of testosterone that are used for anabolic promotion of growth and repair of body tissues and the development of male sexual characteristics. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU]

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Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [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] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

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

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anuria: Inability to form or excrete urine. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Articular: Of or pertaining to a joint. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH]

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Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Avulsion: The forcible separation, or tearing away, of a part of an organ. [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] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] 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] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Beta-Thalassemia: A disorder characterized by reduced synthesis of the beta chains of hemoglobin. There is retardation of hemoglobin A synthesis in the heterozygous form (thalassemia minor), which is asymptomatic, while in the homozygous form (thalassemia major, Cooley's anemia, Mediterranean anemia, erythroblastic anemia), which can result in severe complications and even death, hemoglobin A synthesis is absent. [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 Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH]

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Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Bioassay: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood 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] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [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 metastases: Cancer that has spread from the original (primary) tumor to the bone. [NIH]

Bone Resorption: Bone loss due to osteoclastic activity. [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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH]

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Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Calcifediol: The major circulating metabolite of vitamin D3 produced in the liver and the best indicator of the body's vitamin D stores. It is effective in the treatment of rickets and osteomalacia, both in azotemic and non-azotemic patients. Calcifediol also has mineralizing properties. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcitriol: The physiologically active form of vitamin D. It is formed primarily in the kidney by enzymatic hydroxylation of 25-hydroxycholecalciferol (calcifediol). Its production is stimulated by low blood calcium levels and parathyroid hormone. Calcitriol increases intestinal absorption of calcium and phosphorus, and in concert with parathyroid hormone increases bone resorption. [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] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of

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reference; same as inferior, in human anatomy. [EU] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] 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 Division: The fission of a cell. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the 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] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Check-up: A general physical examination. [NIH] Cholecalciferol: An antirachitic oil-soluble vitamin. [NIH] Chondrosarcoma: A type of cancer that forms in cartilage. [NIH] 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 renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Clinical 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] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire

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functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] 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] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH]

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Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] 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] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Creatinine clearance: A test that measures how efficiently the kidneys remove creatinine and other wastes from the blood. Low creatinine clearance indicates impaired kidney function. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] 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] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [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] Deferoxamine: Natural product isolated from Streptomyces pilosus. It forms iron complexes and is used as a chelating agent, particularly in the form of its mesylate. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline

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is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dermatitis: Any inflammation of the skin. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Ketoacidosis: Complication of diabetes resulting from severe insulin deficiency coupled with an absolute or relative increase in glucagon concentration. The metabolic acidosis is caused by the breakdown of adipose stores and resulting increased levels of free fatty acids. Glucagon accelerates the oxidation of the free fatty acids producing excess ketone bodies (ketosis). [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] 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] Dihydroxy: AMPA/Kainate antagonist. [NIH] Dilantin: A drug that is often used to control seizures. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] 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] Diuretic: A drug that increases the production of urine. [NIH] Diurnal: Occurring during the day. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the

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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] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ectopic: Pertaining to or characterized by ectopia. [EU] 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] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [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] Embolus: 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] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [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] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [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] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH]

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Enterotoxins: Substances that are toxic to the intestinal tract causing vomiting, diarrhea, etc.; most common enterotoxins are produced by bacteria. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [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] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] 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] 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] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Etidronate: A drug that belongs to the family of drugs called bisphosphonates. Bisphosphonates are used as treatment for hypercalcemia (abnormally high levels of calcium in the blood) and for cancer that has spread to the bone (bone metastases). [NIH] Excrete: To get rid of waste from the body. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

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Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Neck Fractures: Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are hip fractures. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibroma: A benign tumor of fibrous or fully developed connective tissue. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluorosis: Discoloration of the tooth enamel due to fluorine. [NIH] Forearm: The part between the elbow and the wrist. [NIH]

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Formulary: A book containing a list of pharmaceutical products with their formulas and means of preparation. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [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] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

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] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Goiter: Enlargement of the thyroid gland. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] 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] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a

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haemodialyzer. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Hemangiopericytoma: A type of cancer involving blood vessels and soft tissue. [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] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Hip Fractures: Fractures of the femur head, the femur neck, the trochanters, or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region. For the fractures of the femur neck the specific term femoral neck fractures is available. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of

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hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [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] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertrichosis: Localized or generalized excess hair. The concept does not include hirsutism, which is excess hair in females and children with an adult male pattern of distribution. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypovitaminosis: A condition due to a deficiency of one or more essential vitamins. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ifosfamide: Positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent. [NIH] Ileum: The lower end of the small intestine. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH]

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Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [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] 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] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

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] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] 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] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH]

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Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique is used in water purification, in research, and in industry. [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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Jejunoileal Bypass: A surgical procedure consisting of the anastomosis of the proximal part of the jejunum to the distal portion of the ileum, so as to bypass the nutrient-absorptive segment of the small intestine, to treat morbid obesity. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH]

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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 Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Lactates: Salts or esters of lactic acid containing the general formula CH3CHOHCOOR. [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] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [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] Lipid: Fat. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [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] 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]

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] 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] Lysine: An essential amino acid. It is often added to animal feed. [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] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] 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] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH]

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Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] 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] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] 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] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] 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] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] 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] 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

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procedures. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]

Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] 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] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrolithiasis: Kidney stones. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light

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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] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Octreotide: A potent, long-acting somatostatin octapeptide analog which has a wide range of physiological actions. It inhibits growth hormone secretion, is effective in the treatment of hormone-secreting tumors from various organs, and has beneficial effects in the management of many pathological states including diabetes mellitus, orthostatic hypertension, hyperinsulinism, hypergastrinemia, and small bowel fistula. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteitis Fibrosa Cystica: A fibrous degeneration, cyst formation, and the presence of fibrous nodules in bone, usually due to hyperparathyroidism. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteocalcin: Vitamin K-dependent calcium-binding protein synthesized by osteoblasts and found primarily in bone. Serum osteocalcin measurements provide a noninvasive specific marker of bone metabolism. The protein contains three residues of the amino acid gammacarboxyglutamic acid (GLA), which, in the presence of calcium, promotes binding to hydroxyapatite and subsequent accumulation in bone matrix. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but

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particularly in the embryo and child and during fracture repair. [NIH] Osteogenic sarcoma: A malignant tumor of the bone. Also called osteosarcoma. [NIH] Osteolysis: Dissolution of bone that particularly involves the removal or loss of calcium. [NIH]

Osteomalacia: A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. [EU]

Osteopetrosis: Excessive formation of dense trabecular bone leading to pathological fractures, osteitis, splenomegaly with infarct, anemia, and extramedullary hemopoiesis. [NIH]

Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Osteosarcoma: A cancer of the bone that affects primarily children and adolescents. Also called osteogenic sarcoma. [NIH] Osteosclerosis: An abnormal hardening or increased density of bone tissue. [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] Ovariectomy: The surgical removal of one or both ovaries. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] 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]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pamidronate: A drug that belongs to the family of drugs called bisphosphonates. Pamidronate is used as treatment for abnormally high levels of calcium in the blood. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is 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] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Paraneoplastic syndrome: A group of symptoms that may develop when substances released by some cancer cells disrupt the normal function of surrounding cells and tissue. [NIH]

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Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parathyroidectomy: Excision of one or both of the parathyroid glands. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] 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] Phosphorous: Having to do with or containing the element phosphorus. [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] 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]

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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] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [NIH] Polyostotic Fibrous Dysplasia: Abnormal tissue development or growth occurring subsequent to the appearance of the primordial cells. [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] 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] Postnatal: Occurring after birth, with reference to the newborn. [EU] 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] Potassium Citrate: A powder that dissolves in water, which is administered orally, and is

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used as a diuretic, expectorant, systemic alkalizer, and electrolyte replenisher. [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] 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 Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] Procollagen: A biosynthetic precursor of collagen containing additional amino acid sequences at the amino-terminal ends of the three polypeptide chains. Protocollagen, a precursor of procollagen consists of procollagen peptide chains in which proline and lysine have not yet been hydroxylated. [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] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] 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] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] 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]

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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] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary 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] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [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] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU]

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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] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [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] 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] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal Osteodystrophy: Decalcification of bone due to hyperparathyroidism secondary to chronic kidney disease. [NIH] Renal tubular: A defect in the kidneys that hinders their normal excretion of acids. Failure to excrete acids can lead to weak bones, kidney stones, and poor growth in children. [NIH] Renal tubular acidosis: A rare disorder in which structures in the kidney that filter the blood are impaired, producing using that is more acid than normal. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the

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cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Schwannoma: A tumor of the peripheral nervous system that begins in the nerve sheath (protective covering). It is almost always benign, but rare malignant schwannomas have been reported. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Scleroproteins: Simple proteins characterized by their insolubility and fibrous structure. Within the body, they perform a supportive or protective function. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [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] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [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] Sepsis: The presence of bacteria in the bloodstream. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins

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have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [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] Skin Pigmentation: Coloration of the skin. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [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] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Sodium Lactate: The sodium salt of racemic or inactive lactic acid. It is a hygroscopic agent used intravenously as a systemic and urinary alkalizer. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the 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 cells: All the body cells except the reproductive (germ) cells. [NIH] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of

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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] Splenomegaly: Enlargement of the spleen. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Steatorrhea: A condition in which the body cannot absorb fat. Causes a buildup of fat in the stool and loose, greasy, and foul bowel movements. [NIH] 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] Sterile: Unable to produce children. [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] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stridor: The loud, harsh, vibrating sound produced by partial obstruction of the larynx or trachea. [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] 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] Strontium: An element of the alkaline earth family of metals. It has the atomic symbol Sr,

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atomic number 38, and atomic weight 87.62. [NIH] 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] 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] Subtrochanteric: Below a trochanter. [NIH] Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective, pepsinostatic, antacid, and bile acid-binding properties. The drug is only slightly absorbed by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. Synovitis is qualified as fibrinous, gonorrhoeal, hyperplastic, lipomatous, metritic, puerperal, rheumatic, scarlatinal, syphilitic, tuberculous, urethral, etc. [EU] Systemic: Affecting the entire body. [NIH] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with

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inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Nodule: A small circumscribed mass of differentiated tissue associated with the thyroid gland. It can be pathogenic or non-pathogenic. The growth of nodules can lead to a condition of nodular goiter. Most nodules appear between the ages of 30 and 50 years and most are benign. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances

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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] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] 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 compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] 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] Tropical Sprue: A condition of unknown cause. Abnormalities in the lining of the small intestine prevent the body from absorbing food normally. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [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] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] 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] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH]

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Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in dialysis separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as hemofiltration or hemodiafiltration (if combined with hemodialysis). [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] 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] 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] Vasculitis: Inflammation of a blood vessel. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] 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] Villous: Of a surface, covered with villi. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH]

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Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [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] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [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] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

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INDEX A Abdominal, 111, 130, 134 Abdominal Pain, 111, 130 Ablation, 7, 111 Abscess, 111, 142 Acceptor, 111, 134, 145 Acidosis, 111, 120 Adenoma, 29, 111 Adenosine, 111, 135 Affinity, 111, 141 Age of Onset, 111, 145 Albumin, 64, 74, 111, 136 Alendronate, 66, 77, 111 Algorithms, 111, 115 Alkaline, 7, 12, 74, 75, 77, 108, 111, 112, 116, 142, 143 Alkaline Phosphatase, 7, 12, 75, 77, 108, 112 Alkalosis, 112, 143 Alopecia, 7, 112, 119 Alpha Particles, 112, 138 Alpha-helix, 112, 128 Alternative medicine, 112 Aluminum, 13, 15, 18, 20, 21, 23, 25, 28, 31, 33, 34, 35, 36, 48, 51, 53, 56, 60, 112, 143 Alveolar Process, 112, 139 Ameliorated, 77, 112 Amenorrhea, 112, 113 Amino Acid Sequence, 112, 113, 137 Amino Acids, 112, 135, 136, 137, 140, 145, 146 Amino-terminal, 112, 137 Amyloid, 43, 112 Anabolic, 20, 84, 112 Anabolic Steroids, 84, 112 Analog, 112, 133 Anastomosis, 112, 128 Anatomical, 56, 112, 121, 127, 140 Anemia, 95, 113, 114, 134, 144 Animal model, 6, 113 Anions, 111, 113, 128, 141 Anorexia, 57, 113, 134, 146 Anorexia Nervosa, 57, 113 Antagonism, 76, 113 Antibacterial, 113, 141 Antibiotic, 113, 135, 141, 144 Antibodies, 78, 113, 125, 136 Antibody, 8, 111, 113, 117, 125, 127, 138

Anticonvulsant, 14, 34, 53, 62, 113, 116 Antiepileptic, 12, 113 Antigen, 111, 113, 118, 124, 126, 127, 138 Anti-inflammatory, 113, 124 Anuria, 113, 129 Arterial, 113, 126, 137 Arteries, 113, 115, 119, 131 Arteritis, 113, 136 Articular, 4, 113, 133 Assay, 6, 113, 138 Asymptomatic, 113, 114, 134 Ataxia, 94, 95, 114, 144 Atrophy, 17, 18, 94, 95, 114 Autodigestion, 114, 134 Avulsion, 15, 114 B Bacteria, 75, 113, 114, 120, 121, 122, 131, 140, 141, 146 Basal Ganglia, 114 Basal Ganglia Diseases, 114 Base, 112, 114, 120, 128, 129, 143, 146 Benign, 56, 111, 114, 123, 132, 133, 140, 144 Benign tumor, 114, 123 Beta-pleated, 112, 114 Beta-Thalassemia, 16, 114 Bilateral, 15, 47, 56, 57, 114 Bile, 66, 114, 115, 124, 128, 129, 137, 143 Bile Ducts, 114, 137 Bile Pigments, 114, 128 Biliary, 114, 134 Biliary Tract, 114, 134 Bilirubin, 111, 114, 115, 126 Bioassay, 21, 115 Biochemical, 21, 46, 82, 84, 115, 129, 133 Biopsy, 3, 18, 43, 84, 108, 115 Biotechnology, 10, 83, 91, 93, 94, 95, 96, 115 Bladder, 115, 127, 137, 146 Bloating, 115, 130 Blood Coagulation, 115, 116 Blood pressure, 115, 126, 131, 141 Blood vessel, 115, 121, 125, 128, 131, 141, 142, 143, 144, 146 Body Fluids, 112, 115, 116, 141 Bone Density, 4, 37, 74, 82, 115 Bone Marrow, 34, 115, 130, 142 Bone metastases, 46, 115, 122 Bone Resorption, 15, 77, 115, 116

Osteomalacia

Bone scan, 16, 30, 39, 43, 115 Bowel, 115, 120, 133, 142 Bowel Movement, 115, 120, 142 Branch, 105, 115, 135 Breakdown, 115, 120, 124 Bypass, 35, 116, 128 C Calcifediol, 116 Calcification, 17, 77, 82, 94, 116 Calcitriol, 27, 116 Calcium, 12, 58, 62, 69, 74, 76, 82, 84, 85, 108, 116, 118, 122, 126, 131, 133, 134, 135, 143 Carbamazepine, 39, 116 Carbohydrate, 116, 136 Carcinogenic, 116, 133, 137 Carcinogens, 116, 133 Carcinoma, 22, 29, 38, 76, 82, 116 Cardiac, 17, 116, 125, 132 Carrier Proteins, 116, 136, 138 Case report, 13, 14, 15, 18, 20, 26, 29, 30, 36, 38, 44, 47, 56, 116 Catabolism, 74, 116 Caudal, 116, 136 Celiac Disease, 63, 65, 117 Cell Division, 94, 114, 117, 131, 136 Cerebellar, 18, 114, 117, 139 Cerebellum, 117, 139 Cerebral, 94, 114, 117, 119, 138 Cerebrum, 117, 145 Character, 117, 119, 124 Check-up, 69, 117 Cholecalciferol, 58, 66, 76, 117 Chondrosarcoma, 50, 117 Chromosome, 6, 117 Chronic renal, 13, 40, 76, 117, 136, 146 Clinical trial, 4, 69, 70, 91, 117, 138 Cloning, 10, 19, 115, 117 Cofactor, 117, 137 Colchicine, 117, 145 Collagen, 74, 117, 123, 137 Colloidal, 111, 117, 141 Complement, 117, 118, 136 Complementary and alternative medicine, 59, 67, 118 Complementary medicine, 59, 118 Computational Biology, 91, 93, 118 Confusion, 118, 146 Connective Tissue, 40, 42, 115, 117, 118, 123, 130, 131, 139, 142 Connective Tissue Cells, 118 Consciousness, 118, 120

150

Contamination, 12, 118 Contraindications, ii, 118 Convulsions, 113, 119 Coronary, 119, 131 Coronary Thrombosis, 119, 131 Cortex, 114, 119, 139 Cortical, 119, 140, 144 Corticosteroids, 119, 124 Cortisol, 111, 119 Creatinine, 42, 64, 119, 129, 146 Creatinine clearance, 42, 64, 119 Curative, 119, 140 Cutaneous, 9, 119 Cyclic, 7, 119 Cyclophosphamide, 119, 126 Cyst, 119, 133 Cytoskeleton, 119, 131 D Databases, Bibliographic, 91, 119 Deferoxamine, 25, 119 Degenerative, 119, 133 Dementia, 48, 53, 119 Density, 4, 16, 30, 115, 120, 133, 134 Dental Caries, 120, 123, 141 Dermatitis, 31, 120 Diabetes Insipidus, 81, 120 Diabetes Mellitus, 81, 120, 124, 125, 127, 133 Diabetic Ketoacidosis, 81, 120 Diagnostic procedure, 73, 120 Dialyzer, 120, 125 Diarrhea, 120, 122, 130 Diffusion, 120, 124, 146 Digestion, 114, 115, 120, 129, 135, 142 Digestive system, 70, 120 Dihydroxy, 45, 75, 76, 120 Dilantin, 18, 67, 120 Direct, iii, 77, 120, 139 Distal, 120, 128, 138 Diuretic, 120, 137 Diurnal, 5, 120 Dorsal, 120, 136 Drug Tolerance, 120, 144 Dyes, 112, 121 Dysplasia, 45, 62, 95, 121 Dystrophy, 23, 44, 94, 121 E Ectopic, 7, 8, 121 Efficacy, 5, 121 Effusion, 121, 143 Elastin, 74, 117, 121

151

Electrolyte, 121, 125, 129, 136, 137, 141, 146 Electrons, 114, 121, 128, 134, 138 Embolus, 121, 127 Embryo, 121, 134 Enamel, 120, 121, 123, 128 Encephalopathy, 28, 56, 121 Endemic, 121, 142 Endocrine System, 121, 132 Endothelial cell, 121, 123 Endotoxin, 75, 121 End-stage renal, 117, 121, 136 Enterotoxins, 75, 122 Environmental Exposure, 122, 133 Environmental Health, 53, 90, 92, 122 Enzymatic, 116, 118, 120, 122 Enzyme, 8, 112, 122, 128, 131, 136, 143, 145, 147 Enzyme Inhibitors, 8, 122, 136 Eosinophilia, 122, 123 Epidemic, 12, 122, 142 Epidemiological, 13, 60, 84, 122 Epidermis, 122, 128 Epidural, 122, 142 Epithelial, 6, 32, 111, 122 Epithelial Cells, 6, 122 Erythrocytes, 113, 115, 122 Esophagitis, 122, 143 Esophagus, 120, 122, 139, 142 Essential Tremor, 94, 122 Etidronate, 63, 122 Excrete, 113, 122, 129, 139 Exhaustion, 113, 122 Exogenous, 122, 145 Expectorant, 122, 137 Extensor, 122, 138 Extracellular, 7, 112, 118, 123, 133, 141, 143 Extracellular Matrix, 118, 123, 133 Extracellular Space, 7, 123 F Family Planning, 91, 123 Fasciitis, 37, 62, 123 Fat, 115, 121, 123, 128, 129, 139, 140, 141, 142 Fatigue, 15, 123 Fatty acids, 111, 120, 123 Femoral, 15, 33, 44, 46, 47, 123, 125 Femoral Neck Fractures, 33, 46, 47, 123, 125 Femur, 18, 25, 31, 123, 125 Fibroblast Growth Factor, 10, 36, 123 Fibroblasts, 118, 123

Fibroma, 38, 123 Fibrosarcoma, 123 Fibrosis, 53, 95, 123, 140 Fistula, 123, 133 Fluorine, 123 Fluorosis, 4, 25, 123 Forearm, 115, 123 Formulary, 82, 124 G Gallbladder, 111, 114, 120, 124 Gas, 120, 123, 124, 126, 130 Gastrectomy, 26, 40, 42, 46, 124 Gastrin, 124, 125 Gastritis, 124, 143 Gastrointestinal, 124, 141, 143 Gene, 6, 7, 8, 11, 34, 47, 49, 77, 78, 83, 95, 96, 115, 124, 129, 133 Genotype, 26, 124, 135 Giant Cells, 124, 140 Gland, 124, 130, 134, 135, 136, 137, 140, 142, 144 Glomerular, 124, 129, 139 Glucocorticoid, 76, 124 Glucose, 94, 120, 124, 125, 127, 138 Glucose Intolerance, 120, 124 Gluten, 11, 47, 117, 124 Goiter, 124, 144 Governing Board, 124, 137 Graft, 124, 126 H Haemodialysis, 28, 41, 124 Haptens, 111, 125, 138 Hemangiopericytoma, 18, 20, 27, 125 Hemodialysis, 32, 33, 120, 125, 129, 146 Hemofiltration, 20, 125, 146 Hemoglobin, 113, 114, 122, 125, 144 Hemoglobinuria, 94, 125 Hemolytic, 123, 125, 144 Hemorrhage, 125, 142 Hepatic, 111, 125 Hereditary, 125, 139, 144 Heredity, 124, 125 Heterodimers, 8, 125 Hip Fractures, 18, 123, 125 Hirsutism, 81, 125, 126 Homeostasis, 6, 7, 8, 28, 36, 50, 76, 125 Hormonal, 8, 76, 114, 125 Hormone, 8, 23, 26, 42, 51, 69, 84, 115, 116, 119, 124, 125, 127, 130, 133, 139, 141, 143, 144 Hormone Replacement Therapy, 84, 125 Host, 75, 78, 126, 147

Osteomalacia

Hydrogen, 111, 114, 116, 126, 131, 133, 134, 135, 137 Hydroxylation, 116, 126 Hydroxylysine, 117, 126 Hydroxyproline, 117, 126 Hyperbilirubinemia, 126, 128 Hypercalcemia, 11, 76, 78, 81, 85, 122, 126 Hypersensitivity, 126, 139 Hypertension, 24, 36, 126, 133, 146 Hyperthyroidism, 44, 81, 126 Hypertrichosis, 125, 126 Hypothyroidism, 81, 126 Hypovitaminosis, 4, 126 I Id, 58, 65, 94, 104, 106, 126 Idiopathic, 35, 76, 84, 126, 140 Ifosfamide, 26, 126 Ileum, 126, 128 Immune response, 113, 125, 126, 143, 145, 147 Immune system, 86, 126, 146, 147 Immunodeficiency, 94, 126 Immunogenic, 126, 138 Immunosuppressive, 119, 124, 126 Impairment, 4, 114, 127, 131 Impotence, 127, 142 In vitro, 31, 45, 127 In vivo, 6, 75, 76, 77, 127 Incontinence, 127, 142 Indicative, 82, 127, 135, 146 Infancy, 127, 140 Infarction, 29, 119, 127, 131 Infection, 123, 126, 127, 129, 130, 135, 139, 143, 147 Infertility, 86, 127 Inflammation, 111, 113, 120, 122, 123, 124, 127, 134, 139, 142, 143, 144, 146 Infusion, 51, 127, 145 Ingestion, 127, 143 Inorganic, 7, 127, 141 Insight, 6, 79, 127 Insulin, 120, 127, 128, 145 Intermittent, 20, 41, 127 Internal Medicine, 6, 11, 14, 31, 121, 127 Interstitial, 123, 127, 139 Intestinal, 3, 35, 40, 76, 85, 116, 117, 122, 127, 130 Intestines, 111, 124, 127 Intoxication, 15, 28, 34, 127 Intracellular, 127, 130, 136 Intravenous, 31, 51, 62, 127, 128 Intrinsic, 4, 111, 128

152

Invasive, 128, 130 Involuntary, 114, 122, 128, 132, 139, 141 Ion Exchange, 6, 128 Ions, 114, 121, 126, 128 Ischemia, 114, 128 Isoenzyme, 108, 128 J Jaundice, 76, 126, 128 Jejunoileal Bypass, 47, 128 Jejunum, 128 Joint, 13, 15, 30, 37, 39, 46, 63, 113, 128, 133, 136, 143 K Kb, 90, 128 Keratin, 7, 128, 140 Ketone Bodies, 120, 128 Ketosis, 120, 128 Kidney Disease, 33, 48, 69, 70, 85, 90, 95, 128, 139 Kidney Failure, 86, 121, 129 Kidney Failure, Acute, 129 Kidney Failure, Chronic, 129 Kidney Transplantation, 27, 129 Kinetic, 8, 129 L Lactates, 74, 129 Large Intestine, 120, 127, 129, 139, 141 Lesion, 56, 129, 142, 145 Lethargy, 126, 129 Leukemia, 94, 129 Leukocytes, 115, 129 Library Services, 104, 129 Ligament, 129, 137 Lipid, 75, 127, 129 Lipopolysaccharide, 75, 129 Liposomes, 78, 129 Liver, 33, 76, 85, 111, 114, 116, 119, 120, 124, 125, 129, 137, 140, 146 Localization, 51, 129 Localized, 111, 120, 125, 126, 127, 129, 136, 140, 142, 145 Lymph, 121, 129, 130, 140 Lymph node, 130, 140 Lymphatic, 127, 129, 130, 131, 142 Lymphoid, 113, 119, 130 Lymphoma, 94, 130 Lysine, 126, 130, 137 M Magnetic Resonance Imaging, 21, 23, 130 Malabsorption, 3, 40, 76, 94, 117, 130 Malabsorption syndrome, 76, 130 Malignancy, 78, 130

153

Malignant, 10, 15, 44, 94, 123, 130, 132, 134, 140 Malnutrition, 111, 114, 130, 132 Mammogram, 116, 130, 131 Mandible, 112, 130, 139 Mediate, 7, 130 MEDLINE, 91, 93, 95, 130 Medullary, 76, 130 Melanocytes, 130, 133 Melanoma, 94, 130 Membrane, 8, 77, 118, 120, 123, 124, 129, 130, 132, 133, 143 Membrane Proteins, 129, 130 Memory, 113, 119, 130 Menopause, 130, 136 Mental Disorders, 71, 131 Mesenchymal, 32, 35, 37, 38, 40, 42, 44, 50, 56, 131 Metabolic disorder, 120, 131 Metabolite, 76, 77, 78, 85, 116, 131 Metastasis, 131 Metastatic, 4, 29, 38, 78, 131 MI, 38, 109, 131 Microbe, 131, 145 Microcalcifications, 116, 131 Microorganism, 117, 131, 147 Microtubules, 56, 131 Milliliter, 115, 131 Mineralization, 3, 5, 7, 77, 78, 131, 134 Mitosis, 79, 131 Mobilization, 76, 131 Modification, 77, 131 Molecular, 6, 7, 8, 19, 35, 49, 79, 91, 93, 115, 118, 129, 131, 145 Molecule, 113, 114, 118, 131, 134, 139 Monitor, 119, 131 Mononuclear, 123, 132 Morphogenesis, 7, 79, 132 Mucosa, 117, 132, 142, 143 Muscle Fibers, 132 Muscular Atrophy, 94, 132 Muscular Dystrophies, 121, 132 Myocardium, 131, 132 Myopathy, 4, 49, 63, 132 Myotonic Dystrophy, 94, 132 N Nausea, 128, 132, 146 NCI, 1, 70, 89, 132 Necrosis, 123, 127, 131, 132, 140 Need, 3, 8, 77, 81, 83, 85, 117, 132, 144 Neoplasia, 30, 94, 132 Neoplasm, 132, 142, 145

Neoplastic, 36, 130, 132 Nephrolithiasis, 82, 132 Nephropathy, 30, 33, 46, 128, 132 Nerve, 114, 132, 135, 140, 142 Nervous System, 94, 132, 135 Neuroendocrine, 10, 11, 132 Neutrons, 112, 132, 138 Nevus, 31, 133 Nuclei, 112, 121, 130, 131, 132, 133, 137 Nucleus, 114, 119, 132, 133, 137, 144 O Octreotide, 15, 37, 38, 133 Oliguria, 129, 133 Oncogene, 94, 133 Opacity, 120, 133 Organ Transplantation, 75, 133 Orthostatic, 133 Osmotic, 111, 133, 141 Ossification, 82, 133, 140 Osteitis Fibrosa Cystica, 76, 133 Osteoarthritis, 8, 78, 133 Osteoblasts, 7, 77, 133 Osteocalcin, 46, 74, 133 Osteogenesis, 74, 133 Osteogenic sarcoma, 134 Osteolysis, 78, 134 Osteopetrosis, 45, 134 Osteoporosis, 4, 9, 15, 41, 47, 52, 62, 74, 75, 76, 78, 81, 82, 83, 84, 85, 111, 134 Osteosarcoma, 12, 134 Osteosclerosis, 76, 134 Outpatient, 42, 134 Ovariectomy, 5, 134 Ovaries, 134, 141 Ovary, 134, 142 Oxidation, 111, 120, 134 P Palliative, 51, 134 Pamidronate, 39, 134 Pancreas, 111, 120, 127, 134, 141 Pancreatic, 94, 134 Pancreatic cancer, 94, 134 Pancreatitis, 19, 134 Paraneoplastic syndrome, 8, 134 Parathyroid, 5, 20, 23, 29, 40, 69, 84, 85, 116, 135, 140, 143 Parathyroid Glands, 135, 140 Parathyroid hormone, 5, 20, 40, 69, 84, 85, 116, 135 Parathyroidectomy, 5, 135 Parotid, 135, 140 Paroxysmal, 94, 135

Osteomalacia

Pathogenesis, 6, 8, 9, 40, 56, 84, 135 Pathologic, 40, 82, 111, 115, 119, 126, 135, 138, 139 Pathophysiology, 6, 41, 82, 135 Pelvic, 135, 137 Penicillin, 113, 135 Peptic, 135, 143 Peptide, 123, 128, 135, 136, 137, 144 Peripheral Nervous System, 135, 140, 141, 143 PH, 33, 47, 49, 115, 135 Pharmacologic, 135, 145 Phenotype, 77, 135 Phosphorous, 6, 76, 135 Phosphorus, 22, 27, 56, 67, 116, 135 Physical Examination, 117, 135 Physiologic, 135, 139 Physiology, 6, 8, 82, 121, 136 Pigment, 115, 130, 136 Pilot study, 5, 136 Pituitary Gland, 123, 136 Plants, 124, 136 Plasma, 42, 62, 64, 111, 113, 124, 125, 129, 136, 139, 140, 141 Plasma cells, 113, 136 Plasma protein, 111, 136, 141 Pleated, 128, 136 Polycystic, 82, 95, 136 Polymyalgia Rheumatica, 4, 136 Polyostotic Fibrous Dysplasia, 62, 136 Polypeptide, 112, 117, 136, 137, 141, 144 Polysaccharide, 75, 113, 136 Posterior, 43, 114, 117, 120, 134, 136 Postmenopausal, 78, 84, 86, 111, 134, 136 Postnatal, 136, 142 Potassium, 74, 136 Potassium Citrate, 74, 136 Practice Guidelines, 92, 137 Precursor, 119, 122, 137, 145 Prevalence, 18, 27, 34, 137 Primary Biliary Cirrhosis, 15, 40, 52, 137 Procollagen, 17, 137 Progression, 113, 137 Progressive, 117, 120, 124, 129, 132, 133, 137, 139, 145 Proline, 117, 126, 137 Promoter, 7, 137 Prophylaxis, 74, 75, 137, 139 Prospective study, 12, 137 Prostate, 22, 38, 43, 94, 137 Protein C, 111, 112, 128, 133, 137, 146 Protein S, 74, 83, 95, 115, 133, 137, 140, 144

154

Proteins, 74, 78, 112, 113, 116, 117, 118, 125, 128, 130, 131, 135, 136, 137, 138, 140 Protons, 112, 126, 137, 138 Proximal, 4, 6, 8, 13, 17, 29, 31, 43, 49, 65, 120, 128, 136, 138 Psoriasis, 86, 138, 139 Psychic, 138, 140 Psychomotor, 116, 138 Puberty, 82, 138 Public Policy, 91, 138 Publishing, 10, 138 Pulmonary, 115, 125, 129, 138 Pulmonary Edema, 129, 138 R Race, 138, 141 Radiation, 9, 14, 61, 122, 138, 147 Radioactive, 115, 126, 133, 138, 143, 146 Radioimmunoassay, 8, 138 Random Allocation, 138 Randomization, 5, 138 Randomized, 121, 138 Reabsorption, 6, 8, 17, 138 Receptor, 6, 7, 113, 138, 139 Reconstitution, 7, 139 Rectum, 115, 120, 124, 127, 129, 137, 139 Red Nucleus, 114, 139 Refer, 1, 117, 129, 133, 139 Reflex, 23, 44, 139 Reflux, 139, 143 Refraction, 139, 141 Regeneration, 7, 123, 139 Regimen, 121, 139 Renal failure, 25, 44, 48, 125, 139 Renal Osteodystrophy, 4, 20, 21, 45, 60, 76, 82, 83, 139 Renal tubular, 34, 40, 43, 44, 45, 47, 57, 64, 65, 139 Renal tubular acidosis, 34, 40, 43, 44, 47, 57, 64, 139 Resection, 28, 139 Resorption, 78, 138, 139 Restoration, 139, 147 Retinoblastoma, 94, 139 Retinoids, 139, 147 Rheumatism, 3, 25, 36, 44, 50, 139 Rheumatoid, 4, 27, 44, 64, 78, 139 Rheumatoid arthritis, 4, 27, 44, 64, 78, 139 Ribosome, 139, 145 Risk factor, 14, 52, 61, 84, 137, 140 S Salivary, 120, 134, 140 Salivary glands, 120, 140

155

Sarcoidosis, 76, 140 Schwannoma, 10, 38, 140 Scleroderma, 123, 140 Scleroproteins, 128, 140 Sclerosis, 94, 140 Screening, 42, 46, 117, 140 Sebaceous, 31, 140 Sebum, 140 Secretion, 5, 126, 133, 140 Seizures, 26, 107, 116, 120, 135, 140 Semen, 137, 140 Senile, 134, 140 Sensory loss, 140, 142, 144 Sepsis, 75, 140 Serum, 6, 11, 15, 20, 21, 46, 61, 64, 76, 82, 108, 111, 117, 129, 133, 138, 139, 140, 141 Serum Albumin, 138, 141 Sex Characteristics, 138, 141, 143 Sex Determination, 95, 141 Skeletal, 5, 6, 9, 18, 21, 23, 39, 44, 56, 59, 77, 78, 82, 132, 141 Skeleton, 7, 74, 123, 128, 141 Skin Pigmentation, 56, 141 Small intestine, 114, 125, 126, 127, 128, 141, 145 Sodium, 63, 74, 84, 138, 141 Sodium Fluoride, 84, 141 Sodium Lactate, 74, 141 Soft tissue, 38, 82, 115, 123, 125, 141 Somatic, 47, 131, 135, 141 Somatic cells, 131, 141 Somatostatin, 133, 141 Spasm, 141, 143 Species, 79, 117, 131, 133, 138, 141, 143, 145, 147 Spectrum, 9, 19, 61, 141 Sperm, 117, 142, 145 Spinal cord, 33, 122, 132, 135, 139, 142 Spinal Cord Compression, 33, 142 Spinal Fractures, 142 Spleen, 130, 140, 142 Splenomegaly, 134, 142 Spondylitis, 4, 11, 142 Sporadic, 23, 48, 139, 142 Standard therapy, 5, 142 Steatorrhea, 76, 142 Stem Cells, 7, 142 Sterile, 135, 142 Sterility, 119, 127, 142 Steroids, 119, 124, 142 Stimulus, 139, 142

Stomach, 111, 114, 120, 122, 124, 125, 127, 128, 132, 139, 141, 142 Stool, 127, 129, 142 Stress, 56, 119, 132, 139, 142 Stridor, 142, 144 Stroke, 71, 90, 142 Stromal, 7, 142 Stromal Cells, 7, 142 Strontium, 32, 48, 142 Subclinical, 46, 127, 140, 143 Subspecies, 141, 143 Substance P, 131, 139, 140, 143 Substrate, 122, 143 Subtrochanteric, 125, 143 Sucralfate, 13, 58, 143 Supplementation, 21, 59, 61, 64, 84, 143 Suppression, 5, 143 Symphysis, 37, 137, 143 Symptomatic, 40, 50, 134, 143 Synovial, 143 Synovial Membrane, 143 Synovitis, 4, 143 Systemic, 56, 77, 78, 115, 127, 137, 140, 141, 143 T Technetium, 41, 143 Telangiectasia, 95, 143 Temporal, 136, 143 Testosterone, 84, 112, 143 Tetany, 12, 135, 143 Tetracycline, 3, 20, 43, 144 Thalamic, 114, 144 Thalamic Diseases, 114, 144 Thalassemia, 41, 114, 144 Thigh, 123, 144 Thrombosis, 137, 142, 144 Thrombus, 119, 127, 144 Thyroid, 82, 124, 126, 135, 144 Thyroid Gland, 124, 126, 135, 144 Thyroid Nodule, 82, 144 Thyroiditis, 82, 144 Thyrotropin, 126, 144 Thyroxine, 111, 144 Tolerance, 56, 124, 144 Tomography, 115, 144 Torsion, 127, 144 Toxic, iv, 122, 144, 145 Toxicity, 21, 75, 143, 145 Toxicology, 92, 145 Trachea, 122, 142, 144, 145 Transfection, 115, 145 Transferases, 26, 145

Osteomalacia

Transfusion, 41, 145 Translation, 6, 145 Transplantation, 27, 42, 43, 48, 117, 145 Trauma, 26, 114, 122, 132, 134, 144, 145 Tropical Sprue, 76, 145 Tryptophan, 117, 145 Tubercle, 15, 145 Tuberous Sclerosis, 34, 95, 145 Tubulin, 56, 131, 145 Tumor-derived, 41, 145 Tumour, 18, 37, 38, 42, 51, 56, 145 Type 2 diabetes, 81, 145 U Ulcer, 143, 145 Ultrafiltration, 125, 146 Ultrasonography, 52, 146 Unconscious, 126, 146 Uraemia, 134, 146 Uranium, 143, 146 Urea, 129, 146 Uremia, 32, 129, 139, 146 Urethra, 137, 146 Urinary, 29, 38, 127, 133, 141, 146 Urine, 69, 113, 115, 119, 120, 125, 127, 128, 129, 133, 146

156

V Vaccine, 145, 146 Vascular, 127, 144, 146 Vasculitis, 134, 146 Vein, 128, 135, 146 Venous, 137, 146 Vertebrae, 142, 146 Vertebral, 142, 146 Veterinary Medicine, 56, 91, 146 Villous, 117, 146 Vinblastine, 145, 146 Vincristine, 145, 147 Viral, 79, 124, 133, 147 Virulence, 145, 147 Virus, 124, 147 Vitamin A, 76, 147 Vitro, 147 Vivo, 6, 77, 147 W White blood cell, 113, 129, 130, 136, 147 Windpipe, 144, 147 Wound Healing, 123, 147 X Xenograft, 113, 147 X-ray, 108, 115, 130, 147 Y Yeasts, 135, 147

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