CAR ISSUE 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., 1960Scar Tissue: 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: 0-597-84617-0 1. Scar Tissue-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:
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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 scar tissue. 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 SCAR TISSUE.............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Scar Tissue .................................................................................... 9 The National Library of Medicine: PubMed ................................................................................ 23 CHAPTER 2. NUTRITION AND SCAR TISSUE .................................................................................... 33 Overview...................................................................................................................................... 33 Finding Nutrition Studies on Scar Tissue................................................................................... 33 Federal Resources on Nutrition ................................................................................................... 34 Additional Web Resources ........................................................................................................... 34 CHAPTER 3. PATENTS ON SCAR TISSUE .......................................................................................... 37 Overview...................................................................................................................................... 37 Patents on Scar Tissue ................................................................................................................. 37 Patent Applications on Scar Tissue ............................................................................................. 57 Keeping Current .......................................................................................................................... 82 CHAPTER 4. BOOKS ON SCAR TISSUE .............................................................................................. 83 Overview...................................................................................................................................... 83 Chapters on Scar Tissue............................................................................................................... 83 CHAPTER 5. MULTIMEDIA ON SCAR TISSUE ................................................................................... 91 Overview...................................................................................................................................... 91 Video Recordings ......................................................................................................................... 91 CHAPTER 6. PERIODICALS AND NEWS ON SCAR TISSUE ................................................................ 93 Overview...................................................................................................................................... 93 News Services and Press Releases................................................................................................ 93 Newsletter Articles ...................................................................................................................... 94 Academic Periodicals covering Scar Tissue ................................................................................. 96 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 99 Overview...................................................................................................................................... 99 NIH Guidelines............................................................................................................................ 99 NIH Databases........................................................................................................................... 101 Other Commercial Databases..................................................................................................... 103 APPENDIX B. PATIENT RESOURCES ............................................................................................... 105 Overview.................................................................................................................................... 105 Patient Guideline Sources.......................................................................................................... 105 Finding Associations.................................................................................................................. 113 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 115 Overview.................................................................................................................................... 115 Preparation................................................................................................................................. 115 Finding a Local Medical Library................................................................................................ 115 Medical Libraries in the U.S. and Canada ................................................................................. 115 ONLINE GLOSSARIES................................................................................................................ 121 Online Dictionary Directories ................................................................................................... 121 SCAR TISSUE DICTIONARY..................................................................................................... 123 INDEX .............................................................................................................................................. 193
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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 scar tissue 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 scar tissue, 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 scar tissue, 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 scar tissue. 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 scar tissue, 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 scar tissue. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON SCAR TISSUE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on scar tissue.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and scar tissue, 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 “scar tissue” (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: •
Treatments for Patients with Pelvic Pain Source: Urologic Nursing. 19(1): 33-35. March 1999. Contact: Available from Society of Urologic Nurses and Associates, Inc. East Holly Avenue, Box 56, Pitman, NJ 08071-0056. (609) 256-2335. E-mail:
[email protected]. Summary: Chronic pelvic pain (CPP) is a vague and confusing term that generally refers to noncyclic pain in the abdominal or pelvic area, that has been present for 6 months or longer, and that may have a negative impact on activities of daily living and quality of life. This article presents an overview of the incidence and types of pelvic pain, followed by some practical information concerning the presentation of patients with pelvic pain. The author explains to nurses simple physical therapy techniques that are used in treating patients with pelvic pain. Symptoms associated with CPP include low back
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pain, heavy feeling in the pelvis, radiating leg pain, pain with urination or defecation, constipation, diarrhea, coccyx pain, suprapubic pain, abdominal pain, bloating, cramping, irregular menstrual cycles, pain with menstruation, and dyspareunia (painful intercourse). An initial evaluation should include a thorough musculoskeletal assessment; referral to a physical therapist should also be considered. Biofeedback can be useful for monitoring the pelvic floor muscles and accessory muscles for patients with CPP. Transcutaneous electrical nerve stimulation (TENS) may be effective for treating patients with CPP. Manual therapy is another essential component of the treatment plan for patients with CPP. Manual therapy may include visceral mobilization of the pelvic organs and supporting structures, soft tissue massage or myofascial techniques to pelvic girdle musculature, scar tissue massage, internal vaginal or anal work to muscles and tissues, and joint mobilization to spine and extremities. 2 tables. 9 references. •
Medical Times Patient Education Chart: Cirrhosis of the Liver Source: Medical Times. 118(2): 45-46. February 1990. Summary: Cirrhosis of the liver is the destruction of living, functioning liver cells, and their replacement with scar tissue. This patient education chart illustrates cirrhosis of the liver and its typical causes. The textual information accompanying the chart discusses the physiology of the liver, the causes of cirrhosis, signs and symptoms, and treatment for cirrhosis of the liver. Other topics include the role of alcohol abuse in cirrhosis, jaundice, needle biopsy, viral hepatitis, and patient survival rates.
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Focus on Penile Disorders Source: Patient Care. 35(1): 51-54, 57, 61. January 15, 2001. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Penile disorders can range from rare, life threatening cancers to more common infections that, while bothersome, can also predispose to more serious conditions. Trauma to the penis can cause deformity and pain that compromise normal sexual function. This article focuses on Peyronie's disease, and includes brief discussions of balanitis, adult circumcision, and penile cancer. Peyronie's disease is characterized by a fibrotic, inelastic scarring of the tunica albuginea, which surrounds the corpora cavernosa of the penis. As the buildup of scar tissue progresses, the penis becomes curved and deformed during erection, which can cause pain and difficulty with penetration during intercourse. The authors discuss the clinical presentation and note that the awareness and diagnosis of Peyronie's disease may be increasing due to the aging of the population (more men living longer and staying sexually active later in their lives) and the increased use of sildenafil (Viagra) and other therapies for treating erectile dysfunction (ED). If Peyronie's disease interferes with sexual function, treatment requires surgical intervention. Balanitis is a common, painless inflammation of the glans penis caused by infection beneath the foreskin. It is the most common cause of phimosis (tightness of the prepuce of the penis that prevents the retraction of the foreskin) and a cause of paraphimosis (inability to replace the foreskin in its normal position after it has been retracted behind the glans penis), which are key indications for adult circumcision. The authors note that religious, social, cosmetic, and hygienic reasons can all contribute to a man's decision to undergo adult circumcision. The final section discusses penile cancer, a rare condition that is almost always a squamous cell carcinoma. Any suspicious, painless penile lesion that does not heal after 2 to 3 weeks of good hygiene
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and application of an antifungal or antibacterial cream requires a biopsy for diagnosis. 1 figure. 1 table. 11 references. •
Rectourethral Fistulae: The Perineal Approach Source: Journal of the American College of Surgeons. 195(1): 138-143. July 2002. Contact: Available from Journal of the American College of Surgeons. P.O. Box 2127, Marion, OH 43306-8227. (800) 214-8489 or (740) 382-3322. Fax (740) 382-5866. Summary: Rectourethral fistulae (openings between the rectum and urethra) are an uncommon complication of trauma, surgery, cancer, or inflammatory disease, but when they occur, they present unique challenges to the colorectal and urologic surgeons. In rare cases, nonoperative management has been successful, but the majority of patients require surgical intervention. This article reports four cases of rectourethral fistulae, one traumatic and three after radical prostatectomy (removal of the prostate), all successfully repaired by a perineal approach. The authors note that the most common criticisms of the perineal approach have been that the dissection is often through scar tissue from the initial injury or operation, and that is requires unusual expertise in perineal surgery. For this reason, the authors recommend that the operation be done jointly by both a colorectal and urologic surgeon. In the four patients described in this article, the midsagittal, transsphincteric perineal approach resulted in excellent repairs with minimal perioperative morbidity and rapid postoperative recovery. 3 figures. 1 table. 18 references.
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Urolume Stents: Lessons Learned Source: Journal of Urology. 167(6): 2477-2480. June 2002. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2334. Fax (301) 824-7290. Summary: The UroLume (American Medical Systems, Minnetonka, MN) endoprosthesis has been commercially available since 1990 and has been advocated for use in men with urethral stricture disease and detrusor-sphincter dyssynergia due to spinal cord injury. Despite reports of its success and ease of removal, the authors of this article have noted management problems with this stent (exandable tube place in the urethra to keep it open) in several complex cases. This article provides data on the outcome of 10 men who required several additional procedures or who experienced complications following UroLume placement. Of the patients, 4 had detrusor-sphincter dyssynergia (a disturbance in the muscular coordination of the bladder wall and ring of muscle around the bladder opening) and 6 had urethral stricture disease (characterized by a narrowing of the urethra as a result of scar tissue or the deposition of abnormal tissue). All patients with detrusor sphincter dyssynergia required hospitalization for management of urosepsis (infection) within 4 to 10 months of stent placement, and all 4 experienced stent migration requiring placement of a tandem stent (3 patients), bladder neck resection (3 patients), or sphincterotomy (1 patient). Two men were in retention following placement of a second stent and required stent explantation (removal). Of the other 6 men, 2 had bulbar and 3 had membranous urethral disease, and 1 had a severe bladder neck contracture following radical retropubic prostatectomy (removal of the prostate). Strictures recurred within the stent lumen in all 6 men and or adjacent to it in 3 men. At least 1 repeat procedure was required in all 6 men (within 6 months in 5 of the men) and 1 experienced significant bleeding during open explantation which required perineal urethrostomy. The authors note that in many cases these adverse outcomes (as noted in this series) may be secondary to improper patient selection. The authors stress
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that judicious use of the UroLume stent and proper case selection are essential since stent removal is not always straightforward. 3 figures. 2 tables. 19 references. •
Heart Burn: A Minor Inconvenience or a Major Health Risk? Source: Digestive Health and Nutrition. p. 17-20. November-December 2000. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email:
[email protected]. Summary: This article describes some of the newer medications and surgical procedures available to provide relief for heartburn and to reduce the potential for serious health problems due to long term acid reflux (return of the stomach's gastric acid up the esophagus). Heartburn (a retrosternal burning sensation) is one of the main symptoms of gastroesophageal reflux disease (GERD). The author describes the physiology of the lower esophageal sphincter (LES), which keeps acid in the stomach and out of the esophagus, then lists the typical symptoms of GERD. The author also cautions that the symptoms of heartburn can mimic those of heart attack, and vice versa. Readers are encouraged to consider chest pain as having a cardiac origin until they are evaluated by a health care provider. The article offers strategies for preventing heartburn, discusses the role of genetics in GERD, and summarizes ways to manage mild heartburn. Readers are recommended to watch food intake, lose weight, chew gum after eating, not smoke, not overeat, not eat late at night, raise the head of the bed, wear loose fitting clothes, and take antacids and over the counter acid reducers. Chronic heartburn that occurs several times a week or even daily can cause serious health problems, including esophagitis (an inflamed esophagus), ulcers, esophageal strictures (narrowing), and Barrett's esophagus (a precancerous condition of the esophageal lining). Readers are encouraged to seek medical care for any chronic heartburn problems, before their quality of life is compromised and they put themselves at risk for medical complications. The article concludes with a brief look at newer drugs such as proton pump inhibitors (PPIs) and H2 blockers, and two new treatments that were recently approved by the Food and Drug Administration (FDA): the use of an endoscope to place stitches below the LES, and the use of beams of heat to build flexible scar tissue around the LES, making it tighter and less likely to open frequently. 2 figures.
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Peyronie's Disease: What Is It and How Is It Treated? Source: Family Urology. 6(2): 10, 12. 2001. Contact: Available from American Foundation for Urologic Disease. 1126 North Charles Street, Baltimore, MD 21201. (800) 242-2383 or (410) 468-1800. Fax (410) 468-1808. Website: www.afud.org. Summary: This article discusses Peyronie's disease, a benign condition that causes significant curvature and shortening of the erect penis. This process, produced by scar formation in the fibrous covering of the erectile bodies of the penis, occurs most often in men in their late forties and early fifties. The cause of Peyronie's disease remains a mystery, although many investigators suspect that repeated injuries to the penis in men who tend to produce increased amounts of scar tissue may produce the changes associated with the condition. The author stresses that Peyronie's disease, while troublesome, is in no way related to sexually transmitted diseases, sexual practices, or cancer of the penis or other organs. Peyronie's disease is often self limiting, running its course over 12 to 18 months. During this time, pain usually resolves spontaneously in 4 to 6 months, curvature may be moderate, and plaque may diminish or soften. Treatment
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begins with medications (vitamin E and Potaba, colchkicine, verapamil, alpha interferon) in an effort to improve wound healing and soften the scar tissue associated with the plaque. During the healing period and the period of evolution of the plaque, it is important for patients to continue to be sexually functional with erectile function and coitus, if possible. If medical therapy fails to resolve the Peyronie's disease and results of the plaque have produced significantly decreased sexual function, surgery can be an alternative. Surgery should not be undertaken until the disease has stabilized and curvature has not progressed for six months or longer. The author briefly describes the surgical procedures that may be used, including the use of penile prostheses in selected patients. •
Infections in Urostomies Source: Metro Washington By-Pass. 85(65): 4. June 1991. Contact: Available from United Ostomy Association. Metropolitan Washington Chapter, Washington Hospital Center, East Building, Room 3102, 110 Irving Street, N.W., Washington, DC 20010. (202) 877-6019. Summary: This brief article discusses infections in urostomies. The author discusses frequent causes of urinary tract infection, including obstruction, such as kidney stones, tumors cysts, or scar tissue; and backflow of urine into the kidneys. The author concludes by noting that improvements in surgical techniques and appliances and continuing research make the outlook for ileal conduits hopeful. The author then lists four steps for prevention and treatment of infections in urostomies: adequate hydration, antibiotic therapy, appliance care, and stoma care.
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Fistula Cannulation: The Buttonhole Technique Source: Nephrology Nursing Journal. 29(2): 195. April 2002. Contact: Available from American Nephrology Nurses' Association. East Holly Avenue, Box 56, Pitman, NJ 08071-0056. (856) 256-2320. Fax (856) 589-7463. Website: www.annanurse.org. Summary: This brief article explains the buttonhole cannulation technique, which is used for patients who had limited access cannulation (the insertion of a needle) sites. The author notes that it was discovered, quite by coincidence, that cannulating the native arterio-venous (AV) fistula repeatedly, in exactly the same spot, actually had benefits. Using the buttonhole technique, cannulating the hemodialysis vascular access became easier. With repeated cannulation into the exact same puncture site, a scar tissue tunnel tract developed, which allowed the needle to pass through to the blood vessel of the fistula following the same path each time. The author explains how the buttonhole site is established and how it can be used by patients who wish to self-cannulate or for those patients who want to dialyze at home. The author also notes that an ongoing access surveillance program is recommended for native fistulae that are being cannulated using the buttonhole technique. 6 references.
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Treatment of Elbow Contractures Source: Current Opinion in Orthopedics. 11(4): 310-318. August 2000. Summary: This journal article provides health professionals with information on the etiology, diagnosis, and treatment of elbow contracture. Loss of motion of the elbow is a common and debilitating problem and can be caused by even minor elbow trauma. Successful treatment depends on proper diagnosis and anticipation of the probable sites
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of motion restricting pathology. Plain radiographs usually reveal areas of ossification. High resolution computed tomography scan is most helpful when plain radiographs are normal and the cause of the contracture is unclear. The surgical approach is dictated by the anticipated pathology, but combined medial and lateral approaches can be safely and easily extended to address virtually any findings. Most experienced elbow surgeons approach elbow contractures through midaxial medial and lateral incisions. Although there has been considerable interest in arthroscopic release of elbow contractures, this is a difficult operation for all but the most minor contractures. Successful treatment frequently requires extensive surgical capsulectomy, periarticular debridement and, if necessary, excision of the ectopic bone. Excellent results are achievable with complete resection of all scar tissue and aggressive postoperative therapy. Rehabilitative therapy emphasizes long flexion extension cycle times and gentle stretching to achieve full motion. Gentle but sustained application of force allows for stress relaxation to occur in the tissues. Static splinting in flexion or extension is used as needed. Manipulation under anesthesia may also be used. 6 figures, 1 table, and 47 references. (AA-M). •
Beneath the Surface of Scars and Wound Healing Source: Healthy Skin and Hair. p. 9-10. Winter 2001. Contact: Available from Quadrant HealthCom, Inc. 26 Main Street, Chatham, NJ 079282402. (973) 701-8900. Fax: (973) 701-8892. Summary: This journal article uses a question and answer format to discuss scars. Scars form after surgery, injury, burns, wounds, or skin diseases caused by bacteria, fungus, or virus. These injuries to the skin prompt an exaggerated healing response resulting in the growth of collagen under the skin. Scars mature in 12 to 18 months and may take up to 24 months to develop completely. There are three types of scars: atrophic, hypertrophic, and keloidal. Atrophic scars cause a depression or hole in the skin. Hypertrophic scars are elevated and subside with time. Keloidal scars are elevated and exceed the boundaries of the original incision or injury. Keloidal scars are actually benign tumors formed by scar tissue. The location and orientation of the original incision or injury will affect the type of scar, and all types of scarring can occur in the body. All scars are red initially due to large amounts of blood vessels under the surface supporting the healing process. Surgery, lasers, and certain collagen inhibiting medications may be used to diminish the appearance of scars. Poor nutrition, skin coloration, and age may lead to problematic scarring.
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When Back Surgery Fails: What's the Next Step? Source: Journal of Musculoskeletal Medicine. 16(6): 342-344,347-348, 351-355. June 1999. Summary: This journal article, the ninth in a special series of articles on the diagnosis and management of back pain, provides health professionals with information on combining information and objective findings from the history, physical examination, and diagnostic studies to identify patients who are likely to benefit from additional lumbar spine surgery if pain recurs following surgery. Many patients continue to experience pain and related symptoms after lumbar surgery, a constellation known as failed back surgery syndrome. A well structured approach to obtaining vital information is essential for determining whether current symptoms are mechanical and amenable to treatment. The patient's symptoms before the initial operation and the extent of pain relief achieved are valuable pieces of diagnostic information. The length of the postoperative pain free interval suggests whether pain is related to residual disc material, scar tissue, or a problem such as new herniation, stenosis, or instability. The
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physical examination includes neurologic and mobility assessments and screening for inorganic findings. Diagnostic imaging results from roentgenograms, myelography, computed tomography, magnetic resonance imaging, and provocative studies must be interpreted within the context of clinical findings. Disc herniation, stenosis, and instability are often amenable to further surgery. Scar tissue, epidural fibrosis, and chronic pain usually respond to conservative care. 2 figures, 4 tables, and 25 references. (AA-M). •
Understanding Abdominal Adhesions Source: Ostomy Quarterly. 38(2): 50-51. Winter 2001. Contact: Available from Ostomy Quarterly. 36 Executive Park, Suite 120, Irvine, CA 92614-6744. (800) 826-0826 or (714) 660-8624. Website: www.uoa.org. Summary: This newsletter article helps patients with ostomies understand the problem of abdominal adhesions. Adhesions are abnormal fibrous or scar tissue that results from the healing process. In the abdomen, adhesions can form between loops of bowel, organs (like the liver or bladder), and the abdominal wall. Up to 95 percent of patients who have surgery develop adhesions. Adhesion does play a good role in limiting the spread of infection and may help health intestinal anastomosis (joining). Adhesions can cause bowel obstructions, problems with female fertility, abdominal pain, and difficulty with subsequent operations. All abdominal surgical procedures have the potential for creating adhesions. The author stresses that prevention is the optimal solution. Prevention can be achieved by four strategies: mechanical bowel fixation to promote benign adhesions that will not lead to obstruction, systemic drug therapy (e.g., antiinflammatory medications), intra abdominal therapy or barriers, and addressing local factors (e.g., surgical technique, foreign bodies). The author discusses each of these approaches, encouraging readers to educate themselves about their own situations and surgeries. 1 table. 6 references.
Federally Funded Research on Scar Tissue The U.S. Government supports a variety of research studies relating to scar tissue. 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 scar tissue. 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 scar tissue. The following is typical of the type of information found when searching the CRISP database for scar tissue:
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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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Project Title: ANISOTROPY IN HEALING MYOCARDIAL SCAR TISSUE Principal Investigator & Institution: Holmes, Jeffrey W.; Biomedical Engineering; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, Ny 10027 Timing: Fiscal Year 2004; Project Start 09-DEC-2003; Project End 30-NOV-2007 Summary: Following myocardial infarction, the mechanical properties of the healing infarct are a critical determinant of ventricular performance, infarct expansion, aneurysm formation and rupture, and ventricular remodeling. Specifically, recent studies have shown that myocardial scar tissue is anisotropic (stiffer in one direction than in others) and suggested that this anisotropy helps to preserve ventricular function. The primary goal of this proposal is to establish the physical mechanisms by which collagen fiber structure, crosslinking, edema, and fibroblast tension determine mechanical anisotropy and to identify their relative importance over the course of postinfarction healing. The proposed studies will progress from an innovative collagen gel model system that reproduces physiologic levels of scar anisotropy to in vitro tissue testing to in vivo functional studies. Work under Specific Aim 1 will utilize state-of-the art biaxial testing to determine the mechanisms by which crosslinking, edema, and fibroblast force generation modify mechanical anisotropy in fibroblast-populated collagen gels, testing the hypotheses: A) Pyridinoline crosslinking modifies anisotropy by limiting shearing between collagen fibers; B) Interstitial edema reduces anisotropy by applying an isotropic prestress to the collagen matrix; and C) Fibroblasts reduce anisotropy by generating an isotropic active stress on the collagen matrix. Next, myocardial scar tissue will be tested in vitro in Specific Aim 2 to determine the relative importance of crosslinking, edema, and fibroblast force generation as determinants of anisotropy during postinfarction healing in the rat, testing the hypotheses: A) Edema and fibroblast force are the primary determinants of anisotropy in the first days; B) Collagen fiber structure is the primary determinant of anisotropy at 1-2 weeks; and C) Pyridinoline crosslinking is a critical determinant of anisotropy at later time points. Finally, Specific Aim 3 will test the hypothesis that acutely reducing anisotropy impairs ventricular function at intermediate and late stages of postinfarction healing in the rat. The resulting fundamental quantitative understanding of structure-function relationships in myocardial scar tissue will be critical to future attempts to understand and predict the effects of medical, surgical, and regenerative therapies as well as to attempts to modify or replace myocardial scar tissue using tissue engineering methods. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ASSESMENT OF A CHRONIC SUBCUTANEOUS GLUCOSE SENSOR Principal Investigator & Institution: Ward, W Kenneth.; Legacy Health System 1919 Nw Lovejoy St Portland, or 97209 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): In the United States, diabetes mellitus is the leading cause of end-stage kidney failure, blindness in adults under age 65, and is the second leading cause (after trauma) of limb amputation. Poorly-controlled glucose levels are the major cause of these complications, but tight glycemic control is difficult to safely achieve using present technology. While a continuously-functioning glucose sensor would assist in safely achieving tight glucose control, such devices are typified by instability and loss of output over time due to the formation of foreign-body scar tissue, which eventually surrounds the sensors. Miniaturized sensors could be implanted under the skin with minimal discomfort. It is possible that the surrounding scar capsule
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could be made much more "friendly" to a glucose sensor by the slow release of growth factor compounds from the sensor surface. The hypothesis is that such compounds would reduce the scar fibrosis and generate many blood vessels in the capsule. These blood vessels are important to the long-term function of the sensor given its need for continuous glucose and oxygen delivery. A study will initially be performed in order to ascertain the optimal dosage of the growth factor. Then the growth factor (or saline control) will be slowly released over one month from miniaturized pumps into the tissue, which directly contacts the sensor. The thickness of the capsule and the formation of new blood vessels will measured by standard histologic staining techniques and by endothelial Factor Vifi immunohistochemistry. Another major problem of glucose sensors is short-term drift. It is frequently observed but poorly understood. It now appears that it may be possible to obtain stable readings from simultaneous recordings of multiple sensor electrodes. The technique which will be used to separate the accurate electrode signals from the inaccurate (outlying) signals is from the field of median statistics and is called the ZMAD method of Rousseeauw. The ZMAD data processing will be performed prospectively and continuously. In addition, the sensors and their transmitters will be miniaturized with the help of a biotelemetry company, MiniMitter. The body can be hostile to compounds which coat implanted devices. We will compare two promising polyurethanes as sensor coats: a carbonate based- vs. ether-based polymer. We will compare their long term function in studies using rabbits, which will be also be used to ascertain the effect of the growth factors and the real-time data processing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CELL SURFACE MOLECULES OF THE DEVELOPING NERVOUS SYSTEM Principal Investigator & Institution: Levine, Joel M.; Professor; Neurobiology and Behavior; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2001; Project Start 01-JUL-1984; Project End 30-JUN-2004 Summary: Oligodendrocytes the myelin forming cells of the CNS, develop from an identified precursor cell (OPC). OPCs are abundant in developing and adult animals suggesting that these cells carry out functions in addition to providing a pool of oligodendrocyte precursors. OPCs express on their surfaces NG2 a chondroitin sulfate proteoglycan that can inhibit axonal growth and guide axon elongation in vitro. The expression of NG2 is maximal during development and again when the brain suffers an injury. This suggests that OPCs can provide negative, growth inhibitory cues to both developing and regenerating axons and that NG2 is the biochemical basis for this contact mediated growth inhibition. The goal of this proposal is to test this hypothesis of OPC function. Under Specific Aim 1 the complete distribution of OPCs and NG2 in the developing CNS will be mapped and compared to the distribution of newly formed axon tracts and to other putative growth inhibitory molecules. This data will provide the anatomical framework against which to evaluate the hypothesis that OPCs define areas that are non-permissive for axon growth during early CNS development. Under Specific Aim 2 the membrane properties of OPCs will be directly evaluated using a in vitro membrane carpet assays. Fusion proteins that encode small regions of NG2 will be prepared and tested for their ability to inhibit axonal outgrowth and neutralizing monoclonal antibodies prepared against those domains of NG2 that are active in these assays. Knock-in cell lines will be created that express these growth inhibitory domains and the ability of these lines to inhibit axon growth evaluated. Time-lapse video microscopy will be used in Specific Aim 3 to determine whether the induction of growth
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cone collapse is a mechanism by which OPCs inhibit axonal growth. In Specific Aim 4 the ability of membranes prepared from CNS scar tissue to promote or inhibit axonal outgrowth will be tested and the role of NG2 in any inhibition evaluated using the domain specific neutralizing anti-NG2 antibodies. This aim also includes a detailed biochemical analysis of the temporal patterns of expression of growth promoting and growth inhibiting molecules after injury. The proposed studies will provide important information concerning the functions of a newly recognized class of glial cells during development, tissue repair and regeneration. They will also provide information concerning the functions of proteoglycans in the CNS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DYNAMICS OF CALCIUM & COLLAGEN ACCRETION IN CHILDREN UNDERGOING ORTHOPEDIC SURGER Principal Investigator & Institution: Klein, Gordon L.; Professor of Pediatrics; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2002 Summary: We previously found that in children recovering from burns of >40% TBSA, disturbances in bone metabolism result in long-term deficits in bone mineral density (BMD) which result in decreased peak bone mass and increase the risks of later fracture. Measurements we made of indirect indices of bone turnover suggest disturbances in bone protein and mineral anabolism and re-modeling, all important processes in bone growth. However, no direct kinetic measurements of these processes have been made either in burned children or in children in whom bone growth would be expected to be normal. Our general hypothesis is that adequate bone growth and mineralization are unlikely to occur unless bone collagen synthesis occurs normally and that in burned children these processes are slowed or arrested. We wish to compare differences in bone metabolism, composition and histomorphometry between children recovering from major burn injury and normal children studied during admission for a elective orthopedic reconstructive surgery, for conditions (e.g. scoliosis) unlikely to have a major impact upon bone metabolism. The present application only concerns studies in normal children since we already have IRB approval for the studies in burned children (IRB 92304). However in order to interpret the results and to gain insights into normal bone physiology currently lacking, we need information on the bone growth in metabolically normal children. In a separate, but related study we wish to examine discover the effects of acute burn injury and recovery on collagen metabolism of unburned skin, and of scar tissue. We therefore wish to sample some skin (~2g) at the margin of the wound made during elective orthopedic surgery to provide samples of unburned, normal skin, analysis. The analysis of this skin will enable us to make comparisons with samples from burned children, to discover what differences if any exist in their respective skin collagen metabolism. Our general hypothesis is that, in burned children, bone (and unburned skin) collagen synthesis and bone calcium turnover are depressed. To test this we will examine bone mineral turnover and collagen synthesis using non-radioactive, stable isotope tracer methodology. We will use Ca, to probe bone mineral accretion and stable tracer amino acids including C6 Phenylalanine, N proline and C proline (applied in a novel flooding dose protocol developed by us) for assay of skin and bone protein, particularly collagen synthesis, which has never before been applied to the study of skin or bone in children. We also wish to examine the relationships of these dynamic measure of bone metabolism with measures of indirect indices of bone collagen and mineral metabolism (e.g. serum C-terminal Type 1 (I) pro-collagen peptide, osteocalcin, parathyroid hormone and urinary deoxypyridinoline excretion). The results will
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provide new information concerning normal human bone collagen and calcium metabolism during growth, an area in which information is almost non-existent. In addition it should allow us to gain insights into the mechanisms impairing bone growth in previously burned children, which may help us to identify new therapeutic targets, thereby possibly benefitting the influence, design and implementation of rehabilitation programs. Furthermore, the new knowledge could help us understand the underlying pathology involved in osteopenia in children and osteoporosis in adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ECM REMODELING IN EXCESSIVE FIBROPLASIA Principal Investigator & Institution: Tuan, Tai-Lan; Assistant Professor of Research; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, Ca 900276062 Timing: Fiscal Year 2004; Project Start 01-JUL-1998; Project End 31-JAN-2008 Summary: (provided by applicant): Long-term goal: To elucidate the cellular and molecular basis of excess scar formation during wound repair. This application will focus on the role of altered expression of plasminogen activator inhibitor-1 (PAI-1) in collagen over-production by keloidfibroblasts. Proteolytic degradation of the provisional fibrin matrix and remodeling of the newly formed collagen-containing scar tissues are essential features in injury repair. Keloids, resulting from improper wound healing, are the extreme form of skin fibrosis with unknown etiology. Using a 3dimensional fibrin gel culture system, we discovered that keloid fibroblasts are defective in fibrin degradation due to PAl-1 over-expression. In the previous granting period, we established, both in vitro and in vivo, that PAI-1 overexpression is phenotypic of keloid fibroblasts and is causal in the elevated collagen accumulation. Reducing PAI-1 activity also abolishes the elevated collagen accumulation in keloid fibroblasts (Tuan et al., Am J Pathol 2003). In addition, we demonstrated that, in vivo, PAI-1 increases as fetal mouse skin wounds transition from scarless (El5) to scar-forming (E18 and after) repair, and aprotinin, a uPA/plasmin inhibitor, causes scar formation in E15 fetal skin wounds (Huang et al., WRR 2002). PAI-1 is the major inhibitor of the plasminogen activator (PA)/plasmin system. This system is central to fibrin degradation, cell adhesion and migration, and metalloproteinase (MMP) activation, which is essential in collagen turnover. Thus, we hypothesize that "PAl-1 contributes to elevated collagen accumulation in keloid fibroblasts by inhibiting MMP activation and or by modulating uPA-mediated cell adhesion". PAI-1 is a down stream target of TGF-beta, and keloid fibroblasts exhibit TGF-beta-mediated differences in matrix contraction and collagen synthesis. Thus, we also hypothesize that "an altered TGF-beta signaling pathway and or utilization of PAI-1 promoter response elements are responsible for increased PAI-1 expression in keloidfibroblasts" The established evidence and the unique experimental models will allow us to test these hypotheses through the following specific aims: Aim I: To investigate the role of PAI-1 increase in MMP- and cell adhesion-mediated collagen accumulation in keloid fibroblasts. Aim II: To determine the biological mechanism of PAI-1 increase resulting from altered TGF-beta signaling events and/or difference in PAI-1 promoter utilization in keloid fibroblasts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GLIAL RESTRICTED PRECURSORS AND SPINAL CORD REPAIR Principal Investigator & Institution: Davies, Stephen J.; Neurosurgery; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2007
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Summary: (provided by applicant): The primary focus of this research application is the development of an in vivo model of traumatic adult mammalian spinal cord injury with which to study the glial and matrix biology of spinal cord scar formation and characterize the ability of glial-restricted precursors (GRPs) and GRP-derived astrocytes (GDAs) to differentiate within forming glial scar tissue, suppress scar formation and provide an axon growth support bridge for axon regeneration. Preliminary data from our laboratory shows that spinal cord scar tissue is rich in a variety of axon growth inhibitory chondroitin sulfate proteoglycans (CSPGs), several of which are associated with astrocytes and adult glial progenitors that accumulate at sites of injury. Interestingly, although adult glial precursors can generate both astrocytes and oligodendrocytes in vitro, astrocytes are the predominant macroglia observed within spinal scar tissue. Experiments in aim 1 will therefore test the hypothesis that the environment of adult spinal scar tissue favors astrocytic differentiation, by transplanting a defined population of tripotent glial-restricted precursors (GRPs) directly into an acute stab injury of adult rat dorsal column white matter and quantifying the proportions of astrocytes and oligodendrocytes that these cells generate. As controls for the possible effects of scar tissue and axotomy on GRP differentiation, the macroglial differentiation of GRPs in the absence of glial scar tissue within intact white matter alone and in the presence of growing axons from adult neurons, will be investigated using an atraumatic micro-transplantation technique. Embryonic GRPs can be induced to differentiate into type-1 astrocytes or type-2 astrocytes in vitro. The generation of these two distinct astrocytic populations from GRPs in vitro permits an investigation of the impact of each of these distinct astrocytic cell types on scar formation and axon regeneration in vivo. Unlike adult astrocytes or type-2 astrocytes, type-1 astrocytes express low levels of CSPGs and transforming growth factor betas (TGFbetas) known to induce CSPG deposition in CNS scar tissue. In aim 2, quantitative western blot and confocal microscopy analysis will test the hypothesis that intra-lesion transplants of type-1 GDAs will suppress TGFbeta and CSPG levels within spinal cord scar tissue compared to type-2 GDAs or control lesions. Preliminary results show that type-1 GDAs are highly supportive of axon growth in vitro. Experiments in aim 3 will therefore test the hypothesis that intra-lesion transplanted type-1 GDAs will retain their axon growth supportive phenotype and promote axon regeneration across spinal cord injuries. Micro-transplantation and axon tracing techniques will be used to compare the ability of type-1 GDAs and type-2 GDAs grafted into injured spinal cord to support regeneration of adult sensory and corticospinal axons at acute to chronic time points post injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPROVING MUSCLE HEALING THROUGH PREVENTION OF FIBROSIS Principal Investigator & Institution: Huard, Johnny; Henry J. Mankin Associate Professor of o; Children's Hosp Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, Pa 152132583 Timing: Fiscal Year 2002; Project Start 10-AUG-2001; Project End 31-JUL-2005 Summary: Muscle injuries, especially pulls and strains, present a challenging problem in traumatology and are among the most common and most often disabling injuries in athletes. The injured muscles are capable of healing, although very slowly and often with incomplete functional recovery. The injured muscle can promptly initiate regeneration for the healing process, but that process in inefficient and is hindered by fibrosis ie, scar tissue formation. More importantly, the scar tissue that replaces the
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damaged myofibers is a potential contributing factor in the tendency of strains to recur. We have identified various growth factors capable of enhancing myoblast proliferation and differentiation, and their delivery within injured muscle improves muscle regeneration, but the development of fibrosis still limits recovery. On the other hand, it has been reported that the over expression of transforming growth factor (TGF-) in various injured tissues is the major cause of fibrosis in animals and humans. Indeed, we have observed that TGF- plays a central role in skeletal muscle fibrosis and, more importantly, that the use of antifibrosis agents, such as decorin, that inactivate the effect of this molecule can reduce muscle fibrosis and consequently improve muscle healing to a near complete recovery after injuries. Our recent observation that decor in can also enhance muscle regeneration makes this molecule more than ideal to improve muscle healing after injury. We therefore propose to investigate the kinetics of TGF- expression, muscle regeneration, and fibrosis after strain and to delineate the mechanism by which this molecule initiates the fibrosis cascade in skeletal muscle. We will consequently develop biological approaches based on decor in to efficiently prevent the scarring process by blocking the action of TGF- and activate muscle regeneration at the adequate time period post-injury. We finally propose to characterize efficient way to deliver therapeutic and lasting levels of decor in into the injured muscle through the following strategies: (1) direct intramuscularly injection of the recombinant proteins and (2) in vivo gene delivery by gene vectors. These studies should further our understanding of the muscle healing process, expedite the methodology to promote efficient muscle healing, and contribute to the development of innovative therapies for other muscle diseases, such as dystrophies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERLEUKIN 6 ROLE IN ALCOHOLIC LIVER CIRRHOSIS Principal Investigator & Institution: Rojkind, Marcos; Research Professor; T.R.U.E. Research Foundation 8610 N New Braunfels, Ste 705 San Antonio, Tx 78217 Timing: Fiscal Year 2002; Project Start 01-APR-1995; Project End 31-MAR-2005 Summary: (Adapted from the Investigator's Abstract): Alcohol-induced liver cirrhosis is a leading cause of death worldwide and accounts for over 50 percent of all deaths due to cirrhosis. There is no proven therapy for this deadly disease and, therefore, multiple attempts are being made at developing novel anti-fibrogenic agents based on the current knowledge of the pathophysiology of the disease. Both local and systemic events play a key role in the development of liver cirrhosis. At a local level, are fibrogenic and induce the expression of type I collagen genes by hepatic stellate cells. These cells are in controlling portal blood flow, producing excess type I collagen and contracting the wound. Liver macrophages and inflammatory cells produce the cytokines and growth factors that play a key role in activating hepatic stellate cells to make scar tissue. At the systemic level, the general response of the organism to non-factor-alpha and inteleukin6, which are produced during the acute phase, play a key role in priming hepatic stellate cells to proliferate and make type I collagen. The investigator's long-term goals are to define molecular mechanisms whereby ethanol induces liver fibrosis and to develop novel and more rational anti-fibrogenic therapies based on these findings. In this application they propose experiments to unravel basic molecular events whereby the acute phase in general, and tumor necrosis factor-alpha and interleukin-6 in particular, contribute to the fibrogenic process. Thus, the PI will use modern techniques in cell and molecular biology to unravel signal transduction pathways involved in the activation of hepatic stellate cells and in establishing pathways through which the acute phase cytokines enhance the fibrogenic actions of acetaldehyde. Moreover, the investigators
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will test whether colchicine, an anti-inflammatory drug with anti-fibrogenic potential that ameliorates live cirrhosis has an effect on the parameters to be investigated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LINEAR LESION DEVICE Principal Investigator & Institution: Sherman, Jon A.; Vice-President; Enable Medical Corporation 6345 Centre Park Dr West Chester, Oh 45069 Timing: Fiscal Year 2003; Project Start 30-SEP-2001; Project End 30-NOV-2004 Summary: (provided by applicant): Atrial Fibrillation is an electrical malfunction of the upper pumping chambers of the heart causing major medical and lifestyle problems. The current treatments are pharmaceutical (side effects and minimal effectiveness), pacemakers (after destroying the electrical system of the heart, expensive and moderately effective), and electrically isolating areas of the heart using the MAZE procedure - surgically cutting the heart and sewing back together creating scar tissue to block malfunctioning electrical pathways. This MAZE procedure has proven to be nearly 100 percent effective, however it is long and extraordinarily difficult. Due to the promising concept, this approach is aggressively being investigated using ablation catheters and probes to create lesions. However, to isolate electrical pathways, a complete electrical block in the tissue must be made and these technologies are limited in their ability to create transmural lesions. With these technologies, charring and extensive atrial damage occur, which can increase risk of stroke. Our technology addresses these issues by incorporating RF Bipolar energy into a device that will quickly and safely create a transmural linear lesion, from endocardium to epicardium, in a single application while protecting the surrounding tissue. In Phase I we will fabricate a prototype and evaluate our lesions for transmurally and ability to electrically isolate tissue. PROPOSED COMMERCIAL APPLICATION: Our technclogy will overcome the limitations of the current methods of treating atrial fibrillation (AF) and can be used to treat AF during open-heart procedures and to reduce the occurrence of post-operative AF episodes. This market alone exceeds $1.2 BB/year. The devices that can be developed using this technology have a strong potential of being incorporated into minimally invasive procedures adding an additional $1.5 BB to the market potential. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOLECULAR ANALYSIS OF SCARLESS FETAL WOUND HEALING Principal Investigator & Institution: Kathju, Sandeep C.; Allegheny-Singer Research Institute 320 E North Ave Pittsburgh, Pa 15212 Timing: Fiscal Year 2003; Project Start 28-JUL-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Adult mammalian tissues respond to injury by healing with scar formation. Scar tissue assists in sealing a wound, but can also lead to significant morbidity. Scar can restrict tendon and muscle movement, obstruct visceral lumens, and impede peripheral nerve regeneration. In the head and neck especially scarring can have severe consequences, causing hearing loss, loss of smell and taste, loss of voice and articulation, airway obstruction, as well as the obvious stigma of gross visible deformity. In contrast to adults, mammalian fetuses are known to heal without scar in a process akin to regeneration. This remarkable ability is known to be intrinsic to fetal tissues, independent of the uterine environment, and is lost in the third trimester of gestation. An understanding of the biological basis for scarless healing might well lead to new strategies to limit the morbidity of scar. We hypothesize that scarless fetal wound healing drives from a subset of differentially expressed genes in fetuses versus
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adults. The aims of this project are to establish microarrays that encompass the full relevant gene set comprising the expressomes of healing fetal and adult wounds, to identify differentially regulated genes, to better characterize selected differentially regulated gene products, and to confirm differential expression at the protein level through a proteomics approach. We will evaluate promising candidate genes thus identified for their biological significance in a number of model systems, including transgenic and knockout animals, and through the use of somatic gene transfer. We will also investigate possible mechanisms controlling the fetal wound-specific downregulation of the eta chaperonin subunit. With these complementary approaches we hope to thereby arrive at a broad understanding of the gene patterns controlling both fetal and adult wound healing, and identify gene products/pathways critical to both. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSPLANT
MYOFIBROBLASTS
AND
FIBROSIS
AFTER
CARDIAC
Principal Investigator & Institution: Strauch, Arthur R.; Professor; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2003 Summary: Chronic rejection in the transplanted heart is associated with interstitial fibrosis and progressive neointimal lesion formation in the coronary arterial bed that impairs tissue perfusion to the point of functional disruption. Our intention in Project 3 is to examine wound repair processes in the transplanted heart that specifically involve activated stromal myofibroblasts. We propose that alloantigen-independent ischemia/reperfusion injury during the early post-operative period as well as chronic, alloantigen-dependent release of TGFbeta1 in long-term accepted grafts promote myofibroblasts activation and histogenic remodeling via a common signaling pathways based on reactive oxygen species (ROS). Myofibroblasts accumulate in the coronary adventitia and cardiac interstitium of heart grafts where they express several injuryresponse genes that are regulated by MSYI, a cold-shock domain (CSD) transcriptional regulatory protein. MSY1 and related proteins are important mediators of the transcriptional response to tissue stress and redox imbalance. The goal of the proposed research is to examine TGFbeta1- and ROS-dependent changes in MSY1 protein complexes that govern VSM alpha-actin promoter activity. Mis-regulation of VSM alpha-actin expression during chronic rejection is associated with accumulation of myofibroblasts, fibrocontractile scar tissue, neointimal smooth muscle cells, and poorly differentiated cardiomyocytes. VSM alpha-actin is encoded by a prototypical injury response gene that shares MSY1 control elements with other genes required for wound repair. Analysis of interactions between MSY1 and other TRPs required for injuryresponse gene expression in human stromal myofibroblasts should provide new information about molecular control points in chronic rejection. In human pathology and intramyocardial biopsy samples, assessment of MSY1:TRP structure and function may provide new prognostic indicators for evaluating and staging chronic rejection in transplant patients before the development of graft-destructive fibrosis. From the standpoint of transplant vascular sclerosis, studiers of stromal myofibroblasts are especially relevant given the demonstrated importance of adventitial fibroblasts in neointima formation as well as the establishment of new microvascular perfusion circuits that are critical for long-term heart graft survival. Finally, TGFbeta1 and/or ROS may modulate expression of other MSY1-dependent, chronic rejection- associated genes such as those encoding MHC class II molecules which compliments Project 1 and 2 aims
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pertaining to alloantibody production, monocyte/macrophage FcR engagement, and the role of TGFbeta1 in graft acceptance vs. fibrosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEW BIOMATERIALS TO MINIMIZE SCAR TISSUE FORMATION Principal Investigator & Institution: Sanders, Joan E.; Associate Professor; Bioengineering; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 15-MAR-2000; Project End 28-FEB-2004 Summary: (verbatim from the proposal): Fibrous encapsulation is an important limitation of current biomaterials intended for integration with soft collagenous tissues (e.g. abdominal wall repair, hernia repair, skin replacement from burn or ulceration, intestinal ulcer repair). A fibrous capsule can wall off the device, produce scar tissue that can adhere to underlying structures, and isolate the material from mechanical or chemical integration. However, preliminary implantation data suggest that if polymer fibers that make up the implant are very small, on the order of collagen fiber dimensions in the soft tissues (0.5-3.0 mm diameter), then fibrous encapsulation is minimized or eliminated. This feature, if validated in a systematic scientific manner, could be utilized in fibro-porous biomaterial design to create more effective devices. A systematic evaluation of a design feature's influence on bio-response (e.g. fiber diameter effect on healing) will be most useful to the biomaterials design community if it is simultaneously compared with a characteristic that has been well-studied. Biomaterial surface chemistry is the feature of interest selected for comparison here. The purpose of this research is to systematically evaluate the influence of material architecture and surface chemistry on in vivo response to fibro-porous materials. The specific aspect of surface chemistry to be evaluated is surface (ionic) electrical charge. The research proceeds in two stages: analysis on single fibers, and analysis on multi-fiber (fibro-porous) meshes. This twostage approach helps to isolate effects of the different features of interest. Because no traditional biomaterials fabrication method exists for making very small diameter fibers, a technology used mainly in non-biomedical industries called electrospinning is pursued and applied. An in vivo model is used to evaluate fibrous capsule thickness as well as foreign body giant cell density and macrophase cell density in tissue adjacent to the micro-fibers. These are key indicators of implant integration or activation of the foreign body reaction. The significance of this research is to apply an innovative material and fabrication method to assess the influence of specific biomaterial architectural and chemical features of a biomaterial to the tissue response. The approach could lead to a new materials fabrication technology to treat a number of soft-tissue complication in which scar tissue formation is an important clinical problem. The health relatedness of this project is to improve the health and function of persons with soft tissue defects, particularly abdominal wall perforation, intestinal ulceration, abdominal herniation, burns and skin ulceration, i.e. soft-tissue complications that require surgical repair through use of a biomaterial. The new materials will prevent scar tissue formation and reduce the occurrence of secondary complications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PET IMAGING OF BREAST CANCER VIA SIGMA-2 RECEPTORS Principal Investigator & Institution: Mach, Robert H.; Professor; Radiology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2004
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Summary: (provided by applicant): The early detection of breast tumors at a stage when it is most treatable represents the most important issue in the clinical management of breast cancer. Although screening mammography is widely accepted as the best procedure for this purpose, there are a number conditions (i.e., women with dense breast tissue, breast implants, or scar tissue for an earlier biopsy study) that interfere with the identification of abnormalities that may be caused by breast tumors. In addition, another major problem in the clinical management of breast cancer is the identification of an appropriate treatment strategy once the disease has been correctly diagnosed. Therefore, a noninvasive imaging procedure that can detect breast tumors in patients that are problematic for mammography, and provide insight into identifying an appropriate strategy for treating this disease, would be an important tool in the clinical management of breast cancer. The goal of the research described in this application is to develop sigma-2 (sigma2) receptor-based radiotracers for imaging breast tumors with the noninvasive imaging technique PET. The choice of this receptor as a target for imaging is based on published reports that human breast tumors possess a high density of sigma2 receptors versus surrounding normal tissue. Therefore, a sigma2 receptorbased imaging agent should be useful in detecting breast tumors is patients that are problematic for mammography. A second reason for focusing on this receptor is our published data demonstrating that sigma2 receptors are expressed in approximately 10fold higher density in proliferative mouse mammary adenocarcinoma cells versus the nonproliferative or quiescent cell population under both in vitro (cell culture) and in vivo (tumor xenografts) conditions. Therefore, a sigma2 receptor PET radiotracer has the potential to provide information regarding the proliferative status of breast cancer. An in vivo imaging procedure that can provide information about the proliferative status of primary breast tumors would represent a significant improvement over current methods used in making this assessment. Our preliminary data also indicate that sigma2-selective radiotracers are predicted to have a better tumor: background ratio than other agents, such as FDG and the DNA precursors, currently used to assess proliferation in PET oncology studies. Consequently, a major goal of this R21/R33 grant application is to conduct the necessary in vivo studies needed to validate this novel, receptor-based imaging approach for determining the proliferative status of breast tumors. A series of studies are also proposed to compare our imaging procedure with that of [18F]FLT, a substrate of thymidine kinase 1 which was recently introduced as a potential proliferation-based radiotracer. We propose to compare our receptor-based approach to the [18F]FLT method, and compare the results of these studies to proliferative status of the tumor determined by flow cytometry of the BUdR labeled DNA. Finally, a series of microPET imaging studies (using the Concorde Microsystems microPET R4 and Focus PET scanners) will be conducted in order to determine if the sigma2 receptor imaging approach can be used to monitor a positive response to antiestrogen and Herceptin therapy in estrogen receptor (+) and Her2/neu receptor (+) human breast tumor xenografts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROTEOGLYCANS IN NORMAL AND SCARRED CORNEAS Principal Investigator & Institution: Funderburgh, James L.; Associate Professor; Ophthalmology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-AUG-1993; Project End 31-JUL-2007 Summary: (provided by applicant): Corneal scars exhibit a disruption of stroma collagen fibril diameter and spacing that contributes to loss of transparency. These alterations are
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closely associated with changes in stromal glycosaminoglycans, acidic polysaccharides that form bridges between adjacent collagen fibrils. This project will examine the hypothesis that altered transcription of genes involved in elongation and sulfation of glycosaminoglycans generates the abnormal glycosaminoglycans of scar tissue and is directly responsible for disruption of stromal transparency. In the past two years genes coding for the enzymes involved in elongation and sulfation of corneal glycosaminoglycans have been identified. At the same time, we have developed and characterized cultures of primary keratocytes that maintain a glycosaminoglycan expression profile similar to that of normal cornea but which can be stimulated to secrete glycosaminoglycans resembling those of scar tissue. These developments present the opportunity to directly test the role of glycosaminoglycans in stromal transparency. We will address the hypothesis in three stages: (1) Identify the genes involved in generating normal and fibrotic stromal glycosaminoglycans. (2) Demonstrate that altered glycosaminoglycan biosynthesis results from transcriptional regulation of biosynthetic genes under the control of gene-specific promoter sequences. (3) Characterize the effects of corneal-specific overexpression of chondroitin sulfotransferase and synthase in vivo. This third aim will generate transgenic mice in which corneal chondroitin sulfate overexpression is inducible. Corneal transparency cellularity and collagen fibril organization of the mice will be documented. Together these three aims will establish which genes are involved in mediating the corneal glycosaminoglycan phenotype and how these genes are controlled, and will show that inappropriate expression of these genes leads to tissue changes similar to those in scars. These experiments will link the long held idea of the importance of glycosaminoglycan in corneal transparency with the expression patterns of specific genes. These results may be relevant to development of therapeutic approaches in the cornea as well as other tissues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RADIOIMMUNOTHERAPY FOR LYMPHOMA Principal Investigator & Institution: Witzig, Thomas E.; Professor of Medicine; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2005 Summary: (Provided by applicant): The majority of non-Hodgkin's lymphomas (NHL) are malignancies of CD2O+ B-lymphocytes. There are approximately 55,000 new cases of NHL each year; and for unexplained reasons, the incidence is rising. A new form of treatment for B-cell NHL involves the use of rituximab, a monoclonal antibody that is targeted to the CD2O antigen. Yttrium-90 is a radioisotope that can be linked to the antiCD2O antibody to target radiation to the malignant B-cells. Preliminary studies have established a safe single dose of Yttrium-90 anti-CD2O antibody (Y2B8) which will produce a tumor response in 82 percent of patients (pts) with low-grade or follicular NHL. The primary toxicity of Y2B8 is reversible myelosuppression, which results in neutropenia and thrombocytopenia and the concomitant increased risk for infection or bleeding. Indium-111 conjugated to the anti-CD2O antibody (In2B8) has been developed to predict tumor and normal organ dosimetry. It is hypothesized that retreatment with Y2B8 delivered 3-4 months after the first dose will improve the complete remission (CR) rate as well as the duration of response. The overall objective of this proposal is to develop a safe treatment strategy that utilizes two sequential doses of Y2B8 separated by 12-16 weeks. After the maximum tolerated two doses (MTD) of Y2B8 is established, a phase II trial will be done to learn if the CR rate can be doubled to 50 percent. It is important to learn the normal organ (including bone marrow) and tumor dosimetry
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using In2B8 scanning prior to each dose of Y2B8. Statistical models using the In2B8 dosimetry results and marrow mass calculations from Tc radiocolloid scans will be investigated to learn whether marrow toxicity can be predicted. The results of the In2B8 scans will be correlated with computerized tomography (CT) and positron emission tomography (PET) scans. CT and PET will be important to evaluate at the time of the second dose of Y2B8 because many pts have residual masses detected by CT. It is hypothesized that if the residual masses are positive by In2B8 or PET scanning that this will represent residual lymphoma rather than benign scar tissue. Since myelosuppression is the major toxicity of Y2B8, it is hypothesized that this can be decreased by utilizing prophylactic colony stimulating factors. After the MTD is established, additional pts will be treated with prophylactic granulocyte macrophage colony stimulating factor (GM-CSF) and thrombopoietic growth factor (Interleukin-II, oprelvekin) to learn whether the myelosuppression can be ameliorated and whether the dose of Y2B8 can be increased. Bone marrow exams will be performed before and after Y2B8 to evaluate marrow toxicity and effect on marrow cytogenetics. Although it is unusual for humans to develop an antibody to this antibody (human anti-murine antimouse antibody - HAMA), it is unknown whether pts will have a higher HAMA rate after two doses of Y2B8 and this will be examined in this protocol. We anticipate that this novel radioimmunotherapy approach will result in more effective treatment for pts with NHL. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SILK SCAFFOLDS FOR BONE FORMATION Principal Investigator & Institution: Kaplan, David L.; Professor and Chair; Chemical & Biological Engineering; Tufts University Medford Boston Ave Medford, Ma 02155 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 30-MAY-2004 Summary: (verbatim) Temporary scaffolds for bone formation must meet a challenging set of requirements both in vitro and in vivo. These requirements will vary depending on whether the scaffold is to be used in vivo or for subsequent surgical transplantation, or for direct incorporation into the body as a biomaterial. In either case, the scaffolds must be biocompatible, mechanically robust, and tailorable to sustain sufficient integrity during repair or bone formation, assemble to fill in all parts of the repair site in vivo to avoid voids that can result in scar tissue, and eventually degrade to nontoxic materials. Silks exhibit excellent mechanical properties and can be genetically tailored to control sequence, composition and structure/properties. This control is particularly important for peptide coupling to these surfaces for control of types, densities and homogeneity of cell adhesion and bone formation. The ability to precisely control the placement and density of these factors is an essential feature in order to fully understand relationships between these peptides and bone growth in vivo or in vitro. Our hypothesis for the proposed study is that silk based polymers, because of their unique properties, including biocompatibility, high mechanical strength yet flexible with excellent resistance to compression, and our ability to genetically tailor the structures, can provide important 2D and 3 D scaffolds for bone formation. We plan to address this hypothesis by exploring the relationships between silk structure, growth factor types and decoration, and cell responses related to bone formation. Silk proteins will be prepared, including regenerated silkworm silk and different spider silks using recombinant DNA techniques (with and without encoded RGD and cysteines). The different silk substrates will be fabricated into 2D and 3D matrices and subsequently decorated by chemical coupling bone related growth factors (PTH 1-34, BMP-2)at different concentrations and in different combinations. Complete chemical, physical,
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and morphological analyses of these materials (e.g., CD, FTIR, ESEM, AFM, Contact Angle, XPS, TEM)will be conducted before and after cell studies. Cell responses to these matrices will be characterized in vitro using osteoblasts and stem cells and the studies will include assays for adhesion and spreading, DNA synthesis, collagen synthesis, alkaline phosphatase, osteocalcin, bone and mineralization. Macrophage assays in vitro and osteogenic potential and inflammation assessments in rat models in vivo will provide preliminary assessments of bone formation. A rat femur model will be used to study the best candidate silk biomaterials. The outcome of these studies will be the identification of the most promising silk-decorated matrices (appropriate types, densities and combinations of growth factors, and adhesion sites) for bone formation. All phases of the planed studies are supported with Preliminary Data that to demonstrate both the feasibility of the proposed experimental directions and the potential for this type of silk scaffolding to provide a new family of matrices for bone formation and eventually orofacial repair. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ULTRASONIC TISSUE CHARACTERIZATION OF CARDIAC REMODELING Principal Investigator & Institution: Wickline, Samuel A.; Professor; Barnes-Jewish Hospital Ms 90-94-212 St. Louis, Mo 63110 Timing: Fiscal Year 2002; Project Start 01-AUG-1989; Project End 31-JUL-2003 Summary: (Adapted from Applicant's Abstract): Comprehensive delineation of the process of ventricular remodeling after myocardial infarction requires an integrated systems approach to elucidate relationships among molecular and cellular mechanisms, complex three dimensional ventricular kinematics and mechanical signals (e.g., shear strains), and altered tissue structures and material properties. Under the aegis of this grant, the applicants reported having demonstrated the utility of high resolution ultrasound tissue characterization methods for quantifying structural alterations and material properties involved in cardiac wound healing at the microscopic level. The applicants now seek to establish specific relationships between the physical properties of tissue, and the molecular and cellular mechanisms responsible for remodeling, and in particular to examine the potential salutary but relatively unappreciated role of angiogenesis as a critically component of remodeling. Accordingly, the applicants proposed to determine: 1. the role of angiogenesis during post-infarction cardiac remodeling and the effects of ACE inhibitors on angiogenesis in would healing; 2. molecular signaling mechanisms responsible for angiogenesis and scar tissue would healing that may depend on mechanical cues such as fiber strain, by comparing spatially and temporally matched parametric images of regional contractile function, tissue material properties, cell composition (e.g., myofibroblasts), and immunocytochemistry for selected signaling events such as expression of mitogen activated protein (MAP) kinase, integrins, tissue factor, vascular endothelial growth factor (VEGF) and its receptors (KDR/flk-1); and 3.the effects of selected therapies such as coronary reperfusion to evaluate the "open artery hypothesis," which potentially evokes enhanced angiogenesis, treatment with growth factors such as bFGF to enhance angiogenesis, and the role of integrins in cardiac remodeling, with the using beta3-deficient mice that exhibit impaired would healing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 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 scar tissue, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “scar tissue” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for scar tissue (hyperlinks lead to article summaries): •
Aging and scar tissue in human heart muscle. Author(s): Sasaki R, Yamagiwa H, Ichikawa S, Ito A, Yamagata S. Source: The Tohoku Journal of Experimental Medicine. 1975 July; 116(3): 253-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1179422
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Altered expression of mast cell chymase and tryptase and of c-Kit in human cutaneous scar tissue. Author(s): Hermes B, Feldmann-Boddeker I, Welker P, Algermissen B, Steckelings MU, Grabbe J, Henz BM. Source: The Journal of Investigative Dermatology. 2000 January; 114(1): 51-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10620115
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Biomaterials, scar tissue and ophthalmic microsurgery. Author(s): Constable IJ. Source: The Australian and New Zealand Journal of Surgery. 1989 October; 59(10): 7559. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2684119
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CD34 immunoreactivity distinguishes between scar tissue and residual tumor in reexcisional specimens of dermatofibrosarcoma protuberans. Author(s): Prieto VG, Reed JA, Shea CR. Source: Journal of Cutaneous Pathology. 1994 August; 21(4): 324-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7528229
3
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text 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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Collagen degradation in cultured keloid and hypertrophic scar tissue. Author(s): Milsom JP, Craig RD. Source: The British Journal of Dermatology. 1973 December; 89(6): 635-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4369871
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Collagen morphology in human skin and scar tissue: no adaptations in response to mechanical loading at joints. Author(s): van Zuijlen PP, Ruurda JJ, van Veen HA, van Marle J, van Trier AJ, Groenevelt F, Kreis RW, Middelkoop E. Source: Burns : Journal of the International Society for Burn Injuries. 2003 August; 29(5): 423-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12880721
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Comparison of self reported and observed length, width, and colour of scar tissue. Author(s): Siana JE, Rex S, Gottrup F. Source: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery / Nordisk Plastikkirurgisk Forening [and] Nordisk Klubb for Handkirurgi. 1992; 26(2): 229-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1411353
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Concentration of orally administered antimicrobial agent in burn scar tissue, granulation tissue, normal skin and serum. Author(s): Sawada Y, Ohkubo T, Kudo M, Sugawara K. Source: Burns : Journal of the International Society for Burn Injuries. 1993 December; 19(6): 529-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8292242
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Dentoalveolar growth inhibition induced by bone denudation on palates: a study of two isolated cleft palates with asymmetric scar tissue distribution. Author(s): Ishikawa H, Iwasaki H, Tsukada H, Chu S, Nakamura S, Yamamoto K. Source: The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association. 1999 September; 36(5): 450-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10499408
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Detection of myocardial scar tissue by M-mode echocardiography. Author(s): Rasmussen S, Corya BC, Feigenbaum H, Knoebel SB. Source: Circulation. 1978 February; 57(2): 230-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=618609
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•
Effect of injection of triamcinolone on type 1 procollagen and fibronectin in scar tissue. Author(s): Wangoo A, Martin N, Cook HT, Glenville B, Shaw RJ. Source: The British Journal of Surgery. 1996 August; 83(8): 1136-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8869328
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Elastic fibers in scar tissue. Author(s): Roten SV, Bhat S, Bhawan J. Source: Journal of Cutaneous Pathology. 1996 February; 23(1): 37-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8720985
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Elastic fibers in scar tissue: scanning and transmission electron microscopic studies. Author(s): Tsuji T, Sawabe M. Source: Journal of Cutaneous Pathology. 1987 April; 14(2): 106-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3597912
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Elastin fibers in scar tissue. Author(s): Bhangoo KS, Quinlivan JK, Connelly JR. Source: Plastic and Reconstructive Surgery. 1976 March; 57(3): 308-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=56760
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Enhanced expression of mRNA for insulin-like growth factor-1 in post-burn hypertrophic scar tissue and its fibrogenic role by dermal fibroblasts. Author(s): Ghahary A, Shen YJ, Nedelec B, Scott PG, Tredget EE. Source: Molecular and Cellular Biochemistry. 1995 July 5; 148(1): 25-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7476930
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Expression and localization of insulin-like growth factor-1 in normal and post-burn hypertrophic scar tissue in human. Author(s): Ghahary A, Shen YJ, Wang R, Scott PG, Tredget EE. Source: Molecular and Cellular Biochemistry. 1998 June; 183(1-2): 1-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9655173
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Fibroblasts from post-burn hypertrophic scar tissue synthesize less decorin than normal dermal fibroblasts. Author(s): Scott PG, Dodd CM, Ghahary A, Shen YJ, Tredget EE. Source: Clinical Science (London, England : 1979). 1998 May; 94(5): 541-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9682679
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Fibrogenic cytokines: the role of immune mediators in the development of scar tissue. Author(s): Kovacs EJ. Source: Immunology Today. 1991 January; 12(1): 17-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2015044
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Fibrosarcoma occurring in scar tissue. Author(s): Hennipman A, van Ginneken PJ. Source: Neth J Surg. 1985 June; 37(3): 93. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4022423
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Fiedler's myocarditis and heart block with scar tissue injury of septal nerves. Author(s): Hirsch EF, Willman VL, Kaiser GC, Cooper T. Source: Imj Ill Med J. 1967 February; 131(2): 170-9 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4382880
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Fine needle aspiration cytodiagnosis of endometriosis arising in scar tissue and in the caecum--case reports. Author(s): Srinivasan R, Nijhawan R, Das A, Walker R. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 1993; 4(6): 357-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8110975
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Histamine and 5-hydroxytryptamine in human scar tissue. Author(s): Nara T. Source: Annals of Plastic Surgery. 1985 March; 14(3): 244-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3994269
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Histometrical estimation of scar tissue in hypertrophied human heart muscle. Author(s): Sasaki R, Yamagiwa H, Ichikawa S, Ito A, Yamagata S. Source: The Tohoku Journal of Experimental Medicine. 1975 January; 115(1): 21-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=124100
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Hyaluronidase in the management of pain due to post-laminectomy scar tissue. Author(s): Borg PA, Krijnen HJ. Source: Pain. 1994 August; 58(2): 273-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7816496
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Immunolocalization of collagenase and tissue inhibitor of metalloproteinases (TIMP) in hypertrophic scar tissue. Author(s): Hembry RM, Ehrlich HP. Source: The British Journal of Dermatology. 1986 October; 115(4): 409-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3022783
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Impact of viability, ischemia, scar tissue, and revascularization on outcome after aborted sudden death. Author(s): van der Burg AE, Bax JJ, Boersma E, Pauwels EK, van der Wall EE, Schalij MJ. Source: Circulation. 2003 October 21; 108(16): 1954-9. Epub 2003 Oct 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14530201
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Incomplete healing (scar tissue) after periapical surgery--radiographic findings 8 to 12 years after treatment. Author(s): Molven O, Halse A, Grung B. Source: Journal of Endodontics. 1996 May; 22(5): 264-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8632141
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Intermolecular cross-linking of collagen in human and guinea pig scar tissue. Author(s): Forrest L, Jackson DS. Source: Biochimica Et Biophysica Acta. 1971 March 23; 229(3): 681-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4929150
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Intramammary scar tissue: a mimic of the mammographic appearance of carcinoma. Author(s): Sickles EA, Herzog KA. Source: Ajr. American Journal of Roentgenology. 1980 August; 135(2): 349-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6773341
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Iodine iontophoresis in reducing scar tissue. Author(s): Tannenbaum M. Source: Physical Therapy. 1980 June; 60(6): 792. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7375511
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Localization of prolidase gene expression in scar tissue using in situ hybridization. Author(s): Senboshi Y, Oono T, Arata J. Source: Journal of Dermatological Science. 1996 June; 12(2): 163-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8814549
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Matrix metalloproteinases: a role in the contraction of vitreo-retinal scar tissue. Author(s): Sheridan CM, Occleston NL, Hiscott P, Kon CH, Khaw PT, Grierson I. Source: American Journal of Pathology. 2001 October; 159(4): 1555-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11583981
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Mechanical analysis of hypertrophic scar tissue: structural basis for apparent increased rigidity. Author(s): Dunn MG, Silver FH, Swann DA. Source: The Journal of Investigative Dermatology. 1985 January; 84(1): 9-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3965583
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Nerves and blood-vessels in pulp wound scar tissue. Author(s): Masterton JB. Source: Dent Pract Dent Rec. 1967 January; 17(5): 164-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4959377
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Neuropeptide-containing nerves in painful hypertrophic human scar tissue. Author(s): Crowe R, Parkhouse N, McGrouther D, Burnstock G. Source: The British Journal of Dermatology. 1994 April; 130(4): 444-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7514432
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Nitric oxide synthase expression and nitric oxide production are reduced in hypertrophic scar tissue and fibroblasts. Author(s): Wang R, Ghahary A, Shen YJ, Scott PG, Tredget EE. Source: The Journal of Investigative Dermatology. 1997 April; 108(4): 438-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9077471
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Osseous metaplasia: a late pathological finding within the scar tissue formed following spinal injury. Author(s): Smith CM, Jefferson AA, Timperley WR, Watson N. Source: Paraplegia. 1983 December; 21(6): 380-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6420760
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Penile implant success in patients with corporal fibrosis using multiple incisions and minimal scar tissue excision. Author(s): Herschorn S. Source: Urology. 2000 February; 55(2): 299-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10688099
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Penile implant success in patients with corporal fibrosis using multiple incisions and minimal scar tissue excision. Author(s): Rajpurkar A, Li H, Dhabuwala CB. Source: Urology. 1999 July; 54(1): 145-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10414742
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Pharmacological control of surgical scar tissue. Author(s): Peacock EE Jr. Source: The American Surgeon. 1978 November; 44(11): 693-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=367235
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Plasmacytoma occurring in scar tissue. Author(s): Cotter M, Enright H. Source: British Journal of Haematology. 2003 June; 121(5): 680. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12780781
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Possible modification of scar tissue by biochemical methods. Author(s): Jackson DS. Source: Equine Veterinary Journal. 1979 April; 11(2): 102-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=383477
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Postoperative nerve root displacement and scar tissue. A prospective cohort study with contrast-enhanced MR imaging one year after microdiscectomy. Author(s): Nygaard OP, Jacobsen EA, Solberg T, Kloster R, Dullerud R. Source: Acta Radiologica (Stockholm, Sweden : 1987). 1999 November; 40(6): 598-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10598846
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Pretibial myxedema localized to scar tissue. Author(s): Wright AL, Buxton PK, Menzies D. Source: International Journal of Dermatology. 1990 January-February; 29(1): 54-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2329028
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Pseudoxanthoma elasticum. An ultrastructural study of scar tissue. Author(s): Danielsen L, Kobayasi T. Source: Acta Dermato-Venereologica. 1974; 54(2): 121-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4133016
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Radiation protection adjacent to scar tissue. Author(s): Hulbert M. Source: The British Journal of Radiology. 1968 March; 41(483): 234. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5641964
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Reduced collagenase gene expression in fibroblasts from hypertrophic scar tissue. Author(s): Arakawa M, Hatamochi A, Mori Y, Mori K, Ueki H, Moriguchi T. Source: The British Journal of Dermatology. 1996 May; 134(5): 863-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8736326
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Repair of huge midline hernias in scar tissue. Author(s): Chaimoff C, Dintsman M. Source: American Journal of Surgery. 1973 June; 125(6): 767-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4710203
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Restoration of curved earlobe configuration with scar tissue advancement flap combined with second-intention wound healing. Author(s): Field LM. Source: J Dermatol Surg Oncol. 1992 October; 18(10): 867-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1430540
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Revascularization of myocardial scar tissue following prostaglandin E1-therapy in patients with ischemic heart disease. Author(s): Mehrabi MR, Serbecic N, Tamaddon F, Huber K, Pacher R, Grimm M, Glogar HD. Source: Pathology, Research and Practice. 2003; 199(3): 129-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812313
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Scanning electron microscopy of normal human scar tissue and keloids. Author(s): Hunter JA, Finlay JB. Source: The British Journal of Surgery. 1976 October; 63(10): 826-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=990706
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Scar tissue associated with the apices of pulpless teeth prior to endodontic therapy. Author(s): Patterson SS, Hillis PD. Source: Oral Surg Oral Med Oral Pathol. 1972 March; 33(3): 450-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4501173
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Scar tissue distribution on palates and its relation to maxillary dental arch form. Author(s): Ishikawa H, Nakamura S, Misaki K, Kudoh M, Fukuda H, Yoshida S. Source: The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association. 1998 July; 35(4): 313-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9684769
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Scar tissue flaps for the correction of postimplant breast rippling. Author(s): Massiha H. Source: Annals of Plastic Surgery. 2002 May; 48(5): 505-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11981190
Studies
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Scar tissue grafting. Author(s): Black PW. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1998 August; 24(8): 935-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9723070
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Scar tissue grafting. Author(s): Field LM. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1998 April; 24(4): 491-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9568210
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Sequence of melanocyte migration into human scar tissue. Author(s): Dressler J, Busuttil A, Koch R, Harrison DJ. Source: International Journal of Legal Medicine. 2001 October; 115(2): 61-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11724430
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Studies on human scar tissue proteoglycans. Author(s): Swann DA, Garg HG, Jung W, Hermann H. Source: The Journal of Investigative Dermatology. 1985 June; 84(6): 527-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3998502
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Sulfate composition of dermatan sulfate from scar tissue. Author(s): Longas MO, Garg HG. Source: Carbohydrate Research. 1992 December 31; 237: 319-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1294295
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Symposium on biological control of scar tissue. Author(s): Peacock EE Jr. Source: Plastic and Reconstructive Surgery. 1968 January; 41(1): 8-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5639214
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The action of fluocinolone acetonide upon scar tissue formation. Author(s): Weaver RG, Berliner DL. Source: The Journal of Urology. 1970 October; 104(4): 591-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4920332
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The healing of wounds of the dental pulp. An investigation of the nature of the scar tissue and of the phenomena leading to its formation. Author(s): Masterton JB. Source: Dent Pract Dent Rec. 1966 May; 16(9): 325-39. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4956604
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The recurrence of pain following operation for herniated lumbar disc: fresh herniation or extradural scar tissue? Author(s): Paus B, Skalpe IO. Source: International Orthopaedics. 1979; 3(2): 133-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=548495
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The treatment of vitreoretinal scar tissue. Author(s): Leaver PK. Source: Eye (London, England). 1994; 8 ( Pt 2): 210-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7958024
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Trichilemmal horn on burn scar tissue. Author(s): Kudo M, Uchigasaki S, Baba S, Suzuki H. Source: European Journal of Dermatology : Ejd. 2002 January-February; 12(1): 77-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11809603
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Tumor recurrence in the abdominal wall scar tissue after large-bowel cancer surgery. Author(s): Hughes ES, McDermott FT, Polglase AL, Johnson WR. Source: Diseases of the Colon and Rectum. 1983 September; 26(9): 571-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6223795
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Two types of translucent membrane of caesarean section scar tissue. Author(s): Fukuda M, Fukuda K, Shimizu T, Natsuyama E, Mochizuki M. Source: Lancet. 1992 January 25; 339(8787): 254-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1346222
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Using computed tomography/discography and enhanced magnetic resonance imaging to distinguish between scar tissue and recurrent lumbar disc herniation. Author(s): Bernard TN Jr. Source: Spine. 1994 December 15; 19(24): 2826-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7899986
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Visual internal urethrotome for incision of dense perirenal scar tissue during percutaneous stone removal. Author(s): Woodside JR, Stevens GF, Friedman HS. Source: Urology. 1987 September; 30(3): 272. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3629773
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CHAPTER 2. NUTRITION AND SCAR TISSUE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and scar tissue.
Finding Nutrition Studies on Scar Tissue 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.4 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 “scar tissue” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4
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 “scar tissue” (or a synonym): •
Glycosaminoglycan composition of uninjured skin and of scar tissue in fetal, newborn and adult sheep. Author(s): Department of Chemical Pathology, St. Vincent's Hospital, Melbourne, Australia. Source: Knight, K R Horne, R S Lepore, D A Kumta, S Ritz, M Hurley, J V O'Brien, B M Res-Exp-Med-(Berl). 1994; 194(2): 119-27 0300-9130
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Peripheral nerve injury fails to induce growth of lesioned ascending dorsal column axons into spinal cord scar tissue expressing the axon repellent Semaphorin3A. Author(s): Graduate School Neurosciences Amsterdam, Netherlands Institute for Brain Research, Amsterdam, The Netherlands. Source: Pasterkamp, R J Anderson, P N Verhaagen, J Eur-J-Neurosci. 2001 February; 13(3): 457-71 0953-816X
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
Nutrition
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to scar tissue; 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 Ascorbic Acid Source: Integrative Medicine Communications; www.drkoop.com Vitamin C (Ascorbic Acid) Source: Integrative Medicine Communications; www.drkoop.com
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CHAPTER 3. PATENTS ON SCAR TISSUE 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.5 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 “scar tissue” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on scar tissue, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Scar Tissue By performing a patent search focusing on scar tissue, 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 5Adapted
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 scar tissue: •
1, 1-disubstituted ethylene adhesive compositions containing polydimethylsiloxane Inventor(s): Narang; Upvan (Raleigh, NC) Assignee(s): Closure Medical Corporation (raleigh, Nc) Patent Number: 6,488,944 Date filed: December 22, 2000 Abstract: An adhesive composition that contains cyanoacrylate monomers and cyclic or alkyl- or phenyl-terminated linear polydimethylsiloxane is particularly useful in applications requiring flexibility and elasticity. A method of removing, reducing or preventing scar tissue including applying an adhesive composition that contains cyanoacrylate monomer and cyclic or alkyl- or phenyl-terminated linear polydimethylsiloxane. Excerpt(s): The invention relates to monomer and polymer adhesive and sealant compositions, and to their production and use for industrial and medical applications. Monomer and polymer adhesives are used in both industrial (including household) and medical applications. Included among these adhesives are the 1,1-disubstituted ethylene monomers and polymers, such as the.alpha.-cyanoacrylates. Since the discovery of the adhesive properties of such monomers and polymers, they have found wide use due to the speed with which they cure, the strength of the resulting bond formed, and their relative ease of use. These characteristics have made the.alpha.-cyanoacrylate adhesives the primary choice for numerous applications such as bonding plastics, rubbers, glass, metals, wood, and, more recently, biological tissues. It is known that monomeric forms of.alpha.-cyanoacrylates are extremely reactive, polymerizing rapidly in the presence of even minute amounts of an initiator, including moisture present in the air or on moist surfaces such as animal (including human) tissue. Monomers of.alpha.-cyanoacrylates are anionically polymerizable or free radical polymerizable, or polymerizable by zwitterions or ion pairs to form polymers. Once polymerization has been initiated, the cure rate can be very rapid. Web site: http://www.delphion.com/details?pn=US06488944__
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Anterior vertebral protection method and device Inventor(s): Shelokov; Alexis P. (3308 Greenbrier Dr., Dallas, TX 75225-4817) Assignee(s): None Reported Patent Number: 6,475,219 Date filed: June 7, 2001 Abstract: A flexible shield or apron formed of a biocompatible material is placed between adjacent vertebral bodies and the vessels and body structure anterior of the spine subsequent to the performance of an anterior spinal surgical procedure. The apron is secured to adjacent vertebral bodies by conventional bone fasteners and is provided with a pleat to allow stretching as a consequence of movement between vertebral bodies to which the apron is connected. The apron may be retracted together with vessels it is shielding during a revision surgical procedure while minimizing risks associated with the formation of adhesions or scar tissue.
Patents 39
Excerpt(s): Spinal disorders requiring surgical procedures are well known. The lumbar region of the human anatomy, for example, is a frequent site of spinal disorders which may be corrected by surgical procedures carried out anteriorly of the lumbar vertebrae including, for example, surgical procedures involving disc removal and/or replacement. In anterior spinal surgical procedures, the initial surgery is through an unscarred and substantially clear path to the surgical site. In revision surgery, however, the path to the surgical site has been scarred and may present certain dangers. With the present technology in spinal surgeries being focused on anterior insertion of intervertebral prostheses, and other anterior surgical procedures, there continue to be concerns about anterior dislocation of prostheses and vertebral structures as well as potential injury to the significant blood vessels located in proximity to the spine. Accordingly, it has been determined that a need exists for a method of protecting against potential vascular injury in the vicinity of the spine as a consequence of anterior surgical procedures. Moreover, a need has, thus, also developed for a device which may be conveniently interposed the spinal column and, particularly, major blood vessels such as the aorta and the vena cava, so that the vessels are not normally subject to injury as a consequence of a surgical procedure and/or are not subject to the development of adhesions or tissue which may produce complications during revision surgery. It is to these ends that the present invention has been developed. Web site: http://www.delphion.com/details?pn=US06475219__ •
Apparatus and methods for stimulating revascularization and/or tissue growth Inventor(s): Ream; John H. (San Jose, CA), Saadat; Vahid (Redwood Shores, CA) Assignee(s): Angiotrax, Inc. (sunnyvale, Ca) Patent Number: 6,120,520 Date filed: March 17, 1999 Abstract: Apparatus and methods for stimulating revascularization and tissue growth are provided using an apparatus having a directable end region carrying a tissue piercing end effector. The apparatus optionally includes electrodes for depositing RF energy to form a controlled degree of scar tissue formation, means for delivering a controlled amount of a bioactive agent at the treatment site, or both. Excerpt(s): The present invention relates to apparatus and methods for stimulating revascularization and tissue growth in an interior region of an organ or vessel, such as the heart. More particularly, the present invention provides a device that enables a clinician to stimulate a healing response, or deposit a bioactive agent at, a series of sites within in interior region of an organ or vessel to stimulate revascularization. A leading cause of death in the United States today is coronary artery disease, in which atherosclerotic plaque causes blockages in the coronary arteries, resulting in ischemia of the heart (i.e., inadequate blood flow to the myocardium). The disease manifests itself as chest pain or angina. In 1996, approximately 7 million people suffered from angina in the United States. Coronary artery bypass grafting (CABG), in which the patient's chest is surgically opened and an obstructed artery replaced with a native artery harvested elsewhere, has been the conventional treatment for coronary artery disease for the last thirty years. Such surgery creates significant trauma to the patient, requires long recuperation times, and causes a great deal of morbidity and mortality. In addition, experience has shown that the graft becomes obstructed with time, requiring further surgery.
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Web site: http://www.delphion.com/details?pn=US06120520__ •
Device for the treatment of infarcted tissue and method of treating infarcted tissue Inventor(s): Laufer; Michael D. (Menlo Park, CA) Assignee(s): Hearten Medical, Inc. (tustin, Ca) Patent Number: 6,071,303 Date filed: December 8, 1996 Abstract: A device and method for treating myocardial infarction by selectively heating the infarct scar to reduce the size of the scar tissue area by shrinking the tissue in the heart, stiffen the floppy portion of the scar tissue, reduce the ventricular systolic wall tension, and increase the overall pumping efficiency of the infarcted heart by eliminating a ventricular aneurism, if present. The heat can be applied to or induced in the infarct scar. Force can also be applied to assist the reduction of the size of the scar area using the device of the present invention which has a heating element and a scissorlike clamp for squeezing two portions of the infarct scar together. Excerpt(s): The present invention is related generally to the modification of heart tissue for the treatment of myocardial infarction. As is well known, the heart has four chambers for receiving and pumping blood to various parts of the body. During normal operation of the heart, oxygen-poor blood returning from the body enters the right atrium. The right atrium fills with blood and eventually contracts to expel the blood through the tricuspid valve to the right ventricle. Contraction of the right ventricle ejects the blood in a pulse-like manner into the pulmonary artery and each lung. The oxygenated blood leaves the lungs through the pulmonary veins and fills the left atrium. The left atrium fills with blood and eventually contracts to expel the blood through the mitral valve to the left ventricle. Contraction of the left ventricle forces blood through the aorta to eventually deliver the oxygenated blood to the rest of the body. Myocardial infarction (i.e., heart attack) can result in congestive heart failure. Congestive heart failure is a condition wherein the heart can not pump enough blood. When patients have a heart attack, part of the circulation to the heart wall muscle is lost usually do to a blood clot which dislodges from a larger artery and obstructs a coronary artery. If the clot is not dissolved within about 3 to 4 hours, the muscle which lost its blood supply necroses and subsequently becomes a scar. The scarred muscle is not contractile, therefore it does not contribute, to the pumping ability of the heart. In addition, the scarred muscle is elastic (i.e., floppy) which further reduces the efficiency of the heart because a portion of the force created by the remaining healthy muscle bulges out the scarred tissue (i.e., ventricular aneurism) instead of pumping the blood out of the heart. Web site: http://www.delphion.com/details?pn=US06071303__
•
Facilitation of repair of neural injury with CM101/GBS toxin Inventor(s): Hellerqvist; Carl G. (Brentwood, TN), Wamil; Artur W. (Nashville, TN), Wamil; Barbara D. (Nashville, TN) Assignee(s): Vanderbilt University (nashville, Tn) Patent Number: 6,476,001 Date filed: July 29, 1999
Patents 41
Abstract: Neural injury may be advantageously treated with CM101, a polysaccharide toxin isolated from Group B.beta.-hemolytic Streptococcus bacteria. CM1O1 treatment aids in the re-establishment of neuronal connectivity, at least partially inhibits scar formation, and increases the probability of survival during the critical period following injury to the central nervous system. Preexisting neural injuries having scar tissue are ameliorated by surgical excision of the scar tissue in conjunction with administration of CM101. Excerpt(s): This invention relates to therapy for enhancing repair of neural injury in the central nervous system or the peripheral nervous system. Neural injury caused by physical trauma, ischemia, or disease can result in profound disability or death. Such disabilities, which may be physical and/or mental, include loss of movement, impaired sensory perception, loss of cognitive functions, seizures, and emotional and personality disorders. Given the incidence of death and the prevalence and possible severity of survivors' disabilities, neural injury takes a heavy toll on individuals and society. Accordingly, there is a need for treatments which facilitate the repair of damaged nerves and neuronal pathways. At present, there is no effective treatment for central nervous system (CNS) injuries. Brain physical trauma, spinal cord compression or transection, ischemia, or surgery cause hypoxia which initiates a cascade of molecular events leading to neural injury (Liu, X. Z. et al., Neuronal and glial apoptosis after traumatic spinal cord injury, J. Neurosci., 17:5395-5406 (1997); Olsson, Y. et al., Release of endogenous neurochemicals may increase vascular permeability, induce edema and influence cell changes in trauma to the spinal cord, Progress in Brain Res., 91:197-203 (1992); Crowe, M. J. et al., Apoptosis and delayed degeneration after spinal cord injury in rats and monkeys, Nature Med., 3:73-76 (1997)). Despite receiving medical attention, many patients die in the first few days following a serious CNS injury. For those patients that survive their injuries, prognosis depends on the ability of the remaining neurons to adapt new functions because, with current technology, neuronal connectivity is rarely restored. Because neural adaptation is slow and frequently incomplete, the potential benefit of a treatment which facilitates neural repair and the re-establishment of neuronal connectivity would be tremendous as would the benefit provided by a treatment that reduces the probability that a patient will die during the critical postinjury period. Web site: http://www.delphion.com/details?pn=US06476001__ •
Hernia mesh Inventor(s): Antikainen; Teuvo (Jyvaskyla, FI), Paasimaa; Senja (Tampere, FI), Tormala; Pertti (Tampere, FI) Assignee(s): Bionx Implants OY (tampere, Fi) Patent Number: 6,319,264 Date filed: April 3, 1998 Abstract: According to the present invention, a flexible, fibrous hernia mesh is provided, which is intended to be implanted to close hernia defects. The mesh has at least two functional components or layers: (1) a rapidly degradable first layer and (2) a more slowly degradable (with respect to the first layer) second layer. Using the fibrous mesh of this invention, the hernia defect can be closed so that a) the second layer supports the area until the scar tissue is strong enough (around 6 months), to prevent recurrent hernia formation, b) while the more rapid degradation of the first layer induces scar tissue formation due to inflammatory reaction, and c) the second layer isolates the first
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layer from the abdominal cavity, preventing tissue to tissue adhesion onto the intestines. The mesh is placed on the uncovered fascia area with its more rapidly absorbable side (the first layer) towards the fascia. Excerpt(s): The present invention relates to a biologically active hernia mesh, and methods of its manufacture. Traditionally, a hernia bulging through any region of the abdominal wall would be repaired by an open hernioplasty and based on a method where the hernia defect becomes closed and reinforced by adjacent tissues. In cases of very large or recurrent hernias, meshes of some nonabsorbable synthetic material have been used for repair. During a period of 3 to 6 months following the hernia operation, the repaired site gradually gathers scar tissue which builds up to strengthen the region. The new trends for hernia repair include mini-invasive techniques, in which the hernia defect is closed by a piece of non-absorbable mesh with minimal tension. The follow-up times thus far are short for such procedures, but it seems that recurrence rates of 1% or below could be expected. Also, the general recovery time has become shorter, and the patients are usually encouraged to begin their normal activities with no restrictions within a week after the operation. Web site: http://www.delphion.com/details?pn=US06319264__ •
Human tissue inhibitor of metalloproteinase- 4 Inventor(s): Greene; John M. (Gaithersburg, MD), Rosen; Craig A. (Laytonsville, MD) Assignee(s): Human Genome Sciences, Inc. (rockville, Md) Patent Number: 6,300,310 Date filed: September 19, 1997 Abstract: A human tissue inhibitor of metalloproteinases-4 polypeptide and DNA (RNA) encoding such polypeptide and a procedure for producing such polypeptide by recombinant techniques. Also disclosed are methods for utilizing such polypeptide for the treatment of diseases, including arthritis and cancer. Antagonists againts such polypeptides and their use as a therapeutic to resorb scar tissue are also disclosed. Diagnostic assays for detecting levels of human TIMP-4 protrin and mutations in human TIMP-4 nucleic acid sequence are also disclosed. Excerpt(s): This invention relates to newly identified polynucleotides, polypeptides encoded by such polynucleotides, the use of such polynucleotides and polypeptides, as well as the production of such polynucleotides and polypeptides. More particularly, the polypeptides of the present invention are human tissue inhibitor of metalloproteinase-4 polypeptides, hereinafter referred to as "human TIMP-4". The invention also relates to inhibiting the action of such polypeptides. The extracellular matrix is a complex structure that contains collagen, proteoglycan, glycosaminoglycan, glycoproteins (fibronectin, chondronectin, laminin) and in some tissues, elastin (Hay, E. D., J. Cell Biol., 91:205-223 (1981)). Matrix metalloproteinases (MMP's) constitute the major group of zinc-binding endopeptidases that degrade extracellular matrix proteins, for example connective tissue, collagen and gelatin, during remodeling of connective tissue during normal physiological and some pathological processes. The unrestrained activity of MMP's may result in extensive tissue damage, and these enzymes have been implicated in a variety of disease processes, including tumor cell invasion, tumor angiogenesis and rheumatoid arthritis (Okada, Y., et al., J. Biol. Chem., 261:14245-14255 (1986)). The MMP's are secreted from cells as inactive zymogens and their activity in the
Patents 43
extracellular environment is regulated by various activators and inhibitors (Matrisian, L. M., Trends Genet., 6:121-125 (1990)). Web site: http://www.delphion.com/details?pn=US06300310__ •
Implantable prosthetic device Inventor(s): Ledergerber; Walter J. (29502 Anna Maria, Laguna Niguel, CA 92677) Assignee(s): None Reported Patent Number: 6,187,043 Date filed: October 21, 1997 Abstract: An implant and coverings for an implant for use in the human body are disclosed. Coverings for implants are constructed to present a biocompatible surface to the body and to provide a textured surface which serves to disorganize scar tissue which forms around the implant. Filaments of expanded PTFEe are attached to a stretch fabric backing in a loose weave configuration. Silicone molded in geometric patterns may be employed to present a textured surface. Compressive structures may be beneficially used on the surface of the implant or in the interior of the implant. Foam is one such compressive structure. Hexagonally shaped compressive cells containing fluid, gas, gel or foam are adapted to receive an insert which contains an outer biocompatible coating. A valve or port is provided to communicate between the cell and the body. Expansion means may be provided to expand the implant in a desired direction. Excerpt(s): This invention relates to implantable prosthetic devices and especially to prosthetic devices for reconstruction or augmentation of the female breast. Implantable prosthetic devices have been used in numerous locations in the body. The most common use has been for restoring or improving upon normal body contour or augmenting as well as reconstructing the female breast. The most common breast prosthesis is similar to that disclosed in U.S. Pat. No. 3,293,663 to Cronin, in which there is a flexible elastomeric container, typically silicone, which is filled with a soft gel, typically silicone gel or a saline solution or a combination of both. It is known that when a prosthetic device, including the Cronin type device, is implanted in the body, fibrous scar tissue encapsulates the device. This encapsulation leads to a problem of spherical scar contracture. As the scar tissue surrounds the prosthetic device it tends to contract, thereby causing the gel filled sac to assume a minimum surface area configuration or spherical configuration. The problem of spherical scar contracture causes the breast implant to change from a shape approximating that of a natural human breast to that of a tennis ball. Web site: http://www.delphion.com/details?pn=US06187043__
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Method and apparatus for radiation treatment of a desired area in the vascular system of a patient Inventor(s): Bonnoitt, Jr.; George K. (Decatur, GA), Crocker; Ian R. (Stone Mountain, GA), Halpern; David S. (Alpharetta, GA), Hillstead; Richard A. (Duluth, GA), Larsen; Charles E. (Cumming, GA), Meloul; Raphael F. (Atlanta, GA), Rosen; Jonathan J. (Alpharetta, GA), Waksman; Ron (Rockville, MD), Weldon; Thomas D. (Gainesville, GA) Assignee(s): Emory University (atlanta, Ga), Novoste Corporation (norcross, Ga) Patent Number: 6,306,074 Date filed: May 4, 1999 Abstract: Apparatus and method are described for delivery of a treating element, such as a radiation source, through a catheter to a desired site in the intraluminal passageways of a patient, such as a coronary artery, for inhibiting the formation of scar tissue such as may occur in restenosis following balloon angioplasty. The apparatus includes an elongated flexible catheter tube having proximal and distal end portions, with a lumen extending therebetween, and a diameter sufficiently small for insertion in to a patient's intraluminal passageways. One or more treating elements, such as a capsule or pellet containing radioactive material, is positionable within the lumen and movable between the proximal and distal end portions under the force of liquid flowing through the lumen. A method for using such apparatus, including a method for using such apparatus simultaneously with a balloon angioplasty procedure, is disclosed. Excerpt(s): The present invention relates generally to the delivery of treating elements by a catheter to a selected location within the intraluminal passageways, either vascular or non-vascular, of a patient. Intraluminal passageways are defined herein as all lumens, passageways, conduits, ducts, channels, canals, vessels, and cavities within the human body. More particularly, the present invention relates to method and apparatus for the delivery of a treating element, such as a radiation source, through a catheter to a desired site, such as a coronary artery, for inhibiting wound healing response, such as restenosis following balloon angioplasty, and also for inhibiting other occurrences of cell migration, proliferation, and enlargement, including that of cancerous cells, which may not result from wound healing response. It is known that the human body's healing response to wounds typically includes the formation of what is commonly called scar tissue. This response also occurs within the vascular system of a person following injury to a blood vessel. An injury that provokes the formation of scar tissue may occur in various locations within the vascular system, such as in the carotid artery or in coronary bypasses, or in various ways, such as trauma from surgical or diagnostic procedures. Just as with lumens within the vascular system, non-vascular intraluminal passageways within a human patient can experience stenosis. Procedures, such as those described below, are performed for eliminating the areas of narrowing in non-vascular body lumens, and the walls of the treated lumens most likely are injured during the process. As a result of the injury, the human body begins its healing response and an overgrowth of tissue due to increased cell proliferation renarrows the lumens. Web site: http://www.delphion.com/details?pn=US06306074__
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Method for objectively assessing the severity of scars Inventor(s): Marshall; George Evelyn (Glasgow, GB) Assignee(s): Remes Biomedical Limited (glasgow, Gb) Patent Number: 6,232,126 Date filed: January 11, 2000 Abstract: A method for objectively assessing the severity of scars, which method comprises:(i) classifying cell nuclei in scar tissue into different types of nuclei such that one of the types is elongated nuclei which is different from other nuclei in that the elongated nuclei has a ratio of length to breadth which exceeds a predetermined number;(ii) measuring the angle that the longest axis of the elongated nuclei makes with the surface of tissue surrounding the scar; and(iii) ranking the severity of the scar on the basis of the degree of alignment of the elongated nuclei with the surface of the tissue surrounding the scar. Excerpt(s): This invention relates to a method for objectively assessing the severity of scars. The scars may be in skin or other tissues such for example as blood vessels, kidneys, liver or other tissue organs. Scarring is clearly undesirable, both from an aesthetic point of view where the scaring is visible, and from a loss of mobility point of view. Scarring that arises from trauma, especially from burns, can cause serious loss of mobility such for example as to the opening and closing of a person's mouth, eyelids and use of limbs. Several potential therapeutic agents have been developed in recent years but their general availability to physicians has been delayed by a lack of an objective assessment as to their effectiveness. Originally, attempts to assess the severity of scars in skin was by visual inspection of the skin surface. These attempts proved unreliable since they are influenced by a wide variety of factors such for example as the brightness of ambient lighting, and the angle at which light strikes the skin. The visual inspection of the skin surface has been replaced with visual assessment of histological sections of scar tissue by a number of trained histologists, who grade the scarring as mild, moderate, severe or very severe. Even this method of visual assessment by a number of trained histologists is not satisfactory as the grading is not reproducible, and the results obtained from the histologists lack consistency. Web site: http://www.delphion.com/details?pn=US06232126__
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Method for preventing scar tissue formation Inventor(s): Hannafin; Jo A. (Greenwich, CT), Williams; Riley J. (New York, NY) Assignee(s): New York Society for the Relief of the Ruptured and Crippled Maintaining (new York, Ny) Patent Number: 6,060,474 Date filed: November 5, 1998 Abstract: Disclosed herein are methods for reducing or preventing scar tissue formation by administering an antifibrotic amount of a fluoroquinolone. Also disclosed are means for inhibiting the activity of fibroblast cells, including their proliferation, metabolism, and invasion into tissue. The invention further contemplates methods and compositions for the delivery of a fluoroquinolone to prevent or treat scar tissue formation, including oral and intravenous delivery means.
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Excerpt(s): This invention relates to methods for inhibiting fibrosis, fibroblast proliferation, matrix synthesis, joint capsule contracture, collagen synthesis, fibroblast proteoglycan synthesis, promoting fibroblast protease synthesis, treating adhesive capsulitis (frozen shoulder), and for treating wounds and attendant complications, such as scar formation and surgical adhesions, using fluoroquinolone antibiotic agents. Fibroblast cells are particularly important in the wound healing process and in the aging of the skin. Hyperplasia and proliferation of soft tissue fibroblasts are vital to normal healing mechanisms. However, in some cases, an exaggerated healing response can result in the production of copious amounts of healing tissue (ground substance), also termed scar tissue. For example, various traumatic incidents, such as bums, surgery, infection and wounds are often characterized by the erratic accumulation of fibrous tissue rich in collagen and having increased proteoglycan ("PG") content. In addition to the replacement of normal tissue which has been damaged or destroyed, excessive and disfiguring deposits of collagen and new tissue sometimes form during the healing process. The excess collagen deposition has been attributed to a disturbance in the balance between matrix synthesis and matrix degradation, resulting from increased fibroblast metabolism and proliferation. Thus, therapies inhibiting fibroblast metabolism and proliferation, deposition of collagen, and formation of new tissue resulting therefrom, would be useful for treating scar tissue formation. Surgical adhesions are attachments of organs or tissues to each other through scar tissue formation; such adhesions can cause severe clinical problems. The formation of some scar tissue after surgery or tissue injury is normal. In some cases, however, the scar tissue overgrows the region of injury and creates surgical adhesions, which tend to restrict the normal mobility and function of affected body parts. In particular, fibroblast proliferation and matrix synthesis is increased locally following such soft tissue injury. Adhesions then form when the body attempts to repair tissue by inducing a healing response. For example, this healing process can occur between two or more otherwise healthy separate structures (such as between loops of bowel following abdominal surgery). Alternately, following local trauma to a peripheral nerve, fibrous adhesions can form, resulting in severe pain during normal movement. Current measures for treating adhesions include localized surgical implants containing an amount of a compound that must remain present at the wound site to provide scar-reducing benefit. However, implants may induce a foreign body reaction in the host subject, and predispose the implantation site to infection. Thus, it would be beneficial to systemically administer a scar-reducing composition since this would allow greater control with respect to dosage and frequency of administration, and is non-invasive. Web site: http://www.delphion.com/details?pn=US06060474__ •
Method for using acoustic shock waves in the treatment of medical conditions Inventor(s): Ogden; John A. (Atlanta, GA), Warlick; John F. (Woodstock, GA) Assignee(s): Healthtronics Inc. (marietta, Ga) Patent Number: 6,368,292 Date filed: December 22, 1999 Abstract: This invention relates to methods for medical treatment of pathological conditions. More particularly, the invention relates to methods for using acoustic shock waves to treat a variety of pathological conditions such as plantar warts, deep bone bruises, prostate cancer, benign prostatic hypertrophy, urinary incontinence, and spinal
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cord injuries, including the reduction or removal of scar tissue to aid in spinal cord regrowth. Excerpt(s): This invention relates to methods for medical treatment of pathological conditions. More particularly, the invention relates to methods for using acoustic shock waves to treat a variety of pathological conditions. The use of energy wave forms for medical treatment of various bone pathologies is known in the art. For example, U.S. Pat. No. 4,530,360, issued on Jul. 23, 1985 to Duarte, teaches the use of ultrasound transducers, in direct contact with the skin of the patient, for transmitting ultrasound pulses to the site of the bone defect. Duarte teaches a nominal ultrasound frequency of 1.3 to 2.0 MHz, a pulse width range of 10 to 2000 microseconds, and a pulse rate varying between 100 and 1000 Hz Duarte maintains the ultrasound power level below 100 milliwatts per square centimeter, with treatments lasting no more than 20 minutes per day. Other devices utilize piezoelectric materials fastened adjacent to the pathological site on the patient's limb to produce ultrasonic energy in the vicinity of the bone pathology for administering therapy. Examples of such prior art references include U.S. Pat. Nos. 5,211,160, 5,259,384, and 5,309,898. Clinicians have also utilized shock waves to treat various pathologies. Early approaches of using shock waves for medical treatment required immersing the patient in water and directing a shock wave, generated by an underwater spark discharge, at a solid site to be treated, such as a bone or kidney stone. When the shock wave hits the solid site, a liberation of energy from the change of acoustic impedance from water to the solid site produces pressure in the immediate vicinity of the site. For example, U.S. Pat. No. 4,905,671 to Senge et al., issued on Mar. 6, 1990, teaches a method applying acoustic shock waves to induce bone formation. Senge et al. teaches that the acoustical sound waves utilized by Duarte (and similar references) for treatment of bone have a generally damped sinusoidal wave form centered on ambient pressure. More specifically, Senge et al. teaches that the pressure of an acoustical sound wave utilized by Duarte rises regularly to a maximum value above ambient, falls regularly through ambient and on to a minimum value below ambient in a continued oscillation above and below ambient until complete damping occurs. Portions of the wave above ambient represent acoustic compression, while portionsbelow ambient represent acoustic tension. Web site: http://www.delphion.com/details?pn=US06368292__ •
Methods for electrosurgical treatment of turbinates Inventor(s): Eggers; Philip E. (Dublin, OH), Ellsberry; Maria B. (Fremont, CA), Hovda; David C. (Mountain View, CA), Thapliyal; Hira V. (Los Altos, CA) Assignee(s): Arthrocare Corporation (sunnyvale, Ca) Patent Number: 6,063,079 Date filed: April 2, 1998 Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. In one aspect, a method is provided for reducing the volume of enlarge swollen tissue in the patient's nose, such as swollen nasal tissue, mucus membranes, turbinates, polyps, neoplasms, cartilage (e.g., the nasal septum) or the like. In particular, the turbinates are treated by positioning one or more electrode terminal(s) adjacent to the turbinates, and delivering electrically conductive fluid, such as isotonic saline, to the nasal cavity to substantially surround the electrode terminal(s) with the fluid. High frequency voltage is applied between the
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electrode terminal(s) and one or more return electrode(s) to remove a small tissue segment, channel or hole from the region near or in the turbinates to shrink the turbinates and prevent swelling, due to the formation of scar tissue as the wound heals. The high frequency voltage may be selected to effect a small amount of thermal damage to the walls of the channel or hole to facilitate the formation of scar tissue without extending this thermal damage beyond the immediate region of the target site. Excerpt(s): The present invention relates generally to the field of electrosurgery, and more particularly to surgical devices and methods which employ high frequency electrical energy to treat tissue in regions of the head and neck, such as the ear, nose and throat. The present invention is particularly suited for treating enlarged nasal structures, such as turbinates, polyps or other sinus tissue. Sinuses are the air-filled cavities insides the facial bones that open into the nasal cavities. Sinusitis is the inflammation of the mucous membranes of one or more of the paranasal sinus cavities. Sinusitis is often associated with a viral or bacterial upper respiratory infection that spreads to the sinuses. When the sinus opening becomes blocked, the cavities fill, producing deep pain and pressure. Postnasal or nasal drainage, nasal congestion with pressure, headaches, sinus infections and nasal polyps are most commonly associated with chronic sinusitis. Treatment of mild sinusitis typically involves antibiotics, decongestants and analgesics, and is designed to prevent further complications. For more severe or chronic sinusitis, surgery is often necessary to return the nose and sinuses to normal function, particularly with patients who have undergone years of allergy treatment and still suffer from sinus blockage, or patients born with small sinuses and nasal passages. Recent developments in the field of endoscopic surgical techniques and medical devices have provided skilled physicians with instrumentation and methods to perform complicated paranasal sinus surgical procedures. Improved visualization of the nasal cavity and the paranasal sinuses, for example, has now made these anatomical areas more accessible to the endoscopic surgeon. As a result, functional endoscopic sinus surgery (FESS) has become the technique of choice in the surgical approach to sinus disease. Web site: http://www.delphion.com/details?pn=US06063079__ •
Pharmaceutical composition for the prevention and treatment of scar tissue Inventor(s): Niazi; Sarfaraz K (20 Riverside Dr., Deerfield, IL 60015) Assignee(s): None Reported Patent Number: 6,447,820 Date filed: January 22, 2001 Abstract: The disclosed is a treatment of existing and prevention of new skin scars in humans and animals using a topical application containing alcoholic extracts of Cortex Phellodendri and Opuntia ficus indica in a specific combination. Excerpt(s): If an organ receives a physical trauma, such as an injury, surgery, a burn or an electric shock, or experiences inflammation as a result of a pathogenic cause, one of the inevitable consequences of the healing and inflammatory processes, which follow, is the formation of scar tissue. Scar tissue is formed as a result of the formation of a fibrinplatelet network following physical trauma or pathogenic inflammation, and the subsequent rebuilding and replacement of this network by granulation tissue. The complex and typically highly irregular structure of the fibrin-platelet network, formed at an early stage after the trauma or as a result of inflammation, is of key importance in the fate of any wound healing process. Any physical structure, particularly filaments and
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membranes, whether diffusely or distinctly outlined, acts as a guide for the invading granulation tissue. This newly formed tissue is, in accordance with the mechanism described above, eventually rebuilt as scar tissue, organized is fibrous strands or membranes. The invading granulation tissue cells can practically never fully substitute for the original cells and, as a result, the tissue is never regenerated, but merely repaired. This is true for both the skin and for mucosal membranes, including those lining the body cavities, as well as other structures including muscles, tendons and nerves. Moreover, the scar tissue so formed may, in time, contract and remain contracted, deforming and disorganizing the injured area. The proliferation and invasion of fibrin threads by even a few granulation tissue cells (including angiogenic cells) is usually sufficient to induce the formation of adhesions. The direction, density and organization of the individual fibrin threads in the fibrin-platelet network of the clot provides information, and determines the track to be taken by the invading granulation tissue cells, as well as by specific cells such as Schwann cells. Extracellular fibrin may deposit, stick to and establish abnormal bridges between adjacent structures. Thus, the structure of the fibrin-platelet network is of key importance in guiding the invading granulation tissue and thus in the formation of scar tissue. Web site: http://www.delphion.com/details?pn=US06447820__ •
Post-translational activation of TGF-.beta.sub.1 involving the TSP-1 receptor CD36 Inventor(s): Khalil; Nasreen (Winnipeg, CA) Assignee(s): Manitoba Cancer Treatment and Research Foundation (winnipeg, Ca), The University of Manitoba (winnipeg, Ca) Patent Number: 6,090,367 Date filed: November 17, 1997 Abstract: A protein called transforming growth factor-beta (TGF-.beta.) is important in causing the inflammation and progressive scar tissue in pulmonary fibrosis. The TGF.beta.sub.1 isoform is important in the pathogenesis of pulmonary fibrosis. It is usually secreted non-covalently bound to a latency associated peptide (LAP) which renders it biologically inactive. The inactive form is called latent TGF-.beta.sub.1 (L-TGF.beta.sub.1). Activation of L-TGF-.beta.sub.1 involves L-TGF-.beta.sub.1 /TSP-1 complex which interacts with the TSP-1 receptor, CD36, to process L-TGF-.beta.sub.1 to the mature form in the presence of plasmin. Synthetic or natural CD36 peptides or fragments thereof can be used to prevent activation of TGF-.beta.sub.1, in mammalian alveolar macrophages, thereby controlling the inflammation process. Excerpt(s): The present invention relates to a treatment of pulmonary fibrosis which can be caused by a variety of agents and may be associated with a number of diseases. The most common form of pulmonary fibrosis is idiopathic pulmonary fibrosis (IPF). IPF is a progressive and lethal pulmonary disease occurring in between about 9 to 23 people per 100,000 and for which no cure is presently available. Although most physicians generally treat IPF and other fibrotic lung diseases with high doses of corticosteroids, a favourable response rarely occurs, and if it does occur, it is transient. Instead, the use of high dose corticosteroids leads to a variety of complications that can be lethal themselves. It has been demonstrated that a protein called transforming growth factorbeta (TGF-.beta.) is important in causing the inflammation and progressive scar tissue in pulmonary fibrosis. The presence of inflammation and scarring lead to morbidity and mortality. TGF-.beta. exists in three isoforms in mammals, designated as TGF.beta.sub.1, TGF-.beta.sub.2 and TGF-.beta.sub.3. The characteristics as well as the in
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vitro and in vivo biological effects are most extensively reported for TGF-.beta.sub.1. Applicants have found that the TGF-.beta.sub.1 isoform is important in the pathogenesis of pulmonary fibrosis induced by bleomycin. All cells in the body produce TGF-.beta.s and all cells can respond to it. However, it is usually secreted non-covalently bound to a latency associated peptide (LAP) which renders it biologically inactive. The inactive form is called latent TGF-.beta.sub.1 (L-TGF-.beta.sub.1). Applicants have found that in an animal model of pulmonary fibrosis and in samples from patients with IPF, TGF.beta.sub.1 is secreted by alveolar macrophages in an active form. As well, applicants have found indications that in advanced cases of IPF, active TGF-.beta.sub.1 is secreted by epithelial cells. Epithelial cells may be the source of TGF-.beta.sub.1 found subepithelially where there is extensive fibrous connective tissue present. The subepithelial location of TGF-.beta.sub.1 could result in expansion of the fibroblast cell population and enhanced connective tissue synthesis and therefore play a critical role in the pathogenesis of pulmonary fibrosis. Web site: http://www.delphion.com/details?pn=US06090367__ •
Process for the production of stromelysin catalytic domain protein Inventor(s): Baragi; Vijaykumar (Ann Arbor, MI), Hupe; Donald John (Ann Arbor, MI), Johnson; Linda Lea (Ann Arbor, MI), Ye; Qi-Zhuang (Ann Arbor, MI) Assignee(s): Warner-lambert Company (ann Arbor, Mi) Patent Number: 6,284,513 Date filed: July 27, 1994 Abstract: A process for the production of the catalytic domain, without propeptide, of a matrix metalloproteinase is described which comprises culturing transformed host cells carrying a DNA sequence encoding the catalytic domain as well as a method for screening for inhibitors of a matrix metalloproteinase; a method for determining the 3dimensional structure of the catalytic domain of a matrix metalloproteinase; and pharmaceutical compositions of human stromelysin catalytic domain protein which are useful in treating herniated vertebral discs, dermal ulcers, modifying scar tissue formation, and joint diseases. Excerpt(s): The present invention relates to a process for the production of a mammalian stromelysin catalytic domain protein, to a purified mammalian stromelysin catalytic domain protein, to pharmaceutical compositions which include the mammalian stromelysin catalytic domain protein and a pharmaceutically acceptable carrier, and to pharmaceutical methods of treatment. Matrix metalloproteinases, such as stromelysins, collagenases, and gelatinases, are believed to be involved in connective tissue degradation (Woessner J F, FASEB J. 1991;5:2145-2154) in several physiological and pathological processes including the cartilage degradation in arthritis and tumor progression and metastasis (McDonnell S, Matrisian L, Cancer Metastasis Rev. 1990;9:305-319). Therefore, there is great interest in understanding the catalytic mechanism of these matrix metalloproteinases and designing specific inhibitors to control their activity. Similar to other matrix metalloproteinases, the human fibroblast stromelysin (Whitham S E, Murphy G, Angel P, et al, Biochem. J. 1986;240:913-916; Saus J, Quinones S, Otani Y, et al, J. Biol. Chem. 1988;263:6742-6745) has a signal peptide for secretion, a propeptide with a cysteine residue for maintaining latency (Van Wart H E, Birkedal-Hansen H, Proc. Natl. Acad. Sci. U.S.A. 1990;87:5578-5582; Park A J, Matrisian L M, Kells A F, et al, J. Biol. Chem. 1991;266:1584-1590), a catalytic domain with a conserved sequence highly homologous with the zinc binding site in the bacterial zinc
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proteinase thermolysin (Vallee B L, Auld D S, Biochemistry 1990;29:5647-5659), and a Cterminal fragment which may be involved in substrate and inhibitor binding (Allan J A, Hembry R M, Angal S, et al, J. Cell Sci. 1991;99:789-795; Murphy G, Allan J A, Willenbrock F, et al, J. Biol. Chem. 1992;267:9612-9618). The matrix metalloproteinases are all secreted as proenzymes and are activated in vivo by a mechanism not yet determined. However, these enzymes can be activated in vitro with organomercurials, proteolytic enzymes, chaotropic agents, or heat (Okada Y, Harris E D, Nagase H, Biochem. J. 1988;254:731-741; Nagase H, Enghild J J, Suzuki K, Salvesen G, Biochemistry 1990;29:5783-5789; Koklitis P A, Murphy G, Sutton C, Angal S, Biochem. J. 1991;276:217221). Removal of the propeptide from prostromelysin by proteinases and organomercurial compounds is a stepwise process (Okada, supra, 1988; Nagase, supra, 1990) which generates intermediate forms before the propeptide is removed completely by activated stromelysin. The activated enzyme undergoes autolytic cleavage at sites close to the C-terminus, producing a 28-kDa fragment as well as smaller species (Okada, supra, 1988; Koklitis, supra, 1991). The instability of matrix metalloproteinases due to the autodegradation may partially account for the difficulty in structural determination by X-ray crystallography. Matrilysin (formerly called PUMP) is a unique member of this enzyme family in that it lacks the C-terminal portion found in stromelysins, collagenases, and gelatinases (Muller D, Quantin B, Gesnel M-C, et al, Biochem. J. 1988;253:187-192). C-Terminal-deleted stromelysin and collagenase have been made and they have shown activity similar to the full-length enzymes (Marcy A I, Eiberger L L, Harrison R, et al, Biochemistry 1991;30:6476-6483; Lowry C L, McGeehan G, LeVine H I, Proteins: Struct., Funct., Genet. 1992;12:42-48; Murphy, supra, 1992). Thus, Marcy, supra, 1991, expressed a truncated stromelysin containing the catalytic domain and the propeptide. The propeptide was removed in vitro to generate the catalytic domain (Marcy, supra, 1991; Salowe S P, Marcy A I, Cuca G C, et al, Biochemistry 1992;31:45354540). Lowry, supra, 1992, described a stability study using a recombinant 19-kDa collagenase catalytic domain. However, the expression and purification of the collagenase catalytic domain have not been described. More recently, Murphy, supra, 1992, expressed the C-terminal-deleted procollagenase and prostromelysin in mouse cells. Therefore, the N-terminal catalytic domain of stromelysin is responsible and sufficient for the proteinase activity, and the C-terminal portion can be removed without major modification to the active site of the catalytic domain. Web site: http://www.delphion.com/details?pn=US06284513__ •
Radioisotope bandage for reducing scar tissue formation Inventor(s): Fischell; David R. (Fair Haven, NJ), Fischell; Robert E. (Dayton, MD) Assignee(s): Cathco, Inc. (dayton, Md) Patent Number: 6,350,226 Date filed: August 15, 2000 Abstract: Disclosed is a novel wound dressing which applies ionizing radiation to the surface of the wound as soon after the wound is created as is possible. Optimally, the radiation has a range which extends to the bottom surface of the skin but not significantly beyond that depth. An example of a radioactive source that can apply this type of radiation dosing is a beta particle emitting radioisotope such as phosphorous-32 which has a range of approximately 3.5 mm for 90% of the electrons that it emits. Even very small amounts of phosphorous-32 can provide a sufficiently high level of irradiation to significantly diminish scar tissue formation. The radioactive bandage
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would typically be an elongated flexible structure which can be applied along a wound or surgical incision. Typically, the radioactive bandage would extend for approximately 1 to 5 mm beyond the cut in all directions. The radioactive bandage would include a shield structure which surrounds the thin, elongated radioactive portion thus disallowing stray radiation outward from the patient's skin. A radiation dose applied to the top of the incision of between 500 and 2000 cGy can substantially reduce scar tissue formation for most patients. Excerpt(s): This invention is in the field of medical devices that prevent the formation of scar tissue. Specifically, this invention is a radioactive bandage to be applied to wounds to reduce the level of scar tissue formation on the skin surface. When an incision is made in the skin either accidentally or as part of a surgical procedure, the body produces scar tissue to help close the wound. A sterile wound dressing assists in eliminating an infection, however, the wound dressing has no significant effect in reducing the extent of scar tissue formation. Although some patients may have a minimum production of scar tissue, other patients can produce a level of scar tissue which is to some extent disfiguring. An extreme example of excessive scar tissue formation is the case of keloids. A well known treatment for keloids is surgical excision of the excessive scar tissue followed by several sessions of fractionated radiation typically using x-rays. This procedure, though successful in approximately 75% of all cases, is considerably expensive and time consuming. The present invention is a unique wound dressing which applies ionizing radiation to the surface of the wound as soon after the wound is created as is possible. Optimally, the radiation has a range which extends to the bottom surface of the skin but not significantly beyond that depth. An example of a radioactive source that can apply this type of radiation dosing is a beta particle emitting radioisotope such as phosphorous-32 which has a range of approximately 3.5 mm for 90% of the electrons that it emits. Furthermore, phosphorous32 has a half-life of 14.3 days which means that it has a very high rate of specific activity. Therefore, even very small amounts of phosphorous-32 can provide a sufficiently high level of irradiation to significantly diminish scar tissue formation. Web site: http://www.delphion.com/details?pn=US06350226__ •
Robotic system for lengthening muscles and method of use Inventor(s): Meilus; Algis A. (331 N. Tessier Dr., St. Petersburg Beach, FL 33706) Assignee(s): None Reported Patent Number: 6,267,737 Date filed: May 15, 1997 Abstract: A robotic muscular therapy system, and method of use, for applying repeated amounts of concentrated pressure to targeted muscles one-at-a-time to lengthen even deeply positioned muscle tissue layer by layer and thereby reduce limitations on joint extension and flexibility as well as eliminate pain caused by excess muscle contraction. The system comprises a beveled treatment probe designed to concentrate pressure without breaking the skin of an average patient, a probe column assembly for fine X, Y, and Z probe movement over a patient, and a plurality of interchangeable column assembly supports for coarse X, Y, and Z probe movement. Patient safety limitations include a torque-limited and current-limited motor with a slip clutch, a probe which withdraws from its treatment position when a patient grabs it or a pre-set maximum tissue pressure is encountered, and a swivel fitting which allows the probe to give when a patient sneezes and allows patients to easily push the probe away upon demand. The
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system may optionally have an X-Y positionable patient support; automated control means probe movement; a computer learn mode for creating individualized treatment routines; patient movement sensors; and probe sensors for patient progress data collection. Applications can include, but are not limited to, elimination of acute and chronic of pain; treatment of conditions resulting from accidents and injury; pre-surgery conditions involving muscle spasm; post-surgery recovery, reduction of scar tissue, and restoration of flexibility; reduction of stress and tension; improved sports performance; treatment of conditions involving restricted physical movement; and postural improvement. Excerpt(s): This invention relates to robotic devices, specifically to a robotic system that is used to apply repeated amounts of concentrated pressure to targeted muscles in a patient's body for periods up to approximately ten minutes per treatment site. During a period of treatment muscle tissue near the skin surface is first affected, then layer by layer as the tissue above it softens and lengthens, deeper layers of tissue within the same muscle as well as separate layers of muscle more deeply positioned thereunder are successively affected for the purpose of lengthening even the most deeply positioned layer which may not be readily accessible by other procedures such as massage therapy to allow greater extension and flexibility in joints influenced by the treated muscles, as well as elimination of pain resulting from excess muscle contraction due to such causes as disease, stress, overuse, or injury. Applications can include, but are not limited to, elimination of acute and chronic of pain; treatment of conditions resulting from accidents and other injuries; pre-surgery conditions involving muscle spasm; reduction of stress and tension; improved sports performance; treatment of conditions involving restricted physical movement; postural improvement and correction; and post-surgery recovery, reduction of scar tissue, and restoration of flexibility. Many people experience musculoskeletal pain, the source of which can be related to sports activities, other strenuous physical activity, accidents, poor posture, medical conditions, and other causes. Such pain is routinely treated by a variety of procedures that include the use of anti-inflammatory drugs, narcotic medications, thermal devices to raise or lower the temperature of affected tissues, electric stimulation, ultrasound, physical therapy, and muscular massage. However, while use of these treatment procedures can be effective for the temporary relief of adverse symptoms and limited mobility related thereto, such treatments are not usually effective in relieving the cause of the symptoms. Also, the drugs and medications can induce adverse side affects in patients. As a result, the Department of Energy through Technology Development Cooperatives and Technology Transfer Initiatives has recently sponsored research into new therapy approaches to physical medicine that includes the emerging field of muscular therapy developed by the inventor herein which takes an engineering approach to treating the body by viewing it as a series of cables and filicrums. When a repeated activity is conducted to the extent that it causes excess muscle contraction in a muscle or in a group of muscles layered upon one another, pain or discomfort to one or more regions of the body can result. For example, overuse of the biceps causes a change in the fulcrum for lower arm movement. Attempts to work the triceps hard against a shortened biceps will create pain. Reduction in the amount of excess muscle contraction and resulting reduction in the pain and limited mobility caused thereby is then provided through the use of physics and the repetitive application of concentrated pressure layer by layer to targeted muscles in the region. During muscular therapy treatments, concentrated pressure is applied for extended periods of time not to exceed approximately ten minutes first to affect muscles near the skin surface and then layer by layer during the period of treatment to successively affect more remote portions of the muscle as well as separate muscles more deeply positioned thereunder to eventually lengthen layer upon layer of
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targeted muscle tissue so that joints influenced by the treated muscles are able to move with less restriction. Relief provided by muscular therapy is often immediate, allowing the quick resumption of activity. Preventative self-treatment with muscular therapy procedures can prevent problems from recurring. Also, with continued muscular therapy muscles have a faster recovery following exercise, greater stamina, more leverage, and increased power and accuracy. Further, it has been demonstrated that people with a skewed center of gravity, both disease related and that due to poor posture, can achieve better balance through muscular therapy. Also, through muscular therapy, athletes have been shown to achieve improved sports performance. In addition, repetitive application of pressure to injured tissue, besides relieving pain and enhancing blood circulation therein, desensitizes it and helps to speed the maturation of scars. Web site: http://www.delphion.com/details?pn=US06267737__ •
System for measuring an embryo, reproductive organs, and tissue in an animal Inventor(s): Ellis; James S. (Broomfield, CO) Assignee(s): Pheno Imaging, Inc. (broomfield, Co) Patent Number: 6,288,539 Date filed: April 27, 2000 Abstract: A computerized system that scans the animal using Magnetic Resonance Imaging (MRI). The scan data is analyzed within the computer to determine if an embryo is present or to determine if scar tissue is present, or to determine the size of organs within the animal. The scan data is produced as digital pixel values, coded as gray scale values, within scan wave lines wherein the gray scale values represent types of tissue. The size of the embryo is defined by separating the embryo tissue from the surrounding muscle tissue of the uterus. The embryo is classified by size by comparing and ranking within like kinds of animals to determine the age of the embryo. Excerpt(s): This invention relates to animal measuring systems and more particularly to measuring an embryo within the animal, a mammary gland, testicles and other body parts of the animal. Even more particularly, the invention relates to measuring the embryo within the animal, mammary glands, testicles and other body parts through Magnetic Resonance Imaging systems. In modern times it has been very important for domestic livestock producers to determine if individual cow's reproductive organs are healthy and if the cow is or is not pregnant. Just as importantly, is the need to know if the bulls reproductive organs are able to maintain maximum fertility. It is also important to know if other areas of the animal are healthy such as the milk secretion cells of the mammary glands, the digestive tract, lungs, heart, skeleton and even teeth. Each of these body parts are directly related to the productivity and reproductivity of the animal. The function of each of these body parts is directly related to the very economic base of maintaining a profitable herd. They become even more important when the animal is sold for breeding stock or as a production unit for another herd. There have been several means to measure the embryo in the pregnant cow. For many years a skilled veterinarian or technician could palpate the uterus of the cow and determine at 70 to 90 days if an embryo (about the size of a golf ball) was present. Ovaries could also be palpated to detect healthy functions or problems such as a cyst. Some prior art systems use ultra-sound to detect an embryo. These methods have several drawbacks. Both require a skilled technician and on occasion the method of palpation can cause harm to the cow or even dislodge the embryo causing an abortion.
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Web site: http://www.delphion.com/details?pn=US06288539__ •
Treatment of conditions and disease Inventor(s): Asculai; Samuel S. (Toronto, CA), Falk; Rudolf Edgar (Toronto, CA) Assignee(s): Hyal Pharmaceutical Corporation (mississauga, Ca) Patent Number: 6,194,392 Date filed: August 7, 1995 Abstract: A combination for administration to a mammal which combination employs a therapeutically effective amount of a medicinal and/or therapeutic agent to treat a disease or condition and an amount of hyaluronic acid and/or salts thereof and/or homologues, analogues, derivatives, complexes, esters, fragments and subunits of hyaluronic acid sufficient to facilitate the agent's penetration through the tissue (including scar tissue) at the site to be treated, through the cell membranes into the individual cells to be treated. Excerpt(s): The invention relates to, formulations suitable for use to treat conditions and disease, (for example cancer), the use of such formulations to treat conditions and disease, method of treating conditions and disease, and the delivery of medicinal and therapeutic agents for the treatment of disease and conditions. In an article entitled "Solid cores of tumors keeping out best drugs" by Sandra Blakeslee published in the Jul. 8, 1989 edition of the Globe and Mail, Toronto, Ontario, Ms. Blakeslee submitted that a growing number of researchers believe that a basic misunderstanding of the structure of solid tumors has led researchers into designing cancer drugs that are doomed to fail in many patients. She relates that, Dr. Herberman, Director of the Pittsburgh Cancer Center, said that for decades, cancer researchers have simply developed drugs, put them in the bloodstream and assumed they would be carried to the tumor giving almost no consideration to how uniformly the drug is distributed once it reaches the tumor. Web site: http://www.delphion.com/details?pn=US06194392__
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Ultrasonic ablation device and methods for lead extraction Inventor(s): Hata; Cary (Tustin, CA), Tu; Hosheng (Tustin, CA) Assignee(s): Irvine Biomedical, Inc. (irvine, Ca) Patent Number: 6,241,692 Date filed: October 6, 1998 Abstract: An improved lead extraction system using an ultrasonic transducer with a sharp cutting edge that is useful for the extraction and the removal of unwanted lead by a minimal invasive procedure is described. A lead extraction system suitable for ultrasonic ablation of scar tissues surrounding the implanted lead is comprised of an outer catheter sheath and an inner catheter shaft having a distal end, a proximal end and at least one lumen extending therebetween, wherein an optional locking stylet is provided. In one embodiment, the lead extraction system has a fluid infusion and irrigation means at its distal tip section and an ultrasonic transducer for loosening the target scar tissue by applying ultrasonic energy and cooled fluid to the said transducer and its contacted tissue.
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Excerpt(s): The present invention generally relates to the improved system for cardiac lead extraction. More particularly, this invention relates to a catheter system and to methods for removing an implanted endocardial pacemaker lead and/or an implanted transvenous defibrillation lead from the cardiovascular system of a patient using an ultrasonic ablation device. Symptoms of abnormal heart rhythms are generally referred to as cardiac arrhythmias. An abnormally rapid rhythm is referred to as tachycardia, while the arrhythmia rates below the normal rhythm are termed bradycardia. Various factors affect the human heart rate and contribute to the changes of rate from what is termed the normal sinus rate range. These rates generally range in adults from 60 to 100 beats per minute. The heart includes a number of normal pathways, which are responsible for the propagation of electrical signals from the upper to lower chambers, which are necessary for performing normal systole and diastole function. Treatment of arrhythmias may be accomplished by a variety of approaches, including drugs, surgery, implantable pacemakers/defibrillators, and catheter ablation. While drugs may be the treatment of choice for many patients, they only mask the symptoms and do not cure the underlying causes. Surgical and catheter-based treatments can only cure some simple cases. Implantable devices correct the arrhythmia and prevent it from occurring unexpectedly. Web site: http://www.delphion.com/details?pn=US06241692__ •
Vaso-occlusive device with attached polymeric materials Inventor(s): Aganon; Nestor (San Jose, CA), Villar; Francisco S. (Newark, CA) Assignee(s): Target Therapeutics, Inc. (fremont, Ca) Patent Number: 6,287,318 Date filed: May 25, 1999 Abstract: A device for occluding a space within the body, and particularly,the device usefle as a vaso-occlusive device. In partiular, the device typically comprises a metallic core or core member, and two polymeric conjuncts, often polymeric members, of differing thrombogenicity. Typically, the core member comprises a metallic helicallywound coil; the first polymeric member and second polymeric member are fibrous materials woven into a braid. The device may be placed at the desired site within a mammal to facilitate the formation of an occlusion. The device promotes the formation of scar tissue, healing tissue, or neocapillaries in vascular occlusions made by the device. Excerpt(s): This invention relates to a device for occluding a space within the body, and particularly, it is useful as a vaso-occlusive device. In particular, it typically comprises a metallic core or core member, and two polymeric conjuncts, often polymeric members, of differing thrombogenicity. Typically, the core member will comprise a metallic helically-wound coil and the first polymeric member and second polymeric member will be fibrous materials woven into a braid. These devices may be placed at the desired site within a mammal to facilitate the formation of an occlusion. The inventive device has been found to promote the formation of scar tissue, healing tissue, or neocapillaries in vascular occlusions made by the device. Occlusive devices used for the blocking of openings within the human body, particularly vaso-occlusive devices, are now wellknown and widely accepted as specific treatments for a variety of maladies. Although we often discuss the invention herein as one dealing with the occlusion of blood vessel or aneurysm closure, the invention is not so limited and may be used in a variety of other sites in the human body, e.g., fallopian tubes, bile ducts, etc. All members of the
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class of vaso-occlusive devices are surgical implements that may be placed within the vasculature of the human body, typically by a catheter, either to block the flow of blood through the vessel making up that portion of the vasculature, or to fill an aneurysm which stems from such a vessel. One member of the class of widely used vaso-occlusive devices includes the helically wound wire coil. Fibers may be woven into or laid crosswise through the coil windings to provide an additional substrate for clot formation and tissue growth within the chosen site. Vaso-occlusive devices having such a structure are widely commercially available from, for instance, Target Therapeutics Inc. One very early patent, U.S. Pat. No. 4,994,069, to Ritchart et al., describes such a vaso-occlusive coil. This vaso-occiusive device assumes a linear helical configuration when placed within a delivery catheter and a folded, convoluted configuration when relaxed after having been released from the delivery catheter. Ritchart et al. describes a number of secondary or relaxed configurations, each of which is suitable for a specific type of malady. Web site: http://www.delphion.com/details?pn=US06287318__
Patent Applications on Scar Tissue As of December 2000, U.S. patent applications are open to public viewing.6 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 scar tissue: •
1, 1-disubstituted ethylene adhesive compositions containing polydimethysiloxane Inventor(s): Narang, Upvan; (Raleigh, NC) Correspondence: Oliff & Berridge Plc; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20020012678 Date filed: December 22, 2000 Abstract: An adhesive composition that contains cyanoacrylate monomers and cyclic or alkyl- or phenyl-terminated linear polydimethylsiloxane is particularly useful in applications requiring flexibility and elasticity. A method of removing, reducing or preventing scar tissue including applying an adhesive composition that contains cyanoacrylate monomer and cyclic or alkyl- or phenyl-terminated linear polydimethylsiloxane. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/471,392, filed Dec. 23, 1999, the entire disclosure of which is incorporated herein by reference. The invention relates to monomer and polymer adhesive and sealant compositions, and to their production and use for industrial and medical applications. Monomer and polymer adhesives are used in both industrial (including household) and medical applications. Included among these adhesives are the 1,1-disubstituted ethylene monomers and polymers, such as the.alpha.-cyanoacrylates. Since the discovery of the adhesive properties of such monomers and polymers, they have found wide use due to the speed with which they cure, the strength of the resulting bond formed, and their relative ease of use. These characteristics have made the.alpha.-cyanoacrylate adhesives
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This has been a common practice outside the United States prior to December 2000.
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the primary choice for numerous applications such as bonding plastics, rubbers, glass, metals, wood, and, more recently, biological tissues. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Anterior chamber phakic lens and methods of implantation Inventor(s): Buzard, Kurt; (Las Vegas, NV) Correspondence: Frank Frisenda, JR.; Frisenda, Quinton & Nicholson; Suite 470; 3993 Howard Hughes Parkway; Las Vegas; NV; 89109; US Patent Application Number: 20030208267 Date filed: May 4, 2002 Abstract: A unique anterior chamber phakic lens and methods for implantation are provided. The foldable optical zone portion of the lens is secured to a pair of diametrically opposed haptic members extending outwardly from the optical zone periphery to the angle of the eye. Each of the haptic members comprises an elongated arm portion and a distal arcuate portion with an inward curvature having an abraded surface. The inventive phakic lens is angle fixated by inducing a slight amount of scar tissue where the distal ends of lens haptics rest in the angle. Accordingly, the unique phakic lens and implantation methods minimize lens related etiology such as iris chafing, glaucoma, uveitis, distortion of the iris, and/or corneal decompensation. Excerpt(s): The present invention provides an improved angle fixated phakic lens and small incision surgical methods for implantation. Presbyopia is a normal aging problem in which we gradually lose the ability to read without visual aid, starting at around age 40. The origins of refractive surgery can be traced back nearly a century ago to the pioneering efforts of Lans for the correction of astigmatism. It has only been in the past 20 years though, that there has been an explosion of interest in operations designed to reduce or eliminate the need for glasses. The instant invention is the result of the modern renaissance of refractive surgery with many contributions to the treatment of astigmatism, nearsightedness and centration. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Apparatus and method for treating scar tissue Inventor(s): Tadlock, Mark; (Tucson, AZ) Correspondence: Mark E. Ogram; 7454 E. Broadway Ste 203; Tucson; AZ; 85710; US Patent Application Number: 20030212350 Date filed: May 13, 2002 Abstract: A method and kit for the treatment of scar tissue in which the epidermis is raised from the scared area using a suction amount defined by the patient's epidermis. Using a gauge mounted on the manual pump, the operator is able to apply as much or as little suction to accomplish the task of treating the scar tissue, without running the risk of further damaging the site from excessive suction. While the epidermis is raised, manual manipulation or sonic vibrations are used to, disrupt the fibrous tissue of the scar.
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Excerpt(s): This invention relates generally to rehabilitation treatments and apparatus and more particularly to apparatus and methods for reducing scar tissue. The initial stages of healing are the same for all parts of the body. After injury, the blood clots in the damaged areas of tissue, and white blood cells and various chemicals (including histamine, enzymes, and proteins from which new cells are made) accumulate at the site of the damage. Fibrous tissue is laid down within the blood clot to form a supportive structure. In some cases, the cells are unable to proliferate or there may be an inadequate blood supply or persistent infection that prevents tissue regeneration. If this case, the fibrous tissue that forms in the blood clot develops into tough scar tissue that keeps the tissue structure intact. This tough scar tissue often causes a restriction of movement at the affected site. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Apparatus for removing an elongated structure implanted in biological tissue Inventor(s): Goode, Louis B.; (Cranberry Township, PA) Correspondence: Cook Group Patent Office; P.O. Box 2269; Bloomington; IN; 47402 Patent Application Number: 20020007204 Date filed: May 17, 2001 Abstract: Disclosed is a lead removal apparatus for removing an implanted pacemaker or defibrillator lead from the heart. The lead removal apparatus includes a proximal handle that further includes a proximal portion, such as an elongate section of intertwined wire, having a compact, pre-formed first configuration, such as one or more coiled loops. The compact shape permits the operator to utilize the proximal portion without requiring the assistance of a second person to help keep it within the sterile field during a procedure. The operator is thus able to constrain or uncoil the proximal portion into a second configuration that is sufficiently straight such that a medical device, such as a dilator sheath, can be advanced thereover to help separate the lead from scar tissue along the vein path. The proximal portion may include sufficient resiliency to substantially return to the first configuration once the sheath has been advanced. Excerpt(s): This application claims priority of provisional application Serial No. 60/204,652, filed May 17, 2000. This invention relates to elongated structures, such as a catheter implanted in tissue or an electrical pacemaker or defibrillator lead implanted in or on the heart and, particularly, to apparatus for removing such elongated structures implanted in biological tissue. A heart pacemaker is generally implanted subcutaneously in the chest wall along with a coiled structure such as an electrical wire coil lead for conducting electrical signals such as stimulating and sensing signals between the pacemaker and the heart. The lead is surgically implanted through a vein leading to a cavity of the heart. A typical lead includes one or more helical wire coils having a hollow inner passageway that extends the entire length of the wire coil. The coiled structures are positioned in the lead either coaxially or laterally. The wire coils are surrounded by an insulating material such as a flexible tube, sheath, or coating comprising, for example, silicone or polyurethane for insulating the wire coils from body fluids as well as each other. However, one problem is that, over time, fibrotic tissue commonly encapsulates the pacemaker lead especially in areas where there is low velocity blood flow. When small diameter veins through which the lead passes become occluded with fibrotic tissue, separating the lead from the vein is difficult and causes
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severe damage or destruction of the vein. Furthermore, the separation is usually not possible without restricting or containing the movement of the pacemaker lead. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Brachytherapy device and method Inventor(s): Apple, Marc G.; (Fort Wayne, IN), Williams, John I.; (Fort Wayne, IN) Correspondence: Gerald R. Black, ESQ.; Suite 160; 30590 Southfield Road; Southfield; MI; 48076; US Patent Application Number: 20030233136 Date filed: April 24, 2003 Abstract: The present invention provides a system and method of applying low dose, localized radiotherapy which is effective to reduce or eliminate the formation of postoperative scar tissue at surgical sites, such as an epidural site after spinal surgery. In an exemplary embodiment, a device is implantable before closing a surgical site as a barrier, the device being designed to deliver a desired therapeutic amount of energy to particular tissue. The device can be a barrier layer, seed containment unit, radiospike, or catheter. The energy may be provided by the material of the device itself, or may be provided by an external source, such as by circulating radioactive fluid through the device itself. Various embodiments include additional components of the device which deliver drug or chemical agents to targeted tissue and/or shield components to prevent dosage to non-targeted tissue. Excerpt(s): The present invention generally relates to energy therapy with brachytherapy systems, and the invention more particularly relates to devices and methods for localized treatment to minimize postoperative fibrosis/scarring at a variety of bodily sites, such as an epidural site. It also relates to devices and methods to treat cartilaginous (articular or discal) pathology in order to reduce pain or improve function. Surgical intervention is an established and effective treatment modality to manage acute and chronic spine abnormalities for which direct intervention can mechanically alter and alleviate anatomic dysmorphic elements, secondary injury responses, and functional inhibitions from autoimmune or inflammatory diseases. More specifically, surgical treatment in the form of decompressions (e.g. discectomy, laminotomy, laminectomy) and/or fusion, is often performed on one or more levels of the human spine to ameliorate or alleviate symptoms originating from disc herniation, foraminal and/or central stenosis, instability secondary to post-traumatic, degenerative, congenital, iatrogenic, or idiopathic conditions, epidural fibrosis, adhesive arachnoiditis, and compressive radiculopathy and myelopathy resulting from any form of space occupying lesion. Outcomes may not always be optimal to eliminate pain and/or spinal dysfunction. In fact, delayed recurrent pain and functional decline can often follow initial uncomplicated surgery in an average of 20-25% of patients, and up to as many as 40% of patients in some historical clinical series. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Collagen tubes for nerve regeneration Inventor(s): Geistlich, Peter; (Stansstad, CH), Schloesser, Lothar; (Darmstadt, DE), Spector, Myron; (Brookline, MA) Correspondence: Rothwell, Figg, Ernst & Manbeck, P.C.; 555 13th Street, N.W.; Suite 701, East Tower; Washington; DC; 20004; US Patent Application Number: 20020018799 Date filed: June 21, 2001 Abstract: Injured nerves are reconnected and regenerated by inserting injured nerve ends into a collagen tube having an outer compact smooth barrier surface preventing ingrowth of connective tissue, avoiding formation of scar tissue and allowing for unimpaired healing of injured nerves. The tube has an inner fibrous surface opposite the outer smooth barrier surface. The soft fibrous inner surface of the tube facilitates nerve growth promotion. Excerpt(s): This application claims the benefit of provisional application Ser. No. 60/214,848, filed Jun. 28, 2000. The present invention relates to the field of nerve regeneration. 2. Description of the Background Art. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Composite material for wound repair Inventor(s): Butler, Charles E.; (Houston, TX) Correspondence: Vinson & Elkins, L.L.P.; 1001 Fannin Street; 2300 First City Tower; Houston; TX; 77002-6760; US Patent Application Number: 20030225355 Date filed: April 1, 2003 Abstract: A composite comprising a barrier material and a support material used for wound or tissue repair. Benefits include decreased adhesion to organs or other structures adjacent to the repair site, limited fluid flux, increased vascularization and cellular infiltration, decreased inflammation and reduced scar tissue formation. Excerpt(s): The present application claims the benefit of provisional U.S. Serial No. 60/369,063 filed Apr. 1, 2002. The present invention relates to compositions and methods for wound and tissue repair. More specifically, the present invention provides a composition including a support material and a barrier material, as well as methods for using the composition to facilitate wound and tissue repair. A wide variety of implantable biomaterials has been used to repair tissue defects and tissue loss in mammals. Currently, such tissue repairs can only be done with prosthetic material or use of a section of autologous tissue from another location with similar functional characteristics, often from a different organ system. The use of prosthetic material is limited by its non-viability, lack of specialized function, immunologic reaction or rejection and increased risk of infection. Autologous tissue from a separate location is often used to replace tissue defects. For example, intestine can be used for esophageal replacement and bladder reconstruction, and urinary conduit can be used for ureter loss or bile duct replacement. Also, donor veins are used to replace arteries. Using autologous tissue for replacement requires a surgical procedure and tissue loss from an uninjured organ. In addition, the donor tissue often does not have the identical
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structural or function characteristics of the native tissue and suffers from lack of specific anatomic and physiologic function. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Device for shaping infarcted heart tissue and method of using the device Inventor(s): Adlparvar, Payam; (Lake Forest, CA), Kordis, Thomas F.; (Rancho Santa Fe, CA), Laufer, Michael D.; (Menlo Park, CA), Nance, Edward J.; (Corona, CA), Wadhwani, Suresh K.; (Mission Viejo, CA) Correspondence: Burns, Doane, Swecker & Mathis, L.L.P.; P.O. Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20030191511 Date filed: April 9, 2003 Abstract: A device and method for treating an infarct scar on a heart comprising an electric cable with proximal and distal ends; a handle with proximal and distal ends with the proximal end connected to the distal end of the cable; a stem with proximal and distal ends with the proximal end of the stem connected to the distal end of the handle; a heating element with a first surface for contacting infarct scar tissue connected to the distal end of the stem wherein the heating element comprises at least two electrodes and at least one temperature sensor positioned on the first surface for sensing a temperature of infarct scar tissue adjacent to the sensor; an energy source connected to the electrodes via the electric cable; and a regulator connected to the energy source and the temperature sensor of the infarct scar tissue, for controlling the temperature of the infarct scar tissue from about 60 degrees C. to about 99 degrees C. Once the heart has been treated, a restraint is disclosed that allows for the shrinkage to be maintained over time. Excerpt(s): The present invention relates generally to devices and methods that can deliver thermal energy to tissue. More particularly, the present invention is directed to devices and methods that can deliver thermal energy to an area of infarcted heart tissue which shrinks and thickens the infarcted area to thereby improve cardiac function. The mammalian heart has four chambers for receiving and pumping blood to various parts of the body. During normal operation of the heart, oxygen poor blood returning from the body enters the right atrium via the inferior vena cava, superior vena cava, coronary sinus, or the coronary veins. The right atrium fills and eventually contracts to expel the blood through the tricuspid valve and into the right ventricle. The right ventricle fills full of blood and then contracts beginning from the apex of the ventricle to the base of the ventricle and forces blood through the pulmonary valve to the pulmonary arteries and to the lungs. The blood becomes oxygenated at the lungs and then returns from the lungs to the left atrium via the pulmonary veins. The left atrium contracts to expel blood through the mitral valve and into the left ventricle. The left ventricle then fills full of blood and then contracts beginning from the apex of the ventricle to the base of the ventricle and forces blood through the aortic valve, into the aorta, and eventually to the body tissues. The major blood supply to the heart is derived from the coronary arteries, two arteries that branch off from the aorta just distal from the aortic valve. The right coronary artery provides blood to the right side of the heart, the left coronary artery supplies blood to the left side of the heart including the left ventricle. Coronary artery disease usually affects the left coronary artery reducing the blood flow to the left ventricle. When the blood flow supplying oxygen and nutrients cannot meet the demands of the heart, the heart becomes ischemic and the patient usually suffers from
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chest pain (angina). When the flow of blood completely stops due to an occlusion of a coronary artery, the heart muscle becomes very ischemic and will die if blood flow is not restored in a few minutes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Devices and methods for reducing scar tissue formation Inventor(s): Fischell, David R.; (Fair Haven, NJ), Fischell, Robert E.; (Dayton, MD), Fischell, Tim A.; (Richland, MI) Correspondence: Robert E. Fischell; 14600 Viburnum DR.; Dayton; MD; 21036; US Patent Application Number: 20030152609 Date filed: February 11, 2002 Abstract: Disclosed is a cytostatic drug attached to a sterile sheet that is designed to be placed between internal body tissues to prevent the formation of post-operative adhesions, which adhesions are really scar tissue formation. This sheet onto or into which the drug is placed may be either a permanent implant or it may be biodegradable. By impregnating an existing product such as the Johnson & Johnson SURGICEL.TM. absorbable hemostat gauze-like sheet with an anti-proliferative drug such as sirolimus, the biodegradable, drug impregnated mesh would act as a barrier to cell proliferation and hence be a deterrent to the formation of adhesions or scar tissue. Another embodiment of this invention is a cytostatic drug attached to a sheet that is placed at the site of an anastamosis to decrease scar tissue formation from within the vessel at the site of the anastomosis. Excerpt(s): This invention is in the field of devices and methods used to prevent the formation of scar tissue that often occurs as a result of a surgical procedure. Postoperative scar tissue formation, adhesions and blood vessel narrowing are major problems following abdominal, neurological, vascular or other types of surgery. For example, narrowing of a blood vessel at the site of an anastamosis is often caused by the unwanted proliferation of scar tissue at that location. U.S. patent application Ser. No. 09/772,693 by R. E. Fischell, et al, filed on Jan. 1, 2001 describes various means and methods to reduce scar tissue formation resulting from a surgical procedure. However, this patent application does not describe a cytostatic anti-proliferative surgical wrap that is placed around some human tissue where there is a risk of formation of scar tissue. Although several companies have developed products (such as sheets of biodegradable mesh, gels, foams and barrier membranes of various materials) that can be placed between these structures to reduce the tissue growth, none are entirely effective. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Endopelvic fascia treatment for incontinence Inventor(s): Carter, Garry L.; (Pleasanton, CA), Dietz, Timothy G.; (Fremont, CA), Morrison, George A.; (Foster City, CA) Correspondence: Townsend And Townsend And Crew; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20010044642 Date filed: July 9, 2001
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Abstract: Methods, devices, and systems for treating the support structures of the body, particularly for incontinence, take advantage of two mechanisms to enhance the support provided by the fascia, ligaments and tendons: first, the invention increases a modulus of elasticity of these tissues, and particularly of the fascial tissues. The increase in modulus can be effected by directing sufficient energy to the fascial tissue so as to promote the formation of scar tissue. The second mechanism attaches tissue planes together, often by directing energy to an interface between adjacent fascial tissues. Excerpt(s): This application is a continuation of U.S. patent application Ser. No. 09/413,100 filed Oct. 6, 1999, and claims the benefit and priority of U.S. Provisional Patent Application No. 60/153,330 filed Sep. 10,1999, the full disclosures of which are incorporated herein by reference for all purposes. The present invention generally relates to medical devices, methods, and systems, particularly for the treatment of urinary incontinence. Urinary incontinence arises in both men and women with varying degrees of severity, and from different causes. In men, the condition frequently occurs as a result of prostatectomies which result in mechanical damage to the urinary sphincter. In women, the condition typically arises after pregnancy when musculoskeletal damage has occurred as a result of inelastic stretching of the structures supporting the genitourinary tract. Specifically, pregnancy can result in inelastic stretching of the pelvic floor, the external sphincter, and the tissue structures which support the bladder, urethra, and bladder neck region. In each of these cases, urinary leakage typically occurs when a patient's abdominal pressure increases as a result of stress, e.g., coughing, sneezing, laughing, exercise, or the like. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Human tissue inhibitor of metalloproteinase-4 Inventor(s): Greene, John M.; (Gaithersburg, MD), Rosen, Craig A.; (Laytonsville, MD) Correspondence: Human Genome Sciences Inc; 9410 Key West Avenue; Rockville; MD; 20850 Patent Application Number: 20020055158 Date filed: July 11, 2001 Abstract: A human tissue inhibitor of metalloproteinases-4 polypeptide and DNA (RNA) encoding such polypeptide and a procedure for producing such polypeptide by recombinant techniques. Also disclosed are methods for utilizing such polypeptide for the treatment of diseases, including arthritis and cancer. Antagonists against such polypeptides and their use as a therapeutic to resorb scar tissue are also disclosed. Diagnostic assays for detecting levels of human TIMP-4 protein and mutations in human TMP-4 nucleic acid sequence are also disclosed. Excerpt(s): This application is a Continuation-in-Part of U.S. application Ser. No. 09/387,525, filed Sep. 1, 1999, which is a Continuation of U.S. application Ser. No. 08/463,261, filed Jun. 5, 1995, which is a continuation-in-part of PCT/US94/14498, filed Dec. 13, 1994 (filed in English), each of which are hereby incorporated by reference in their entireties. This application also claims benefit under 35 U.S.C.sctn. 119(e), of U.S. Provisional Application Nos. 60/217,419, filed Jul. 11, 2000, and No. 60/220,829, filed Jul. 26, 2000, each of which are hereby incorporated by reference in their entireties. This invention relates to newly identified polynucleotides, polypeptides encoded by such polynucleotides, the use of such polynucleotides, polypeptides, and antibodies, as well as the production of such polynucleotides and polypeptides. More particularly, the
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polypeptides of the present invention are human tissue inhibitor of metalloproteinase-4 polypeptides, hereinafter referred to as "human TIMP-4". The invention also relates to inhibiting the action of such polypeptides. The extracellular matrix is a complex structure that contains collagen, proteoglycan, glycosaminoglycan, glycoproteins (fibronectin, chondronectin, laminin) and in some tissues, elastin (Hay, E. D., J. Cell Biol., 91:205-223 (1981)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Implantable lead with dissolvable coating for improved fixation and extraction Inventor(s): Heil, John E.; (White Bear Lake, MN), Heil, Ronald W. JR.; (Roseville, MN), Westlund, Randy; (Minneapolis, MN) Correspondence: Schwegman, Lundberg, Woessner & Kluth, P.A.; P.O. Box 2938; Minneapolis; MN; 55402; US Patent Application Number: 20020045926 Date filed: July 16, 2001 Abstract: A cardiac rhythm management system provides an endocardial cardiac rhythm management lead with an at least partially dissolvable coating at least partially on insulating portions of the lead body at or near its distal end. Upon dissolution, the coating promotes tissue ingrowth to secure the lead in place within fragile vascular structures or elsewhere. Dissolution of one such coating releases a therapeutic agent, such as a steroid that modifies the fibrotic scar tissue content of tissue ingrowth, such that the resulting bond between the tissue and the lead is weak, so that the lead can be easily extracted if desired. One such lead includes an insulating elongate body carrying at least. The lead also includes an at least partially dissolvable coating on an insulating portion of the peripheral distal lead surface. The coating provides one or more of a rough surface, a porous surface, or a swollen surface after being exposed to an aqueous substance. Excerpt(s): This invention relates generally to electrical leadwires and particularly, but not by way of limitation, to a cardiac rhythm management system providing an endocardial cardiac rhythm management lead with an at least partially dissolvable coating on at least portions of an insulating lead body for improved fixation and extraction. When functioning properly, the human heart maintains its own intrinsic rhythm, and is capable of pumping adequate blood throughout the body's circulatory Asystem. However, some people have irregular cardiac rhythms, referred to as cardiac arrhythmias. Such arrhythmias result in diminished blood circulation. One mode of treating cardiac arrhythmias uses drug therapy. Drugs are often effective at restoring normal heart rhythms. However, drug therapy is not always effective for treating arrhythmias of certain patients. For such patients, an alternative mode of treatment is needed. One such alternative mode of treatment includes the use of a cardiac rhythm management system. Such systems are often implanted in the patient and deliver therapy to the heart. Cardiac rhythm management systems include, among other things, pacemakers, also referred to as pacers. Pacers deliver timed sequences of low energy electrical stimuli, called pace pulses, to the heart, such as via a transvenous leadwire or catheter (referred to as a "lead") having one or more electrodes disposed in or about the heart. Heart contractions are initiated in response to such pace pulses (this is referred to as "capturing" the heart). By properly timing the delivery of pace pulses, the heart can be induced to contract in proper rhythm, greatly improving its efficiency as a pump. Pacers
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are often used to treat patients with bradyarrhythmias, that is, hearts that beat too slowly, or irregularly. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Massager and method of using same Inventor(s): Calvert, Jay Wynn; (Costa Mesa, CA) Correspondence: Pepper Hamilton Llp; One Mellon Center, 50th Floor; 500 Grant Street; Pittsburgh; PA; 15219; US Patent Application Number: 20030158505 Date filed: February 21, 2002 Abstract: A massage device to be used pre-operatively, intra-operatively and postoperatively. The device that includes a housing with a base portion and a handle portion, a drive unit contained in the base portion of the housing; and a massage node operably connected to the drive unit by coupling means such that operation of the drive unit causes the massage node to provide a massage effect.The present massage device is capable of smoothing the skin and fat irregularities associated with any liposuction procedure including suction assisted lipectomy, ultrasonic assisted lipectomy, and direct lipectomy; improving the contour irregularities assisted with any liposuction procedure; preconditioning the skin and fat prior to any liposuction procedure to minimize blood vessel damage; removing scar tissue from patients who have recently undergone any liposuction procedure; and treating skin irregularities due to "cellulite". Excerpt(s): Aesthetic body contour surgery has become a routine procedure by which to increase the attractiveness of the human form. One particular method of body contour surgery, suction lipectomy or liposuction, is a procedure that permits elimination of localized fat deposits through small incisions, which leave inconspicuous scars. Liposuction is one of the most common aesthetic procedures performed by plastic and reconstructive surgeons today. Liposuction has been used to remove fat from many regions of the body. The regions most frequently treated include the trochanteric region, flanks, buttocks, interaspect of the knee, the anterior abdominal wall, gynecomastia, and "love handles." Although it was once believed that the fat cell removed by liposuction would later be replaced, the presently accepted theory is that the body contains a limited number of fat cells, which cannot regenerate. Fatty tissue is not caused by an increase in the number of fat cells, but by an increase in the amount of lipid matter found within the cell. Therefore, the removal of fat cells by liposuction should create a contour that will retain its form (absent undue expansion of lipid matter in remaining cells). Liposuction was first performed in Europe by J. Schrudde in 1972 using a uterine curette. Currently, the procedure is performed using a special type of curette known as a cannula. The cannula is attached to a vacuum source, which carries away the fat tissue. The vacuum required is inversely proportional to the size of the suction aperture and the tube diameter (i.e., the smaller the tube and the orifice, the higher the negative pressure needed for the evacuation of the fat). The vacuum pressure in one often used cannula, known as the Aspiradeps, manufactured by Ulrich A. G., in St. Gall, Switzerland, is usually on the order of 0.4 to 0.6 atmospheres. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Meniscus-type implant with hydrogel surface reinforced by three-dimensional mesh Inventor(s): Mansmann, Kevin A.; (Paoli, PA) Correspondence: Patrick D. Kelly; 11939 Manchester RD. #403; ST. Louis; MO; 63131; US Patent Application Number: 20020022884 Date filed: March 27, 2001 Abstract: A device designed for surgical implantation to replace damaged tissue (such as a meniscus in a knee) is disclosed, having a hydrogel component reinforced by a three-dimensional mesh. The mesh component provides strength and structural support for the implant, which has at least one articulating surface, and at least one anchoring surface. In one embodiment, the mesh emerges from one or more selected locations around the peripheral rim of a meniscal implant, to provide anchoring attachments that can be sutured, pinned, clipped, or otherwise securely affixed to the fibrous capsule that surrounds the knee. Preferably, the rim surface should be porous, to promote scar tissue (or, in some cases, bone tissue) ingrowth into the implant, to create a strong permanent anchoring support for the implant. In addition, at least some portion of the mesh component preferably should extend through most of the thickness of the hydrogel portion, to create a reinforcing "interpenetrating network" (IPN) of fibers, modelled after certain types of natural body tissues. The "articulating" surfaces of a meniscal wedge, which will rub and slide against femoral and tibial cartilage, should be coated with a hydrogel layer which is smooth and nonabrasive, and made of a material that remains constantly wet. This composite structure, with hydrogel layers surrounding an embedded mesh component, provides a joint-repair implant with improved anchoring, strength, and performance compared to implants of the prior art. Because of certain design advantages, this type of implant may also be useful in surgical repair of other joints, such as damaged shoulders, wrists, ankles or elbows, or in surgical repair of feet or hands. Excerpt(s): This application claims the benefit under 35 USC.sctn.119(e) of a prior U.S. provisional patent application, Ser. No. 60/192,482, filed Mar. 27, 2001. This invention relates to surgical implants that are designed to replace meniscal tissue and possibly cartilage in a mammalian joint, such as a knee. The structure and components of soft tissues are discussed in nearly any textbook on human physiology (e.g., Guyton and Hall, Textbook of Medical Physiology, 9th edition (1996) at page 186). Very briefly, the cells in most types of "soft tissue" (excluding bones, teeth, fingernails, etc.) are held together by a matrix (i.e., a three-dimensional network) of two types of fibers. One type is composed mainly of collagen, a fibrous protein that provides most of the tensile strength of tissue. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method and apparatus for closing septal defects Inventor(s): Beer, Nicholas De; (Burlingame, CA), Dieck, Martin; (Cupertino, CA) Correspondence: Brian M. Berliner; O'melveny & Myers Llp; 400 South Hope Street; Los Angeles; CA; 90071-2899; US Patent Application Number: 20030139819 Date filed: January 18, 2002
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Abstract: Septal defect occluders are disclosed which can be used with a catheter deployment system to occlude a septal defect. The septal defect occluders of the present invention comprise a metallic frame structure that supports a biodegradable member. The frame structure is made from a shape memory metal such as Nitinol. The frame forms two opposing umbrella or disc shaped halves that are connected via a central region. The biodegradable member is attached to the umbrella or disc shaped halves and can be any of numerous biodegradable materials and is preferably a co-polymer of glycolide and lactide. This material initially forms a barrier to blood flow that occludes the defect. Over time, this material is replaced by the body with scar tissue formation and endothelial cells. The metal frame is left coated with the body's own material that blocks the defect. Excerpt(s): The present invention relates to an apparatus and method for closing septal defects including patent foramen ovales, atrial septal defects, and ventricular septal defects. The term "septal defect" generally refers to a defect that passes through a septum (i.e., a thin wall of muscle or other tissue) that divides or separates distinct areas within the body. Such defects can occur either congenitally or by acquisition between chambers of the heart (i.e., atrium or ventricle) or the great vessels causing shunting of blood through the opening. In the case of the atrium, the presence of a significantly large septal defect can cause blood to shunt across the defect from the right atrium to the left atrium and hence on to the left ventricle, aorta and brain. If the defect is not closed, the risk of stroke is increased. Studies have shown that adults with strokes of unknown origin (i.e., cryptogenic strokes) have about twice the normal rate of patent foramen ovales than adults with closed foramen ovales. A foramen ovale is a curtain-like opening between the left and right atria. The opening is used during fetal circulation to shunt oxygenated blood away from the lungs because the lungs of a fetus do not fill with air and do not need much blood flow. Foramen ovales normally close and seal after birth; however, in up to 20% of the population the foramen ovale remains open (i.e., patent) and can cause problems later in life. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for the treatment of scar tissue and wrinkles Inventor(s): Duffy, David M.; (Torrance, CA) Correspondence: Bradley J. Bereznak; Burgess & Bereznak, Llp; Suite 180; 800 West EL Camino Real; Mountain View; CA; 94040; US Patent Application Number: 20030130628 Date filed: January 8, 2002 Abstract: According to the method of the present invention, a regulated vacuum pressure is applied to a skin defect (e.g., a depressed scar or wrinkle) on the surface of the skin. The vacuum pressure is either applied as a single treatment in preparation for other techniques, or as a structured series of applications to effect changes in the skin. The tissue is lifted using an air pressure differential, as may be generated by the vacuum source. It is emphasized that this abstract is provided to comply with the rules requiring an abstract that will allow a searcher or other reader to quickly ascertain the subject matter of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. 37 CFR 1.72(b). Excerpt(s): The present invention relates generally to the repair of skin and soft tissue defects, including scars and wrinkles. Skin defects such as scarring from acne vulgaris,
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rhytids, stretch marks, wrinkles, and other types of traumatic and non-traumatic cutaneous depressions are difficult for physicians to treat. Although there are a number of treatment options available, most of these options are either not completely effective or produce unwanted side effects. For example, dermal and subdermal fillers have been used for many years to improve the appearance of acne scar depressions and rhytids. Implants of inert biomaterials injected beneath an acne scar, for instance, build up the tissue under the scar, thereby reducing the depression caused by the scar. The injection of material into the body (and especially into the face) to obtain a more aesthetic appearance dates back to the turn of the nineteenth century. In the years prior to World War I, the injection of paraffin was used to correct facial contour defects. However, complications from this practice and the inability to achieve satisfactory long-terms results caused the procedure to be abandoned. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for treating a desired area in the vascular system of a patient Inventor(s): Crocker, Ian R.; (Stone Mtn., GA), Hillstead, Richard A.; (Duluth, GA), Larsen, Charles E.; (Cumming, GA), Meloul, Raphael F.; (Atlanta, GA), Rosen, Jonathan J.; (Alpharetta, GA), Waksman, Ron; (Atlanta, GA), Weldon, Thomas D.; (Gainesville, GA) Correspondence: Mark J. Murphy; Cook, Alex, Mcfarron, Manzo,; Cummings & Mehler, LTD.; 200 West Adams ST., STE. 2850; Chicago; IL; 60606; US Patent Application Number: 20030229259 Date filed: April 11, 2003 Abstract: Apparatus and method are described for delivery of a treating element, such as a radiation source, through a catheter to a desired site in the vascular system of a patient, such as a coronary artery, for inhibiting the formation of scar tissue such as may occur in restenosis following balloon angioplasty. The apparatus includes an elongated flexible catheter tube having proximal and distal end portions, with a lumen extending therebetween, and a diameter sufficiently small for insertion in to a patient's vascular system. One or more treating elements, such as a capsule or pellet containing radioactive material, is positionable within the lumen and movable between the proximal and distal end portions under the force of liquid flowing through the lumen. A method for using such apparatus, including a method for using such apparatus simultaneously with a balloon angioplasty procedure, is disclosed. Excerpt(s): The present invention relates generally to the delivery of treating elements by a catheter to a selected site within the vascular system of a patient. More particularly, the present invention relates to method and apparatus for the delivery of a treating element, such as a radiation source, through a catheter to a desired site, such as a coronary artery, for inhibiting wound healing response, such as restenosis following balloon angioplasty. It is known that the human body's healing response to wounds typically includes the formation of what is commonly called scar tissue. This response also occurs within the vascular system of a person following injury to a blood vessel. An injury that provokes the formation of scar tissue may occur in various locations within the vascular system, such as in the carotid artery or in coronary bypasses, or in various ways, such as trauma from surgical or diagnostic procedures. One area of the vascular system of particular concern with respect to such injuries is coronary arteries that are subjected to procedures for removing or reducing blockages due to plaque within the arteries. Partial and even complete blockage of coronary arteries by the formation of an
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atherosclerotic plaque is a well known and frequent medical problem. Such blockages may be treated using atherectomy devices, which mechanically remove the plaque; hot or cold lasers, which vaporize the plaque; stents, which hold the artery open; and other devices and procedures which have the objective of allowing increased blood flow through the artery. The most common such procedure is the percutaneous transluminal coronary angioplasty (PTCA) procedures--more commonly referred to as balloon angioplasty. In this procedure, a catheter having an inflatable balloon at its distal end is introduced into the coronary artery, the uninflated balloon is positioned at the stenotic site and the balloon is inflated. Inflation of the balloon disrupts and flattens the plaque against the arterial wall, and stretches the arterial wall, resulting in enlargement of the intraluminal passageway and increased blood flow. After such expansion, the balloon is deflated and the balloon catheter removed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for tubal occlusion Inventor(s): Bowman, Brett S.; (Redwood City, CA), Carr-Brendel, Victoria E.; (Redwood City, CA), Harrington, Douglas C.; (Redwood City, CA) Correspondence: Crockett & Crockett; Suite 400; 24012 Calle DE LA Plata; Laguna Hills; CA; 92653; US Patent Application Number: 20010016738 Date filed: March 16, 2001 Abstract: Methods and devices for occlusion of the fallopian tubes of a woman. The method involves thermally damaging the lining of the utero-tubal junction with relatively low power, followed by placement of a reticulated foam plug. In one embodiment, vascularized tissue grows into the plug and prevents or discourages formation of scar tissue around the plug. Another embodiment with a relatively small foam pore size encourages formation of a vascularized capsule around the plug. The presence of this vascularized capsule limits the patient's foreign body response, so that the capsule does not constrict around the plug. Also presented is a catheter designed for wounding the epithelial layer of the utero-tubal junction, and a method of using the catheter to form a long yet shallow lesion in the utero-tubal junction. Excerpt(s): This application is a continuation of U.S. application Ser. No. 09/241,790 filed Feb. 1, 1999, now U.S. Pat. No. 6,______. The present invention relates to an apparatus and method for permanently closing body vessels such as the utero-tubal junction, uterine isthmus, and fallopian tubes. In particular, this invention is directed to a relatively simple surgical procedure for sterilizing human females which may be performed in the physician's office. It is often desired or necessary for medical reasons to permanently close the fallopian tubes of women. The procedures currently proposed for occluding the fallopian tubes to effect sterilization include surgical ligation, occlusion by insertion of a foreign body, and occlusion by scarring in response to severe wounding. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method of promoting tissue adhesion Inventor(s): Filipi, Charles J.; (Omaha, NE), Lehman, Glen; (Indianapolis, IN) Correspondence: Kirkpatrick & Lockhart Llp; 75 State Street; Boston; MA; 02109-1808; US Patent Application Number: 20040034371 Date filed: June 5, 2003 Abstract: The present invention provides methods and devices for promoting tissue adhesion, which utilizes the healing process and scar tissue formation to bond two tissue surfaces together. A tissue injury is accomplished by destroying the mucosal layer of tissue. After the injury is initiated, the tissue is preferably held in close contact by a tissue apposition means such as a suture, staple or clip device placed adjacent to the treatment site. The tissue injury may be initiated by electrical/radiofrequency energy; chemical or mechanical means integrated with the tissue apposition device or delivered by a separate instrument such as an electrocautery catheter through an endoscope. As scar tissue created by the injury forms, the tissue surfaces become bonded together in a permanent union. Excerpt(s): The present invention relates to methods of treating tissue of the human body, specifically, methods of promoting adhesion between tissue surfaces. Securely joining one tissue portion to another is important to the successful treatment of various medical ailments. However, because tissue is soft, pliable, and moist and is often subject to dynamic movement, it can be difficult to maintain different segments of tissue joined together. Common methods for joining tissue segments together include: suturing with surgical thread secured by a surgical knot, lock device or application of surgical staples. The success of knotted sutures is dependent on the skill of the physician forming a strong surgical knot. Both stapling and suturing are susceptible to failure if the tissue surrounding the suture or staple tears permitting the material to break free and release the tissue. Another method for retaining segments of tissue together involves the application of adhesive. Adhesives may be applied in connection with a reinforcing substrate that is flexible, such as a bandage or flexible strip. Alternatively, the adhesive may be applied directly to the tissue folds. Biologically safe tissue adhesives are sometimes used in surgical applications to help maintain tissues joined together. However, the moist pliable nature of tissue makes successfully bonding tissue surfaces together difficult. The bonding agent may not adhere to the tissue surface in the presence of biological fluids, etc. Additionally, the dynamic environments in which most tissue areas exist tend to weaken bonds created by adhesives. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Methods and use of motoneuronotrophic factors Inventor(s): Chau, Raymond Ming Wah; (Hong Kong, HK) Correspondence: James W. Collett, PH.D.; Sheldon & Mak; 225 S. Lake Avenue, 9th Floor; Pasadena; CA; 91101; US Patent Application Number: 20020086831 Date filed: November 20, 2001 Abstract: The invention is directed to a method of administering motoneuronotrophic factors for promoting the survival, growth, proliferation, or maintenance of mammalian
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neurons. The method is useful for promoting the survival, growth, proliferation, regeneration, or maintenance of mammalian neurons, promoting axonal regeneration, for inhibiting the effects of hereditary motoneuron disease, for minimizing or inhibiting the effects of scar tissue formation, and for accelerating wound healing while concomitantly minimizing or inhibiting the effects of scar tissue and keloid formation. Excerpt(s): This application is a continuation in part of U.S. patent application Ser. No. 09/592,018, filed Jun. 12, 2000, by Raymond Ming Wah Chan, entitled "Isolation and Use of Motoneuronotrophic Factors;" which is a continuation of U.S. patent application Ser. No. 08/928,862, filed Sep. 12, 1997, by Raymond Ming Wah Chau, entitled "Isolation and Use of Motoneuronotrophic Factors;" which is a continuation-in-part of U.S. patent application Ser. No. 08/751,225, filed Nov. 15, 1996, by Raymond Ming Wah Chau, entitled "Motoneuronotrophic Factors," now abandoned; which is a continuation in part of U.S. provisional patent application No. 60/026,792, by Raymond Ming Wah Chau, filed on Sep. 27, 1996, now abandoned; which are hereby incorporated by reference in their entirety. The present invention relates to the human genes which encode a specialized group of proteins which promote the growth, maintenance, survival, and functional capabilities of selected populations of neurons. Neuronotrophic factors (NTFs) are a specialized group of proteins which function to promote the survival, growth, maintenance, and functional capabilities of selected populations of neurons. Recent studies have demonstrated that neuronal death occurs in the nervous systems of vertebrates during certain periods of growth and development. However, the addition of soluble neuronal trophic factors from associated target tissues serves to mitigate this phenomenon of neuronal death. The following citations discuss neuronal trophic factors and their disclosures are hereby incorporated by reference: Chau, R. M. W., et al., Neuronotrophic Factor, 6 Chin. J. Neuroanatomy 129 (1990); Kuno, M., Target Dependence of Motoneuronal Survival: The Current Status, 9 Neurosci. Res. 155 (1990); Bard, Y. A., Trophic Factors and Neuronal Survival, 2 Neuron 1525 (1989); Oppenheim, R.W., The Neurotrophic Theory and Naturally Occurring Motoneuron Death, 12 TINS 252 (1989); Bard, Y. A., What, If Anything, is a Neurotrophic Factor?, 11 TINS 343 (1988); and Thoenen, H., and Edgar, D., Neurotrophic Factors, 229 Science 238 (1985). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Neuro decompression device Inventor(s): Picha, George J.; (Independence, OH) Correspondence: Pearne & Gordon Llp; 526 Superior Avenue East; Suite 1200; Cleveland; OH; 44114-1484; US Patent Application Number: 20030078673 Date filed: September 24, 2002 Abstract: A neuro decompression device is disclosed that significantly reduces fibroplasia proximate to nerve tissue. The device utilizes particular surface topographies to disrupt scar tissue formation around nerves, and which may include one or more drugs to influence tissue growth. Excerpt(s): The present invention relates to a device and technique for limiting fibroplasia around nerves, and specifically, proximate the spinal canal, such as may occur after a decompression procedure. Decompression procedures are performed to release pressure on a nerve trunk by surgically excising constricting bands of tissue or widening a bony canal through which the nerve trunk passes. Details concerning
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decompression procedures are provided in "Spondylolisthesis Treated by a Single-Stage Operation Combining Decompression with in Situ Posterolateral and Anterior Fusion," Michael D. Smith, Henry H. Bohlman, Journal of Bone and Joint Surgery, Vol. 72-A, No. 3, pages 415-421, March 1990; "Lumbar Spondylolisthesis and Nerve-Root Compression, Operative Experience with 19 Cases Without Spinal Fusion," A. Benin; Neurochirurgia, 23:167, 1980; and "Spinal Cord Injury, Spinal Fracture, and Spinal Stenosis in Ankylosing Spondylitis," Philip R. Weinstein, Robert R. Karpman, Eric P. Gall, and Michael Pitt, Journal of Neurosurgery, 57:609-616, 1982; all of which are herein incorporated by reference. An unfortunate consequence of such procedures is the formation of scar tissue adjacent the exposed nerve trunk or dura. Scar tissue formation surrounding the dura or nerve trunk tends to contract and calcify, thereby compressing the nerve or spinal cord. Such compression often results in neural complications including for instance, pain in the lower back and hip radiating down the back of the thigh, and dysfunction of the bowel and bladder. Accordingly, there is a need to minimize scar tissue formation around a nerve trunk, and particularly, to limit fibroplasia and recalcification around nerves subsequent to a decompression procedure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Nitric oxide donors, compositions and methods of use related applications Inventor(s): Fang, Xinqin; (Lexington, MA), Garvey, David S.; (Dover, MA), Gaston, Ricky D.; (Malden, MA), Lin, Chia-En; (Burlington, MA), Ranatunga, Ramani R.; (Lexington, MA), Richardson, Stewart K.; (Tolland, CT), Wang, Tiansheng; (Concord, MA), Wang, Weiheng; (Bedford, MA), Wey, Shiow-Jyi; (Woburn, MA) Correspondence: Edward D Grieff; Hale & Dorr Llp; 1455 Pennsylvania Ave, NW; Washington; DC; 20004; US Patent Application Number: 20030203915 Date filed: April 7, 2003 Excerpt(s): This application claims priority to U.S. application No. 60/369,873 filed Apr. 5, 2002. The invention describes novel nitric oxide donors and novel compositions comprising at least one nitric oxide donor. The invention also provides novel compositions comprising at least one nitric oxide donor, and, optionally, at least one therapeutic agent. The compounds and compositions of the invention can also be bound to a matrix. The invention also provides methods for treating cardiovascular diseases, for the inhibition of platelet aggregation and platelet adhesion caused by the exposure of blood to a medical device, for treating pathological conditions resulting from abnormal cell proliferation; transplantation rejections, autoimmune, inflammatory, proliferative, hyperproliferative, vascular diseases; for reducing scar tissue or for inhibiting wound contraction, particularly the prophylactic and/or therapeutic treatment of restenosis by administering the nitric oxide donor optionally in combination with at least one therapeutic agent. The invention also provides methods for treating inflammation, pain, fever, gastrointestinal disorders, respiratory disorders and sexual dysfunctions. The nitric oxide donors donate, transfer or release nitric oxide, and/or elevate endogenous levels of endothelium-derived relaxing factor, and/or stimulate endogenous synthesis of nitric oxide and/or are substrates for nitric oxide synthase and are capable of releasing nitric oxide or indirectly delivering or transferring nitric oxide to targeted sites under physiological conditions. The therapeutic agent can optionally be substituted with at least one NO and/or NO.sub.2 group (i.e., nitrosylated and/or nitrosated). The invention also provides novel compositions and kits comprising at least one nitric oxide
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donor and/or at least one therapeutic agent. Endothelium-derived relaxing factor (EDRF) is a vascular relaxing factor secreted by the endothelium and is important in the control of vascular tone, blood pressure, inhibition of platelet aggregation, inhibition of platelet adhesion, inhibition of mitogenesis, inhibition of proliferation of cultured vascular smooth muscle, inhibition of leukocyte adherence and prevention of thrombosis. EDRF has been identified as nitric oxide (NO) or a closely related derivative thereof (Palmer et al, Nature, 327:524-526 (1987); Ignarro et al, Proc. Natl. Acad. Sci. USA, 84:9265-9269 (1987)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Novel use of cytokine inhibitors Inventor(s): Olmarker, Kjell; (Molndal, SE) Correspondence: Benton S. Duffett, JR.; Burns, Doane, Swecker & Mathis, L.L.P.; P.O. Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20030176332 Date filed: March 8, 2002 Abstract: The present invention relates to a method for prevention or reduction of scar tissue and/or adhesion formation wherein a therapeutically effective amount of a substance that inhibits a pro-inflammatory cytokine such as TNF or IL-1, is administered to a patient in need of said treatment. Excerpt(s): This application claims priority under 35 U.S.C.sctn.sctn.119 and/or 365 to Swedish Patent Application Serial No. 0200667-4 entitled "Novel Use of Cytokine Inhibitors" and filed on Mar. 5, 2002, the entire content of which is hereby incorporated by reference in its entirety. The present invention relates to pharmaceutical compositions and methods for prevention and/or reduction of formation of scar tissue and/or formation of adhesions. In general, wound healing is a positive physiological reaction that may restore anatomy and function of various tissues after trauma. The trauma may be accidental, the result of surgical intervention or the effect of a disease or genetic condition. The ideal end result of wound healing should be to restore the tissues to the situation before the trauma. One important part of the wound healing process is to form connective tissues or scar tissue that may support the healing tissues during wound healing and regeneration. However, in many cases during wound healing, the newly formed connective tissues (scar tissue) may interfere negatively with the normal function of the healing tissues. The wound healing with formation of new connective tissues may also induce adhesions that may induce pathological conditions per se. Adhesions and scarring may also reduce the possibilities of later surgical intervention of the injured tissue if needed. Scar tissue may also induce cosmetically undesirable results such as cheloid formation. Examples of adhesions and scarring may be found virtually in any organ or tissue undergoing wound healing after trauma or surgery. Following abdominal surgery and following gynecological surgery it is not uncommon that the surgical procedure per se may induce adhesions that may both make later surgery more difficult and even induce pathological conditions such as ileus. Following spinal surgery it is common to have a situation with a dense scar formation called epidural fibrosis. This may in certain case induce significant difficulties for repeated surgery and has also been suggested to induce compression of the adjacent nerve tissue. In other organs excessive wound healing may induce unwanted fixation of tissues and structures that may reduce function and induce pathological conditions. In general, a method for
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controlling the wound healing, particularly the formation of scar tissue and adhesions, would be of a great value in most cases of posttraumatic or post surgical wound healing. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Pacemaker electrode Inventor(s): Sanchez-Zambrano, Sergio; (Cleburne, TX) Correspondence: Charles D. Gunter, JR.; Bracewell & Patterson, Llp; Suite 1600; 201 Main Street; Fort Worth; TX; 76102; US Patent Application Number: 20020198581 Date filed: December 20, 2001 Abstract: An extractable endocardial tip for an electrode of an electrical stimulator has a tip body with a front end for positioning the electrode within a desired area and a back end for connecting to an electrical source. A fin protrudes from the tip body and has an anterior leading edge and a posterior receding edge wherein the posterior receding edge is serrated to form a cutting surface. The tip body also has an internally threaded bore for engaging a mating externally threaded stylet. When the tip body is pulled by pulling on the mating stylet, the serrated edge cuts through any fibrous scar tissue or any other material that surrounds the electrode to facilitate the relatively easy withdrawal of the electrode from the heart. Excerpt(s): This case is a continuation-in-part of earlier filed Ser. No. 09/891,998, filed Jun 26, 2001, entitled "Pacemaker Electrode", by the same inventor. The present invention is directed to electro-stimulators and a pacemaker electrode, and specifically for the removal of implanted endocardial pacemaker electrodes from a patient's heart and the venous paths thereto. Various types of pacemaker leads and their electrodes are used in different chambers of the heart, including the right ventricle, right atrial appendage, the atrium and the coronary sinus. The leads provide an electrical pathway between a pulse generator, connected to the proximal end of the lead, and the electrode connected to the distal end of the lead. The electrode tip is often placed in contact with the endocardial or myocardial tissue by passage through a venous access, such as the subclavian vein or one of its tributaries, which leads to the endocardial surface of the heart chambers. The electrode tip of many available leads include flexible tines, wedges or finger-like projections which project radially outward to help prevent dislodgment of the lead tip from the cardiac tissue. Once an endocardial lead is implanted within a heart chamber, the body's reaction to its presence furthers its fixation within the heart. Shortly after placement, blood clots form about the electrode due to enzymes released in response to the irritation of the cardial tissue caused by the electrode tip. Over time, fibrous scar tissue eventually forms over the distal end, usually in three to six months. Electrical pulses emitted by the pacemaker travel through the pacemaker lead, to the electrode and into the heart muscle and stimulate the heart to restore healthy heart rhythms for patient's whose hearts are beating irregularly. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Resorbable barrier micro-membranes for attenuation of scar tissue during healing Inventor(s): Calhoun, Christopher J.; (San Diego, CA), Holmes, Ralph E.; (San Diego, CA) Correspondence: Kenton R. Mullins; Stout, Uxa, Buyan & Mullins, Llp; Suite 300; 4 Venture; Irvine; CA; 92618; US Patent Application Number: 20020001609 Date filed: March 12, 2001 Abstract: Resorbable polylactide polymer scar tissue reduction barrier membranes and methods of their application are disclosed. The scar-tissue reduction barrier membranes are constructed entirely of polylactide resorbable polymers, which are engineered to be absorbed into the body relatively slowly over time in order to reduce potential negative side effects. The scar tissue reduction barrier membranes are formed to have thicknesses on the order of microns, such as, for example, thicknesses between 10 and 300 microns. The membranes are preshaped with welding flanges and stored in sterile packaging. Excerpt(s): This application claims the benefit of priority under 35 U.S.C. section 119(e) of provisional application No. 60/231,800, filed Sep. 11, 2000, and of provisional application No. 60/196,869, filed Mar. 10, 2000. The present invention relates generally to medical devices and, more particularly, to devices and methods for attenuating the formation of post-surgical adhesions between a post-surgical site and adjacent surrounding tissue. A major clinical problem relating to surgical repair or inflammatory disease is adhesion which occurs during the initial phases of the healing process after surgery or disease. Adhesion is a condition which involves the formation of abnormal tissue linkages. These linkages which form can impair bodily function, produce infertility, obstruct the intestines and other portions of the gastrointestinal tract (bowel obstruction) and produce general discomfort, e.g. pelvic pain. The condition can be life threatening. The most common form of adhesion occurs after surgery as a result of surgical interventions, although adhesion may occur as a result of other processes or events such as pelvic inflammatory disease, mechanical injury, radiation treatment and the presence of foreign material. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Scar tissue treatment bandage and method Inventor(s): Lawry, Roger; (Ojai, CA) Correspondence: Robert J. Schaap; 21241 Ventura Boulevard, Suite 188; Woodland Hills; CA; 91364; US Patent Application Number: 20020156410 Date filed: April 19, 2001 Abstract: A burn treatment bandage in which a silicone composition, primarily a silicone gel, is located on a bandage of the type having an adhesive strip capable of being attached to a user's skin along with a gauze portion thereon. The silicone and, particularly, the silicone gel is pre-incorporated into the gauze, such that when one attempts to treat a burn or other scar tissue, the user may merely apply the bandage such that the silicone material is in contact with the scar tissue. Excerpt(s): This invention relates in general to certain new and useful improvements in devices and methods for treating scar tissue resulting from burns and lacerations and,
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more particularly, to a device in the nature of a bandage which is pre-impregnated with a silicone containing gel for application to scar tissue. It is well known that silicone compounds and, particularly, silicone gels are effective in reducing the oppressive and unsightly appearance of scar tissue resulting from burns and lacerations, and, to some extent, for improving the condition of the scared tissue. Although the pathogeneses for such treatment may not be fully understood, the results have been recognized and substantiated. Moreover, there are a number of prior art references which support the use of silicone containing compounds and, particularly, silicone gels for treating the oppressive and unsightly appearance of scar tissue and particularly scar tissue resulting from burns. The exact pathological mechanism for treatment of hypertrophic scars is not fully know, although the manifestations thereof are observable and have been well established in the literature. See, for example, "Silicone Gel in Scar Treatment" by Karen J. Quinn, Controlled Therapeutics (Scotland Limited East Kilbride, Scotland). Other literature reports the beneficial effects of silicone on certain types of hypertrophic scars. For example, "Management of Evolving Hypertrophic and Keloid Scars" was reported in Elsevier Science, Inc. 1076-0512/95 by James E. Fulton, M.D., Ph.D. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Surgically implanted devices having reduced scar tissue formation Inventor(s): Fischell, David R.; (Fair Haven, NJ), Fischell, Robert E.; (Dayton, MD), Fischell, Scott J.S.; (Glenelg, MD), Fischell, Tim A.; (Richland, MI) Correspondence: Robert E. Fischell; 14600 Viburnum DR.; Dayton; MD; 21036; US Patent Application Number: 20020055701 Date filed: January 31, 2001 Abstract: This invention is an anti-proliferative drug placed onto or within a sterile sheet or mesh that is designed to be placed between internal body tissues to prevent the formation of post-operative adhesions, which adhesions are really scar tissue formation. This mesh or gauze onto or into which the drug is placed may be either a permanent implant or it may be biodegradable. By impregnating an existing product such as the Johnson & Johnson SURGICEL.TM. absorbable hemostat gauze-like sheet with an antiproliferative drug such as Rapamycin or Taxol, the biodegradable, drug impregnated mesh would act as a barrier to cell proliferation and hence be a deterrent to the formation of adhesions. Another embodiment of this invention is an anti-proliferative drug attached to a bandage that is placed onto a cut in the skin to decrease scar tissue formation. Still another embodiment of the invention is an anti-proliferative drug that is attached to a surgical suture or coated onto a surgical staple both of which are used for connecting human tissues. The suture or staple then being more capable for decreasing cellular proliferation where the suture or staple material passes through the human tissue. Excerpt(s): This is a continuation-in-part application of the patent application Ser. No. 09/705,999 filed on Nov. 6, 2000. This invention is in the field of materials used to prevent the formation of scar tissue subsequent to a surgical procedure or accidental skin cut of a human subject. Post-operative adhesions are a major problem following abdominal and other surgical procedures. These adhesions are caused by the unwanted proliferation of scar tissue between internal tissues and structures of the human body generally after surgery. Several companies have developed sheets of biodegradable mesh that can be placed between these structures to reduce the tissue growth. None are entirely effective as some scar tissue typically grows through the mesh. U.S. Pat. No.
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5,795,286 describes the use of a beta emitting radioisotope to reduce the proliferation of tissue through a biocompatible material placed into the human body. Although radioisotopes may be effective at preventing the cell proliferation associated with adhesions, the limited shelf life and safety issues associated with radioisotopes makes them less than ideal for this purpose. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Thin film scar dressing and use thereof Inventor(s): Gilman, Thomas H.; (Spring Grove, IL) Correspondence: Marshall, Gerstein & Borun Llp; 6300 Sears Tower; 233 S. Wacker Drive; Chicago; IL; 60606; US Patent Application Number: 20030220597 Date filed: May 16, 2003 Abstract: A scar dressing of thin polymeric film having a thickness no greater than about 10 mils (0.254 mm) is disclosed. The film is preferably coated on one side with a hypoallergenic pressure-sensitive adhesive, and the dressing as a whole has a permeability profile for moisture vapor and oxygen that renders the dressing particularly suitable for treating scar tissue, particularly where the scarring has become, or may become, hypertropic or keloidal. Excerpt(s): This application claims priority from U.S. Provisional Patent application Serial No. 60/382,908 filed May 23, 2003. Hypertrophic scarring is a condition that sometimes develops after a wound has healed and is recovered with new epithelium. Tissue builds under the new epithelium to a level above the normal skin level, resulting in a scar that is raised. It is also often red, puritic, and painful. Distinguishing keloids from hypertrophic scars can be difficult. Clinically, keloids can be distinguished from hypertrophic scars in that keloids extend beyond the original wound and rarely regress, whereas hypertrophic scars remain within the confines of the original wound and often spontaneously regress. Both keloids and hypertrophic scars are abnormal wound responses and result from a connective tissue response to trauma, inflammation, surgery, or bums and occasionally seem to occur spontaneously. Both are characterized by the abundant deposition of collagen and glycoprotein. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Transplants for myocardial scars Inventor(s): Li, Ren-Ke; (Scarborough, CA), Mickle, Donald A. G.; (Toronto, CA), Weisel, Richard D.; (Toronto, CA) Correspondence: Kristina Bieker-brady, PH.D.; Clark & Elbing Llp; 176 Federal Street; Boston; MA; 02110; US Patent Application Number: 20020127210 Date filed: January 29, 2002 Abstract: A method is provided for forming a graft in heart tissue which comprises the transplantation of cells chosen from cardiomyocytes, fibroblasts, smooth muscle cells, endothelial cells and skeletal myoblasts. The grafts are especially useful in treating scar tissue on the heart.
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Excerpt(s): The present invention relates to novel methods of cell transplantation into scar tissue in the heart in order to improve heart function, stimulate angiogenesis, and to salvage myocardium. The invention also relates to the preparation and culturing of the subject cells prior to transplantation, a mechanism for the delivery of gene therapy using such transplants, and to grafts comprising such cells. Organ transplantation and surgical resection have been used to replace or remove diseased non-functional myocardial tissue. Recently, fetal cellular transplantation has been used to improve neurological deficiencies found in Parkinson's disease (Tompson, L. et al., Science 257:868-870, 1992). In a similar approach, normal myoblasts have been transplanted into the skeletal muscle of patients with Duchenne muscular dystrophy (Gussoni, E. et al., Nature 356:435-438, 1992), where the transplanted cells expressed dystrophin. Fetal ventricular cardiomyocytes, atrial tumor cells, and skeletal myoblasts have been transplanted into normal myocardium (Koh, G Y et al., Journal of Clinical Investigation 92:1548-54, 1993; Soonpaa, M H et al., Science 264:98-101, 1994; U.S. Pat. No. 5,602,301). In the studies described in these references, the cells were transplanted into the middle and thickest layer of the heart, composed of cardiac muscle, which has an excellent blood supply. Transplanted atrial tumor cells formed intercalated disc junctions with the host cardiomyocytes. Myocardial function was not assessed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Treatment of conitions and disease Inventor(s): Asculai, Samuel S.; (Toronto, CA), Falk, Rudolf Edgar; (Toronto, CA) Correspondence: Schwegman, Lundberg, Woessner & Kluth, P.A.; P.O. Box 2938; Minneapolis; MN; 55402; US Patent Application Number: 20040019011 Date filed: July 28, 2003 Abstract: A combination for administration to a mammal which combination employs a therapeutically effective amount of a medicinal and/or therapeutic agent to treat a disease or condition and an amount of hyaluronic acid and/or salts thereof and/or homologues, analogues, derivatives, complexes, esters, fragments and subunits of hyaluronic acid sufficient to facilitate the agent's penetration through the tissue (including scar tissue) at the site to be treated, through the cell membranes into the individual cells to be treated. Excerpt(s): The invention relates to, formulations suitable for use to treat conditions and disease, (for example cancer), the use of such formulations to treat conditions and disease, methods of treating conditions and disease, and the delivery of medicinal and therapeutic agents for the treatment of disease and conditions. In an article entitled "Solid cores of tumors keeping out best drugs" by Sandra Blakeslee published in the Jul. 8, 1989 edition of the Globe and Mail, Toronto, Ontario, Ms. Blakeslee submitted that a growing number of researchers believe that a basic misunderstanding of the structure of solid tumors has led researchers into designing cancer drugs that are doomed to fail in many patients. She relates that, Dr. Herberman, Director of the Pittsburgh Cancer Center, said that for decades, cancer researchers have simply developed drugs, put them in the bloodstream and assumed they would be carried to the tumor giving almost no consideration to how uniformly the drug is distributed once it reaches the tumor. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Use of hyaluronic acid derivatives in the preparation of biomaterials with a physical haemostatic and plugging activity and a preventive activity in the formation of adhesions following anastomosis Inventor(s): Pressato, Daniele; (Montegrotto Terme, IT), Rivarossa, Alberto; (Fossano, IT) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030060448 Date filed: May 7, 2002 Abstract: The present invention describes the use of polysaccharide derivatives for the preparation of biocompatible and biodegradable biomaterials with absorbent properties for body fluids and physical hemostatic activity, to be used in both venous and arterial vascular anastomoses to create a physical hemostatic barrier and to prevent scar tissue formation and formation of post-surgical adherence of the vessels to the surrounding tissues. Excerpt(s): This application is a continuation of U.S. application Ser. No. 09/493,943, filed on Jan. 28, 2000, which is a continuation-in-part of PCT international application No. PCT/EP98/04716, which has an international filing date of Jul. 28, 1998, which designated the United States, the entire contents of which are hereby incorporated by reference. The present invention describes the use of polysaccharide derivatives for the preparation of biocompatible and biodegradable biomaterials with absorbent properties for body fluids and physical haemostatic activity. These biomaterials can be used during anastomotic surgery to create a physical haemostatic barrier by surrounding the surgical joining and to prevent scar tissue formation or the formation of post-surgical adherence of the vessels with the surrounding tissues. Anastomosis generally means the surgical joining of an opening formed between vessels or organs. This includes venous and arterial anastomosis of blood vessels (both venous and arterial), bowel anastomosis (including joining of segments of the intestinal tract after partial or total colectomy), the surgical implantation of catheters, and with endoscopic surgical procedures. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Wound healing Inventor(s): Ferguson, Mark William James; (Skuupl Evczauo, GB), Foreman, David Michael; (Manchester, GB), Shah, Mamta; (Manchester, GB) Correspondence: Nixon & Vanderhye P.C.; 8th Floor; 1100 North Glebe Road; Arlington; VA; 22201; US Patent Application Number: 20020187149 Date filed: April 8, 2002 Abstract: A composition for use in the treatment of wounds to inhibit scar tissue formation during healing is disclosed, comprising an effective activity-inhibiting amount of a growth factor neutralising agent or agents specific against only fibrotic growth factors together with a pharmaceutically acceptable carrier. The method of preparation of said composition and method of administering the composition to a host suffering from tissue wounding is also disclosed. Excerpt(s): This invention relates to the healing of wounds and to agents and techniques for facilitating repair and healing of animal tissue, especially, but not exclusively, skin or
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other epithelial tissue, that has been damaged by, for example, wounds resulting from accidental injury, surgical operations or other trauma. The invention has particular reference to the healing of wounds in humans and other vertebrates. As is well known, the healing of wounds in tissue such as skin generally involves, at least in adult humans and other mammals, a process of extra-cellular matrix (ESC) biosynthesis, turnover and organisation which commonly leads to the production of fibrous, connective tissue scars and consequential loss of normal tissue function. In the realm of surgery scar tissue formation and contraction is a major clinical problem for which there is no entirely satisfactory solution at present. Likewise, scarring and fibrosis following accidental burning or other injuries or trauma, particularly in children, often has serious results, leading to impaired function, defective future growth, and to unsightly aesthetic effects, and again presents a major problem. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Wound healing composition and method for use thereof Inventor(s): Dawson, Monica E.; (Lenexa, KS) Correspondence: Mayer, Brown, Rowe & Maw; P.O. Box 2828; Chicago; IL; 60690; US Patent Application Number: 20030176345 Date filed: January 31, 2003 Abstract: A method for reducing or preventing the formation of scar tissue is disclosed. The method comprises applying a pharmacologically effective amount of a composition comprising about 5.0% by weight of ovalbumin, about 1.0% phenoxyethanol, about 0.5% carbomer, and about 0.3% triethanolamine. A method for stimulating fibroblast production is also disclosed. The method comprises applying a pharmacologically effective amount of a composition comprising about 5.0% by weight of ovalbumin, about 1.0% phenoxyethanol, about 0.5% carbomer, and about 0.3% triethanolamine. Excerpt(s): This invention pertains to wound healing compositions and, particularly, to such a composition comprising of a growth hormone and growth factor in a balanced mixture that will deliver the maximum therapeutic results with non-healing wounds, burns, trauma, and certain dermatological disorders. There have been recent dramatic strides with the discovery of growth factors as wound healing agents. Indeed, the discovery of growth factors has triggered great optimism into the possibility of mastering the art of wound healing and intense effort has been launched on the part of medical researchers and pharmaceutical companies to procure, characterize, and harvest these healing enhancement agents. Because it is believed that administering growth factors to patients with dermal and subdermal wounds enhances the speed by which wounds heal, as discussed in greater detail below, it is the object of this invention to provide a topical composition containing growth factors to increase the body's wound healing properties. Since their discovery almost 30 years ago, growth factors have been shown to stimulate neovascularization in vitro and in animal studies. In the past 10 years, knowledge of growth factors has grown immensely. Broadly defined, growth factors are multifunctional, locally acting, intercellular signaling polypeptides which, among other things, organize and coordinate cellular profileration. Most growth factors are large peptides or glycoproteins secreted by many cells as a base function, or in response to a challenge, such as a wound or carcinogen. These peptides represent a system of signals that mediate physiologic and pathologic cellular growth and repair, including embryogenesis, wound healing and carcinogenesis.
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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 scar tissue, 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 “scar tissue” (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 scar tissue. You can also use this procedure to view pending patent applications concerning scar tissue. 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 4. BOOKS ON SCAR TISSUE Overview This chapter provides bibliographic book references relating to scar tissue. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on scar tissue include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Chapters on Scar Tissue In order to find chapters that specifically relate to scar tissue, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and scar tissue using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “scar tissue” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on scar tissue: •
Management in Bilaterally Obliterated Cochleae Source: in Uziel, A.S.; Mondain, M., eds. Cochlear Implants in Children: Advances in Otorhinolaryngology, Volume 50. Basel, Switzerland: S. Karger AG. 1995. p. 54-58. Contact: Available from S. Karger AG. 26 West Avon Road, P.O. Box 529, Framington, CT 06085. (800) 828-5479 or (203) 675-7834. PRICE: $99.50 plus shipping and handling, unless prepaid. ISBN: 3805560958. Summary: Bacterial meningitis is known to lead to a bony or scar tissue obliteration of the inner ear. In this chapter from a text on cochlear implants in children, the authors recommend a strategy for the management of meningitis deafness. Topics covered include the need for early diagnosis; diagnostic and screening tests used; determining cochlear implant candidacy; informing and working with the child's parents; and long term monitoring of the child. The authors present their experiences with three young children and one adolescent. They stress that early diagnosis of postmeningitic deafness is possible by watchful pediatricians. Only close cooperation among pediatrician,
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otologist, and radiologist allows satisfactory management of imminent cochlear obliteration. 5 figures. 5 references. (AA-M). •
Cirrhosis Source: in Okuda, K., ed.,et al. Hepatobiliary Diseases: Pathophysiology and Imaging. Malden, MA: Blackwell Science, Inc. 2001. p. 119-151. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail:
[email protected]. Website: www.blackwell-science.com. PRICE: $275.00. ISBN: 0632055421. Summary: Cirrhosis (liver scarring) is an end stage of chronic diffuse liver disease. Cirrhosis is characterized by alteration of the normal liver architecture into structurally abnormal nodules of liver cells, surrounded by fibrosis (scar tissue). This chapter on cirrhosis is from a textbook that familiarizes the reader with various imaging modalities, the information they provide, and the merits of each, in order to facilitate the combined use of different imaging techniques in the diagnosis and management of hepatobiliary (liver and bile tract) diseases. Diseases that cause cirrhosis include alcoholic liver disease, chronic viral hepatitis, biliary obstruction, heart failure, metabolic disorders such as copper overload (Wilson's disease), and many others, but alcohol and hepatitis virus are by far the most common etiology. Clinical manifestations including wasting, ascites (fluid accumulation) and edema, splenomegaly (enlarged spleen), esophageal varices (enlarged veins or arteries in the esophagus), and encephalopathy (involvement of the brain tissue). The disease is progressive if it in not treated or if the offending agent is not removed, and for advanced cirrhosis, transplantation is the only cure. Most patients with uncomplicated cirrhosis die of variceal bleeding or hepatic (liver) failure. The author discusses epidemiology, pathophysiology, viral cirrhosis, clinical features, ascites and hepatic lymph, hepatic hydrothorax, portal-systemic encephalopathy, imaging features in cirrhosis, prognosis, and less common types of cirrhosis. 51 figures. 64 references.
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Endoscopic Management of Small Bowel, Anastomotic, and Colonic Strictures in Crohn's Disease Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 509-513. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email:
[email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: Historically, refractory (resistant to treatment) disease and obstruction are the most common indications for surgery in Crohn's disease, and obstruction refractory to medical management (such as drug therapy) is the most common indication for reoperation. This chapter on endoscopic management of strictures (narrowing of the intestine, usually as a result of scar tissue) of Crohn's disease (CD) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with CD and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). Strictures in IBD can be symptomatic, featuring chronic constipation (obstipation), pain, and distention in small bowel; colonic or anastomotic stenoses; nausea, vomiting, and postprandial (after a meal) pain with gastroduodenal strictures. Alternatively, they may simply be radiographic or
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endoscopic areas of narrowing that preclude subsequent tissue sampling by virtue of their small diameter. Balloon dilation of Crohn's strictures, particularly anastomotic ones, appears reasonable in patients with persistent or rapidly recurring obstructive symptoms despite good medical therapy. The approach should be used prior to additional surgical intervention in most patients unless there is an acute obstruction with potentially compromised bowel, uncertainty about concomitant malignancy, or an associated fistula within the stenosis. Although yet to be proven, concomitant injection of a long-acting corticosteroid should be considered in patients intolerant of or unwilling to take oral corticosteroids, those who develop an anastomotic stricture within 6 months of surgical resection, or those patients who rapidly restenose following a technically successful balloon dilation. Finally, radial electrocautery is contraindicated in these patients, and use of expandable prostheses clearly is investigational. 4 figures. 4 tables. 11 references. •
Surgical Care for Voice Problems of the Elderly Source: in Linville, S.E. Vocal Aging. San Diego, CA: Singular Publishing Group. 2001. p. 265-284. Contact: Available from Thomson Learning Group. P.O. Box 6904, Florence, KY 41022. (800) 842-3636. Fax (606) 647-5963. Website: www.singpub.com. PRICE: $43.95 plus shipping and handling. ISBN: 1565939026. Summary: In recent years, there has been a rapid evolution of phonosurgical procedures designed to preserve or improve the voice. These procedures are used to correct dysphonias resulting from structural abnormalities of the vocal folds as well as neuromuscular disorders of the larynx. This chapter on surgical care for voice problems is from a text devoted to the properties of the aging voice, with emphasis on diagnosis and treatment of voice disorders in elderly patients. In this chapter, the author discusses vocal fold injection, with Teflon, collagen, or fat; and laryngeal framework surgery, including medialization thyroplasty, nerve muscle pedicle reinnervation, arytenoid adduction, and vocal fold tension adjustment. In elderly patients, these phonosurgical procedures may be used to treat glottal insufficiency resulting from pathological processes (paralaysis or paresis, neurologic disease, laryngeal trauma), atrophic changes in the vocal folds, or vocal fold segmental problems associated with scar tissue from previous surgery. Typically, phonosurgery is considered only if vocal symptoms did not respond to voice therapy or if the glottal gap is severe. Two case examples are presented in the chapter. 1 figure. 67 references.
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Crooked Tale: Treatment of Peyronie's Disease Source: in Newman, A.J. Beyond Viagra: Plain Talk About Treating Male and Female Sexual Dysfunction. Montgomery, AL: Starrhill Press. 1999. p. 94-99. Contact: Available from Black Belt Press. P.O. Box 551, Montgomery, AL 36101. (800) 959-3245 or (334) 265-6753. Fax (334) 265-8880. PRICE: $13.95 plus shipping and handling. ISBN: 1573590142. Summary: Peyronie's disease is the result of an often painful inflammation of the wall of the erectile cylinders of the penis. Usually, this involves the formation of scar tissue, or plaque, along the top of the penis. The scarring causes the penis to curve upward or to the side. This chapter on the treatment of Peyronie's disease is from a book that discusses the drug sildenafil (Viagra) in the context of a larger discussion about sexuality and sexual dysfunction. The author notes that how physicians treat Peyronie's disease depends on the degree of difficulty the individual is having with side effects of
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the inflammation. The overall goals are to reduce the initial pain involved with the acute inflammatory phase, to decrease penile curvature when it is causing a functional problem with erections, and to restore normal erectile function when the patient has inadequate erections that are usually accompanied by a severe curvature deformity. Topics include the natural course of the disease, medical management, and surgical treatment of the disease. The majority of patients will not need surgery. There is no standard treatment protocol; every patient is treated individually. The chapter is written in nontechnical language, but includes enough medical information to be of use to medical professionals wishing to learn more about sexuality and sexual dysfunction. •
Lesions of the Lamina Propria Source: in Brown, W.S.; Vinson, B.P.; Crary, M.A. Organic Voice Disorders: Assessment and Treatment. San Diego, CA: Singular Publishing Group, Inc. 1996. p. 245-260. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $49.95 plus shipping and handling. ISBN: 1565932684. Summary: This chapter on lesions of the lamina propria is from a textbook on the diagnosis and treatment of voice disorders. Lesions of the lamina propria are located, by definition, between the mucosal cover and the body of the vocal ligament, that is, within Reinke's space. This includes but is not limited to true cysts, epidermoid or mucosal retention, submucosal scar tissue from years of misuse, sulcus vocalis, and Reinke's enema or polypoid corditis. The author begins with a detailed discussion of the pathogenesis recognition and differentiation of these lesions. Other topics include demographic information (the incidence of the problem), onset and course of the disorder, medical considerations, diagnosis (vocal characteristics, endoscopy, acoustic analysis, and aerodynamics), social implications, and treatment options, including speech pathology and surgical management. These lesions interfere with normal mucosal wave, normal vocal fold vibration, and, consequently, normal phonation. Changing the vocal pattern may help the patient to improve phonation while leaving the lesion in place. If this is not possible, surgical excision of the pathology is appropriate if the patient desires a more normal voice. 4 figures. 21 references.
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Liver Disease Source: in King, J.E., ed. Mayo Clinic on Digestive Health. Rochester, MN: Mayo Clinic. 2000. p. 151-166. Contact: Available from Mayo Clinic Health Information. 5505 36th Street, SE, Grand Rapids, MI 49512. (800) 291-1128. Website: www.mayoclinic.com. PRICE: $14.95 plus shipping and handling. ISBN: 1893005046. Summary: This chapter on liver disease is from a comprehensive guidebook from the Mayo Clinic that focuses on a variety of digestive symptoms, including heartburn, abdominal pain, constipation, and diarrhea, and the common conditions that are often responsible for these symptoms. Written in nontechnical language, the book includes practical information on how the digestive system works, factors that can interfere with its normal functioning, and how to prevent digestive problems. The first section of the chapter focuses on hepatitis, including the key signs and symptoms of hepatitis, notably fatigue, loss of appetite, nausea, unexplained weight loss, and yellowing of skin and eyes (jaundice). The authors describe the different types of hepatitis (alcohol or drug induced, hepatitis A, hepatitis B, hepatitis C, hepatitis D and E, autoimmune hepatitis,
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and nonalcoholic steatohepatitis); review the blood tests (liver function tests) that may be used to help diagnose or monitor hepatitis; and discuss treatment options, including corticosteroids, interferon, lamivudine, and liver transplantation. A final section reviews healthy lifestyle approaches for living with hepatitis, and strategies for preventing the disease. The next section of the chapter addresses hemochromatosis (a genetic abnormality that causes the intestines to absorb too much iron), noting that the symptoms can include fatigue, joint pain, impotence (erectile dysfunction) or loss of sex drive, increased skin pigmentation (bronzing), and increased thirst and urination. This section also reviews diagnosis, determining whether screening is necessary for family members of patients with hemochromatosis, and the use of diet therapy (reduced iron intake) to help treat the disease. One sidebar mentions Wilson's disease and alpha 1 antitrypsin deficiency as other inherited liver disease. The last section of the chapter addresses cirrhosis, a condition in which scar tissue forms in the liver and keeps it from functioning normally. 1 figure. •
Sclerosing Cholangitis Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 299-302. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email:
[email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: This chapter on sclerosing cholangitis is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and Ulcerative Colitis (UC), together known as inflammatory bowel disease (IBD). Sclerosing cholangitis is a cholestatic liver disorder characterized by diffuse strictures (scar tissue causing a narrowing) of the bile ducts. The disorder may be primary (idiopathic) or secondary due to structural abnormalities of the bile ducts. Primary sclerosing cholangitis (PSC) is clinically indistinguishable from disorders that cause secondary sclerosing cholangitis. There is a strong association of PSC and IBD, particularly ulcerative colitis. Approximately 4 percent of patients with IBD will either have or develop PSC. In this chapter, the authors review the relevant data on the management of PSC. The treatment of PSC has been limited by uncertainty about its cause. The medical management is divided into management of symptoms and complications and specific therapy of the underlying disease process. The author discusses the use of drugs, including corticosteroids and azathioprine, D penicillamine, colchicine, cyclosporine, urodeoxycholic acid, methotrexate, pentoxifylline, and tacrolimus. However, liver transplantation is the only effective treatment and is recommended for patients with end-stage disease who have symptomatic portal hypertension, liver failure, and recurrent or intractable bacterial cholangitis. 10 references.
•
Stricture Management in Primary Sclerosing Cholangitis Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 303-304. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email:
[email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
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Summary: This chapter on stricture management in primary sclerosing cholangitis is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and Ulcerative Colitis (UC), together known as inflammatory bowel disease (IBD). Sclerosing cholangitis is a cholestatic liver disorder characterized by diffuse strictures (scar tissue causing a narrowing) of the bile ducts. The disorder may be primary (idiopathic) or secondary due to structural abnormalities of the bile ducts. Primary sclerosing cholangitis (PSC) is clinically indistinguishable from disorders that cause secondary sclerosing cholangitis. There is a strong association of PSC and IBD, particularly ulcerative colitis. Approximately 4 percent of patients with IBD will either have or develop PSC. The mainstay of treatment of PSC is liver transplantation with survival rates of greater than 80 percent at 5 years posttransplant. The author cautions that the use of other palliative treatment options such as endoscopic, nontransplant surgical or radiologic interventions should be evaluated in the context of the effectiveness of liver transplantation. The concern of underlying cholangiocarcionoma (biliary tract cancer) should be a priority when evaluating and treating these strictures. 11 references. •
Drip by Drip: How Our Plumbing Works Source: in Dierich, M. and Froe, F. Overcoming Incontinence: A Straightforward Guide to Your Options. Somerset, NJ: John Wiley and Sons, Inc. 2000. p. 7-12. Contact: Available from John Wiley and Sons, Inc. Distribution Center, 1 Wiley Drive, Somerset, NJ 08875-1272. (800) 225-5945 or (732) 469-4400. Fax (732) 302-2300. E-mail:
[email protected]. Website: www.wiley.com. PRICE: $14.95 plus shipping and handling. ISBN: 0471347957. Summary: This chapter on the physiology of the urinary tract is from a practical guide that dispels the many myths associated with urinary incontinence, offering readers information about the latest options for treatment, from simple lifestyle changes and exercises to devices, medications, and surgery. The authors emphasize that incontinence can be prevented, is almost always treatable, and is often curable. In this chapter, the authors review the normal anatomy and physiology of the urinary tract, including how the urinary tract produces urine, stores urine, and releases urine in a timely manner. The authors describe the involuntary parts of the urinary tract, including the ureters, bladder, internal sphincter, and urethra, and the voluntary parts, notably the pelvic muscles. The kidneys make the urine, the bladder fills and stores the urine, and when full, it sends a message to the brain, which in turn determines an appropriate time to release the pelvic muscles to relax. The authors note that changes in the nerve pathways due to back injuries, stroke, or diseases such as multiple sclerosis (MS) can leave the muscles functioning abnormally. Surgery and childbirth can injure the muscles or nerves by over stretching and causing scar tissue both at the site of the surgery and near other organs. The muscles of the urethra and the pelvis then lose their ability to function well, although they are still receiving messages from the brain. Finally, diseases such as Alzheimer's can cause problems with the interpretation of signals sent to and from the bladder, even though the nerves and muscles function properly. 5 figures.
•
Ureteral Stricture Source: in Graham, S.D., Jr., et al., eds. Glenn's Urologic Surgery. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins. 1998. p. 173-178.
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Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Fax (301) 824-7390. Website: lww.com. PRICE: $199.00 plus shipping and handling. ISBN: 0397587376. Summary: Ureteral strictures (scar tissue in the ureter that reduces the opening of the tube) may result from a variety of causes, including stone passage, endoscopic urologic procedures, radiation therapy, open or laparoscopic surgery, and penetrating traumatic injuries. This chapter on ureteral strictures is from an exhaustive textbook on urologic surgery. Although the need for surgical repair of a ureteral injury may be immediately evident in some cases, many patients with ureteral obstruction and or fistulas do not present until weeks or months following surgery. In particular, ureteral strictures that result from endoscopic manipulation of the upper urinary tract may not be noted for prolonged intervals because of the slow development of ureteral fibrosis (thickening of the tissue). The presentation of patients with ureteral strictures is variable and may range from acute flank pain with sepsis and pyelonephritis to the incidental finding of hydronephrosis in an asymptomatic individual. The indications for surgical management of ureteral strictures, disruptions, and fistulas (an abnormal passage out of the ureter) are dependent on the etiology of the lesion and the clinical situation. The author reviews the surgical techniques used, including ureteroureterostomy, the psoas hitch procedure, and the Boari flap procedure; complications and results are also discussed. The author concludes that surgical repair of ureteral strictures is associated with excellent long term success rates. The most important factors responsible for these results include selection of the most appropriate surgical technique, based on the site and length of stricture. 4 figures. 6 references. •
Vesicovaginal Fistula Source: in Graham, S.D., Jr., et al., eds. Glenn's Urologic Surgery. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins. 1998. p. 219-225. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Fax (301) 824-7390. Website: lww.com. PRICE: $199.00 plus shipping and handling. ISBN: 0397587376. Summary: Vesicovaginal fistula (characterized by continuous leakage of urine into the vagina, with varying degrees of severity) are extremely distressing as well as disabling to the patient. This chapter on vesicovaginal fistula (VVF) is from an exhaustive textbook on urologic surgery. In industrialized societies, VVFs occur most frequently as a result of iatrogenic injury at the time of gynecologic surgery, in particular hysterectomy. Other causes of VVFs are technically difficult surgical procedures or impaired wound healing (as a result of infection, neoplasia, previous radiation therapy, foreign bodies, or pelvic trauma) that is frequently complicated by medical conditions such as diabetes mellitus or atherosclerosis. For diagnosis, a careful history, including the details of prior surgery, and a thorough physical examination are the usual prerequisites. Successful treatment of VVF depends largely on careful preparation of the patient and on the ability of the urologist to vary the operative technique according to the requirements of each individual patient and to perform the technical details with meticulous precision. The author outlines the surgical techniques, including transvaginal repair, the suprapubic approach, and anticipated outcomes. The vast majority of VVFs can be successfully repaired transvaginally. The complication of most concern is a recurrent urine leak. Reasons for failed repair are insufficient debridement of nonviable and scar tissue before closure, excessive tension on the suture lines, inadequate closure of dead space, postoperative bladder distension, abscess formation, and poor tissue healing. 15 figures. 11 references.
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CHAPTER 5. MULTIMEDIA ON SCAR TISSUE Overview In this chapter, we show you how to keep current on multimedia sources of information on scar tissue. 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 scar tissue is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “scar tissue” 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 “scar tissue” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on scar tissue: •
Hepatitis C: Unknown Epidemic Source: Princeton, NJ: Films for the Humanities and Sciences. 1998. (videocassette). Contact: Available from Films for the Humanities and Sciences. P.O. Box 2053, Princeton, NJ 08543-2053. (800) 257-5126 or (609) 275-1400. Fax (609) 275-3767. E-mail:
[email protected]. Website: www.films.com. PRICE: $99.00 to purchase; $75.00 for rental; plus shipping and handling. Order number BVL9342. Summary: This videotape offers a segment of ABC's Nightline program that explores the epidemic of hepatitis C virus (HCV) infection in the United States. In this program, ABC News anchor Forrest Sawyer investigates the virus with Dr. Miriam Alter, epidemiologist at the Centers for Disease Control and Prevention; Dr. Jerome Groopman, professor at Harvard Medical School; and Andi Thomas, founder of the advocacy group Hep-C ALERT. Together they examine topics including risk factors associated with the disease, improvements in blood screening, the results of targeted looks back at past blood recipients, and the need for additional funding to increase
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research. Hepatitis C is characterized as a definite health epidemic: 15 percent of the people who get infected successfully fight it off; in 80 percent of those infected, the disease becomes chronic; and in 5 percent of those infected, HCV results in liver cirrhosis (scar tissue), which can then lead to cancer and death. It is virtually impossible to predict who will be in which category. The disease is spread predominantly through needle sharing, sexual contact, and blood transfusions occurring prior to the 1990's. The disease has been called the silent epidemic because it was only identified 10 years ago and the infection remains symptomless for decades. The three panelists interviewed share their information and differences of opinions on the wisdom of getting tested for HCV, the magnitude of the public health problem of the disease, the need for targeted look back for people who received blood transfusions, and the emotions of dealing with the disease.
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CHAPTER 6. PERIODICALS AND NEWS ON SCAR TISSUE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover scar tissue.
News Services and Press Releases One of the simplest ways of tracking press releases on scar tissue is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “scar tissue” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to scar tissue. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “scar tissue” (or synonyms). The following was recently listed in this archive for scar tissue: •
Scar tissue and low ejection fraction predict arrhythmia in sudden death survivors Source: Reuters Industry Breifing Date: October 06, 2003
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “scar tissue” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “scar tissue” (or synonyms). If you know the name of a company that is relevant to scar tissue, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “scar tissue” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly
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to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “scar tissue” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on scar tissue: •
Peyronie's Disease: Embarrassing but Treatable Source: Mayo Clinic Health Letter. 19(11): 6. November 2001. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465. Summary: This brief article familiarizes readers with Peyronie's disease, a condition characterized by a penis that is bent while erect. In Peyronie's disease, a hard fibrous layer of scar tissue (plaque) forms under the skin on one side of the penis. When the penis is erect, the scar tissue pulls the penis off at an angle. Peyronie's may appear suddenly or develop more slowly, and the condition appears primarily in men between the ages of 40 and 60 years. The article reviews the symptoms of Peyronie's, the possible causes of the condition, and treatment options, including vitamin E, chemical injections, and surgery. Surgical methods commonly used include Nesbit plication, plaque excision, tissue grafting, and the use of a penile prosthesis. Treatment is usually delayed for several months while the condition is monitored; scar tissue can soften over time and the disease may improve on its own. Researchers are still looking for a safe, effective nonsurgical treatment for Peyronie's disease.
•
Skin Sarcoidosis Source: Sarcoidosis Networking. 7(4): 2. July-August 1999. Contact: Available from Sarcoidosis Networking. 13925 80th Street East, Puyallup, WA 98372-3614. (253) 845-3108. E-mail:
[email protected]. Summary: This newsletter article provides people who have sarcoidosis with information on the skin lesions associated with this multisystem granulomatous disease of unknown cause. Skin lesions of sarcoidosis are classified as specific and nonspecific. Biopsy of lesions of the specific type show evidence of granulomas, whereas no granuloma tissue is found in the biopsy for the nonspecific type. Erythema nodosum is an example of this latter form. Papule lesions are the most common and usually have a brownish or reddish brown hue. The sarcoid lesions of lupus pernio, which are reddish, purple leash clusters, are more common among African Americans than Caucasians. Sarcoid granulomas found in scar tissue form bumps or nodules, making the scar appear reddish or purple. These are often called keloid formations. A very invasive form of sarcoidosis is a loss of hair where granulomas infiltrate and destroy the hair follicles. Ulcerative sarcoid lesions are mainly seen on lower extremities. Dairier-Roussy lesions are asymptomatic, subcutaneous lesions that can appear over the trunk and extremities under the surface skin. Psoriasiform changes, which are rare, look like psoriasis on the trunk and extremities. Treatment options include topical or systemic corticosteroids. Good personal hygiene is very important in preventing skin breakdown.
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Academic Periodicals covering Scar Tissue Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to scar tissue. In addition to these sources, you can search for articles covering scar tissue that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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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 Institute7: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
7
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
Physician Resources 101
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 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:9 •
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
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
8
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). 9 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 Gateway10 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.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “scar tissue” (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 13295 123 406 6 20 13850
HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 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.14 Simply search by “scar tissue” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
10
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
11
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). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14
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 Biologists15 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.16 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.17 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/.
15 Adapted 16
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. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on scar tissue 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 scar tissue. 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 scar tissue. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “scar tissue”:
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Acne http://www.nlm.nih.gov/medlineplus/acne.html Breast Reconstruction http://www.nlm.nih.gov/medlineplus/breastreconstruction.html Plastic and Cosmetic Surgery http://www.nlm.nih.gov/medlineplus/plasticandcosmeticsurgery.html Scars http://www.nlm.nih.gov/medlineplus/scars.html Skin Aging http://www.nlm.nih.gov/medlineplus/skinaging.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on scar tissue. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Ureteral Stents: Treating a Urinary Blockage Source: San Bruno, CA: StayWell Company. 2001. [2 p.]. Contact: StayWell Company: Krames Health and Safety Education. 780 Township Line Road, Yardley, PA 19067. (800) 333-3032. Fax (415) 244-4512. E-mail:
[email protected]. Website: www.staywell.com. PRICE: $21.95 per pack of 50; plus shipping and handling. Order number 91867. Summary: A ureteral stent is a soft plastic tube with holes all around it; the stent is inserted into a ureter to help drain urine from the kidney into the bladder. It is often used to bypass a blockage in the kidney or ureter (for example, due to a kidney stone). The stent allows urine to drain normally into the bladder. This brochure describes the use of the stent, the surgical technique used to place the stent, and patient care during the time a stent is in place. The brochure begins with a brief review of the anatomy of the urinary tract and a description of how kidney stones can cause a blockage. The brochure notes that a blockage can also be caused by scar tissue or by a tumor growing in or around a ureter. The stent is most often taken out after the blockage has been removed or the ureter has healed. If a stent is needed for a long time, it will be changed every few months. The stent is usually placed during an outpatient procedure at a hospital or surgery center. The tube used for the stent has a coil on each end to keep it
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from falling out; one end stays in the kidney, the other end stays in the bladder. While the stent is in place the patient may feel some discomfort; patients are encouraged to drink plenty of fluids and to work in close tandem with health care providers. The brochure lists the indications for calling the physician. The stent is usually removed in an office procedure. The brochure is illustrated with full color line drawings. 7 references. •
Impotence?: A Guide to Understanding and Treating Erectile Dysfunction Source: Minnetonka, MN: American Medical Systems. 2001. 29 p. Contact: Available from American Medical Systems. 10700 Bren Road West, Minnetonka, MN 55343. (800) 328-3881 or (612) 933-4666. Fax (612) 930-6592. Website: www.VisitAMS.com. PRICE: Single copy free. Order number 21600026. Summary: Erectile dysfunction (ED, or impotence) is the inability to maintain an erection that is firm enough or that lasts long enough to have successful sexual intercourse. It is a frustrating condition that may have either physical or psychological causes. This brochure offers a guide to understanding and treating ED. In more than half of all men with ED, the cause is physical; ED can be the result of diabetes, a hormone problem, blocked arteries, or other causes. And in many cases, physical causes can produce psychological side effects. Diagnosing the cause is the first step before determining an appropriate treatment. Psychological causes can include misinformation, performance anxiety, depression, or stress. Physical causes can include diabetes, vascular problems, pelvic surgery or trauma, neurological disorders, medications, alcoholism, or hormone problems. The brochure describes the physiology of the penis and how an erection occurs, including the stages of the flaccid state, the tumescent penis, and erection. The brochure describes what to expect at the urologist's examination, including the external physical (checking for the pulse to the penis), the rectal examination (to check for prostatitis), and checking for physical abnormalities such as Peyronie's disease (a curved and painful erection caused by scar tissue in the penis). Laboratory tests that may be called for include blood tests and urine analysis, penile blood flow studies, and sleep monitoring. The brochure briefly reviews treatment options, including counseling and sex therapy, oral medications, intraurethral suppositories, injection therapy, vacuum erection devices, venous and arterial surgery, and penile implants. Penile prostheses are described in some detail, including the advantages and disadvantages of the malleable prosthesis, the self contained inflatable prosthesis, the two piece inflatable prosthesis, and the three piece inflatable prosthesis. Diagrams are provided for each type of prosthesis. The brochure concludes with a self test: 23 questions that readers can ask themselves (and share with their urologists) to help ascertain the causes of ED. 26 figures.
•
Hepatitis B: An Unexpected Threat to Your Child's Life.You Can Prevent It Source: Silver Spring, MD: Hepatitis Foundation International. 1998. 6 p. Contact: Available from Hepatitis Foundation International. 504 Blick Drive, Silver Spring, MD 20904-2901. (800) 891-0707 or (301) 662-4200. Fax (301) 622-4702. E-mail:
[email protected]. Website: www.HepatitisFoundation.org. PRICE: $2.00 single copy; bulk pricing available. Summary: Hepatitis B is a dangerous virus that attacks the liver, killing liver cells and replacing them with scar tissue (cirrhosis). This brochure explains to parents the risks of hepatitis B and the importance of giving hepatitis B immunization to their children. The brochure describes the hepatitis B viral infection and the damage that hepatitis B can do
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to the liver, reviews the role of the liver, explains how children can get hepatitis B, notes the problem of sexual transmission of hepatitis B among adolescents, and stresses the need to vaccinate children against hepatitis B. The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that all infants, as well as 11 to 12 year olds, be vaccinated to prevent the spread of hepatitis B and to bring this disease under control. The brochure is illustrated with graphic depictions of a happy cartoon liver. •
Understanding Your Liver: A Primer for Patients Source: Kenilworth, NJ: Schering Corporation. 1998. 14 p. Contact: Available from Schering Corporation. 2000 Galloping Hill Road, Kenilworth, NJ 07033. (800) 446-8766 or (908) 298-4000. Fax (908) 298-4490. Website: www.scheringplough.com. PRICE: Single copy free for patients; available to health professionals through local sales representatives. Summary: The liver performs many varied and complex functions, including cleaning and purifying the blood supply, breaking down certain chemical substances in the blood, storing sugars, fats and vitamins until they are needed, and manufacturing (synthesizes) substances such as complex proteins. This pocket sized booklet briefly reviews the anatomy and physiology of the liver. Topics include the location of the liver, functions of the liver, the physical exam, the architecture of the normal liver, the use of biopsy to determine whether there is liver damage, complications of hepatitis, and the symptoms of cirrhosis (liver scarring). Each topic includes a full color illustration and a brief description. If viral hepatitis infection occurs, it may resolve on its own or become chronic. However, many patients with chronic hepatitis often do not experience symptoms. Others complain of excessive fatigue, weakness, and a reduced capacity for exercise. Since liver damage may occur even in asymptomatic cases (no patient complaints), it is important to perform a biopsy and determine whether there is ongoing liver damage. The biopsy can indicate cellular necrosis (death of the liver cells), inflammation, and scarring (in which scar tissue begins to replace functioning liver cells). The booklet includes blank space for readers to record their notes or questions.
•
Cirrhosis of the Liver Source: Bethesda, MD: American Gastroenterological Association (AGA). 2001. [6 p.]. Contact: Available from American Gastroenterological Association (AGA). 4930 Del Ray Avenue, Bethesda, MD 20814-3015. (301) 654-2055. Fax (301) 654-3978. Website: www.gastro.org. PRICE: Single copy free to patient. Summary: The liver weighs about three pounds and is the largest organ in the body. When chronic diseases cause the liver to become permanently injured and scarred, the condition is called cirrhosis. This brochure outlines cirrhosis, noting that the scar tissue that forms in cirrhosis harms the structure of the liver, blocking the flow of blood through the organ. The loss of normal liver tissue slows the processing of nutrients, hormones, drugs, and toxins by the liver. Also slowed is production of proteins and other substances made by the liver. The brochure reviews the major causes of cirrhosis, the symptoms of the condition, diagnostic tests used to confirm and monitor cirrhosis, treatment options, and complications of cirrhosis and how they are treated. The brochure includes a simplified illustration of the digestive tract and a list of additional readings. 3 figures. 5 references.
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Some Facts About Your Liver Source: idInsight. 2(3): 8. 1999. Contact: Available from Iron Disorders Institute. P.O. Box 2031, Greenville, SC 29602. (864) 241-0111. Fax (864) 244-2104. Website: www.irondisorders.org. Summary: This brief newsletter article describes the basic functions of the liver. The liver produces bile, which emulsifies fats, metabolizes carbohydrates, stores cholesterol and vitamins, and scavenges for bacteria and old red blood cells. Everything a person eats or drinks, including medications, is processed by the liver. In addition to these functions, the liver has a great restorative capability, enabling it to function in spite of scar tissue, tumor, or when impaired by excessive consumption of alcohol and high fat diets. The liver is also one of the only organs in the body with a regenerative capability. The article includes a simple line drawing of the liver and its place in the abdomen. One chart summarizes the liver's functions in five categories: metabolic, filtering, defense, storage, and excretion. 1 figure. 1 table.
•
Anal Fissure: Questions and Answers Source: Arlington Heights, IL: American Society of Colon and Rectal Surgeons. 1996. [2 p.]. Contact: Available from American Society for Colon and Rectal Surgeons (ASCRS). 85 West Algonquin Road, Suite 550, Arlington Heights, IL 60005. (800) 791-0001 or (847) 290-9184. Website: www.fascrs.org. PRICE: Single copy free. Summary: This brochure describes anal fissures, which are small tears in the lining of the anus which can cause pain, bleeding, or itching. A hard, dry bowel movement can cause a tear in the anal lining, resulting in a fissure. Other causes of a fissure include diarrhea and inflammation of the anorectal area. At least 50 percent of fissures heal either by themselves or with nonoperative treatment, including application of medicated cream, use of stool softeners, avoidance of constipation, and the use of sitz baths. A fissure that fails to respond to treatment should be reexamined to determine if a definitive reason exists for the lack of healing. Those fissures that continue to cause pain or bleeding can be corrected by surgery. Surgery usually consists of a small operation to remove the fissure and the underlying scar tissue. Complete healing occurs in a few weeks, although pain often disappears after a few days. More than 90 percent of the patients who require surgery for this problem have no further trouble from fissures. 2 figures.
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Ostomy: Questions and Answers Source: Arlington Heights, IL: American Society of Colon and Rectal Surgeons (ASCRS). 1996. [2 p.]. Contact: Available from American Society for Colon and Rectal Surgeons (ASCRS). 85 West Algonquin Road, Suite 550, Arlington Heights, IL 60005. (800) 791-0001 or (847) 290-9184. PRICE: Single copy free. Also available for free at www.fascrs.org. Summary: This brochure describes ostomies, which are defined as surgically created openings connecting an internal organ to the surface of the body. The most common types of ostomies in intestinal surgery are an ileostomy (connecting the small intestine to the skin) and a colostomy (connecting the large intestine to the skin). An ostomy may be temporary or permanent. A temporary ostomy may be required if the intestinal tract can't be properly prepared for surgery because of blockage by disease or scar tissue, or
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if a disease process or operative site needs to heal without irritation by the passage of stool. A permanent ostomy may be required when disease, or its treatment, impairs normal intestinal function, or when the muscles that control the rectum do not work properly or require removal. The most common causes of these conditions are low rectal cancer and inflammatory bowel disease. After the ostomy has been placed, the surgeon or enterostomal therapy (ET) nurse will teach the patient how to apply and wear a pouch called an ostomy appliance. The pouch is made of a special form of plastic that is held to the body with an adhesive skin barrier. The frequency of bowel movements will vary, depending on the type of ostomy, diet, and bowel habits prior to surgery. Physical activities, including active sports, may be resumed once healing from surgery is complete. Most patients with ostomies resume their usual sexual activity. The brochure notes that it is often comforting and reassuring for a patient who is facing a permanent ostomy to visit with another person who has already been through the surgery and adjusted to his or her ostomy. The brochure concludes with a brief description of the work and training of the colon and rectal surgeon. •
Hepatitis Puts a Dent in Lovin' Source: Cedar Grove, NJ: Hepatitis Foundation International. 199x. 2 p. Contact: Available from Hepatitis Foundation International. 30 Sunrise Terrace, Cedar Grove, NJ 07009. (800) 891-0707. PRICE: Single copy free. Summary: This brochure provides basic information about hepatitis and how to prevent it. The brochure notes that the liver works to convert food into energy, muscles, hormones, immune factors, and clotting factors, and to remove toxins and poisons from all ingested substances. The brochure then explains how hepatitis viruses B and C attack the liver, first causing the liver to become inflamed and eventually killing liver cells, which are replaced with scar tissue, called cirrhosis. Both hepatitis B and C are spread by contact with blood or body fluids that carry these viruses. Hepatitis B is highly infectious, especially through sexual contact; however, vaccination can provide protection against HBV. Hepatitis C is not as easily spread through sexual contact; however, the virus can enter through minor cuts or scrapes by razors, toothbrushes, or on needles used for giving tattoos, drug injection, body piercing or on materials used to snort cocaine. There is no vaccine for HCV, so avoiding exposure is important. The brochure briefly mentions hepatitis A, how it is spread, and the vaccination that can protect against it. (AA-M).
•
Treatment for Spider and Varicose Veins Source: Schaumburg, IL: American Society for Dermatologic Surgery (ASDS). 1998. 6 p. Contact: Available from American Society for Dermatologic Surgery. ATTN: Pamphlets, 930 North Meacham Road, Schaumburg, IL 60173-6016. (800) 441-2737 or (847) 330-9830. Fax (847) 330-1135. Website: www.asds-net.org. PRICE: Package of 50 for members, $25.00; for nonmembers, $40.00; bulk orders sold to physicians only. Call '800' number or access website for single free copy. Summary: This brochure uses a question and answer format to provide the general public with information on the treatment of spider and varicose veins. The fact sheet describes these veins and the factors contributing to them, identifies the health hazards posed by varicose veins, presents treatment methods, and notes possible complications. One method of treating spider or varicose veins is sclerotherapy. This relatively inexpensive procedure involves injecting a saline or specially developed chemical solution into the vein; this causes it to close up or collapse and become scar tissue that is
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eventually absorbed. Other methods include laser surgery, electrodesiccation, surgical ligation and stripping, and ambulatory phlebectomy. The fact sheet provides information on the American Society for Dermatologic Surgery and presents a source for further information. •
About Chalmydia Contact: Washington State Department of Health Office of STD Services, PO Box 47842, Olympia, WA, 98504-7842, http://www.doh.wa.gov/cfh/STD/default.htm. Summary: This brochure, written for the general public, provides information about the sexually transmitted disease (STD), chlamydia. Chlamydia is a disease caused by bacteria and is the most common STD. If not treated, chlamydia can infect the tubes of the sex organs of men and women, blocking them with scar tissue, leading to sterility. It also can cause pelvic inflammatory disease (PID), perihepatitis of the liver, nongonococcal urethritis (NGU), epididymitis of the testicles, Reiter's syndrome, conjunctivitis of the eye, proctitis of the anus, and eye infections and pneumonia in infants. The symptoms of chlamydia include painful urination, genital discharge, swelling of the testicles in men, and soreness of the rectum. Women should make sure that they get tested for chlamydia. Chlamydia is cured by antibiotics. During treatment, individuals should adhere to the regimen guidelines. Individuals can help to prevent chlamydia by abstaining from sex, avoiding substance abuse, which can affect decision making about sex, not injecting drugs, learning more about STDs in general, limiting their sex partners, talking with their partners about safer sex with condoms, and engaging in safer sex with condoms.
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Adhesive Capsulitis Source: American Academy of Family Physicians. March 2003. 2 p. Contact: Available online from American Academy of Family Physicians. Website: http://familydoctor.org. Summary: This fact sheet discusses adhesive capsulitis, a condition in which patients have pain or stiffness when trying to move their shoulder in any direction. Scar tissue forms in the shoulder when patients stop using their shoulders because of the pain. As the scar tissue forms, patients go through a painful stage lasting 3 to 8 months. During the adhesive stage (which lasts 4 to 6 months) and during the recovery stage (which lasts from 1 to 3 months, patients have less pain but more stiffness. After the recovery stage, the stiffness goes away, and the patient can move his or her shoulder again. Treatment to help break up the scar tissue consists of various exercises such as climbing the wall, the Codman exercise, and reaching.
•
Acne Keloidalis Nuchae Source: Kirksville, MO: American Osteopathic College of Dermatology (AOCD). 2001. 1 p. Contact: Available online from American Osteopathic College of Dermatology. 1501 East Illinois Street, P.O. Box 7525, Kirksville, MO 63501. (800) 449-2623 or (660) 665-2184. Fax (660) 627-2623. E-mail:
[email protected]. Website: www.aocd.org/skin/dermatologic_diseases/ index.html. Summary: This fact sheet provides people who have acne keloidalis nuchae (AKN) with information on this condition. AKN occurs primarily among people with stiff or curly hair and those with darker skin. Hairs on the back of the head and neck grow into the
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skin, become inflamed, and cause scar tissue. Treatment options include suppression of the inflammation with antibiotics and steroid gels or intralesional steroid injections. Surgery is used to remove larger lumps of AKN that have been present for a while or have not responded to treatment. Hair removal lasers may be a useful tool in early AKN. 2 figures. •
Esophageal Atresia and Tracheoesophageal Fistula Source: American Family Physician. 59(4): 919-920. February 15, 1999. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. Summary: This fact sheet, designed to be duplicated and distributed by family physicians, reviews esophageal atresia and tracheoesophageal fistula. In babies with esophageal atresia, the esophagus does not go into the stomach; it just ends in a pouch, so nothing the baby swallows gets into the stomach. When a child has a tracheoesophageal fistula, the breathing tube (trachea) and swallowing tube (esophagus) are connected. This means that food or milk in the stomach can get into the lungs and can cause breathing problems and even pneumonia. The fact sheet briefly reviews the causes and diagnosis of these problems, then explains why the baby will need surgery to fix either or both of them. If the baby is not premature and does not have any other problems (like pneumonia or birth defects), the surgery can usually be done when the baby is just a few days old. In less complicated cases, the baby may be eating by a week after surgery. Some babies with esophageal atresia have heart problems, kidney problems, stomach and bowel problems, or muscle and bone problems. Babies born with esophageal atresia sometimes have long term problems, most notably gastroesophageal reflux disease (GERD) or scar tissue where the esophagus connects to the stomach.
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Infusion Tips: Success with Infusion Sets Source: Sylmar, CA: Mini Med Technologies. 1991. 2 p. Contact: Available from Mini Med Technologies. 12744 San Fernando Road, Sylmar, CA 91342. (800) 933-3322. PRICE: Single copy free. Summary: This pamphlet provides infusion tips for patients who use insulin pumps. The pamphlet lists ingenious ways that customers and health care providers have improved the way infusion sets are used. Topics covered include site care, including antiseptics and preventing skin irritation; Sof-set insertion problems, including cannula crimping, cannula bent in L shape, and problems with scar tissue; and tape stickiness, notably tape choices (recommended products) and skin preparations to help tape stick. The pamphlet lists and describes various products that patients have found useful. 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 scar tissue. 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
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specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to scar tissue. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with scar tissue. 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 scar tissue. 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 “scar tissue” (or a synonym), and you will receive information on all relevant organizations listed in the database.
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Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “scar tissue”. 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 “scar tissue” (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 “scar tissue” (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.18
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
18
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)19: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
19
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 117
•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 119
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
121
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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SCAR TISSUE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablate: In surgery, is to remove. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Abscess: A localized, circumscribed collection of pus. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Keloid: A type of acneiform disorder in which secondary pyogenic infection in and around pilosebaceous structures ends in keloidal scarring. It manifests as persistent folliculitis of the back of the neck associated with occlusion of the follicular orifices. It is most often encountered in black or Asian men. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Actin: Essential component of the cell skeleton. [NIH] Actinin: A protein factor that regulates the length of R-actin. It is chemically similar, but immunochemically distinguishable from actin. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as
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dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adduction: The rotation of an eye toward the midline (nasally). [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH] Adhesives: Substances that cause the adherence of two surfaces. They include glues (properly collagen-derived adhesives), mucilages, sticky pastes, gums, resins, or latex. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Air Pressure: The force per unit area that the air exerts on any surface in contact with it. Primarily used for articles pertaining to air pressure within a closed environment. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [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
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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] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] 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] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] 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] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino-terminal: The end of a protein or polypeptide chain that contains a free amino group (-NH2). [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH]
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Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [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] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurism: A localized abnormal dilatation of a blood vessel filled with fluid or clotted blood, forming a pulsating tumor, and resulting from disease of the vessel wall. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] 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] Anisotropy: A physical property showing different values in relation to the direction in or along which the measurement is made. The physical property may be with regard to thermal or electric conductivity or light refraction. In crystallography, it describes crystals whose index of refraction varies with the direction of the incident light. It is also called acolotropy and colotropy. The opposite of anisotropy is isotropy wherein the same values characterize the object when measured along axes in all directions. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anterior chamber: The space in front of the iris and behind the cornea. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU]
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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] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [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] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal
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phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]
Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Endopeptidases: A sub-subclass of endopeptidases that depend on an aspartic acid residue for their activity. EC 3.4.23. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astigmatism: A condition in which the surface of the cornea is not spherical; causes a blurred image to be received at the retina. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called endarterectomy. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU]
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Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmune Hepatitis: A liver disease caused when the body's immune system destroys liver cells for no known reason. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Axillary Vein: The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Axotomy: Transection or severing of an axon. This type of denervation is used often in experimental studies on neuronal physiology and neuronal death or survival, toward an understanding of nervous system disease. [NIH] Back Injuries: General or unspecified injuries to the posterior part of the trunk. It includes injuries to the muscles of the back. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [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] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Balanitis: Inflammation of the glans penis. [NIH] Balloon dilation: A treatment for benign prostatic hyperplasia or prostate enlargement. A tiny balloon is inflated inside the urethra to make it wider so urine can flow more freely from the bladder. [NIH]
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Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] 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]
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Bladder: The organ that stores urine. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [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 Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]
Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachiocephalic Veins: Large veins on either side of the root of the neck formed by the junction of the internal jugular and subclavian veins. They drain blood from the head, neck, and upper extremities, and unite to form the superior vena cava. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
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Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Implants: Implants used to reconstruct and/or cosmetically enhance the female breast. They have an outer shell or envelope of silicone elastomer and are filled with either saline or silicone gel. The outer shell may be either smooth or textured. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Broad Ligament: A broad fold of peritoneum that extends from the side of the uterus to the wall of the pelvis. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caecum: The blind pouch in which the large intestine begins and into which the ileum opens from one side. [NIH] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [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-, poly-
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and heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catalytic Domain: The region of an enzyme that interacts with its substrate to cause the enzymatic reaction. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheter Ablation: Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DCshock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH]
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Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [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 Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [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] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH]
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Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]
Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Cicatrix: The formation of new tissue in the process of wound healing. [NIH] Cicatrix, Hypertrophic: An elevated scar, resembling a keloid, but which does not spread into surrounding tissues. It is formed by enlargement and overgrowth of cicatricial tissue and regresses spontaneously. [NIH] Circumcision: Excision of the prepuce or part of it. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical series: A case series in which the patients receive treatment in a clinic or other medical facility. [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] Clot Retraction: Retraction of a clot resulting from contraction of platelet pseudopods attached to fibrin strands that is dependent on the contractile protein thrombosthenin. Used as a measure of platelet function. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a
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sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Implants: Electronic devices implanted beneath the skin with electrodes to the cochlear nerve to create sound sensation in persons with sensorineural deafness. [NIH] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Coitus: Sexual intercourse. [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] Colectomy: An operation to remove the colon. An open colectomy is the removal of the colon through a surgical incision made in the wall of the abdomen. Laparoscopic-assisted colectomy uses a thin, lighted tube attached to a video camera. It allows the surgeon to remove the colon without a large incision. [NIH] Colitis: Inflammation of the colon. [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] Collagenases: Enzymes that catalyze the degradation of collagen by acting on the peptide bonds. EC 3.4.24.-. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH]
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Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Complete response: The disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily
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concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consensus Sequence: A theoretical representative nucleotide or amino acid sequence in which each nucleotide or amino acid is the one which occurs most frequently at that site in the different sequences which occur in nature. The phrase also refers to an actual sequence which approximates the theoretical consensus. A known conserved sequence set is represented by a consensus sequence. Commonly observed supersecondary protein structures (amino acid motifs) are often formed by conserved sequences. [NIH] Conserved Sequence: A sequence of amino acids in a polypeptide or of nucleotides in DNA or RNA that is similar across multiple species. A known set of conserved sequences is represented by a consensus sequence. Amino acid motifs are often composed of conserved sequences. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constrict: Tighten; narrow. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [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] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH]
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Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [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 heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]
Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyanoacrylates: A group of compounds having the general formula CH2=C(CN)-COOR; it polymerizes on contact with moisture; used as tissue adhesive; higher homologs have hemostatic and antibacterial properties. [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] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH]
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Cyst: A sac or capsule filled with fluid. [NIH] Cysteine Endopeptidases: Endopeptidases which have a cysteine involved in the catalytic process. This group of enzymes is inactivated by sulfhydryl reagents. EC 3.4.22. [NIH] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytostatic: An agent that suppresses cell growth and multiplication. [EU] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decompensation: Failure of compensation; cardiac decompensation is marked by dyspnea, venous engorgement, and edema. [EU] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Defibrillation: The act to arrest the fibrillation of (heart muscle) by applying electric shock across the chest, thus depolarizing the heart cells and allowing normal rhythm to return. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU]
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Dermal: Pertaining to or coming from the skin. [NIH] Dermatofibrosarcoma protuberans: A type of tumor that begins as a hard nodule and grows slowly. These tumors are usually found in the dermis (the inner layer of the two main layers of tissue that make up the skin) of the limbs or trunk of the body. They can grow into surrounding tissue, but do not spread to other parts of the body. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]
Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU]
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Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dosimetry: All the methods either of measuring directly, or of measuring indirectly and computing, absorbed dose, absorbed dose rate, exposure, exposure rate, dose equivalent, and the science associated with these methods. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyspareunia: Painful sexual intercourse. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophin: A muscle protein localized in surface membranes which is the product of the Duchenne/Becker muscular dystrophy gene. Individuals with Duchenne muscular dystrophy usually lack dystrophin completely while those with Becker muscular dystrophy have dystrophin of an altered size. It shares features with other cytoskeletal proteins such as spectrin and alpha-actinin but the precise function of dystrophin is not clear. One possible role might be to preserve the integrity and alignment of the plasma membrane to the myofibrils during muscle contraction and relaxation. MW 400 kDa. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elastomers: A generic term for all substances having the properties of natural, reclaimed, vulcanized, or synthetic rubber, in that they stretch under tension, have a high tensile
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strength, retract rapidly, and recover their original dimensions fully. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric Conductivity: The ability of a substrate to allow the passage of electrons. [NIH] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrodesiccation: The drying of tissue by a high-frequency electric current applied with a needle-shaped electrode. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] 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] Embryogenesis: The process of embryo or embryoid formation, whether by sexual (zygotic) or asexual means. In asexual embryogenesis embryoids arise directly from the explant or on intermediary callus tissue. In some cases they arise from individual cells (somatic cell embryoge). [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH]
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Endopeptidases: A subclass of peptide hydrolases. They are classified primarily by their catalytic mechanism. Specificity is used only for identification of individual enzymes. They comprise the serine endopeptidases, EC 3.4.21; cysteine endopeptidases, EC 3.4.22; aspartic endopeptidases, EC 3.4.23, metalloendopeptidases, EC 3.4.24; and a group of enzymes yet to be assigned to any of the above sub-classes, EC 3.4.99. EC 3.4.-. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enterostomal Therapy: A nurse who cares for patients with an ostomy. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] 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] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [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] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales.
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Also called squamous cell carcinoma. [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] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]
Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethmoid: An unpaired cranial bone which helps form the medial walls of the orbits and contains the themoidal air cells which drain into the nose. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excisional: The surgical procedure of removing a tumor by cutting it out. The biopsy is then examined under a microscope. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excrete: To get rid of waste from the body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH]
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Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] 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] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibril: Most bacterial viruses have a hollow tail with specialized fibrils at its tip. The tail fibers attach to the cell wall of the host. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU]
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Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectins: Glycoproteins found on the surfaces of cells, particularly in fibrillar structures. The proteins are lost or reduced when these cells undergo viral or chemical transformation. They are highly susceptible to proteolysis and are substrates for activated blood coagulation factor VIII. The forms present in plasma are called cold-insoluble globulins. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibrotic tissue: Inflamed tissue that has become scarred. [NIH] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flaccid: Weak, lax and soft. [EU] Flank Pain: Pain emanating from below the ribs and above the ilium. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure
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of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Follicles: Shafts through which hair grows. [NIH] Folliculitis: Inflammation of follicles, primarily hair follicles. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU]
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Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gelatinases: A class of enzymes that catalyzes the degradation of gelatin by acting on the peptide bonds. EC 3.4.24.-. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] 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]
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Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomeruli: Plural of glomerulus. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [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] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]
Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Survival: The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid
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cells, macrophages, and plasma cells. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [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] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [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] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic
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alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatitis Viruses: Any of the viruses that cause inflammation of the liver. They include both DNA and RNA viruses as well viruses from humans and animals. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [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] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]
Herniated: Protrusion of a degenerated or fragmented intervertebral disc into the intervertebral foramen compressing the nerve root. [NIH] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homodimer: Protein-binding "activation domains" always combine with identical proteins. [NIH]
Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydration: Combining with water. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [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
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isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydronephrosis: Abnormal enlargement of a kidney, which may be caused by blockage of the ureter (such as by a kidney stone) or chronic kidney disease that prevents urine from draining into the bladder. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [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] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [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] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterectomy: Excision of the uterus. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileal: Related to the ileum, the lowest end of the small intestine. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH]
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Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunophilins: Members of a family of highly conserved proteins which are all cis-trans peptidyl-prolyl isomerases (peptidylprolyl isomerase). They bind the immunosuppressant drugs cyclosporine; tacrolimus and sirolimus. They possess rotomase activity, which is inhibited by the immunosuppressant drugs that bind to them. EC 5.2.1.- [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotoxins: Semisynthetic conjugates of various toxic molecules, including radioactive isotopes and bacterial or plant toxins, with specific immune substances such as immunoglobulins, monoclonal antibodies, and antigens. The antitumor or antiviral immune substance carries the toxin to the tumor or infected cell where the toxin exerts its poisonous effect. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incidental: 1. Small and relatively unimportant, minor; 2. Accompanying, but not a major part of something; 3. (To something) Liable to occur because of something or in connection with something (said of risks, responsibilities, .) [EU] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a
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specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inferior vena cava: A large vein that empties into the heart. It carries blood from the legs and feet, and from organs in the abdomen and pelvis. [NIH] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [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] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH]
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Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] 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 Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [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
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is used in water purification, in research, and in industry. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iontophoresis: Therapeutic introduction of ions of soluble salts into tissues by means of electric current. In medical literature it is commonly used to indicate the process of increasing the penetration of drugs into surface tissues by the application of electric current. It has nothing to do with ion exchange, air ionization nor phonophoresis, none of which requires current. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irrigation: The washing of a body cavity or surface by flowing solution which is inserted and then removed. Any drug in the irrigation solution may be absorbed. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isotonic: A biological term denoting a solution in which body cells can be bathed without a net flow of water across the semipermeable cell membrane. Also, denoting a solution having the same tonicity as some other solution with which it is compared, such as physiologic salt solution and the blood serum. [EU] 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]
Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Joint Capsule: The sac enclosing a joint. It is composed of an outer fibrous articular capsule and an inner synovial membrane. [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] Keloid: A sharply elevated, irregularly shaped, progressively enlarging scar resulting from formation of excessive amounts of collagen in the dermis during connective tissue repair. It is differentiated from a hypertrophic scar (cicatrix, hypertrophic) in that the former does not spread to surrounding tissues. [NIH]
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Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney Pelvis: The flattened, funnel-shaped expansion connecting the ureter to the kidney calices. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lacerations: Torn, ragged, mangled wounds. [NIH] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Lamivudine: A reverse transcriptase inhibitor and zalcitabine analog in which a sulfur atom replaces the 3' carbon of the pentose ring. It is used to treat HIV disease. [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] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH]
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Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lethal: Deadly, fatal. [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] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Light microscope: A microscope (device to magnify small objects) in which objects are lit directly by white light. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipectomy: Removal of localized subcutaneous fat deposits by suction curettage or blunt cannulization in the cosmetic correction of obesity and other esthetic contour defects. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]
Lucida: An instrument, invented by Wollaton, consisting essentially of a prism or a mirror through which an object can be viewed so as to appear on a plane surface seen in direct view
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and on which the outline of the object may be traced. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] 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] Macroglia: A type of neuroglia composed of astrocytes. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mammary: Pertaining to the mamma, or breast. [EU] Mammography: Radiographic examination of the breast. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work
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properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] 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] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Meniscus: A fibro-cartilage within a joint, especially of the knee. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metalloendopeptidases: Endopeptidases which use a metal, normally zinc, in the catalytic mechanism. This group of enzymes is inactivated by metal chelators. EC 3.4.24. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH]
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Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microsurgery: Surgical procedures on the cellular level; a light microscope and miniaturized instruments are used. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] 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] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH]
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Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU]
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Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelography: X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space. [NIH] Myelosuppression: A condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Myelosuppression is a side effect of some cancer treatments. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]
Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myofibrils: Highly organized bundles of actin, myosin, and other proteins in the cytoplasm of skeletal and cardiac muscle cells that contract by a sliding filament mechanism. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myxedema: A condition characterized by a dry, waxy type of swelling with abnormal deposits of mucin in the skin and other tissues. It is produced by a functional insufficiency of the thyroid gland, resulting in deficiency of thyroid hormone. The skin becomes puffy around the eyes and on the cheeks and the face is dull and expressionless with thickened nose and lips. The congenital form of the disease is cretinism. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH]
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Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nasal Polyps: Focal accumulations of edema fluid in the nasal mucosa accompanied by hyperplasia of the associated submucosal connective tissue. Polyps may be neoplasms, foci of inflammation, degenerative lesions, or malformations. [NIH] Nasal Septum: The partition separating the two nasal cavities in the midplane, composed of cartilaginous, membranous and bony parts. [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] Nearsightedness: The common term for myopia. [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] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [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] 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] Nerve Regeneration: Renewal or physiological repair of damaged nerve tissue. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroglia: The non-neuronal cells of the nervous system. They are divided into macroglia (astrocytes, oligodendroglia, and schwann cells) and microglia. They not only provide physical support, but also respond to injury, regulate the ionic and chemical composition of the extracellular milieu, participate in the blood-brain and blood-retina barriers, form the myelin insulation of nervous pathways, guide neuronal migration during development, and exchange metabolites with neurons. Neuroglia have high-affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitters, but their role in signaling (as in many other functions) is unclear. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous
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system. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Obstipation: Intractable constipation. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Oncology: The study of cancer. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmic: Pertaining to the eye. [EU]
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Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orofacial: Of or relating to the mouth and face. [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] 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] 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] Ostomy: Surgical construction of an artificial opening (stoma) for external fistulization of a duct or vessel by insertion of a tube with or without a supportive stent. [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] Ovalbumin: An albumin obtained from the white of eggs. It is a member of the serpin superfamily. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [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
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gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH] 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] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH]
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Pedicle: Embryonic link between the optic vesicle or optic cup and the forebrain or diencephalon, which becomes the optic nerve. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillamine: 3-Mercapto-D-valine. The most characteristic degradation product of the penicillin antibiotics. It is used as an antirheumatic and as a chelating agent in Wilson's disease. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penile Prosthesis: Rigid, semi-rigid, or inflatable cylindric hydraulic devices, with either combined or separate reservoir and pumping systems, implanted for the surgical treatment of organic impotence. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptic Ulcer Hemorrhage: Bleeding from a peptic ulcer. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Hydrolases: A subclass of enzymes from the hydrolase class that catalyze the hydrolysis of peptide bonds. Exopeptidases and endopeptidases make up the sub-subclasses for this group. EC 3.4. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The
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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] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phimosis: The inability to retract the foreskin over the glans penis due to tightness of the prepuce. [NIH] Phonation: The process of producing vocal sounds by means of vocal cords vibrating in an expiratory blast of air. [NIH] Phonophoresis: Use of ultrasound to increase the percutaneous adsorption of drugs. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] 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] Physical Medicine: A medical specialty concerned with the use of physical agents, mechanical apparatus, and manipulation in rehabilitating physically diseased or injured patients. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase
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"physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]
Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [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] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides,
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proteins, plastics). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Polyurethanes: A group of thermoplastic or thermosetting polymers containing polyisocyanate. They are used as elastomers, as coatings, as fibers and as foams. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Portal Hypertension: High blood pressure in the portal vein. This vein carries blood into the liver. Portal hypertension is caused by a blood clot. This is a common complication of cirrhosis. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Postural: Pertaining to posture or position. [EU] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prepuce: A covering fold of skin; often used alone to designate the preputium penis. [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]
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Primary Sclerosing Cholangitis: Irritation, scarring, and narrowing of the bile ducts inside and outside the liver. Bile builds up in the liver and may damage its cells. Many people with this condition also have ulcerative colitis. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] 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] Proctitis: Inflammation of the rectum. [EU] Proenzymes: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] 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] Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU]
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Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostatitis: Inflammation of the prostate. [EU] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [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] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]
Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]
Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU]
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Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH] Pulmonary Valve: A valve situated at the entrance to the pulmonary trunk from the right ventricle. [NIH] Pulmonary Veins: The veins that return the oxygenated blood from the lungs to the left atrium of the heart. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] 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
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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] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiologist: A doctor who specializes in creating and interpreting pictures of areas inside the body. The pictures are produced with x-rays, sound waves, or other types of energy. [NIH]
Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to
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crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recuperation: The recovery of health and strength. [EU] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reoperation: A repeat operation for the same condition in the same patient. It includes reoperation for reexamination, reoperation for disease progression or recurrence, or reoperation following operative failure. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration
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(= cell respiration). [NIH] Response Elements: Nucleotide sequences, usually upstream, which are recognized by specific regulatory transcription factors, thereby causing gene response to various regulatory agents. These elements may be found in both promotor and enhancer regions. [NIH]
Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retropubic prostatectomy: Surgery to remove the prostate through an incision made in the abdominal wall. [NIH] Retrosternal: Situated or occurring behind the sternum. [EU] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rheology: The study of the deformation and flow of matter, usually liquids or fluids, and of the plastic flow of solids. The concept covers consistency, dilatancy, liquefaction, resistance to flow, shearing, thixotrophy, and viscosity. [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] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU]
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Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rituximab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. [NIH] Rod: A reception for vision, located in the retina. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoid: A cutaneus lesion occurring as a manifestation of sarcoidosis. [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] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Sclerotherapy: Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. [NIH] Scoliosis: A lateral curvature of the spine. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH]
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Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] 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] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [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] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] 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] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septum: A dividing wall or partition; a general term for such a structure. The term is often used alone to refer to the septal area or to the septum pellucidum. [EU] Septum Pellucidum: A triangular double membrane separating the anterior horns of the lateral ventricles of the brain. It is situated in the median plane and bounded by the corpus callosum and the body and columns of the fornix. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serine Endopeptidases: Any member of the group of endopeptidases containing at the active site a serine residue involved in catalysis. EC 3.4.21. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH]
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Serrated: Having notches or teeth on the edge as a saw has. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicone Elastomers: Polymers of silicone that are formed by crosslinking and treatment with amorphous silica to increase strength. They have properties similar to vulcanized natural rubber, in that they stretch under tension, retract rapidly, and fully recover to their original dimensions upon release. They are used in the encapsulation of surgical membranes and implants. [NIH] Silicone Gels: Synthetic organosiloxane gels that are formed from synthetic polymers of silicone oxide with organic sidechains (polydimethylsiloxane) by lengthening the polymer chains. Unlike silicone elastomers, they are not treated with amorphous silica. They are used as fillers in breast implants. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Sirolimus: A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. [NIH] Sitz Bath: A special plastic tub. A person sits in a few inches of warm water to help relieve discomfort of hemorrhoids or anal fissures. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH]
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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] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrin: A high molecular weight (220-250 kDa) water-soluble protein which can be extracted from erythrocyte ghosts in low ionic strength buffers. The protein contains no lipids or carbohydrates, is the predominant species of peripheral erythrocyte membrane proteins, and exists as a fibrous coating on the inner, cytoplasmic surface of the membrane. [NIH]
Sperm: The fecundating fluid of the male. [NIH] Sphenoid: An unpaired cranial bone with a body containing the sphenoid sinus and forming the posterior part of the medial walls of the orbits. [NIH]
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Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] 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] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spinous: Like a spine or thorn in shape; having spines. [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] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stellate: Star shaped. [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] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH]
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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] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Sternum: Breast bone. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stoma: A surgically created opening from an area inside the body to the outside. [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] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb. [NIH] Subclavian Vein: The continuation of the axillary vein which follows the subclavian artery and then joins the internal jugular vein to form the brachiocephalic vein. [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] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a
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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] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superior vena cava: Vein which returns blood from the head and neck, upper limbs, and thorax. It is formed by the union of the two brachiocephalic veins. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Systemic: Affecting the entire body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] 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]
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Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [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 inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Thermal: Pertaining to or characterized by heat. [EU] Thermolysin: A thermostable extracellular metalloendopeptidase containing four calcium ions. (Enzyme Nomenclature, 1992) 3.4.24.27. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] 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] Thymidine: A chemical compound found in DNA. Also used as treatment for mucositis. [NIH]
Thymidine Kinase: An enzyme that catalyzes the conversion of ATP and thymidine to ADP and thymidine 5'-phosphate. Deoxyuridine can also act as an acceptor and dGTP as a donor. (From Enzyme Nomenclature, 1992) EC 2.7.1.21. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Adhesives: Substances used to cause adherence of tissue to tissue or tissue to nontissue surfaces, as for prostheses. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs
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(including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheoesophageal Fistula: Abnormal communication between the esophagus and the trachea, acquired or congenital, often associated with esophageal atresia. [NIH] Traction: The act of pulling. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer
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both local and systemic cellular immunity to nonimmune recipients. [NIH] Transforming Growth Factor beta: A factor synthesized in a wide variety of tissues. It acts synergistically with TGF-alpha in inducing phenotypic transformation and can also act as a negative autocrine growth factor. TGF-beta has a potential role in embryonal development, cellular differentiation, hormone secretion, and immune function. TGF-beta is found mostly as homodimer forms of separate gene products TGF-beta1, TGF-beta2 or TGF-beta3. Heterodimers composed of TGF-beta1 and 2 (TGF-beta1.2) or of TGF-beta2 and 3 (TGFbeta2.3) have been isolated. The TGF-beta proteins are synthesized as precursor proteins. [NIH]
Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Traumatology: The branch of surgery which deals with wounds and disability from injuries. [NIH]
Tricuspid Valve: The valve consisting of three cusps situated between the right atrium and right ventricle of the heart. [NIH] Trophic: Of or pertaining to nutrition. [EU] Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [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] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]
Turbinates: The scroll-like bony plates with curved margins on the lateral wall of the nasal cavity. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH]
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Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urethritis: Inflammation of the urethra. [EU] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]
Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. [NIH]
Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasodilator: An agent that widens blood vessels. [NIH]
190
Scar Tissue
Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]
Ventricular Remodeling: The geometric and structural changes that the ventricle undergoes, usually following myocardial infarction. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vesicovaginal Fistula: An abnormal communication between the bladder and the vagina. [NIH]
Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] 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] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitreoretinal: A rare familial condition characterized by a clear vitreous, except for preretinal filaments and veils which have been loosened from the retina, a dense hyaloid membrane which is perforated and detached, and masses of peripheral retinal pigmentation inters. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used
Dictionary
191
together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Voice Disorders: Disorders of voice pitch, loudness, or quality. Dysphonia refers to impaired utterance of sounds by the vocal folds. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zalcitabine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chainterminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
193
INDEX 3 3-dimensional, 13, 50, 123 A Abdomen, 9, 109, 123, 131, 134, 136, 155, 156, 159, 169, 183, 184, 186 Abdominal, 3, 9, 18, 32, 42, 46, 63, 64, 66, 74, 77, 86, 123, 132, 167, 178, 188 Abdominal Pain, 4, 9, 86, 123, 188 Ablate, 123, 133 Ablation, 16, 55, 56, 123 Abortion, 54, 123 Abscess, 89, 123, 180, 183 Acceptor, 123, 186 Acetylcholine, 123, 166 Acne, 68, 106, 111, 123 Acne Keloid, 111, 123 Acne Vulgaris, 68, 123 Acoustic, 46, 47, 86, 123 Actin, 17, 123, 163, 164 Actinin, 123, 142 Activities of Daily Living, 3, 123 Acute renal, 124, 151 Adaptation, 41, 124 Adduction, 85, 124 Adenocarcinoma, 19, 124 Adhesions, 9, 38, 39, 46, 49, 63, 74, 76, 77, 80, 124 Adhesives, 38, 57, 71, 124 Adjustment, 85, 124 Adjuvant, 124, 149 Adrenal Cortex, 124, 139, 173 Adverse Effect, 124, 181 Affinity, 124, 128, 165 Agar, 124, 171 Air Pressure, 68, 124 Airway, 16, 124 Albumin, 124, 167 Algorithms, 125, 130 Alkaline, 22, 125, 132, 186 Alkaline Phosphatase, 22, 125 Alkaloid, 125, 136, 163 Alpha Particles, 125, 176 Alternative medicine, 94, 125 Ameliorated, 21, 41, 125 Amine, 125, 152 Amino Acid Sequence, 125, 127, 138, 149, 173 Amino-terminal, 125, 173
Amphetamines, 125, 136 Ampulla, 125, 144 Amputation, 10, 125 Anaesthesia, 126, 155 Anal, 4, 109, 126, 147, 181 Anal Fissure, 109, 126, 181 Analgesics, 48, 126 Analog, 126, 158 Anaplasia, 126 Anastomosis, 9, 63, 80, 126 Anatomical, 11, 48, 126, 128, 135, 154, 162, 179 Androgens, 124, 126, 139 Anesthesia, 8, 124, 126, 128, 143 Aneurism, 40, 126 Aneurysm, 10, 56, 126 Angina, 39, 63, 126 Angiogenesis, 22, 42, 79, 126, 161 Angioplasty, 44, 69, 126, 128, 164 Animal model, 50, 126 Anisotropy, 10, 126 Ankle, 126, 189 Anorectal, 109, 126 Anterior chamber, 58, 126, 157 Antibacterial, 5, 126, 139 Antibiotic, 7, 46, 127, 169 Antibodies, 12, 64, 127, 152, 153, 154, 160, 163, 171, 176 Antibody, 20, 124, 127, 137, 152, 154, 155, 157, 163, 176, 179, 182, 191 Anticoagulant, 127, 174 Antifungal, 5, 127, 181 Antigen, 20, 124, 127, 137, 149, 152, 153, 154, 155, 156, 162 Anti-inflammatory, 16, 53, 127, 139, 150, 168 Anti-Inflammatory Agents, 127, 139 Antimetabolite, 127, 162 Antimicrobial, 24, 127 Antineoplastic, 127, 131, 139, 162, 181 Anuria, 127, 158 Anus, 109, 111, 126, 127, 128, 131, 136, 144, 169, 177 Anxiety, 107, 127 Aorta, 39, 40, 62, 68, 127, 184, 190 Aortic Valve, 62, 127 Aperture, 66, 127, 175 Apoptosis, 41, 127
Scar tissue
Aqueous, 65, 127, 130, 140, 143, 159 Arachidonic Acid, 127, 173 Arginine, 128, 166, 188 Arrhythmia, 56, 93, 128, 190 Arterial, 17, 70, 80, 107, 128, 150, 153, 174, 185 Arteries, 39, 61, 62, 69, 84, 107, 127, 128, 131, 139, 162, 164 Arterioles, 128, 131, 132, 162 Arteriosus, 128, 175 Artery, 22, 39, 40, 44, 62, 69, 126, 128, 139, 143, 164, 168, 175, 177, 184 Articular, 60, 128, 157 Articulation, 16, 128 Aseptic, 128, 184 Aspartic, 128, 144 Aspartic Endopeptidases, 128, 144 Aspiration, 26, 128 Assay, 12, 128 Astigmatism, 58, 128, 177 Astrocytes, 14, 128, 160, 162, 165 Asymptomatic, 89, 95, 108, 128 Atherectomy, 70, 128, 143 Atresia, 112, 128, 187 Atrial, 16, 68, 75, 79, 128 Atrial Fibrillation, 16, 128 Atrium, 40, 62, 68, 75, 128, 162, 175, 188, 190 Attenuation, 76, 129 Autoimmune disease, 129, 163 Autoimmune Hepatitis, 86, 129 Autologous, 61, 129 Autonomic, 123, 129, 170 Autonomic Nervous System, 129, 170 Axillary, 129, 184 Axillary Vein, 129, 184 Axonal, 11, 72, 129, 191 Axons, 11, 14, 34, 129, 167 Axotomy, 14, 129 B Back Injuries, 88, 129 Back Pain, 8, 129 Bacteria, 8, 41, 109, 111, 126, 127, 129, 130, 143, 144, 145, 146, 162, 176, 180, 187, 189 Bacterial Physiology, 124, 129 Bactericidal, 129, 145 Bacteriophage, 129, 171, 187 Bacterium, 129, 151 Balanitis, 4, 129 Balloon dilation, 85, 129 Base, 54, 62, 66, 81, 130, 140, 149, 157, 158, 185
194
Basement Membrane, 130, 146, 158 Basophils, 130, 151, 159 Benign, 6, 8, 9, 21, 46, 129, 130, 165, 176, 191 Benign prostatic hyperplasia, 129, 130 Bile, 56, 61, 84, 87, 88, 109, 130, 135, 148, 149, 157, 159, 173, 184 Bile Acids, 130, 149, 184 Bile Acids and Salts, 130 Bile duct, 56, 61, 87, 88, 130, 135, 173 Bile Pigments, 130, 157 Biliary, 84, 88, 130 Biliary Tract, 88, 130 Biochemical, 11, 29, 127, 130, 148, 158 Biological response modifier, 130, 156 Biological therapy, 130, 151 Biopsy, 5, 17, 19, 95, 108, 130, 145, 169 Biotechnology, 23, 94, 101, 130 Bladder, 5, 9, 61, 64, 73, 88, 89, 106, 129, 130, 131, 148, 153, 154, 163, 174, 177, 178, 189, 190 Bleomycin, 50, 131 Bloating, 4, 131 Blood Coagulation, 131, 132, 147, 186 Blood Platelets, 131, 186 Blood pressure, 74, 131, 133, 150, 153, 163, 172 Blood transfusion, 92, 131 Blood vessel, 7, 8, 11, 39, 44, 45, 56, 63, 66, 69, 80, 126, 131, 132, 133, 134, 135, 144, 151, 157, 159, 160, 169, 175, 182, 183, 184, 186, 189 Blot, 14, 131 Body Fluids, 59, 80, 110, 131, 132, 142 Bone Marrow, 20, 131, 139, 149, 154, 160, 164, 182, 184 Bone scan, 131, 179 Bowel, 9, 32, 46, 73, 76, 80, 84, 87, 109, 110, 112, 126, 131, 141, 144, 155, 156, 184, 188 Bowel Movement, 109, 110, 131, 141, 184 Brachiocephalic Veins, 131, 185 Brachytherapy, 60, 131, 156, 157, 176, 191 Bradycardia, 56, 131 Bradykinin, 131, 166 Branch, 62, 119, 131, 140, 143, 160, 168, 175, 182, 188 Breakdown, 95, 132, 141, 148, 167 Breast Implants, 19, 132, 181 Breeding, 54, 132 Broad Ligament, 132, 146 Bronchi, 132, 187 Bronchial, 132, 152
195
Buccal, 132, 160 Bulbar, 5, 132 Burns, 8, 12, 18, 24, 45, 76, 81, 132 Burns, Electric, 132 Bypass, 39, 106, 132, 164 C Caecum, 26, 132 Caesarean section, 32, 132 Calcium, 12, 132, 137, 160, 164, 167, 168, 181, 186, 190 Calcium channel blocker, 132, 190 Callus, 132, 143 Cannula, 66, 112, 132 Capillary, 131, 132, 190 Capsules, 132, 149 Carbohydrate, 31, 132, 139, 150, 172 Carbon Dioxide, 133, 140, 147, 177 Carcinogen, 81, 133 Carcinogenesis, 81, 133 Carcinogenic, 133, 155, 166, 173, 184 Carcinoma, 27, 133 Cardiac, 6, 17, 22, 56, 62, 65, 75, 79, 128, 133, 140, 143, 164, 167, 184, 185 Cardiovascular, 56, 73, 133 Cardiovascular disease, 73, 133 Cardiovascular System, 56, 133 Carotene, 133, 178 Case report, 26, 133 Case series, 133, 135 Catalytic Domain, 50, 133 Catheter, 44, 55, 56, 57, 59, 60, 65, 68, 69, 70, 71, 128, 133, 143 Catheter Ablation, 56, 133 Catheterization, 126, 133, 164 Caudal, 133, 141, 172 Causal, 13, 133 Cause of Death, 15, 39, 133 Cecum, 134, 158 Cell Adhesion, 13, 21, 134, 156 Cell Death, 127, 134, 149 Cell Differentiation, 134, 181 Cell Division, 129, 134, 140, 151, 162, 171 Cell membrane, 55, 79, 134, 140, 157, 170 Cell proliferation, 44, 63, 73, 77, 78, 134, 181 Cell Size, 134, 148 Cell Survival, 134, 151 Cell Transplantation, 79, 134 Cellulose, 134, 148, 171 Central Nervous System, 41, 123, 125, 129, 134, 136, 148, 150, 162, 163, 167 Cerebral, 134, 147
Cerebral Cortex, 134, 147 Cerebrospinal, 134, 181 Cerebrospinal fluid, 134, 181 Cerebrovascular, 133, 134 Cervix, 123, 134, 147 Character, 134, 140 Chest Pain, 6, 39, 63, 134 Chest wall, 59, 134 Chin, 72, 135, 161 Chlorophyll, 135, 148 Cholangitis, 87, 88, 135 Cholesterol, 109, 130, 135, 139, 184 Chondroitin sulfate, 11, 14, 20, 135 Chromatin, 127, 135, 144 Chromosome, 135, 159 Chronic Disease, 108, 135 Cicatrix, 135, 157 Cicatrix, Hypertrophic, 135, 157 Circumcision, 4, 135 Cirrhosis, 4, 15, 84, 87, 107, 108, 110, 135, 151, 172 CIS, 135, 154, 178 Clamp, 40, 135 Cleft Palate, 24, 30, 135 Clinical Medicine, 135, 172 Clinical series, 60, 135 Clinical trial, 9, 101, 135, 139, 168, 174 Cloning, 130, 135 Clot Retraction, 135, 171 Coagulation, 131, 135, 151, 158, 186 Coca, 136 Cocaine, 110, 136 Cochlea, 136, 155 Cochlear, 83, 136 Cochlear Implants, 83, 136 Cochlear Nerve, 136 Coitus, 7, 136 Colchicine, 16, 87, 136 Colectomy, 80, 136 Colitis, 87, 88, 136 Collagenases, 50, 136 Collapse, 12, 110, 132, 136 Colon, 32, 109, 110, 136, 137, 155, 158, 188 Colorectal, 5, 136 Colostomy, 109, 137 Complement, 137, 156 Complete remission, 20, 137, 177 Complete response, 137 Computational Biology, 101, 137 Computed tomography, 8, 9, 32, 137, 179 Computerized tomography, 21, 137 Conception, 123, 137, 146, 184
Scar tissue
Concomitant, 20, 85, 137 Condoms, 111, 137 Conduction, 133, 137 Cone, 12, 137, 185 Congestion, 48, 138 Congestive heart failure, 40, 138 Conjugated, 20, 130, 138 Conjunctiva, 138 Conjunctivitis, 111, 138 Connective Tissue Cells, 138 Consciousness, 126, 138, 175 Consensus Sequence, 138 Conserved Sequence, 50, 138 Constipation, 4, 84, 86, 109, 138, 166 Constrict, 70, 138 Constriction, 138, 157 Consumption, 109, 138, 177 Contamination, 138, 152 Contractility, 138, 142 Contracture, 5, 7, 43, 46, 138 Contraindications, ii, 138 Contrast medium, 138, 164 Conus, 138, 175 Conventional therapy, 138, 139 Conventional treatment, 39, 138, 139 Coordination, 5, 139, 163 Cornea, 20, 126, 128, 139, 150, 179, 184, 189 Corneum, 139, 144 Coronary, 17, 22, 39, 40, 44, 62, 69, 75, 133, 139, 162, 164 Coronary heart disease, 133, 139 Coronary Thrombosis, 139, 162, 164 Corpus, 139, 169, 173, 180, 190 Cortical, 139, 180 Corticosteroid, 85, 139 Cranial, 136, 139, 145, 167, 168, 170, 182 Cues, 11, 22, 139 Curettage, 139, 159 Curette, 66, 139 Cutaneous, 23, 25, 69, 139, 160 Cyanoacrylates, 38, 57, 139 Cyclic, 38, 57, 139, 151, 166, 170, 173 Cyclosporine, 87, 139, 154 Cyst, 54, 140 Cysteine Endopeptidases, 140, 144 Cytogenetics, 21, 140 Cytokine, 74, 140, 169, 181 Cytoplasm, 127, 130, 134, 140, 144, 164 Cytoskeleton, 140, 156 Cytostatic, 63, 140 Cytotoxic, 140, 176, 181
196
D Data Collection, 53, 140 Decarboxylation, 140, 152 Decision Making, 111, 140 Decompensation, 58, 140 Decompression, 72, 140 Defecation, 4, 140 Defense Mechanisms, 140, 156 Defibrillation, 56, 140 Degenerative, 60, 138, 140, 151, 165 Deletion, 127, 140 Dendrites, 140, 165 Density, 12, 18, 19, 21, 49, 140, 148, 166, 182 Depolarization, 140, 181 Dermal, 25, 50, 69, 81, 141 Dermatofibrosarcoma protuberans, 23, 141 Dermis, 141, 157 Diabetes Mellitus, 10, 89, 141, 150 Diagnostic procedure, 37, 44, 69, 94, 141 Dialyzer, 141, 151 Diarrhea, 4, 86, 109, 141 Diastole, 56, 141 Diencephalon, 141, 169 Digestion, 130, 131, 141, 156, 159, 169, 184 Digestive system, 86, 141, 163 Digestive tract, 54, 108, 141, 182, 183 Dilatation, 123, 126, 141, 173, 190 Dilation, 85, 128, 131, 141 Dilator, 59, 141 Direct, iii, 12, 15, 21, 47, 60, 66, 133, 135, 141, 142, 159, 177, 184 Discrete, 141, 186 Disease Progression, 141, 177 Disinfectant, 141, 145 Dislocation, 39, 141, 183 Dissection, 5, 141 Distal, 44, 55, 58, 62, 65, 69, 70, 75, 129, 133, 141, 143, 149, 174 Distention, 84, 141 Dopamine, 136, 142, 166 Dorsal, 14, 34, 142, 172, 183 Dosimetry, 20, 142 Drive, ii, vi, 4, 33, 66, 87, 88, 107, 142 Duct, 125, 132, 133, 142, 167, 179, 183 Duodenum, 130, 142, 144, 148, 168, 169, 184 Dura mater, 142, 161, 167 Dyspareunia, 4, 142 Dyspnea, 140, 142, 175 Dystrophin, 79, 142
197
Dystrophy, 79, 142 E Echocardiography, 24, 142 Ectopic, 8, 142 Edema, 10, 41, 84, 140, 142, 164, 165 Effector, 39, 123, 137, 142, 170 Ejection fraction, 93, 142 Elastic, 25, 40, 142, 182 Elasticity, 38, 57, 64, 142 Elastin, 25, 42, 65, 136, 142, 146 Elastomers, 142, 172 Elective, 12, 143 Electric Conductivity, 126, 143 Electric shock, 48, 140, 143 Electrode, 11, 47, 75, 143 Electrodesiccation, 111, 143 Electrolyte, 139, 143, 158, 162 Electrophysiological, 143, 190 Embolus, 143, 155 Embryo, 54, 123, 134, 143, 155 Embryogenesis, 81, 143 Emulsion, 143, 147 Encephalopathy, 84, 143 Endarterectomy, 126, 128, 143 Endocardium, 16, 143 Endogenous, 41, 73, 142, 143, 174, 187 Endometrial, 143 Endometriosis, 26, 143 Endometrium, 143, 161 Endopeptidases, 42, 128, 140, 144, 161, 169, 180 Endoscope, 6, 71, 144 Endoscopic, 48, 80, 84, 88, 89, 144 Endoscopy, 86, 144 Endothelial cell, 68, 78, 143, 144, 186 Endothelium, 73, 144, 166, 171 Endothelium, Lymphatic, 144 Endothelium, Vascular, 144 Endothelium-derived, 73, 144, 166 Endotoxin, 144, 188 Enema, 86, 144 Enhancer, 144, 178 Enterostomal Therapy, 110, 144 Environmental Health, 100, 102, 144 Enzymatic, 125, 132, 133, 137, 144, 152, 178 Eosinophils, 144, 151, 159 Epidemic, 91, 144 Epidermal, 144, 191 Epidermis, 58, 139, 141, 144, 152, 175 Epidermoid carcinoma, 144, 183 Epidural, 9, 60, 74, 145, 183 Epithelial, 50, 70, 81, 124, 145, 152, 158
Epithelial Cells, 50, 145, 152, 158 Epithelium, 78, 130, 144, 145, 157 Erectile, 4, 6, 85, 87, 107, 145, 169 Erection, 4, 107, 145 Erythrocytes, 131, 145, 177 Esophageal, 6, 61, 84, 112, 145, 179, 187 Esophageal Stricture, 6, 145 Esophageal Varices, 84, 145, 179 Esophagitis, 6, 145 Esophagus, 6, 84, 112, 128, 141, 145, 149, 151, 159, 169, 170, 177, 184, 187 Estrogen, 19, 145 Estrogen receptor, 19, 145 Ethanol, 15, 145 Ether, 11, 145 Ethmoid, 145, 168 Eukaryotic Cells, 145, 154 Evacuation, 66, 138, 145 Excisional, 23, 145 Excitation, 125, 145, 147, 166 Excrete, 127, 145, 158 Exogenous, 143, 145, 174 Expiratory, 145, 170 Extensor, 146, 175 External-beam radiation, 146, 157, 176, 191 Extracellular, 42, 49, 65, 128, 138, 146, 147, 156, 160, 165, 167, 186 Extracellular Matrix, 42, 65, 138, 146, 147, 156, 160, 167 Extracellular Matrix Proteins, 42, 146, 160 Extracellular Space, 146 Extraction, 55, 56, 65, 146 Extremity, 146, 168 Eye Infections, 111, 146 F Facial, 48, 69, 146, 168 Fallopian tube, 56, 70, 146 Family Planning, 101, 146 Fat, 66, 85, 109, 127, 130, 131, 133, 139, 143, 146, 150, 159, 163, 178, 180, 182 Fatigue, 86, 108, 146, 151 Fatty acids, 125, 146, 173 Feces, 138, 146, 184 Femoral, 67, 146 Femur, 22, 146 Fetus, 68, 123, 146, 172, 189 Fibril, 19, 146 Fibrillation, 16, 140, 146 Fibrin, 13, 48, 131, 135, 147, 171, 186 Fibrinogen, 147, 171, 186
Scar tissue
Fibroblasts, 10, 13, 17, 25, 28, 29, 46, 78, 138, 147, 156 Fibronectins, 146, 147 Fibrosis, 9, 11, 13, 14, 15, 17, 28, 46, 49, 60, 74, 81, 84, 89, 138, 147, 175, 179 Fibrotic tissue, 59, 147 Fine-needle aspiration, 147, 165 Fissure, 109, 135, 147 Fistula, 7, 85, 89, 112, 147, 148 Fixation, 9, 65, 74, 75, 147 Flaccid, 107, 147 Flank Pain, 89, 147 Flatus, 147, 148 Flexion, 8, 147 Flow Cytometry, 19, 147 Fluorescence, 147, 148 Fluorescent Dyes, 147, 148 Fold, 19, 85, 86, 132, 147, 148, 172 Follicles, 148 Folliculitis, 123, 148 Foramen, 68, 135, 148, 152 Forearm, 131, 148 Fovea, 147, 148 Fundus, 147, 148 Fungi, 127, 146, 148, 162, 191 Fungus, 8, 148 G Gallbladder, 123, 130, 141, 148 Gamma Rays, 148, 176 Ganglia, 123, 148, 165, 170 Gas, 43, 133, 147, 148, 152, 166, 185 Gastric, 6, 148, 149, 151, 152, 166, 169, 179 Gastrin, 148, 152 Gastroduodenal, 84, 148 Gastroesophageal Reflux, 6, 112, 149 Gastrointestinal, 73, 76, 131, 145, 149, 183, 185 Gastrointestinal tract, 76, 145, 149, 183 Gelatin, 42, 149, 150, 185 Gelatinases, 50, 149 Gels, 10, 63, 77, 112, 149, 181 Gene, 15, 17, 20, 27, 29, 79, 130, 142, 149, 178, 188 Gene Expression, 17, 27, 29, 149 Gene Therapy, 79, 149 Generator, 75, 149 Genetic Code, 149, 166 Genetics, 6, 140, 149 Genital, 111, 149, 189 Genitourinary, 64, 149, 189 Genotype, 149, 170 Gestation, 16, 149
198
Giant Cells, 149, 179 Gland, 54, 124, 150, 160, 167, 168, 171, 174, 180, 184, 186 Glomeruli, 150, 175 Glucocorticoids, 124, 139, 150 Glucose, 10, 134, 141, 150, 155, 179 Glucose Intolerance, 141, 150 Glutamic Acid, 150, 166, 173 Glycine, 125, 130, 150, 166, 180 Glycoprotein, 78, 147, 149, 150, 158, 186, 188 Glycosaminoglycan, 20, 34, 42, 65, 135, 150 Gonadal, 150, 184 Gout, 136, 150 Governing Board, 150, 172 Grade, 20, 45, 150 Grading, 45, 150 Graft, 17, 39, 78, 150, 152, 164 Graft Survival, 17, 150 Grafting, 31, 39, 95, 150, 154 Granulation Tissue, 24, 48, 150 Granulocyte, 21, 151 Granuloma, 95, 151 Growth factors, 11, 15, 21, 22, 80, 81, 151, 162 Guanylate Cyclase, 151, 166 H Haemorrhage, 123, 151 Hair follicles, 95, 141, 148, 151 Half-Life, 52, 151 Heart attack, 6, 40, 133, 151 Heart failure, 40, 84, 151, 175 Heartbeat, 151, 185 Heartburn, 6, 86, 151 Hemochromatosis, 87, 151 Hemodialysis, 7, 141, 151, 158 Hemoglobinopathies, 149, 151 Hemolytic, 41, 151 Hemorrhage, 151, 164, 184 Hemorrhoids, 151, 179, 181 Hemostasis, 151, 156 Hepatic, 15, 84, 125, 151, 159 Hepatitis, 84, 86, 91, 107, 108, 110, 151, 152, 190 Hepatitis A, 110, 152 Hepatitis Viruses, 110, 152 Hepatocytes, 152 Hepatovirus, 152 Hereditary, 72, 150, 152 Heredity, 123, 149, 152 Hernia, 18, 41, 42, 152
199
Herniated, 32, 50, 152 Heterodimers, 152, 156, 188 Histamine, 26, 59, 152 Histidine, 152 Histology, 152, 168 Homodimer, 152, 188 Homologous, 50, 149, 152, 185 Hormonal, 139, 152 Hormone, 81, 107, 139, 148, 152, 155, 161, 164, 173, 178, 181, 186, 188 Horny layer, 144, 152 Host, 46, 50, 79, 80, 129, 146, 150, 152, 154, 189, 190 Hybridomas, 152, 156 Hydration, 7, 152 Hydrogel, 67, 152 Hydrogen, 123, 125, 130, 132, 146, 152, 163, 166, 174, 191 Hydrolysis, 128, 153, 169, 170, 174, 188 Hydronephrosis, 89, 153 Hydrophilic, 152, 153 Hydroxylysine, 136, 153 Hydroxyproline, 125, 136, 153 Hygienic, 4, 153 Hyperbilirubinemia, 153, 157 Hyperplasia, 46, 153, 165 Hypersensitivity, 153, 178 Hypertension, 133, 153, 168, 172 Hypertrophy, 46, 130, 153 Hypoxia, 41, 153 Hysterectomy, 89, 153 I Id, 34, 113, 118, 120, 153 Idiopathic, 49, 60, 87, 88, 153, 179 Ileal, 7, 153 Ileostomy, 109, 153 Ileum, 132, 134, 153 Ileus, 74, 153 Immune function, 153, 188 Immune response, 124, 127, 129, 139, 153, 154, 185, 189, 190 Immune Sera, 153, 154 Immune system, 129, 130, 153, 154, 160, 163, 189, 191 Immunization, 107, 154 Immunoglobulin, 127, 154, 163 Immunohistochemistry, 11, 154 Immunologic, 61, 154, 169, 176 Immunophilins, 154, 181 Immunosuppressant, 154, 162, 181 Immunosuppressive, 154, 185 Immunotoxins, 154, 176
Impairment, 146, 154 Implant radiation, 154, 156, 157, 176, 191 Implantation, 18, 46, 58, 67, 80, 137, 154 Impotence, 87, 107, 145, 154, 169, 183 In situ, 27, 154 In Situ Hybridization, 27, 154 In vitro, 10, 11, 13, 14, 19, 21, 50, 51, 81, 149, 154, 185 In vivo, 10, 13, 14, 15, 18, 19, 20, 21, 50, 51, 149, 154, 185 Incidental, 89, 154 Incision, 8, 32, 52, 58, 132, 136, 154, 156, 174, 178 Incompetence, 149, 154 Incontinence, 46, 63, 64, 88, 154, 183 Indicative, 154, 168, 189 Induction, 11, 126, 154 Infarction, 22, 40, 155, 177 Inferior vena cava, 62, 155 Infertility, 76, 155 Infiltration, 61, 155 Inflammatory bowel disease, 84, 87, 88, 110, 155 Infusion, 55, 112, 155, 164, 179, 188 Initiator, 38, 155 Inlay, 155, 178 Inner ear, 83, 155 Inorganic, 9, 155, 163 Insight, 19, 155 Insulator, 155, 163 Insulin, 25, 112, 155 Insulin-dependent diabetes mellitus, 155 Insulin-like, 25, 155 Integrins, 22, 156 Interferon, 7, 87, 156 Interferon-alpha, 156 Interleukin-6, 15, 156 Internal radiation, 156, 157, 176, 191 Interstitial, 10, 17, 131, 146, 156, 157, 191 Intervertebral, 39, 152, 156, 159 Intervertebral Disk Displacement, 156, 159 Intestinal, 9, 18, 80, 109, 133, 156 Intestine, 61, 84, 130, 131, 156, 158 Intoxication, 156, 191 Intracellular, 155, 156, 161, 166, 173, 181 Intravenous, 45, 155, 156 Intrinsic, 16, 65, 124, 130, 156 Invasive, 16, 42, 46, 55, 95, 156, 160 Involuntary, 88, 146, 156, 164, 182 Ion Channels, 128, 156, 165 Ion Exchange, 134, 156, 157
Scar tissue
Ionization, 157 Ionizing, 51, 52, 125, 157, 176 Ions, 130, 143, 152, 156, 157, 186 Iontophoresis, 27, 157 Iris, 58, 126, 128, 139, 157, 175, 189 Irradiation, 51, 52, 157, 191 Irrigation, 55, 157 Ischemia, 17, 27, 39, 41, 157, 164, 177 Isotonic, 47, 157 J Jaundice, 4, 86, 153, 157 Joint, 4, 46, 50, 52, 67, 73, 87, 128, 157, 160, 161, 183, 185 Joint Capsule, 46, 157, 185 K Kb, 100, 157 Keloid, 13, 24, 72, 77, 95, 135, 157 Kidney Disease, 100, 153, 158 Kidney Failure, 10, 158 Kidney Failure, Acute, 158 Kidney Failure, Chronic, 158 Kidney Pelvis, 158, 189 Kidney stone, 7, 47, 106, 153, 158 Kinetic, 12, 157, 158 L Labyrinth, 136, 155, 158, 180, 190 Lacerations, 76, 158 Laminin, 42, 65, 130, 146, 158 Lamivudine, 87, 158 Large Intestine, 109, 132, 134, 141, 156, 158, 177, 182 Laryngeal, 85, 158 Larynx, 85, 158, 187, 191 Laser Surgery, 111, 158 Latency, 49, 50, 158 Latent, 49, 50, 158 Lens, 58, 159 Lethal, 49, 129, 159 Leukemia, 149, 159 Leukocytes, 130, 131, 144, 156, 159, 188 Library Services, 118, 159 Ligament, 86, 159, 174, 183 Ligands, 156, 159 Ligation, 70, 111, 159 Light microscope, 159, 162 Linkages, 76, 159, 191 Lipectomy, 66, 159 Lipid, 66, 155, 159, 163 Liver Cirrhosis, 15, 92, 159 Liver scan, 159, 179 Liver Transplantation, 87, 88, 159 Localization, 25, 27, 154, 159
200
Localized, 29, 46, 60, 66, 123, 126, 142, 147, 155, 158, 159, 171, 179, 183, 188 Loop, 152, 153, 159 Low Back Pain, 4, 159 Lower Esophageal Sphincter, 6, 149, 159 Lucida, 158, 159 Lumbar, 8, 32, 39, 73, 129, 156, 159, 160 Lumen, 5, 44, 55, 69, 132, 144, 160 Lupus, 95, 160 Luxation, 141, 160 Lymph, 84, 129, 144, 160, 179 Lymph node, 129, 160, 179 Lymphatic, 144, 155, 160, 182, 183, 186 Lymphatic system, 160, 182, 183, 186 Lymphocyte, 127, 160 Lymphoid, 127, 150, 160 Lymphoma, 21, 160 Lysine, 153, 160, 173, 188 M Macroglia, 14, 160, 162, 165 Macrophage, 18, 21, 22, 160 Magnetic Resonance Imaging, 9, 32, 54, 160, 179 Malignancy, 85, 160 Malignant, 20, 124, 127, 160, 165, 176 Mammary, 19, 54, 160 Mammography, 19, 160 Manifest, 129, 160 Mannans, 148, 160 Matrix metalloproteinase, 27, 42, 50, 160 Maxillary, 30, 161, 168 Medial, 8, 145, 161, 182 Mediate, 81, 136, 142, 161 Medicament, 161, 185 MEDLINE, 101, 161 Melanin, 157, 161 Membrane Proteins, 161, 174, 182 Memory, 68, 161 Meninges, 134, 142, 161, 184 Meningitis, 83, 161 Meniscus, 67, 161 Menstrual Cycle, 4, 161, 173 Menstruation, 4, 161 Mental, iv, 9, 41, 100, 102, 134, 135, 146, 154, 161, 175, 179, 189 Mental Health, iv, 9, 100, 102, 161, 175 Mercury, 147, 161 Metabolic disorder, 84, 150, 161 Metalloendopeptidases, 144, 161 Metaplasia, 28, 161 Metastasis, 50, 161 Methotrexate, 87, 162
201
MI, 50, 63, 77, 86, 121, 162 Microbe, 162, 187 Microbiology, 124, 162 Microcirculation, 159, 162, 171 Microglia, 128, 162, 165 Microorganism, 162, 190 Microscopy, 11, 14, 30, 130, 162 Microsurgery, 23, 162 Migration, 5, 13, 31, 44, 162, 165 Mineralization, 12, 22, 162 Mineralocorticoids, 124, 139, 162 Mitosis, 127, 162 Mitral Valve, 40, 62, 162 Mobility, 9, 45, 46, 53, 162 Mobilization, 4, 162 Modeling, 12, 162 Modification, 29, 40, 51, 125, 163, 175, 191 Molecular, 13, 15, 17, 22, 25, 41, 101, 103, 130, 137, 140, 147, 163, 171, 182, 187, 188 Molecule, 15, 127, 130, 135, 137, 142, 144, 145, 150, 151, 153, 163, 174, 176, 181, 187 Monitor, 19, 87, 108, 163 Monoclonal, 11, 20, 152, 154, 157, 163, 176, 179, 191 Monoclonal antibodies, 11, 154, 163, 179 Monocyte, 18, 163 Mononuclear, 151, 163, 188 Morphine, 163, 165 Morphological, 22, 143, 148, 163 Morphology, 24, 163 Motion Sickness, 163, 165 Mucociliary, 163, 181 Mucosa, 160, 163, 165 Mucositis, 163, 186 Mucus, 47, 163, 188 Multiple sclerosis, 88, 163 Muscle Contraction, 52, 53, 142, 163 Muscular Dystrophies, 142, 163 Musculature, 4, 163, 183 Mydriatic, 141, 164 Myelin, 11, 163, 164, 165, 180 Myelography, 9, 164 Myelosuppression, 20, 164 Myocardial infarction, 10, 22, 40, 139, 162, 164, 190 Myocardial Reperfusion, 164, 177 Myocardial Reperfusion Injury, 164, 177 Myocarditis, 26, 164 Myocardium, 39, 79, 162, 164 Myofibrils, 142, 164 Myopia, 164, 165, 177 Myosin, 163, 164
Myxedema, 29, 164 N Narcosis, 164, 165 Narcotic, 53, 163, 165 Nasal Cavity, 47, 48, 165, 168, 188 Nasal Mucosa, 165 Nasal Polyps, 48, 165 Nasal Septum, 47, 165 Nausea, 84, 86, 165, 189 Nearsightedness, 58, 164, 165 Need, 3, 11, 12, 39, 41, 54, 58, 68, 73, 74, 83, 86, 89, 91, 94, 108, 112, 114, 160, 165 Needle biopsy, 4, 147, 165 Needle Sharing, 92, 165 Neoplasia, 89, 165 Neoplasm, 165, 183 Neoplastic, 126, 152, 160, 165 Nerve Regeneration, 16, 61, 165 Nervous System, 41, 72, 129, 134, 165, 166, 169 Neural, 40, 41, 73, 162, 165 Neuroglia, 160, 165 Neurologic, 9, 85, 165 Neuromuscular, 85, 123, 165 Neuronal, 41, 72, 129, 164, 165 Neurons, 14, 41, 72, 136, 140, 148, 165, 185 Neurosyphilis, 166, 168 Neurotransmitter, 123, 125, 131, 142, 150, 152, 156, 166, 181, 185 Neutrons, 125, 157, 166, 176 Nitric Oxide, 28, 73, 166 Nitrogen, 125, 126, 146, 147, 158, 166, 188 Nuclei, 45, 125, 136, 149, 160, 162, 166, 167, 174 Nucleic acid, 42, 64, 149, 154, 166, 191 Nucleus, 127, 129, 130, 135, 136, 139, 140, 144, 145, 148, 156, 163, 166, 174 O Obstipation, 84, 166 Ointments, 166, 168 Oliguria, 158, 166 Omeprazole, 166, 174 Oncogenic, 156, 166 Oncology, 19, 166 Opacity, 140, 166 Ophthalmic, 23, 166 Ophthalmology, 19, 147, 167 Opsin, 167, 178 Optic cup, 167, 169 Optic Nerve, 167, 169, 178, 179 Orofacial, 22, 167 Ossification, 8, 167
Scar tissue
Osteoblasts, 22, 167 Osteocalcin, 12, 22, 167 Osteoporosis, 13, 167 Ostomy, 7, 9, 109, 144, 167 Outpatient, 106, 167 Ovalbumin, 81, 167 Ovum, 149, 167, 173, 191 P Pacemaker, 56, 59, 75, 167 Pachymeningitis, 161, 167 Palate, 24, 30, 135, 167 Palliative, 88, 167 Palpation, 54, 167 Pancreas, 123, 141, 151, 155, 167, 168, 188 Pancreatic, 149, 168 Pancreatic Juice, 149, 168 Paraffin, 69, 168 Paralysis, 132, 168 Paranasal Sinuses, 48, 168, 181 Paraparesis, 168 Parathyroid, 12, 168, 186 Parathyroid Glands, 168 Parathyroid hormone, 12, 168 Paresis, 85, 168 Parotid, 168, 179 Pathogenesis, 49, 50, 86, 168 Pathologic, 81, 127, 130, 139, 153, 168, 175 Pathologic Processes, 127, 168 Pathologies, 47, 168 Pathophysiology, 15, 84, 168 Patient Education, 4, 106, 116, 118, 121, 168 Patient Selection, 5, 168 Pedicle, 85, 169 Pelvic, 3, 64, 76, 88, 89, 107, 111, 143, 169, 174 Pelvic inflammatory disease, 76, 111, 169 Pelvis, 4, 88, 123, 132, 155, 160, 169, 175, 189 Penicillamine, 87, 169 Penicillin, 169, 189 Penile Prosthesis, 95, 169 Penis, 4, 6, 85, 95, 107, 129, 137, 169, 170, 172 Pentoxifylline, 87, 169 Peptic, 169, 179 Peptic Ulcer, 169, 179 Peptic Ulcer Hemorrhage, 169, 179 Peptide, 12, 21, 49, 50, 125, 136, 144, 149, 169, 173, 174 Peptide Hydrolases, 144, 169 Perception, 41, 138, 169, 179
202
Percutaneous, 32, 70, 169, 170 Perforation, 18, 127, 148, 169 Perfusion, 17, 153, 169, 187 Perineal, 5, 169, 176 Perineum, 169 Perioperative, 5, 169 Peripheral Nervous System, 41, 166, 168, 169, 185 Personality Disorders, 41, 170 Petroleum, 168, 170 Phallic, 147, 170 Pharmaceutical Preparations, 134, 145, 149, 170 Pharmacologic, 126, 151, 170, 187 Pharynx, 149, 165, 170 Phenotype, 14, 20, 170 Phenyl, 38, 57, 170 Phimosis, 4, 170 Phonation, 86, 170 Phonophoresis, 157, 170 Phosphodiesterase, 169, 170 Phospholipases, 170, 181 Phospholipids, 146, 170 Phosphorous, 51, 52, 170 Phosphorus, 132, 168, 170 Physical Examination, 8, 89, 170 Physical Medicine, 53, 170 Physical Therapy, 3, 27, 53, 170 Physiologic, 10, 62, 81, 151, 157, 161, 170, 173, 176 Physiology, 4, 6, 12, 67, 88, 107, 108, 129, 143, 171 Pigmentation, 171, 190 Pigments, 130, 133, 171, 178 Pitch, 171, 191 Pituitary Gland, 139, 171 Plants, 125, 132, 133, 136, 150, 163, 171, 179, 187 Plaque, 6, 39, 69, 85, 95, 126, 128, 171 Plasma, 124, 127, 134, 142, 144, 147, 149, 150, 151, 158, 162, 171, 180, 187 Plasma cells, 127, 151, 171 Plasmin, 13, 49, 171 Plasminogen, 13, 171 Plasminogen Activators, 171 Platelet Activation, 171, 181 Platelet Aggregation, 73, 166, 169, 171 Platelets, 164, 166, 171, 186 Pneumonia, 111, 112, 138, 171 Poisoning, 156, 161, 165, 171 Polymers, 21, 38, 57, 76, 171, 172, 174, 181
203
Polysaccharide, 41, 80, 127, 134, 150, 172, 174 Polyurethanes, 11, 172 Port, 43, 172 Port-a-cath, 172 Portal Hypertension, 87, 172 Portal Vein, 172 Posterior, 75, 126, 128, 129, 142, 157, 167, 172, 179, 182 Postmenopausal, 167, 172 Postnatal, 172, 183 Postoperative, 5, 8, 29, 60, 89, 172 Postprandial, 84, 172 Postsynaptic, 172, 181 Post-traumatic, 60, 172 Postural, 53, 172 Potentiation, 172, 181 Practice Guidelines, 102, 172 Precancerous, 6, 172 Precursor, 11, 128, 142, 144, 171, 172, 173, 188, 189 Premalignant, 172 Prenatal, 143, 172 Prepuce, 4, 135, 170, 172 Prevalence, 41, 172 Primary Sclerosing Cholangitis, 87, 88, 173 Probe, 12, 52, 173 Procollagen, 25, 173 Proctitis, 111, 173 Proenzymes, 51, 173 Progesterone, 173, 184 Progression, 50, 126, 173 Progressive, 17, 49, 84, 134, 135, 151, 158, 163, 171, 173, 175 Proline, 12, 136, 153, 173 Promoter, 13, 17, 20, 173 Promotor, 173, 178 Prophylaxis, 173, 189 Proportional, 66, 173 Prostaglandin, 30, 173 Prostaglandins A, 173, 174 Prostate, 5, 46, 129, 130, 174, 176, 178 Prostatectomy, 174, 176 Prostatitis, 107, 174 Prosthesis, 43, 107, 174 Protease, 46, 174 Protein Binding, 174, 187 Protein C, 17, 49, 125, 129, 167, 174, 182 Protein S, 130, 138, 149, 167, 174 Proteins, 11, 17, 21, 51, 59, 72, 108, 125, 127, 128, 131, 134, 135, 136, 137, 142,
144, 146, 147, 152, 154, 160, 161, 163, 164, 166, 169, 171, 172, 174, 176, 181, 187, 188 Proteoglycan, 11, 42, 46, 65, 174 Proteolytic, 13, 51, 137, 147, 171, 174 Protocol, 12, 21, 86, 174 Proton Pump, 6, 166, 174 Proton Pump Inhibitors, 6, 174 Protons, 125, 152, 157, 174, 176 Proximal, 44, 55, 59, 62, 69, 75, 141, 165, 174, 180 Psoriasis, 95, 175 Psychiatry, 147, 175, 184 Psychic, 161, 175, 180 Psychoactive, 175, 191 Public Health, 92, 102, 175 Public Policy, 101, 175 Pulmonary, 40, 49, 62, 131, 138, 158, 175, 190 Pulmonary Artery, 40, 131, 175, 190 Pulmonary Edema, 158, 175 Pulmonary Fibrosis, 49, 175 Pulmonary Valve, 62, 175 Pulmonary Veins, 40, 62, 175 Pulse, 40, 47, 75, 107, 163, 175 Pupil, 139, 141, 164, 175 Purifying, 108, 175 Pustular, 123, 175 Pyelonephritis, 89, 175 Pyogenic, 123, 175 Q Quality of Life, 3, 6, 175 Quiescent, 19, 175 R Race, 162, 175 Radiation, 20, 29, 44, 51, 52, 69, 76, 89, 123, 146, 148, 156, 157, 176, 179, 191 Radiation therapy, 89, 123, 146, 156, 157, 176, 191 Radical prostatectomy, 5, 176 Radioactive, 12, 44, 51, 52, 60, 69, 131, 151, 153, 154, 156, 157, 159, 163, 166, 176, 179, 191 Radioimmunotherapy, 21, 176 Radioisotope, 20, 51, 52, 78, 176, 187 Radiolabeled, 157, 176, 191 Radiological, 169, 176 Radiologist, 84, 176 Radiopharmaceutical, 149, 176 Radiotherapy, 60, 131, 157, 176, 191 Reactive Oxygen Species, 17, 176
Scar tissue
Receptor, 19, 49, 124, 127, 137, 142, 176, 181 Recombinant, 15, 21, 42, 51, 64, 176 Recombinant Proteins, 15, 176 Recombination, 149, 176 Rectal, 107, 109, 110, 177 Rectum, 5, 32, 110, 111, 126, 127, 131, 136, 140, 141, 147, 148, 154, 155, 158, 173, 174, 177, 185 Recuperation, 39, 177 Recur, 15, 177 Recurrence, 32, 42, 177 Red blood cells, 109, 145, 151, 164, 177, 179 Reductase, 162, 177 Refer, 1, 132, 137, 147, 148, 159, 166, 176, 177, 180, 187 Reflux, 6, 149, 177 Refraction, 126, 164, 177 Refractory, 84, 177 Regeneration, 12, 14, 16, 59, 72, 74, 177 Regimen, 111, 177, 178 Regurgitation, 149, 151, 177 Remission, 177 Renal pelvis, 158, 177 Reoperation, 84, 177 Reperfusion, 17, 22, 164, 177 Reperfusion Injury, 17, 177 Resection, 5, 8, 79, 85, 174, 177 Respiration, 133, 163, 177 Response Elements, 13, 178 Restoration, 30, 53, 164, 170, 177, 178, 191 Retina, 128, 138, 159, 164, 165, 167, 178, 179, 189, 190 Retinal, 27, 137, 167, 178, 190 Retinol, 178 Retreatment, 20, 178 Retropubic, 5, 174, 176, 178 Retropubic prostatectomy, 5, 176, 178 Retrosternal, 6, 178 Retroviral vector, 149, 178 Rheology, 169, 178 Rheumatism, 178 Rheumatoid, 42, 178 Rheumatoid arthritis, 42, 178 Rhodopsin, 167, 178 Rigidity, 28, 171, 178 Risk factor, 91, 179 Rituximab, 20, 179 Rod, 129, 135, 179 S Salivary, 141, 179
204
Salivary glands, 141, 179 Saponins, 179, 184 Sarcoid, 95, 179 Sarcoidosis, 95, 179 Scans, 21, 54, 179 Schizoid, 179, 191 Schizophrenia, 179, 191 Schizotypal Personality Disorder, 179, 191 Sclera, 138, 179, 189 Sclerosis, 17, 163, 179 Sclerotherapy, 110, 179 Scoliosis, 12, 179 Screening, 9, 19, 50, 83, 87, 91, 135, 179 Scrotum, 179, 186 Sebum, 123, 180 Secondary tumor, 161, 180 Secretion, 50, 54, 123, 139, 150, 152, 155, 162, 163, 166, 180, 188 Segmental, 85, 180 Segmentation, 180 Seizures, 41, 180 Self Care, 123, 180 Semen, 174, 180 Semicircular canal, 155, 180 Senile, 167, 180 Sensor, 10, 62, 180 Sensory loss, 180, 183 Sepsis, 89, 180 Septal, 26, 67, 68, 180 Septum, 68, 180 Septum Pellucidum, 180 Serine, 144, 180, 188 Serine Endopeptidases, 144, 180 Serous, 144, 180 Serrated, 75, 181 Serum, 12, 24, 124, 137, 153, 157, 158, 162, 167, 180, 181, 188 Sexually Transmitted Diseases, 6, 181 Shock, 17, 46, 47, 133, 181, 188 Shunt, 68, 181 Side effect, 16, 69, 76, 85, 107, 124, 130, 164, 181, 187, 191 Signal Transduction, 15, 181 Signs and Symptoms, 4, 86, 177, 181 Silicone Elastomers, 181 Silicone Gels, 77, 181 Sinusitis, 48, 181 Sirolimus, 63, 154, 181 Sitz Bath, 109, 181 Skeletal, 15, 78, 79, 126, 135, 163, 164, 181, 182 Skeleton, 54, 123, 146, 157, 173, 181, 182
205
Skin Pigmentation, 87, 182 Skull, 182, 185 Small intestine, 109, 134, 142, 152, 153, 156, 182, 188 Smooth muscle, 17, 74, 78, 125, 138, 152, 163, 182, 185 Sneezing, 64, 182 Social Environment, 175, 182 Soft tissue, 4, 18, 46, 67, 68, 131, 182 Solid tumor, 55, 79, 126, 131, 182 Solvent, 145, 182 Soma, 182 Somatic, 17, 143, 162, 170, 182 Sound wave, 47, 137, 176, 182 Spasm, 53, 182, 186 Specialist, 113, 141, 182 Species, 51, 134, 136, 138, 162, 163, 175, 176, 182, 184, 188, 190, 191 Specificity, 124, 144, 182, 187 Spectrin, 142, 182 Sperm, 126, 135, 182, 186 Sphenoid, 168, 182 Sphincter, 5, 64, 88, 158, 183 Spinal Cord Compression, 41, 183 Spinal Fractures, 183 Spinal Nerves, 170, 183 Spinous, 144, 183 Spleen, 84, 160, 179, 183 Splenomegaly, 84, 183 Sprains and Strains, 159, 183 Squamous, 4, 145, 183 Squamous cell carcinoma, 4, 145, 183 Squamous cells, 183 Staging, 17, 179, 183 Steel, 135, 183 Stellate, 15, 183 Stem Cells, 22, 183 Stenosis, 8, 44, 60, 73, 85, 183, 184 Stent, 5, 106, 167, 183 Sterile, 52, 59, 63, 76, 77, 128, 168, 184 Sterility, 111, 155, 184 Sterilization, 70, 184 Sternum, 178, 184 Steroid, 65, 112, 130, 179, 184 Stimulant, 152, 184, 189 Stimulus, 138, 142, 143, 145, 156, 158, 184 Stoma, 7, 167, 184 Stomach, 6, 112, 123, 141, 145, 148, 149, 152, 159, 165, 169, 170, 174, 177, 182, 183, 184 Stool, 109, 110, 136, 154, 158, 184
Stress, 5, 8, 10, 17, 53, 64, 83, 107, 129, 165, 178, 184 Stricture, 5, 85, 87, 88, 89, 183, 184 Stroke, 16, 68, 88, 100, 133, 184 Stroma, 19, 157, 184 Stromal, 17, 20, 143, 184 Stupor, 164, 165, 184 Subacute, 155, 181, 184 Subclavian, 75, 129, 131, 184 Subclavian Artery, 184 Subclavian Vein, 75, 129, 131, 184 Subclinical, 155, 180, 184 Subcutaneous, 95, 142, 159, 184 Subspecies, 182, 184 Substance P, 180, 185 Substrate, 19, 51, 57, 71, 133, 143, 185 Suction, 58, 66, 159, 185 Sudden death, 27, 93, 185 Sulfur, 146, 158, 185 Superior vena cava, 62, 131, 185 Suppositories, 107, 149, 185 Suppression, 112, 139, 185 Survival Rate, 4, 88, 185 Symphysis, 135, 174, 185 Symptomatic, 84, 87, 185 Synaptic, 166, 181, 185 Synovial, 157, 185 Synovial Membrane, 157, 185 Systemic, 9, 15, 84, 95, 127, 131, 155, 157, 176, 179, 185, 188, 191 Systole, 56, 185 Systolic, 40, 153, 185 T Tachycardia, 56, 185 Tacrolimus, 87, 154, 185 Temporal, 12, 185 Tendon, 16, 186 Testicles, 54, 111, 179, 186 Tetany, 168, 186 Thermal, 48, 53, 62, 126, 166, 186 Thermolysin, 51, 186 Thigh, 73, 146, 186 Thoracic, 129, 184, 186 Thorax, 123, 160, 185, 186 Thrombin, 147, 171, 174, 186 Thrombocytopenia, 20, 186 Thrombolytic, 171, 186 Thrombomodulin, 174, 186 Thrombosis, 74, 156, 174, 179, 184, 186 Thrombus, 139, 155, 164, 171, 186 Thymidine, 19, 186 Thymidine Kinase, 19, 186
Scar tissue
Thymus, 154, 160, 186 Thyroid, 164, 168, 186 Thyroid Gland, 164, 168, 186 Tissue, 4, 5, 6, 7, 8, 9, 10, 12, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 34, 35, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 83, 84, 85, 86, 87, 88, 89, 92, 93, 95, 106, 107, 108, 109, 110, 111, 112, 123, 126, 127, 130, 131, 132, 133, 135, 136, 138, 139, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 163, 164, 165, 167, 169, 171, 177, 178, 181, 182, 183, 184, 186, 188, 189, 191 Tissue Adhesives, 71, 186 Tissue Distribution, 24, 30, 186 Tomography, 21, 137, 179, 187 Tone, 74, 187 Tonicity, 157, 187 Tonus, 187 Tooth Preparation, 124, 187 Topical, 48, 81, 95, 145, 168, 187 Torsion, 155, 187 Toxic, iv, 154, 187, 191 Toxicity, 20, 161, 187 Toxicology, 102, 187 Toxin, 40, 41, 144, 154, 187 Tracer, 12, 187 Trachea, 112, 132, 158, 170, 186, 187 Tracheoesophageal Fistula, 112, 187 Traction, 135, 187 Transcriptase, 158, 187, 191 Transcription Factors, 178, 187 Transduction, 181, 187 Transfection, 130, 149, 187 Transfer Factor, 154, 187 Transforming Growth Factor beta, 14, 188 Transfusion, 188 Translation, 125, 188 Translational, 49, 188 Transmitter, 123, 128, 142, 156, 165, 188 Transplantation, 14, 21, 73, 78, 79, 84, 88, 154, 158, 188 Trauma, 4, 5, 7, 10, 39, 41, 44, 45, 46, 48, 69, 74, 78, 81, 85, 89, 107, 145, 188 Traumatology, 14, 188 Tricuspid Valve, 40, 62, 188 Trophic, 72, 188
206
Trypsin, 173, 188, 191 Tryptophan, 136, 188 Tumor Necrosis Factor, 15, 188 Tunica, 4, 143, 163, 188 Turbinates, 47, 48, 188 U Ulcer, 18, 150, 169, 188, 189 Ulceration, 18, 169, 188 Ulcerative colitis, 84, 87, 88, 155, 173, 188 Unconscious, 140, 153, 189 Uremia, 158, 189 Ureter, 61, 89, 106, 153, 158, 177, 189 Urethra, 5, 64, 88, 129, 130, 169, 174, 189 Urethritis, 111, 189 Urinary, 7, 12, 46, 61, 64, 88, 89, 106, 149, 154, 166, 174, 178, 189 Urinary tract, 7, 88, 89, 106, 189 Urinary tract infection, 7, 189 Urine, 7, 88, 89, 106, 107, 127, 129, 130, 131, 153, 154, 158, 166, 177, 189 Urogenital, 149, 189 Urologist, 89, 107, 189 Uterine Contraction, 123, 189 Uterus, 54, 123, 132, 134, 139, 143, 147, 148, 153, 161, 173, 189 Uvea, 189 Uveitis, 58, 189 V Vaccination, 110, 189 Vaccine, 110, 124, 174, 189 Vagina, 89, 134, 161, 189, 190 Vaginal, 4, 189 Valine, 169, 189 Varicose, 110, 179, 189 Varicose vein, 110, 179, 189 Vascular, 7, 17, 22, 39, 41, 44, 56, 63, 65, 69, 73, 80, 107, 141, 144, 150, 155, 159, 162, 166, 171, 186, 189 Vascular endothelial growth factor, 22, 189 Vasodilator, 131, 142, 152, 164, 189 Vein, 59, 110, 126, 155, 156, 168, 172, 184, 185, 190 Vena, 39, 190 Venous, 7, 75, 80, 107, 129, 140, 151, 174, 190 Ventricle, 40, 62, 68, 75, 127, 162, 175, 185, 188, 190 Ventricular, 10, 22, 40, 68, 79, 142, 164, 190 Ventricular Dysfunction, 142, 190 Ventricular Function, 10, 190 Ventricular Remodeling, 10, 22, 190
207
Venules, 131, 132, 144, 162, 190 Verapamil, 7, 190 Vertebrae, 39, 156, 183, 190 Vertebral, 38, 39, 50, 183, 190 Vesicovaginal Fistula, 89, 190 Vestibule, 136, 155, 180, 190 Veterinary Medicine, 101, 190 Viral, 4, 48, 84, 107, 108, 147, 149, 166, 187, 190, 191 Viral Hepatitis, 4, 84, 108, 190 Virulence, 187, 190 Virus, 8, 84, 91, 107, 110, 129, 144, 149, 156, 171, 178, 187, 190 Visceral, 4, 16, 129, 190 Vitreoretinal, 32, 190 Vitreous, 159, 178, 190 Vitro, 10, 11, 14, 21, 51, 190 Vivo, 13, 14, 18, 19, 21, 191 Vocal cord, 170, 191 Voice Disorders, 85, 86, 191
Volition, 156, 191 W Warts, 46, 191 White blood cell, 59, 127, 151, 159, 160, 163, 164, 171, 191 Withdrawal, 75, 191 Womb, 189, 191 Wound Healing, 7, 8, 13, 16, 22, 30, 44, 46, 48, 69, 72, 74, 81, 89, 135, 156, 161, 191 X Xenograft, 126, 191 X-ray, 51, 52, 137, 138, 148, 157, 164, 176, 179, 191 X-ray therapy, 157, 191 Y Yeasts, 148, 170, 191 Z Zalcitabine, 158, 191 Zymogen, 173, 174, 191
Scar tissue
208
