ENDOMETRIAL BIOPSY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Endometrial Biopsy: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00399-6 1. Endometrial Biopsy-Popular works.I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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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 endometrial biopsy. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ENDOMETRIAL BIOPSY.............................................................................. 3 Overview........................................................................................................................................ 3 Federally Funded Research on Endometrial Biopsy....................................................................... 3 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND ENDOMETRIAL BIOPSY .................................................................... 35 Overview...................................................................................................................................... 35 Finding Nutrition Studies on Endometrial Biopsy...................................................................... 35 Federal Resources on Nutrition ................................................................................................... 36 Additional Web Resources ........................................................................................................... 36 CHAPTER 3. DISSERTATIONS ON ENDOMETRIAL BIOPSY ............................................................... 39 Overview...................................................................................................................................... 39 Dissertations on Endometrial Biopsy........................................................................................... 39 Keeping Current .......................................................................................................................... 39 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 45 Overview...................................................................................................................................... 45 NIH Guidelines............................................................................................................................ 45 NIH Databases............................................................................................................................. 47 Other Commercial Databases....................................................................................................... 49 APPENDIX B. PATIENT RESOURCES ................................................................................................. 51 Overview...................................................................................................................................... 51 Patient Guideline Sources............................................................................................................ 51 Finding Associations.................................................................................................................... 54 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 57 Overview...................................................................................................................................... 57 Preparation................................................................................................................................... 57 Finding a Local Medical Library.................................................................................................. 57 Medical Libraries in the U.S. and Canada ................................................................................... 57 ONLINE GLOSSARIES.................................................................................................................. 63 Online Dictionary Directories ..................................................................................................... 64 ENDOMETRIAL BIOPSY DICTIONARY .................................................................................. 65 INDEX ................................................................................................................................................ 89
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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 endometrial biopsy is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about endometrial biopsy, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to endometrial biopsy, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on endometrial biopsy. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to endometrial biopsy, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on endometrial biopsy. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON ENDOMETRIAL BIOPSY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on endometrial biopsy.
Federally Funded Research on Endometrial Biopsy The U.S. Government supports a variety of research studies relating to endometrial biopsy. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to endometrial biopsy. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore endometrial biopsy. The following is typical of the type of information found when searching the CRISP database for endometrial biopsy: •
Project Title: A MINIMALLY INVASIVE DEVICE FOR ENDOMETRIAL IMAGING Principal Investigator & Institution: Natarajan, Ananth; Ceo; Infinite Biomedical Technologies, Llc 2850 N Charles St, Ste 100 Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 13-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant):Endometrial carcinoma is the most common gynecological cancer in the United States, affecting over 1 in 50 women during her
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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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Endometrial Biopsy
lifetime. Image-guided biopsy using the hysteroscope is significantly more sensitive than blind endometrial biopsy (EMB) for diagnosis of endometrial pathology. However, the majority of gynecologists do not use hysteroscopy, largely due to a steep learning curve. Therefore, we propose development of an automated minimally invasive imaging device which is as easy to use as an EMB. The device uses a 3mm rigid rod-optic endoscope. It is automatically controlled by a servomotor to produce a single two-dimensional image of the entire endometrial cavity, including visualization of lesions. Subsequently, a directed biopsy may be accomplished using the servomotor system and the coordinates of the lesion from the Endometrial Map. The Phase I prototype will incorporate a 360-degree panoramic imaging endoscope, special imageprocessing software, and full color CCD technology to produce a single integrated Endometrial Map. We will test this system in ex-vivo human uteri and characterize its performance relative to visual inspection of the dissected uterus. If we obtain proof-ofconcept of the imaging system, we hope to proceed to Phase II, which will focus on integration of the biopsy apparatus, and testing the device in an animal model and in a clinical study. It is our long-term goal that the device will be used as a minimally invasive tool for accurate identification and directed biopsy of endometrial pathology. PROPOSED COMMERCIAL APPLICATION: This year alone there will be 38,300 new cases of endometrial cancer in women. If the device proves to create a simple method to image the endometrium and direct biopsies, it will have a major impact on the clinical practice of gynecology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AUTO/PARACRINE MECHANISMS IN HUMAN IMPLANTATION Principal Investigator & Institution: Giudice, Linda C.; Professor; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 02-MAY-2002; Project End 31-MAR-2007 Summary: For successful implantation in humans, the endometrium must be adequate prepared by steroid hormones to allow attachment of the embryo to the epithelium, passage through the epithelium, and invasion of the trophoblast into the maternal stroma. We have had a long-standing interest in the insulin-like growth factor (IGF) family and its role in the invasive phase of human implantation. IGF-II is exclusively expressed by the invading trophoblast, and it regulates restraints of invasion produced by the maternal decidua. Two inhibitors of IGF action, IGF binding protein (IGFBP)-1 and IGFBP-1, are made by the decidua. We have identified an enzyme that cleaves IGFBP-4 and decreases its affinity for IGF-II and identified it as a known protein with unknown function, pregnancy-associated plasma protein-A (PAPP-1). Its naturally occurring inhibitor is also a major product of the invading trophoblast in human pregnancy. In this grant we propose to investigate the hypothesis that IGFBP-4 proteolysis increases IGF-II bioavailability in the placental bed to enhance IGF-II action on the decidua, resulting in regulation of maternal restraints on invasion. In addition to the invasive phase, we have initiated studies relevant to paracrine dialogs between the endometrial epithelium and stroma important during the window of implantation. Our recent gene profiling of human endometrial biopsy specimens reveals marked upregulation of IGF and wnt family mRNAs during the implantation window. Wnts are important in epithelial- mesenchymal interactions, and we have identified selective expression of wnt family members in human endometrial epithelial and stroma. IGF-II and wnt signaling may interface through a common, pathway, suggesting a role for stromal-derived. IGF-II interacting with epithelium-derived wnt on effects on the stroma during the implantation window. Herein, we propose: (1) during the invasive
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phase of implantation to investigate the function(s) of IGF-II, IGFBP-4, PAPP-A, and its inhibitor at the decidual: trophoblast interface; (2) during the window of implantation, to investigate the role of wnt and IGF-II signaling in epithelial-stromal communication. We work with the human model because of uniqueness of implantation in humans. These studies have relevance to infertility, ectopic pregnancy, and contraception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COOPERATIVE MULTICENTER REPRODUCTIVE MEDICINE NETWORK Principal Investigator & Institution: Coutifaris, Christos; Associate Professor and Director; Obstetrics and Gynecology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-APR-2000; Project End 31-MAR-2005 Summary: Through this application, the University of Pennsylvania seeks to continue its participation in the network of clinical reproductive medicine units (RMU). The University has established strength in clinical and basic research in infertility, endocrinology and reproductive biology. High volume clinical programs in the surgical and medical treatment of female and male infertility have been in place for over three decades. Laboratories dedicated to reproductive medicine (assisted reproductive technologies, andrology, and reproductive endocrinology) and an NIH-supported Clinical Research Center enhance the clinical and research programs. The participating faculty brings expertise in gynecology, andrology, psychiatry, clinical epidemiology and biostatistics, clinical chemistry and computer and information technology. The proposed administrative structure for the RMU includes a Principal Investigator, Christos Coutifaris, M.D., Ph.D., Director of the Division of Reproductive Endocrinology and Infertility, who will be assisted by two co- principal investigators Luigi Mastroianni, Jr., M.D., previous director of the division and original P.I. of the Penn RMU and Kurt Barnhart, M.D., M.S.C.E., director of the division's clinical research unit. In addition, an Executive Committee will oversee the progress and functions of the RMU. During the previous period of funding, the first two clinical trials were completed and the initial analysis of the superovulation/intrauterine insemination (SO/IUI) protocol was published in the New England Journal of Medicine. Analyses of the fertile male study results and those of a number of ancillary studies stemming from the SO/IUI trial are currently being performed. If funding is extended, the University of Pennsylvania RMU will continue to recruit patients for the endometrial biopsy study (Penn's "concept protocol" in the previous submission) recently approved as a Network-wide protocol and will participate in any new studies decided upon by the steering committee and NICHD. It is anticipated that two additional years will be required for completion of the endometrial biopsy study. It is also anticipated that the protocol for the use of Methotrexate for treatment of ectopic pregnancy will be implemented in all RMN sites. With the recent establishment of a clinical research unit within the Division, which has dedicated space, equipment and personnel, the Penn RMU is in the unique position to undertake and successfully participate in multiple concurrent clinical trials. It is our expectation that as the Reproductive Medicine Network has now matured, multiple protocols will successfully be implemented. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORE--TISSUE PROCUREMENT Principal Investigator & Institution: Stern, Judy E.; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755
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Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Description (provided by applicant): The Tissue Procurement Core Facility is designed as a central tissue acquisition and distribution facility. The Core enables the efficient collection and use of patient tissues and their subsequent distribution to Project Investigators. Services provided by the Core Facility include making initial patient contact and gaining informed consent, acquisition of pertinent patient information from chart and patient interviews, clinical/pathologic evaluation of collected tissues, and the initial processing and distribution of tissues. Tissues for the Program Project are obtained from reproductive tracts of patients undergoing hysterectomy or endometrial biopsy. The Core Facility identifies and enrolls patients and evaluates the appropriateness of clinical cases. In addition, the facility oversees the collection of information on endocrine condition, clinical diagnoses, and gross pathology. The second major function of the Core Facility is to coordinate tissue distribution to investigators. The third function of this Core is the collation of patient data on selected clinical parameters including the maintenance of a Project database to enable rapid correlation of clinical, endocrinologic an immunologic parameters of different tissue samples. This database will enable investigators to easily evaluate hypotheses that arise in the course of the research. The Core combines the expertise of its members, which include a Core Director, a Medical Coordinator, and Pathologist who provide consultation and support for all of the Core services. In addition, the Core has the services of a Clinical Coordinator who contacts the patients to obtain clinical histories and oversees the caseload. The biostatistical shared service and the Norris Cotton Cancer Center at DHMC will provide consultation for the statistical evaluations and maintenance of the database. A microbiologist, in conjunction with the Clinic Microbiological laboratories, will provide consultation on the diagnosis and identification of STDs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTIVENESS OF OUTPATIENT TREATMENT OF PID Principal Investigator & Institution: Ness, Roberta B.; Professor and Chair; Epidemiology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-JUL-2004 Summary: (provided by applicant): Pelvic inflammatory disease (PID) affects about 8 percent of all U.S. women and 11 percent of African-American women of reproductive age. It is thought to result in frequent infertility, chronic pelvic pain, and recurrence. Almost all of our knowledge of the natura1 history of and prognosis after PID comes from a single Swedish prospective study initiated 40 years ago. We propose to further knowledge of the sequelae after PID by building on the nearly-completed PID Evaluation and Clinical Health (PEACH) Study, a multicenter, randomized clinical trial of inpatient versus outpatient antibiotic management among women with clinically suspected mild-to-moderate PID. Thus far, we have accomplished an average of over 2 years (range 0.6-3.6 years) of follow-up of this predominantly African-American, indigent cohort with a follow-up rate of 85 percent. In this proposed extension, we will continue to follow women enrolled in the trial (831 randomized) for an additional 3.5 years. At the end of that time period, we will draw blood for HLA testing and for convalescent heat shock protein-60 testing. These follow-up data allow us to accomplish three aims: 1) to better describe the rates of inability to achieve pregnancy, chronic pelvic pain, and recurrence after PID; 2) to develop and validate a clinical prediction rule(s) that identifies women at risk for these consequences; and 3) to identify whether inpatient treatment is more effective than outpatient treatment in reducing the risk of
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sequelae among prognostic subsets of women. With additional follow-up and the use of the extensive, already-collected, baseline data set including the results of the endometrial biopsy, cervical/vaginal swab testing, blood collection, clinical examination and patient interviews, we have sufficient power to formulate and validate multivariate clinical prediction tool(s). Analytic techniques will include ROC analyses, logistic regression, and CART techniques. We will also have the power to compare the effectiveness of inpatient versus outpatient treatment within risk subgroups using life table techniques and multivariate adjusted relative risks. The importance of this extension is that it represents a unique opportunity to examine the natural history of PID, to identify women who are at highest risk for sequelae, and to test the potential benefit of more intensive management among high-risk women. We gain great efficiency in the use of the extensive resources and excellent follow-up success within the PEACH cohort. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HBEGF - A ROLE IN HUMAN IMPLANTATION Principal Investigator & Institution: Leach, Richard E.; Asociate Professor; Obstetrics and Gynecology; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 28-FEB-2006 Summary: (Scanned from the applicant's abstract) The steroid-regulated Epidermal Growth Factor (EGF) family and their receptors (HERs) are expressed in the endometrium during implantation in specific spatiotemporal patterns. While there is a well-developed body of knowledge regarding the altered expression of these proteins and adverse effects on implantation in rodents, their expression patterns have not been comprehensively studied in humans during the endometrial cycle and implantation, nor is it known how the hormonal manipulations used during in vitro fertilization (IVF) alter their expression patterns. Our central hypothesis is that the synchronous development of endometrium and invasive trophoblast during early pregnancy is coordinated through the activities of EGF family growth factors, which are expressed in a steroid-dependent, spatiotemporal pattern. Interruption of these signaling pathways by an altered steroid state found during IVF procedures will impact significantly on implantation rates. We will compare the spatiotemporal expression patterns of EGF family growth factors and HER receptor subtypes in endometrial biopsy specimens obtained from women undergoing controlled ovarian hyperstimulation with gonadotropins for the purpose of oocyte donation. We will determine how estrogen and/or progesterone regulate EGF family growth factors and HER gene expression in isolated and co-cultured human uterine epithelial and stromal cells to identify how the Hyperestrogenic State alters this expression. With this information in hand we will determine the effect of candidate EGF family growth factors determined above on specific HER-mediated signaling on trophoblast cell proliferation and invasiveness using in vitro cultured cytotrophoblast cells. Our hypothesis predicts that trophoblast proliferation and differentiation are promoted in a ligand and receptor-specific manner. At the conclusion of this proposed research we will know the effect of hormonal changes found during IVF on EGF family growth factors and their receptors. Further, we will know the effect of this altered expression on trophoblast function. This information will provide mechanistic based strategies to correct the altered endometrial changes associated with IVF treatment. This information in turn can be used in the future to test IVF ovulation induction protocols to improve implantation rates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Endometrial Biopsy
Project Title: HISTOMETRIC ANALYSIS OF PREMALIGNANT ENDOMETRIAL LESIONS Principal Investigator & Institution: Garcia, Francisco Ar.; Obstetrics and Gynecology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: Adenocarcinoma of the endometrium is the most common gynecologic malignancy in the United States. It accounts for about 36,000 cases of invasive cancer each year and is among the top five neoplasms affecting women. Hyperplastic abnormalities of the endometrium follow a continuum of severity, with the risk of progression to carcinoma being related to the complexity of the lesion. At this time dilation and curettage with hysteroscopy, remain the major means of diagnosis. The current management of atypical endometrial hyperplasia is limited to hysterectomy. The overall goal of this research is to establish the foundation for the objective characterization of hyperplastic endometrial lining abnormalities associated with neoplasia of the uterine corpus, based on computer histometric/karyometric analysis. We hypothesize that: 1) The orderly progression from normality, to simple hyperplasia, atypical hyperplasia, and endometrial carcinoma in the uterine lining has distinct morphometric characteristics that can be identified using computer-based histometric analysis. 2) Endometrial adenocarcinoma causes distinct identifiable changes in adjacent hyperplastic and otherwise normal endometrial surfaces, which permit its identification prior to hysterectomy. 3) The responsiveness of atypical hyperplasia to a chemopreventive regimen can be objectively quantified using histometric/karyometric analysis. Our specific aims are to: 1) Develop procedures for the automated digital processing of high resolution microscopic images of histopathologic sections of endometrial biopsies and hysterectomy specimens, including the development of a knowledge file for automated scene segmentation and karyometry. 2) Establish an objective, numeric assessment and grading system for endometrial lesions. 3) Define a nuclear signature of preneoplastic endometrial lesions. These will be accomplished within the context of an ongoing two-part study of atypical hyperplasia (GOG Protocol 167). The ubiquity of preneoplastic abnormalities of the endometrial lining of the uterus, and the potential morbidity, time loss and expense associated with their surgical therapy, require the development of novel diagnostic modalities that reliably predict malignant potential. Digital microscopy and nuclear morphometric analysis will extend the utility of the histopathologic analysis of otherwise negative endometrial biopsy material, by allowing the identification of women with synchronous endometrial carcinoma, or at risk for malignant progression of their hyperplasia. This will allow the development and testing of chemopreventive interventions in low risk patients, and facilitate efficient surgical therapy in those women with potentially aggressive disease. Such capabilities could prevent unnecessary surgery, as well as the vast majority of advanced endometrial cancers. The technique of computerized morphometric analysis has tremendous potential to increase our understanding of the biological behavior of endometrial cancer, as well as revolutionize its diagnosis and treatment endometrial cancer. This proposed research project fits within the context, of a highly structured, multi-faceted, Mentored Patient Oriented Research Career Development Plan that focuses on the prevention and control of preneoplastic gynecologic disease. It utilizes the unique resources available at the University of Arizona, to foster an environment in which academic productivity is optimized and the necessary supervision is received to insure a successful career in clinical investigation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOLECULAR PROGRESSION OF ENDOMETRIAL CANCER Principal Investigator & Institution: Loose-Mitchell, David S.; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: Estrogen exposure is well-documented to be important in the pathogenesis of endometrial cancer. We hypothesize that normal growth control pathways induced by estrogen are dysregulated in endometrial hyperplasia and cancer. By identifying genes that are dysregulated, we can 1) further our understanding of the step-wise progression in endometrial carcinogenesis and 2) identify genes that can be used as surrogate biomarkers of endometrial cancer risk. Identification of these tissue biomarkers is crucial for the successful design of chemoprevention trials. In addition, these biomarkers potentially can be used clinically as tissue indicators of risk in high-risk groups. High risk groups include women using SERMs such as tamoxifen, women with HNPCC, and women with obesity and type 2 diabetes. We have recently analyzed gene expression changes in post-menopausal endometrium exposed to different estrogen preparations using DNA microchip army analysis and real-time quantitative PCR (Q-PCR). The array analysis identified several hundred genes that are regulated by estrogen. From this large set of estrogen regulated genes, and additional genes selected for their role in the development of endometrial hyperplasia, a set of 33 transcripts was identified that are involved in proliferation in the endometrium. Our approach will be to make quantitative measurements of mRNA levels of this set of potential biomarkers in endometrial biopsy samples in different states of proliferation: normal, hyperplasia, and cancer. Specifc Aim 1: Quantitate the set of 33 candidate biomarkers in normal quiescent post-menopausal endometrium; normal proliferative post-menopausal endometrium from women treated with conjugated estrogens; normal secretory and normal proliferative pre-menopausal endometrium; hyperplastie endometrium both with and without nearby cancer; Type I endometrial cancer; and Type II endometrial cancer. Using laser capture microdissection, we will focus on the precancerous lesion endometrial intraepithelial neoplasia (EIN) and assess transcript levels in EIN and in normal adjacent regions. Specific Aim 2: High density microarrays will be screened to identify new genes whose expression is altered in hyperplasia and cancer compared to normal endometrium. Genes that are identified by the microchip analysis will be validated by Q-PCR. The combination of Aims 1 and 2 will identify a set of "abnormal proliferation" biomarker transcripts. Specific Aim 3: We will test the ability of the biomarkers to predict changes in proliferation by quantitating transcript levels in women treated with progestins for atypical hyperplasia. We hypothesize that biomarkers that are elevated in abnormal proliferation will be reduced by progestin treatment. Biomarkers will also be quantitated in endometrial biopsies from women treated with tamoxifen, a group at risk for developing endometrial cancer. This panel of biomarkers may be extended for use in the future analysis of the endometrial effects of newer SERMs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PHYTOESTROGEN ENDOMETRIUM
SUPPLEMENT
ON
POSTMENOPAUSAL
Principal Investigator & Institution: Balk, Judith L.; Assistant Professor; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002
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Summary: Phytoestrogens will be used to supplement the diets of post-menopausal women for the purpose of assessing alleviation of menopausal symptoms and endometrial histology. An initial endometrial biopsy is performed to asses study eligibility. If adequate, non-hyperplastic, non-cancerous, inovulatory biopsy is obtained, subjects are randomized to dietary supplementation with phytoestrogens or a placebo. After a study period of six months, repeat biopsies are done to evaluate estrogenis stimulation. Additionally, vaginal microflora will be assessed at the time of each biopsy. All subjects maintain dietary logs for two weeks prior and during the study period to assess intake of phytoestrogens. Subjects will also maintain a log of side effects. Menopausal symptom questionnaires will be administered after enrollment and again at the end of the study period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 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 endometrial biopsy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “endometrial biopsy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for endometrial biopsy (hyperlinks lead to article summaries): •
A comparative study between panoramic hysteroscopy and endometrial biopsy. Analysis of 150 cases. Author(s): Pungetti D, Dimicco R, Mattucci M, Nardi M, Maruizio G, Lenzi M, Mazzoli F, Cantiero D, Travisani D, Zanardi E. Source: Acta Eur Fertil. 1990 July-August; 21(4): 201-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2085062
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A comparative study of the endometrial jet-washing technic and endometrial biopsy. Author(s): Abate SD, Edwards CL, Vellios F. Source: American Journal of Clinical Pathology. 1972 August; 58(2): 118-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5047601
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.
Studies
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A comparative study of transvaginal uterine ultrasound and endometrial biopsy for evaluating the endometrium of postmenopausal women taking hormone replacement therapy. Author(s): Archer DF, Lobo RA, Land HF, Pickar JH. Source: Menopause (New York, N.Y.). 1999 Fall; 6(3): 201-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10486789
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A comparison of the performance of endometrial biopsy with the Pipelle by nurses and physicians. Author(s): Dantas MC, Hidalgo MM, Bahamondes L, Marchi NM. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1994 May; 45(2): 164-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7915689
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A randomised controlled trial comparing transvaginal ultrasound, outpatient hysteroscopy and endometrial biopsy with inpatient hysteroscopy and curettage. Author(s): Kremer C, Duffy S. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 August; 107(8): 1058-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10955446
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A randomised controlled trial comparing transvaginal ultrasound, outpatient hysteroscopy and endometrial biopsy with inpatient hysteroscopy and curettage. Author(s): Tahir MM, Bigrigg MA, Browning JJ, Brookes ST, Smith PA. Source: British Journal of Obstetrics and Gynaecology. 1999 December; 106(12): 1259-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10609719
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A randomized clinical trial comparing Pipelle and Tis-u-trap for endometrial biopsy. Author(s): Frishman G, Jacobs S. Source: Obstetrics and Gynecology. 1990 August; 76(2): 315-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2196501
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A randomized clinical trial comparing Pipelle and Tis-u-trap for endometrial biopsy. Author(s): Koonings PP, Moyer DL, Grimes DA. Source: Obstetrics and Gynecology. 1990 February; 75(2): 293-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2405324
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Abnormal uterine bleeding: an evaluation endometrial biopsy, vaginal ultrasound and outpatient hysteroscopy. Author(s): Hunter DC, McClure N. Source: Ulster Med J. 2001 May; 70(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11428321
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Accuracy of endometrial biopsy dating in relation to the midcycle luteinizing hormone peak. Author(s): Koninckx PR, Goddeeris PG, Lauweryns JM, De Hertogh RC, Brosens IA. Source: Obstetrical & Gynecological Survey. 1977 September; 32(7): 613-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=904794
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Accuracy of endometrial biopsy dating in relation to the midcycle luteinizing hormone peak. Author(s): Koninckx PR, Goddeeris PG, Lauweryns JM, de Hertogh RC, Brosens IA. Source: Fertility and Sterility. 1977 April; 28(4): 443-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=844619
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Accuracy of endometrial biopsy with the Cornier pipelle for diagnosis of endometrial cancer and atypical hyperplasia. Author(s): Machado F, Moreno J, Carazo M, Leon J, Fiol G, Serna R. Source: Eur J Gynaecol Oncol. 2003; 24(3-4): 279-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12807240
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Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer: a systematic quantitative review. Author(s): Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 March; 109(3): 313-21. Review. Summary for Patients In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11950187
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Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial hyperplasia. Author(s): Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2001 September; 80(9): 784-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11531627
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Actinomycosis documented by cervicovaginal smear and endometrial biopsy: implications for patient management. Author(s): Bornstein J, Montgomery L, Kaufman RH. Source: Acta Cytol. 1987 November-December; 31(6): 955-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3425157
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Anesthetic effect of intrauterine lidocaine plus naproxen sodium in endometrial biopsy. Author(s): Dogan E, Celiloglu M, Sarihan E, Demir A. Source: Obstetrics and Gynecology. 2004 February; 103(2): 347-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14754707
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Anesthetic efficacy of intrauterine lidocaine for endometrial biopsy: a randomized double-masked trial. Author(s): Trolice MP, Fishburne C Jr, McGrady S. Source: Obstetrics and Gynecology. 2000 March; 95(3): 345-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10711541
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Assessing the importance of endometrial biopsy prior to oocyte donation. Author(s): Sauer MV, Paulson RJ, Moyer DL. Source: Journal of Assisted Reproduction and Genetics. 1997 February; 14(2): 125-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9048244
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Can serology diagnose upper genital tract Chlamydia trachomatis infections? Studies on women with pelvic pain, with or without chlamydial plasmid DNA in endometrial biopsy tissue. Author(s): Chernesky M, Luinstra K, Sellors J, Schachter J, Moncada J, Caul O, Paul I, Mikaelian L, Toye B, Paavonen J, Mahony J. Source: Sexually Transmitted Diseases. 1998 January; 25(1): 14-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9437779
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Caramel test for ovulation and its correlation with endometrial biopsy and cervical mucus fern test. Author(s): Razdan S. Source: J Indian Med Assoc. 1986 July; 84(7): 208-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3794354
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Cervical cytology and endometrial biopsy in women using long acting injectable progesterone (DMPA)--a preliminary report. Author(s): Gopalkrishnan K, Virkar KD. Source: The Indian Journal of Medical Research. 1980 March; 71: 372-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7390572
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Clinical over- and under-estimation in patients who underwent hysterectomy for atypical endometrial hyperplasia diagnosed by endometrial biopsy: the predictive value of clinical parameters and diagnostic imaging. Author(s): Kimura T, Kamiura S, Komoto T, Seino H, Tenma K, Ohta Y, Yamamoto T, Saji F. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 June 10; 108(2): 213-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12781414
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Clinical significance of amniotic fluid, amniotic membranes, and endometrial biopsy cultures at the time of cesarean section. Author(s): Cooperman NR, Kasim M, Rajashekaraiah KR. Source: American Journal of Obstetrics and Gynecology. 1980 July 1; 137(5): 536-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7386547
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Comparison of cytospat and pipelle endometrial biopsy instruments. Author(s): Antoni J, Folch E, Costa J, Foradada CM, Cayuela E, Combalia N, Rue M. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1997 March; 72(1): 57-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9076423
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Comparison of D&C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer. Author(s): Larson DM, Johnson KK, Broste SK, Krawisz BR, Kresl JJ. Source: Obstetrics and Gynecology. 1995 July; 86(1): 38-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7784020
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Comparison of endometrial biopsy and peritoneal fluid cytologic testing with laparoscopy in the diagnosis of acute pelvic inflammatory disease. Author(s): Paavonen J, Aine R, Teisala K, Heinonen PK, Punnonen R. Source: American Journal of Obstetrics and Gynecology. 1985 March 1; 151(5): 645-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3156502
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Comparison of endometrial biopsy and urinary pregnanediol glucuronide concentration in the diagnosis of luteal phase defect. Author(s): Miller MM, Hoffman DI, Creinin M, Levin JH, Chatterton RT Jr, Murad T, Rebar RW. Source: Fertility and Sterility. 1990 December; 54(6): 1008-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2245826
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Comparison of endometrial biopsy with plasma progesterone estimation for the assessment of luteal function in infertile women. Author(s): Radwanska E, Hughesdon PE, Swyer GI. Source: Mater Med Pol. 1976 January-March; 8(1): 18-20. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1263579
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Comparison of endometrial biopsy with the endometrial Pipelle and Vabra aspirator. Author(s): Kaunitz AM, Masciello A, Ostrowski M, Rovira EZ. Source: J Reprod Med. 1988 May; 33(5): 427-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3385697
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Comparison of Novak and Pipelle endometrial biopsy instruments. Author(s): Silver MM, Miles P, Rosa C. Source: Obstetrics and Gynecology. 1991 November; 78(5 Pt 1): 828-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1923207
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Comparison of office hysteroscopy, transvaginal ultrasonography and endometrial biopsy in evaluation of abnormal uterine bleeding. Author(s): Pal L, Lapensee L, Toth TL, Isaacson KB. Source: Jsls. 1997 April-June; 1(2): 125-30. Erratum In: J Soc Laparoendosc Surg 1997 October-December; 1(4): 395. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9876659
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Comparison of serum progesterone and endometrial biopsy for confirmation of ovulation and evaluation of luteal function. Author(s): Shepard MK, Senturia YD. Source: Fertility and Sterility. 1977 May; 28(5): 541-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=856637
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Comparison of single serum progesterone and endometrial biopsy for confirmation of ovulation in infertile Nigerian women. Author(s): Ilesanmi AO, Adeleye JA, Osotimehin BO. Source: Afr J Med Med Sci. 1995 March; 24(1): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7495209
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Comparison of the Z-sampler and Novak endometrial biopsy instruments for inoffice diagnosis of endometrial cancer. Author(s): Larson DM, Krawisz BR, Johnson KK, Broste SK. Source: Gynecologic Oncology. 1994 July; 54(1): 64-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8020841
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Comparison of transvaginal sonography with endometrial biopsy in asymptomatic postmenopausal women. Author(s): Shipley CF 3rd, Simmons CL, Nelson GH. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1994 February; 13(2): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7932969
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Comparison of transvaginal ultrasonography and endometrial biopsy in endometrial surveillance in postmenopausal HRT users. Author(s): Hanggi W, Bersinger N, Altermatt HJ, Birkhauser MH. Source: Maturitas. 1997 June; 27(2): 133-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9255748
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Controlled analysis of factors associated with insufficient sample on outpatient endometrial biopsy. Author(s): Bakour SH, Khan KS, Gupta JK. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 October; 107(10): 1312-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11028588
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Correlation between endometrial biopsy and luteal phase plasma progesterone in women complaining for couple infertility. Author(s): Noci I, Dubini V, Piacentini R, Colafranceschi M, Taddei G, Scarselli G. Source: J Endocrinol Invest. 1988 May; 11(5): 361-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3183299
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Correlation of endometrial biopsy and plasma progesterone in infertile women. Author(s): Cooke ID, Morgan CA, Parry TE. Source: The Journal of Endocrinology. 1972 June; 53(3): 63-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5039235
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Correlation of endometrial biopsy and plasma progesterone levels in infertile women. Author(s): Cooke ID, Morgan CA, Parry TE. Source: J Obstet Gynaecol Br Commonw. 1972 July; 79(7): 647-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5065083
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Cost analysis model: US versus endometrial biopsy in evaluation of peri- and postmenopausal abnormal vaginal bleeding. Author(s): J Fam Pract. 2002 Jul;51(7):600 Source: Radiology. 2002 March; 222(3): 619-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12160493
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Cycle of conception endometrial biopsy. Author(s): Wentz AC, Herbert CM 3rd, Maxson WS, Hill GA, Pittaway DE. Source: Fertility and Sterility. 1986 August; 46(2): 196-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3732525
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Dating the endometrial biopsy by flow cytometry. Author(s): Bulletti C, Galassi A, Parmeggiani R, Polli V, Alfieri S, Labate AM, Flamigni C. Source: Fertility and Sterility. 1994 July; 62(1): 96-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8005311
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Dating the endometrial biopsy. Author(s): Noyes RW, Hertig AT, Rock J. Source: American Journal of Obstetrics and Gynecology. 1975 May; 122(2): 262-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1155504
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Delayed abdominal pain after outpatient endometrial biopsy in the luteal phase. Author(s): Li TC, Cooke ID. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1990 July; 32(3): 267-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1972120
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Detection of aromatase cytochrome P-450 in endometrial biopsy specimens as a diagnostic test for endometriosis. Author(s): Kitawaki J, Kusuki I, Koshiba H, Tsukamoto K, Fushiki S, Honjo H. Source: Fertility and Sterility. 1999 December; 72(6): 1100-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10593388
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Determining the time of the urinary luteinizing hormone surge. Does it facilitate the interpretation of endometrial biopsy results? Author(s): Smith S. Source: J Reprod Med. 1992 September; 37(9): 785-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1453398
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Development of a method to isolate and culture highly purified populations of stromal and epithelial cells from human endometrial biopsy specimens. Author(s): Osteen KG, Hill GA, Hargrove JT, Gorstein F. Source: Fertility and Sterility. 1989 December; 52(6): 965-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2687030
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Does endometrial biopsy miss endometrial carcinoma? Author(s): Heller DS, Drosinos S, Westhoff C. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1995 January; 48(1): 107-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7698370
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Effect of adjuvant tamoxifen on the endometrium in women with breast cancer: a prospective study using office endometrial biopsy. Author(s): Barakat RR, Gilewski TA, Almadrones L, Saigo PE, Venkatraman E, Hudis C, Hoskins WJ. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2000 October 15; 18(20): 3459-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11032585
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Embolic vascular seeding of endometrial adenocarcinoma, a complication of hysteroscopic endometrial biopsy. Author(s): Workman RD, Wong DS, Pitts WC. Source: Gynecologic Oncology. 1999 February; 72(2): 261-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10021312
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Endometrial biopsy and improved conception and implantation. Author(s): Ansbacher R. Source: Fertility and Sterility. 2003 November; 80(5): 1288-9; Author Reply 1289. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14607599
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Endometrial biopsy and lavage. Results in 170 patients in private practice. Author(s): Vaughan RA. Source: Trans Pac Coast Obstet Gynecol Soc. 1970; 37: 50-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5513877
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Endometrial biopsy and lavage. Results in 170 patients in private practice. Author(s): Vaughan RA. Source: Trans Pac Coast Obstet Gynecol Soc. 1969; 37: 50-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5406671
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Endometrial biopsy and ovarian hormonal failure. Author(s): Myhre E. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1966; 45: Suppl 9: 143-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5958384
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Endometrial biopsy at the time of embryo transfer: correlation of histological diagnosis with therapy and pregnancy rate. Author(s): Abate V, De Corato R, Cali A, Stinchi A. Source: J in Vitro Fert Embryo Transf. 1987 June; 4(3): 173-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3611926
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Endometrial biopsy collection from women receiving Norplant. Author(s): Hadisaputra W, Affandi B, Witjaksono J, Rogers PA. Source: Human Reproduction (Oxford, England). 1996 October; 11 Suppl 2: 31-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8982743
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Endometrial biopsy dating. Interobserver variation and its impact on clinical practice. Author(s): Smith S, Hosid S, Scott L. Source: J Reprod Med. 1995 January; 40(1): 1-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7722968
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Endometrial biopsy during a cycle of conception. Author(s): Sulewski JM, Ward SP, McGaffic W. Source: Fertility and Sterility. 1980 December; 34(6): 548-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7450073
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Endometrial biopsy during hormone replacement cycle in donor oocyte recipients before in vitro fertilization-embryo transfer. Author(s): Potter DA, Witz CA, Burns WN, Brzyski RG, Schenken RS. Source: Fertility and Sterility. 1998 August; 70(2): 219-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9696210
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Endometrial biopsy during outpatient hysteroscopy: evaluation and comparison of two devices. Author(s): Agostini A, Shojai R, Cravello L, Rojat-Habib MC, Roger V, Bretelle F, Blanc B. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 August; 97(2): 220-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11451552
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Endometrial biopsy during treatment of luteal phase defects is predictive of therapeutic outcome. Author(s): Daly DC, Walters CA, Soto-Albors CE, Riddick DH. Source: Fertility and Sterility. 1983 September; 40(3): 305-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6884533
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Endometrial biopsy findings in infertility: analysis of 12,949 cases. Author(s): Sahmay S, Oral E, Saridogan E, Senturk L, Atasu T. Source: Int J Fertil Menopausal Stud. 1995 November-December; 40(6): 316-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8748922
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Endometrial biopsy in DUB. Author(s): Ash SJ, Farrell SA, Flowerdew G. Source: J Reprod Med. 1996 December; 41(12): 892-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8979202
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Endometrial biopsy in the cycle of conception. Author(s): Rosenfeld DL, Garcia CR. Source: Fertility and Sterility. 1975 November; 26(11): 1088-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1183634
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Endometrial biopsy in the cycle of conception: histologic and lectin histochemical evaluation. Author(s): Mazur MT, Duncan DA, Younger JB. Source: Fertility and Sterility. 1989 May; 51(5): 764-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2468536
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Endometrial biopsy in the evaluation of infertility. Author(s): Wentz AC. Source: Fertility and Sterility. 1980 February; 33(2): 121-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7353687
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Endometrial biopsy in the evaluation of infertility: a 15 years review at Ramathibodi Hospital. Author(s): Sugkraroek P, Chaturachinda K. Source: J Med Assoc Thai. 1988 March; 71 Suppl 1: 118-21. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3418258
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Endometrial biopsy in the infertility investigation. The experience at two institutions. Author(s): Wild RA, Sanfilippo JS, Toledo AA. Source: J Reprod Med. 1986 October; 31(10): 954-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3783537
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Endometrial biopsy in the luteal phase of the cycle of conception. Author(s): Karow WG, Gentry WC, Skeels RF, Payne SA. Source: Fertility and Sterility. 1971 August; 22(8): 482-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5110231
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Endometrial biopsy in the office setting. Author(s): Mashburn J. Source: Journal of Nurse-Midwifery. 1993 March-April; 38(2 Suppl): 31S-35S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8387103
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Endometrial biopsy in women with primary infertility. Author(s): Rameshkumar K, Thomas JA. Source: The Indian Journal of Medical Research. 1991 February; 94: 20-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2071179
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Endometrial biopsy inadvertently taken during conception cycle. Author(s): Buxton CL, Olson LE. Source: American Journal of Obstetrics and Gynecology. 1969 November 1; 105(5): 702-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5823890
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Endometrial biopsy inadvertently taken in the cycle of conception. Author(s): Balasch J, Vanrell JA, Marquez M, Gonzalez-Merlo J. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1984 April; 22(2): 95-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6145645
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Endometrial biopsy interpretation. Shortcomings and problems in current gynecologic practice. Author(s): Van Bogaert LJ, Maldague P, Staquet JP. Source: Obstetrics and Gynecology. 1978 January; 51(1): 25-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=619334
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Endometrial biopsy using a plastic curette (Mi-Mark). Author(s): Ansari AH, Essien JD, Hoffman D, Ansari VM. Source: Int J Fertil. 1981; 26(1): 45-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6113208
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Endometrial biopsy using Gravlee Jet Washer and suction curette. Author(s): Ansari AH, Cowdry CR. Source: Int J Fertil. 1974; 19(3): 129-32. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4375121
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Endometrial biopsy using the Tao Brush method. A study of 50 women in a general gynecologic practice. Author(s): Yang GC, Wan LS. Source: J Reprod Med. 2000 February; 45(2): 109-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10710740
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Endometrial biopsy with uretral plastic No. 12 sonde. Author(s): Guerreiro ID, Castanho PR, Baracat FF. Source: Rev Paul Med. 1995 January-February; 113(1): 698-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8578079
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Endometrial biopsy, bacteremia, and endocarditis risk. Author(s): Livengood CH 3rd, Land MR, Addison WA. Source: Obstetrics and Gynecology. 1985 May; 65(5): 678-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3982745
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Endometrial biopsy. Author(s): Zuber TJ. Source: American Family Physician. 2001 March 15; 63(6): 1131-5, 1137-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11277550
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Endometrial biopsy. Author(s): Shelly MS. Source: American Family Physician. 1997 April; 55(5): 1731-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9105201
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Endometrial biopsy. Author(s): Strickland DM. Source: Fertility and Sterility. 1986 April; 45(4): 581-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3956773
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Endometrial biopsy. Pathologic findings in 3,600 biopsies from selected patients. Author(s): Baitlon D, Hadley JO. Source: American Journal of Clinical Pathology. 1975 January; 63(1): 9-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1111280
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Endometrial biopsy: another look. Author(s): Hofmeister FJ. Source: American Journal of Obstetrics and Gynecology. 1974 March 15; 118(6): 773-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4815857
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Endometrial biopsy--interpretation. Author(s): Abell MR. Source: J Ark Med Soc. 1967 February; 63(9): 317-23. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4227072
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Endometrial lymphoid tissue in the timed endometrial biopsy: morphometric and immunohistochemical aspects. Author(s): Klentzeris LD, Bulmer JN, Warren A, Morrison L, Li TC, Cooke ID. Source: American Journal of Obstetrics and Gynecology. 1992 September; 167(3): 667-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1530020
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Endometrial safety during hormone replacement therapy: comparison of transvaginal sonography and endometrial biopsy. Author(s): Goldstein SR. Source: Menopause (New York, N.Y.). 1998 Summer; 5(2): 132-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9689208
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Endometrial status in post-menopausal women on long-term continuous combined hormone replacement therapy (Kliofem). A comparative study of endometrial biopsy, outpatient hysteroscopy and transvaginal ultrasound. Author(s): Piegsa K, Calder A, Davis JA, McKay-Hart D, Wells M, Bryden F. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1997 April; 72(2): 175-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9134398
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Evaluation of endometrial biopsy in the cycle of conception. Author(s): Arronet GH, Bergquist CA, Parekh MC, Latour JP, Marshall KG. Source: Int J Fertil. 1973; 18(4): 220-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4359690
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Evaluation of endometrial biopsy using an aspiration curet without cervical tenaculum. Author(s): Meeks GR, Woodliff JM, Box ST, Cesare CD. Source: Southern Medical Journal. 1993 September; 86(9): 1011-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8367745
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Evaluation of the office endometrial biopsy in the detection of endometrial carcinoma and atypical hyperplasia. Author(s): Greenwood SM, Wright DJ. Source: Cancer. 1979 April; 43(4): 1474-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=445344
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Evaluation of the Pipelle curette for endometrial biopsy. Author(s): Henig I, Chan P, Tredway DR, Maw GM, Gullett AJ, Cheatwood M. Source: J Reprod Med. 1989 October; 34(10): 786-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2795561
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Five years experiences with endometrial biopsy in infertile patients. Author(s): Mansuwan K, Chongwatana V, Egkarntrong P, Boonvisut S, Apichaisiri P. Source: Asia Oceania J Obstet Gynaecol. 1982 June; 8(2): 155-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7138381
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Hertig and beyond: a systematic and practical approach to the endometrial biopsy. Author(s): Crum CP, Hornstein MD, Nucci MR, Mutter GL. Source: Advances in Anatomic Pathology. 2003 November; 10(6): 301-18. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14581820
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Histologic classification and pathologic findings for endometrial biopsy specimens obtained from 2964 perimenopausal and postmenopausal women undergoing screening for continuous hormones as replacement therapy (CHART 2 Study). Author(s): Korhonen MO, Symons JP, Hyde BM, Rowan JP, Wilborn WH. Source: American Journal of Obstetrics and Gynecology. 1997 February; 176(2): 377-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9065185
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Hysteroscopy and endometrial biopsy. Author(s): Noci I, Tantini C, Dubini V, Piacentini R, Bargelli G, Scarselli G, Colafranceschi M, Taddei G. Source: Acta Eur Fertil. 1987 January-February; 18(1): 59-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3630570
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Hysterosonographically guided endometrial biopsy: technical feasibility. Author(s): Dubinsky TJ, Reed S, Mao C, Waitches GM, Hoffer EK. Source: Ajr. American Journal of Roentgenology. 2000 June; 174(6): 1589-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10845487
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Implications of sampling the implantation site in the endometrial biopsy for infertility. Author(s): Kaminski PF, Lyon DS. Source: J Reprod Med. 1990 March; 35(3): 208-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2325028
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Improved prediction of postovulatory day using temperature recording, endometrial biopsy, and serum progesterone. Author(s): Pillet MC, Wu TF, Adamson GD, Subak LL, Lamb EJ. Source: Fertility and Sterility. 1990 April; 53(4): 614-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2318322
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Investigation of the infertile couple: hysteroscopy with endometrial biopsy is the gold standard investigation for abnormal uterine bleeding. Author(s): Revel A, Shushan A. Source: Human Reproduction (Oxford, England). 2002 August; 17(8): 1947-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12151418
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Is outpatient diagnostic hysteroscopy more useful than endometrial biopsy alone for the investigation of abnormal uterine bleeding in unselected premenopausal women? A randomised comparison. Author(s): Bain C, Parkin DE, Cooper KG. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 July; 109(7): 805-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12135218
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Metastatic carcinoma of breast diagnosed following hysteroscopy and endometrial biopsy. Author(s): Adjetey V, Reid BA, Graham CT, Taylor AR. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 May; 22(3): 331-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521527
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Microhysteroscopy and endometrial biopsy results following failed diagnostic dilatation and curettage in women with postmenopausal bleeding. Author(s): Altaras MM, Aviram R, Cohen I, Markov S, Goldberg GL, Beyth Y. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1993 September; 42(3): 255-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7901082
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Midluteal endometrial biopsy and alphavbeta3 integrin expression in the evaluation of the endometrium in infertility: implications for fecundity. Author(s): Ordi J, Creus M, Ferrer B, Fabregues F, Carmona F, Casamitjana R, Vanrell JA, Balasch J. Source: International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists. 2002 July; 21(3): 231-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12068168
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Midluteal phase endometrial biopsy does not accurately predict luteal function. Author(s): Batista MC, Cartledge TP, Merino MJ, Axiotis C, Platia MP, Merriam GR, Loriaux DL, Nieman LK. Source: Fertility and Sterility. 1993 February; 59(2): 294-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8425621
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Necessity of endometrial biopsy in women with enlarged uteri and a preoperative diagnosis of uterine leiomyomata. Author(s): Duplantier N, Finan MA, Barbe T. Source: J Reprod Med. 2003 January; 48(1): 23-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12611090
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Office procedures. Endometrial biopsy. Author(s): Apgar BS, Newkirk GR. Source: Primary Care. 1997 June; 24(2): 303-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174041
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Oral misoprostol before office endometrial biopsy. Author(s): Perrone JF, Caldito G, Mailhes JB, Tucker AN, Ford WR, London SN. Source: Obstetrics and Gynecology. 2002 March; 99(3): 439-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11864671
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Outpatient endometrial biopsy: clinical, endocrinologic and histologic consequences. Author(s): Li TC, Cooke ID. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1990 January; 31(1): 35-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1968016
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Outpatient endometrial biopsy: the pipelle. Author(s): Youssif SN, McMillan DL. Source: Br J Hosp Med. 1995 September 6-19; 54(5): 198-201. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8528525
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Outpatient endometrial sampling with Endocyte: comparative study of its effectiveness with endometrial biopsy. Author(s): Ferenczy A, Gelfand MM. Source: Obstetrics and Gynecology. 1984 March; 63(3): 295-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6700851
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Outpatient pipelle endometrial biopsy in the investigation of postmenopausal bleeding. Author(s): Batool T, Reginald PW, Hughes JH. Source: British Journal of Obstetrics and Gynaecology. 1994 June; 101(6): 545-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8018649
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Paracervical anesthesia for hysteroscopy and endometrial biopsy in postmenopausal women. A randomized, double-blind, placebo-controlled study. Author(s): Cicinelli E, Didonna T, Schonauer LM, Stragapede S, Falco N, Pansini N. Source: J Reprod Med. 1998 December; 43(12): 1014-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9883403
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Pelvic inflammatory disease in a diabetic patient after endometrial biopsy. Author(s): Ries A, Sundborg M, Macri CI. Source: Obstetrical & Gynecological Survey. 1999 May; 54(5): 283-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10234696
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Pipelle: a more acceptable technique for outpatient endometrial biopsy. Author(s): Eddowes HA, Read MD, Codling BW. Source: British Journal of Obstetrics and Gynaecology. 1990 October; 97(10): 961-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2223693
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Practice tips. Endometrial biopsy. Author(s): Greiver M. Source: Can Fam Physician. 2000 February; 46: 308-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10690487
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Predicting the histologic dating of an endometrial biopsy specimen with the use of Doppler ultrasonography and hormone measurements in patients undergoing spontaneous ovulatory cycles. Author(s): Sterzik K, Abt M, Grab D, Schneider V, Strehler E. Source: Fertility and Sterility. 2000 January; 73(1): 94-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10632420
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Prevalence of out-of-phase endometrial biopsy specimens. Author(s): Peters AJ, Lloyd RP, Coulam CB. Source: American Journal of Obstetrics and Gynecology. 1992 June; 166(6 Pt 1): 1738-45; Discussion 1745-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1615982
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Role of transvaginal sonography and endometrial biopsy in the evaluation of dysfunctional uterine bleeding in premenopausal women. Author(s): Dubinsky T, Abu-Gazzeh Y, Stroehlein K. Source: Journal of Clinical Ultrasound : Jcu. 1998 March-April; 26(3): 180-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9502044
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Routine prehysterectomy endometrial biopsy in a series of 523 women. Author(s): Stever MR, Farmer G, Hernandez E, Miyazawa K. Source: J Am Osteopath Assoc. 1986 September; 86(9): 558-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3771304
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Secondary amyloidosis: diagnosis from an endometrial biopsy. Author(s): Yue CC, Lampman JH, Park CH, Ballou SP. Source: Arthritis and Rheumatism. 1983 October; 26(10): 1295-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6626292
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Sedation for outpatient endometrial biopsy: comparison of remifentanil-propofol and alfentanil-propofol. Author(s): Dogru K, Madenoglu H, Yildiz K, Boyaci A. Source: J Int Med Res. 2003 January-February; 31(1): 31-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635531
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Sharp-tipped dissecting scissors as an aid in performing endometrial biopsy. Author(s): Hanif F, Leonetti HB, Skutches J, Anasti JN. Source: J Reprod Med. 2004 April; 49(4): 253-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15134149
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Significant difference in the frequency of out-of-phase endometrial biopsies depending on the use of the Novak curette or the flexible polypropylene endometrial biopsy cannula ('Pipelle'). Author(s): Honore LH, Cumming DC, Fahmy N. Source: Gynecologic and Obstetric Investigation. 1988; 26(4): 338-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3229667
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Sonohysterography compared with endometrial biopsy for evaluation of the endometrium in tamoxifen-treated women. Author(s): Hann LE, Kim CM, Gonen M, Barakat R, Choi PH, Bach AM. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 2003 November; 22(11): 1173-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620887
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Tamoxifen and the endometrium: findings of pelvic ultrasound examination and endometrial biopsy in asymptomatic breast cancer patients. Author(s): Bertelli G, Venturini M, Del Mastro L, Garrone O, Cosso M, Gustavino C, Cusimano E, Guido T, Nicolo G, Rosso R. Source: Breast Cancer Research and Treatment. 1998 January; 47(1): 41-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9493974
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The accuracy of endometrial biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding. Author(s): Mihm LM, Quick VA, Brumfield JA, Connors AF Jr, Finnerty JJ. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5): 858-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12015495
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The efficacy of the pipelle endometrial biopsy in detecting endometrial carcinoma. Author(s): Ferry J, Farnsworth A, Webster M, Wren B. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1993 February; 33(1): 76-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8498946
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The endometrial biopsy as a guide to the management of luteal phase defect. Author(s): Witten BI, Martin SA. Source: Fertility and Sterility. 1985 October; 44(4): 460-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4054317
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The endometrial biopsy as a guide to the treatment of the luteal phase defect associated with hyperprolactinemia. Author(s): Witten BI. Source: Fertility and Sterility. 1986 September; 46(3): 397-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3743791
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The endometrial biopsy as a predictive factor of pregnancy rate in women with unexplained infertility. Author(s): Klentzeris LD, Li TC, Dockery P, Cooke ID. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1992 July 3; 45(2): 119-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1499846
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The endometrial biopsy for diagnosis of luteal phase deficiency. Author(s): Balasch J, Vanrell JA, Creus M, Marquez M, Gonzalez-Merlo J. Source: Fertility and Sterility. 1985 November; 44(5): 699-701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4054350
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The late luteal phase in infertile women: comparison of simultaneous endometrial biopsy and progesterone levels. Author(s): Cumming DC, Honore LH, Scott JZ, Williams KP. Source: Fertility and Sterility. 1985 May; 43(5): 715-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3996616
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The Pipelle: a disposable device for endometrial biopsy. Author(s): Cornier E. Source: American Journal of Obstetrics and Gynecology. 1984 January 1; 148(1): 109-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6691367
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The reliability of endometrial biopsy performed during hysteroscopy. Author(s): Marty R, Amouroux J, Haouet S, De Brux J. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1991 February; 34(2): 151-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1671370
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The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive technologies. Author(s): La Sala GB, Montanari R, Dessanti L, Cigarini C, Sartori F. Source: Fertility and Sterility. 1998 August; 70(2): 378-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9696242
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The role of endovaginal ultrasonography and the value of endometrial biopsy in breast cancer patients on tamoxifen therapy. Author(s): Sivalingam N, Pathmalingam A. Source: Singapore Med J. 1999 June; 40(6): 402-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10489508
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The role of pipelle endometrial biopsy in patients with postmenopausal bleeding. Author(s): Habiba M, Akkad A, al-Azzawi F. Source: British Journal of Obstetrics and Gynaecology. 1995 March; 102(3): 262. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7646704
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The role of transvaginal sonography and endometrial biopsy in the evaluation of peri- and postmenopausal bleeding. Author(s): Dubinsky TJ, Parvey HR, Maklad N. Source: Ajr. American Journal of Roentgenology. 1997 July; 169(1): 145-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9207515
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The significance of dating an endometrial biopsy for the prognosis of the infertile couple. Author(s): Driessen F, Holwerda PJ, vd Putte SC, Kremer J. Source: Int J Fertil. 1980; 25(2): 112-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6117524
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The significance of psammoma bodies that are found incidentally during endometrial biopsy. Author(s): Fausett MB, Zahn CM, Kendall BS, Barth WH Jr. Source: American Journal of Obstetrics and Gynecology. 2002 February; 186(2): 180-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11854631
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The significance of secretory features and coincident hyperplastic changes in endometrial biopsy specimens. Author(s): Bell CD, Ostrezega E. Source: Human Pathology. 1987 August; 18(8): 830-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3610133
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The ultrastructure of the glandular epithelium in the timed endometrial biopsy. Author(s): Dockery P, Li TC, Rogers AW, Cooke ID, Lenton EA. Source: Human Reproduction (Oxford, England). 1988 October; 3(7): 826-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3182973
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The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy. Author(s): Zupi E, Luciano AA, Valli E, Marconi D, Maneschi F, Romanini C. Source: Fertility and Sterility. 1995 February; 63(2): 414-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7843454
•
The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy. Author(s): Zupi E, Luciano AA, Marconi D, Valli E, Patrizi G, Romanini C. Source: The Journal of the American Association of Gynecologic Laparoscopists. 1994 May; 1(3): 249-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9050495
•
The usefulness of endometrial biopsy for luteal phase evaluation in infertility. Author(s): Balasch J, Fabregues F, Creus M, Vanrell JA. Source: Human Reproduction (Oxford, England). 1992 August; 7(7): 973-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1430139
•
The value of endometrial biopsy in infertility. Author(s): Nisa Z. Source: J Pak Med Assoc. 1983 December; 33(12): 304-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6418930
•
The value of routine endometrial biopsy in gynaecological practice in Nigeria. Author(s): Adewole IF, Babarinsa IA, Akang EE, Thompson MO. Source: West Afr J Med. 1997 October-December; 16(4): 242-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9473961
•
The value of the endometrial biopsy. A study of 14,655 office endometrial biopsies. Author(s): Hofmeister FJ, Vondrak B, Barbo DM. Source: American Journal of Obstetrics and Gynecology. 1966 May 1; 95(1): 91-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5934059
•
Timing of the endometrial biopsy may be critical for the accurate diagnosis of luteal phase deficiency. Author(s): Castelbaum AJ, Wheeler J, Coutifaris CB, Mastroianni L Jr, Lessey BA. Source: Fertility and Sterility. 1994 March; 61(3): 443-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8137964
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•
Topical anaesthesia for diagnostic hysteroscopy and endometrial biopsy for postmenopausal women: a randomised placebo-controlled double-blind study. Author(s): Barik S. Source: British Journal of Obstetrics and Gynaecology. 1997 November; 104(11): 1326-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9386041
•
Topical anaesthesia for diagnostic hysteroscopy and endometrial biopsy in postmenopausal women: a randomised placebo-controlled double-blind study. Author(s): Cicinelli E, Didonna T, Ambrosi G, Schonauer LM, Fiore G, Matteo MG. Source: British Journal of Obstetrics and Gynaecology. 1997 March; 104(3): 316-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9091008
•
Transvaginal ultrasonography compared with endometrial biopsy for the detection of endometrial disease. Postmenopausal Estrogen/Progestin Interventions Trial. Author(s): Langer RD, Pierce JJ, O'Hanlan KA, Johnson SR, Espeland MA, Trabal JF, Barnabei VM, Merino MJ, Scully RE. Source: The New England Journal of Medicine. 1997 December 18; 337(25): 1792-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9400035
•
Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding: is it always necessary to perform an endometrial biopsy? Author(s): Gull B, Carlsson S, Karlsson B, Ylostalo P, Milsom I, Granberg S. Source: American Journal of Obstetrics and Gynecology. 2000 March; 182(3): 509-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10739500
•
Transvaginal uterine ultrasonography compared with endometrial biopsy for the detection of endometrial disease in perimenopausal women with uterine bleeding. Author(s): Paraskevaidis E, Kalantaridou SN, Papadimitriou D, Pappa L, MalamouMitsi V, Zikopoulos K, Kazantzis E, Lolis ED, Agnantis NJ. Source: Anticancer Res. 2002 May-June; 22(3): 1829-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12168877
•
Triage of abnormal postmenopausal bleeding: a comparison of endometrial biopsy and transvaginal sonohysterography versus fractional curettage with hysteroscopy. Author(s): O'Connell LP, Fries MH, Zeringue E, Brehm W. Source: American Journal of Obstetrics and Gynecology. 1998 May; 178(5): 956-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9609566
Studies
33
•
Ultrasound, hysteroscopy and endometrial biopsy in the investigation of endometrial cancer. Author(s): Symonds I. Source: Best Practice & Research. Clinical Obstetrics & Gynaecology. 2001 June; 15(3): 381-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11476560
•
Usefulness of pipelle endometrial biopsy in the diagnosis of women at risk for ectopic pregnancy. Author(s): Barnhart KT, Gracia CR, Reindl B, Wheeler JE. Source: American Journal of Obstetrics and Gynecology. 2003 April; 188(4): 906-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712084
•
Vaginal ultrasonography versus endometrial biopsy in women with postmenopausal bleeding. Author(s): Weber AM, Belinson JL, Bradley LD, Piedmonte MR. Source: American Journal of Obstetrics and Gynecology. 1997 October; 177(4): 924-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9369846
•
Value of the endometrial biopsy. Author(s): Kahler VL, Creasy RK, Morris JA. Source: Obstetrics and Gynecology. 1969 July; 34(1): 91-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5791316
•
Who needs an endometrial biopsy? Author(s): Samson SL, Gilmour D. Source: Can Fam Physician. 2002 May; 48: 885-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12053633
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CHAPTER 2. NUTRITION AND ENDOMETRIAL BIOPSY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and endometrial biopsy.
Finding Nutrition Studies on Endometrial Biopsy 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 “endometrial biopsy” (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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Endometrial Biopsy
The following information is typical of that found when using the “Full IBIDS Database” to search for “endometrial biopsy” (or a synonym): •
A comparative study of transvaginal uterine ultrasound and endometrial biopsy for evaluating the endometrium of postmenopausal women taking hormone replacement therapy. Author(s): Clinical Research Center, Eastern Virginia Medical School, Norfolk 235071912, USA. Source: Archer, D F Lobo, R A Land, H F Pickar, J H Menopause. 1999 Fall; 6(3): 201-8 1072-3714
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
•
The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
•
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/
•
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/
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
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
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
Nutrition
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. DISSERTATIONS ON ENDOMETRIAL BIOPSY Overview In this chapter, we will give you a bibliography on recent dissertations relating to endometrial biopsy. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “endometrial biopsy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on endometrial biopsy, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Endometrial Biopsy ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to endometrial biopsy. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
The relationship of endometrial biopsy and rectal palpation findings to reproductive performance in postpartum cows by Bonnett, Brenda Nora; PhD from University of Guelph (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL44904
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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APPENDICES
45
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 Institute5: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
5
These publications are typically written by one or more of the various NIH Institutes.
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Endometrial Biopsy
•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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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
•
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
•
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
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.6 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:7 •
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
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
6
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). 7 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 Gateway8 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.9 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “endometrial biopsy” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 10489 99 821 11 19 11439
HSTAT10 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.11 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.12 Simply search by “endometrial biopsy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
8
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
9
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). 10 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 11 12
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.
Physician Resources
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Coffee Break: Tutorials for Biologists13 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.14 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.15 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/.
13 Adapted 14
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. 15 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 endometrial biopsy can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased 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 endometrial biopsy. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to endometrial biopsy. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “endometrial biopsy”:
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Endometrial Biopsy
Breast Cancer http://www.nlm.nih.gov/medlineplus/breastcancer.html Infertility http://www.nlm.nih.gov/medlineplus/infertility.html Uterine Cancer http://www.nlm.nih.gov/medlineplus/uterinecancer.html Uterine Diseases http://www.nlm.nih.gov/medlineplus/uterinediseases.html Vaginal Cancer http://www.nlm.nih.gov/medlineplus/vaginalcancer.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 endometrial biopsy. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Repeated Miscarriage Source: Washington, DC: American College of Obstetricians and Gynecologists. 2000. 6 p. Contact: Available from American College of Obstetricians and Gynecologists, Distribution Center, P.O. Box 4500, Kearneysville, WV 25430-4500. (800) 762-2264, ext. 931 (orders), (304) 725-8410, ext. 339 (orders), (800) 525-5562 (Fax),
[email protected] (Email), http://www.acog.org (Web Site). $17.50 for a package of 50 brochures. Order No. AP100. Summary: Miscarriage is the loss of a pregnancy before 20 weeks' gestation. This pamphlet focuses on repeated miscarriage, which is defined as three or more miscarriages in a row. Miscarriage occurs in about 15 to 20 percent of all pregnancies, usually during the first 3 months. Often the reason for repeated miscarriage is not known, but one major cause is problems with the chromosomes of the fetus. Most chromosomal problems occur by chance, and are not likely to occur again in a later pregnancy. However, in a small number of cases, problems with the parents' chromosomes can cause repeated miscarriage. There are tests to find out if chromosomal problems are a factor in repeated miscarriage. Another cause of repeated miscarriage is illness in the mother. Illnesses that have been linked to repeated miscarriage include
Patient Resources
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systemic lupus erythematosus and other autoimmune disorders, congenital heart disease, severe kidney disease, diabetes that is uncontrolled, thyroid disease, and intrauterine infection. Other causes include lack of progesterone (this is needed to fertilize the egg); disorders of the immune system; abnormalities of the uterus; and environmental and lifestyle factors such as smoking, drinking alcohol, using illegal drugs, and being exposed to high levels of radiation or toxic agents. Since repeated miscarriage has many possible causes, one's doctor will need to gather a lot of information to diagnose the problem. He or she will need to do a complete medical history and a complete physical exam. Other tests that may be done include blood analysis, chromosomal testing of both parents, genital tract cultures, chromosomal testing of fetal tissue, endometrial biopsy, hysterosalpingography, hysteroscopy, laparoscopy, and ultrasound. Sometimes the problem can be treated with surgery, antibiotics, or hormone therapy. If chromosomal problems are found in the parents, genetic counseling may be prescribed. To have a successful pregnancy, mothers are encouraged to have a complete medical workup before getting pregnant again, get early prenatal care, and follow their doctor's instructions. Repeated miscarriage often leads to grief and emotional stress. Grieving will help the parents accept the losses and move on with their lives. Parents who are having a difficult time dealing with their feelings should not hesitate to ask others for comfort and support, including their doctor, a support group, or a professional counselor. 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 endometrial biopsy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to endometrial biopsy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with endometrial biopsy. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about endometrial biopsy. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “endometrial biopsy” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “endometrial biopsy”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “endometrial biopsy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “endometrial biopsy” (or a synonym) into the search box, and click “Submit Query.”
57
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.16
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
16
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)17: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
17
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
61
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
63
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on endometrial biopsy: •
Basic Guidelines for Endometrial Biopsy Endometrial biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003917.htm
•
Signs & Symptoms for Endometrial Biopsy Abnormal menstrual periods Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003263.htm
•
Diagnostics and Tests for Endometrial Biopsy Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm
•
Background Topics for Endometrial Biopsy Adolescent test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002054.htm
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Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Cervix Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002317.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
65
ENDOMETRIAL BIOPSY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [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] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alfentanil: A short-acting opioid anesthetic and analgesic derivative of fentanyl. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons,
66
Endometrial Biopsy
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] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amnion: The extraembryonic membrane which contains the embryo and amniotic fluid. [NIH]
Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] 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] 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] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [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] 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
Dictionary 67
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] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Aspiration: The act of inhaling. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Atypical hyperplasia: A benign (noncancerous) condition in which cells have abnormal features and are increased in number. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [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] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
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] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH]
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Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone 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] 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] Bupivacaine: A widely used local anesthetic agent. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] 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] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] 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] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell
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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] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemopreventive: Natural or synthetic compound used to intervene in the early precancerous stages of carcinogenesis. [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] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] 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
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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] 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] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [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] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as
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cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Dilatation and Curettage: Dilatation of the cervix uteri followed by a scraping of the endometrium with a curette. [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] Dilation and curettage: D&C. A minor operation in which the cervix is expanded enough (dilation) to permit the cervical canal and uterine lining to be scraped with a spoon-shaped instrument called a curette (curettage). [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Duct: A tube through which body fluids pass. [NIH] Dysmenorrhea: Painful menstruation. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]
Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The
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numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] 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] Endoscope: A thin, lighted tube used to look at tissues inside the body. [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]
Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] 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] Estrogen: One of the two female sex hormones. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [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]
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Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [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] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [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] Genital: Pertaining to the genitalia. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] 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] 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] Gonadal: Pertaining to a gonad. [EU]
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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]
Grafting: The operation of transfer of tissue from one site to another. [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] Gynaecological: Pertaining to gynaecology. [EU] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Histology: The study of tissues and cells under a microscope. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [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] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [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] Hyperstimulation: Excessive stimulation. [EU] 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]
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Hysterectomy: Excision of the uterus. [NIH] Hysterosalpingography: Radiography of the uterus and fallopian tubes after the injection of a contrast medium. [NIH] Hysteroscopy: Endoscopic examination, therapy or surgery of the interior of the uterus. [NIH]
Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltrating cancer: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called invasive cancer. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role
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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] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intraepithelial: Within the layer of cells that form the surface or lining of an organ. [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]
Invasive cancer: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [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] Localized: Cancer which has not metastasized yet. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH]
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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] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [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] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [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 Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] 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] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH]
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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] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Misoprostol: A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties. [NIH] 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] Morphological: Relating to the configuration or the structure of live organs. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Naproxen: An anti-inflammatory agent with analgesic and antipyretic properties. Both the acid and its sodium salt are used in the treatment of rheumatoid arthritis and other rheumatic or musculoskeletal disorders, dysmenorrhea, and acute gout. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephropathy: Disease of the kidneys. [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] Nidation: Implantation of the conceptus in the endometrium. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH]
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Orderly: A male hospital attendant. [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] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovulation Induction: Techniques for the artifical induction of ovulation. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxytocic: 1. Pertaining to, characterized by, or promoting oxytocia (= rapid labor). 2. An agent that hastens evacuation of the uterus by stimulating contractions of the myometrium. [EU]
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 gland that secretes digestive enzymes. [NIH] Partnership Practice: A voluntary contract between two or more doctors who may or may not share responsibility for the care of patients, with proportional sharing of profits and losses. [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] Patient Education: The teaching or training of patients concerning their own health needs. [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] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
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Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] 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] 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] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH]
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Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality. [NIH] Preoperative: Preceding an operation. [EU] Private Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [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] Propofol: A widely used anesthetic. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein 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] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino
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acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psammoma bodies: Structures found in some benign (noncancerous) or malignant (cancerous) tumor cells that look like hardened concentric rings when viewed under a microscope. Can be a sign of chronic inflammation. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [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] Pupil: The aperture in the iris through which light passes. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [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] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH]
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Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] 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] 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] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rod: A reception for vision, located in the retina. [NIH] Saline: A solution of salt and water. [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] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [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.
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[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] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] 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] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU]
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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] 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] Superovulation: Occurrence or induction of release of more ova than are normally released at the same time in a given species. The term applies to both animals and humans. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Testicular: Pertaining to a testis. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [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]
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Transvaginal ultrasound: A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An instrument is inserted into the vagina, and sound waves bounce off organs inside the pelvic area. These sound waves create echoes, which a computer uses to create a picture called a sonogram. Also called TVS. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] 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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] 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
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treat cancer. [NIH] Zygote: The fertilized ovum. [NIH]
89
INDEX A Abdominal, 17, 65, 69, 79, 80 Abdominal Pain, 17, 65 Adenocarcinoma, 8, 18, 65 Adjuvant, 17, 65 Adrenal Cortex, 65, 81 Adrenal Glands, 65, 66 Adverse Effect, 7, 65, 84 Affinity, 4, 65, 84 Age of Onset, 65, 86 Agonist, 65, 85 Albumin, 65, 80 Alfentanil, 28, 65 Alpha Particles, 65, 82 Amino Acids, 66, 79, 81 Amnion, 66 Amniotic Fluid, 14, 66 Amyloidosis, 27, 66 Anaesthesia, 32, 66, 75 Analgesic, 65, 66, 78 Analog, 66, 78 Anaplasia, 66, 78 Androgens, 65, 66, 67 Anesthesia, 26, 31, 66, 81 Animal model, 4, 66 Antibiotic, 6, 66 Antibody, 65, 66, 69, 74, 75, 83, 84 Antigen, 65, 66, 69, 75, 83 Anti-inflammatory, 67, 78 Antipyretic, 67, 78 Anus, 67, 76, 82 Aromatase, 17, 67 Aspiration, 23, 67 Asymptomatic, 15, 28, 67 Atypical, 8, 9, 12, 13, 23, 67 Atypical hyperplasia, 8, 9, 12, 23, 67 B Bacteremia, 21, 67 Bacteria, 66, 67, 77, 78, 80, 86 Base, 67, 76 Benign, 67, 78, 82 Bile, 67, 73, 76, 84 Bioavailability, 4, 67 Biochemical, 67, 73, 76 Biological therapy, 67, 74 Biomarkers, 9, 67 Biopsy specimen, 4, 7, 17, 24, 27, 30, 68 Bladder, 68, 81, 86
Blastocyst, 68, 70, 72, 80 Blood pressure, 68, 78, 84 Blood vessel, 68, 77, 79, 86 Body Fluids, 67, 68, 71, 84, 86 Bone Marrow, 68, 77, 84 Bradykinin, 68, 80 Bupivacaine, 68, 76 C Cannula, 28, 68 Carcinogenesis, 9, 68, 69 Carcinogenic, 68, 84 Carcinoma, 3, 8, 17, 23, 25, 28, 68 Cardiac, 68, 72, 76, 84 Carrier Proteins, 68, 80 Case report, 68, 69 Case series, 68, 69 Cell, 7, 65, 67, 68, 69, 70, 72, 73, 74, 76, 78, 79, 80, 81, 82, 84, 86 Cell Division, 67, 68, 69, 74, 80 Cell proliferation, 7, 68 Cell Size, 69, 73 Cell Survival, 69, 74 Cervical, 7, 13, 23, 69, 71 Cervix, 64, 69, 71 Cesarean Section, 14, 69 Chemoprevention, 9, 69 Chemopreventive, 8, 69 Cholesterol, 67, 69, 84, 85 Chromosomal, 52, 69, 80 Chronic, 6, 69, 75, 76, 82, 84, 85 Clinical study, 4, 69 Clinical trial, 3, 5, 47, 69, 70, 71, 82 Coagulation, 69, 80 Complement, 69, 80 Computational Biology, 47, 70 Concentric, 70, 82 Conception, 16, 18, 19, 20, 21, 23, 70, 73, 84 Conjugated, 9, 70, 71 Connective Tissue, 68, 70, 77, 84, 85 Consciousness, 65, 66, 70, 71 Consultation, 6, 70 Continuum, 8, 70 Contraception, 5, 70 Contraindications, ii, 70 Contrast medium, 70, 75 Controlled study, 26, 70 Cornea, 70, 84 Corpus, 8, 70, 81
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Endometrial Biopsy
Corpus Luteum, 70, 81 Curettage, 11, 32, 70, 71 Curette, 21, 23, 28, 70, 71 Cytochrome, 17, 67, 70 D Decidua, 4, 71, 80 Diagnostic Imaging, 13, 71 Dilatation and Curettage, 25, 71 Dilation, 8, 68, 71 Dilation and curettage, 8, 71 Direct, iii, 4, 71, 82 Dissociation, 65, 71 Double-blind, 26, 32, 71 Duct, 68, 71 Dysmenorrhea, 71, 78 E Ectopic, 5, 33, 71 Ectopic Pregnancy, 5, 33, 71 Efficacy, 13, 28, 71 Electrolyte, 71, 84 Electrons, 67, 71, 79, 82 Embryo, 4, 18, 19, 66, 68, 72, 75 Embryo Transfer, 18, 19, 72 Endocarditis, 21, 72 Endocardium, 72 Endocrine System, 72 Endocrinology, 5, 16, 72, 74 Endometriosis, 17, 72 Endometrium, 4, 7, 8, 9, 11, 17, 25, 28, 32, 36, 71, 72, 77, 78 Endoscope, 4, 72 Environmental Health, 46, 48, 72 Enzyme, 4, 67, 72, 79, 80, 82, 86 Enzyme Inhibitors, 72, 80 Epithelial, 4, 7, 17, 65, 71, 72 Epithelial Cells, 17, 72 Epithelium, 4, 31, 72 Estrogen, 7, 9, 32, 67, 72, 83, 85 Excitation, 72, 73 Exogenous, 72, 81, 86 Extracellular, 70, 72, 84 F Fallopian tube, 72, 75, 86 Family Planning, 47, 72 Fentanyl, 65, 73 Fetus, 52, 69, 73, 80, 81, 86 Fibrinogen, 73, 80 Flow Cytometry, 16, 73 Fluorescence, 73 Fluorescent Dyes, 73 G Gallbladder, 65, 73
Gas, 73, 85 Gastric, 73, 78 Gastric Acid, 73, 78 Gastrin, 73, 74 Gene, 4, 7, 9, 67, 73 Gene Expression, 7, 9, 73 Genital, 13, 53, 73, 74 Gestation, 52, 73, 80 Gland, 65, 73, 77, 79, 81, 83, 85 Glucose, 73, 76, 83 Gonadal, 73, 84 Gout, 74, 78 Governing Board, 74, 80 Grade, 14, 74 Grading, 8, 74 Grafting, 74, 75 Growth factors, 7, 74 Gynaecological, 31, 74 H Haptens, 65, 74 Heredity, 73, 74 Heterogeneity, 65, 74 Histology, 10, 74 Homogeneous, 70, 74 Hormonal, 7, 18, 74 Hormone, 11, 12, 17, 19, 22, 23, 27, 36, 53, 73, 74, 75, 81, 83, 85 Hormone Replacement Therapy, 11, 22, 23, 36, 74 Hormone therapy, 53, 74 Hyperplasia, 8, 9, 12, 13, 74 Hyperstimulation, 7, 74 Hypertrophy, 74 Hysterectomy, 6, 8, 13, 75 Hysterosalpingography, 53, 75 Hysteroscopy, 4, 8, 10, 11, 15, 19, 23, 24, 25, 26, 29, 30, 31, 32, 33, 53, 75 Hysterotomy, 69, 75 I Immune response, 65, 66, 74, 75 Immune system, 53, 67, 75, 86 Immunoglobulins, 75, 80 Immunologic, 6, 75 Immunology, 65, 73, 75 Implantation, 4, 7, 18, 24, 70, 75, 78 In vitro, 7, 19, 72, 75, 83 In vivo, 75 Incision, 75, 76 Induction, 66, 75, 79, 85 Infection, 53, 67, 75, 77, 83, 85, 86 Infertility, 5, 6, 16, 19, 20, 24, 25, 29, 31, 52, 75
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Infiltrating cancer, 75, 76 Inflammation, 65, 67, 75, 80, 82, 85 Informed Consent, 6, 75 Inorganic, 75, 78 Insulin, 4, 75, 76, 86 Insulin-dependent diabetes mellitus, 76 Insulin-like, 4, 76 Internal Medicine, 72, 76 Intestines, 65, 76, 83 Intracellular, 75, 76, 81 Intraepithelial, 9, 76 Intrinsic, 65, 76 Invasive, 4, 7, 8, 75, 76 Invasive cancer, 8, 75, 76 K Kb, 46, 76 Kidney Disease, 46, 53, 76 L Laparoscopy, 14, 53, 76 Large Intestine, 76, 82, 84 Lectin, 20, 76 Lesion, 4, 8, 9, 76, 86 Lidocaine, 12, 13, 76 Lipid, 76 Liver, 65, 66, 67, 73, 76 Localized, 66, 75, 76, 80, 86 Lupus, 76, 85 Luteal Phase, 14, 16, 17, 19, 20, 29, 31, 76 Lymph, 69, 77 Lymph node, 69, 77 Lymphatic, 75, 77, 84 Lymphocytes, 66, 77, 84, 86 Lymphoid, 22, 77 M Malignancy, 8, 77 Malignant, 8, 65, 77, 78, 82 Mammary, 77, 85 MEDLINE, 47, 77 Membrane, 66, 70, 72, 77, 78, 83 Menopause, 11, 22, 36, 77, 80, 81 Menstrual Cycle, 76, 77, 81 Menstruation, 71, 76, 77 Mental, iv, 3, 46, 48, 71, 77, 82 Mental Disorders, 77, 82 Mercury, 73, 77 Mesenchymal, 4, 77 Metastasis, 77, 78 Microbiology, 67, 77 Microorganism, 78, 86 Microscopy, 8, 78 Miscarriage, 52, 78 Misoprostol, 26, 78
Molecular, 47, 49, 70, 73, 78 Molecule, 66, 67, 69, 71, 72, 76, 78, 79, 80, 82 Monitor, 78 Morphological, 72, 78 Mucosa, 76, 78, 84 Mucus, 13, 78 Mydriatic, 71, 78 N Naproxen, 12, 78 Neoplasia, 8, 9, 78 Neoplasms, 8, 78 Nephropathy, 76, 78 Neutrons, 65, 78, 82 Nidation, 72, 78 Nuclear, 8, 72, 78 O Odds Ratio, 78, 82 Orderly, 8, 79 Outpatient, 6, 11, 12, 16, 17, 19, 23, 24, 26, 27, 28, 79 Ovaries, 67, 79 Ovary, 70, 79, 84 Ovulation, 7, 13, 15, 76, 79 Ovulation Induction, 7, 79 Ovum, 70, 71, 73, 79, 81, 86, 87 Oxidation, 70, 79 Oxytocic, 78, 79 P Palpation, 39, 79 Pancreas, 65, 67, 75, 79, 86 Partnership Practice, 79, 81 Pathologic, 6, 22, 24, 79 Patient Education, 52, 58, 60, 64, 79 Pelvic, 6, 13, 14, 26, 28, 72, 79, 81, 86 Pelvic inflammatory disease, 6, 14, 26, 79 Pelvis, 79, 86 Pepsin, 78, 79 Peptide, 79, 81 Perfusion, 79, 85 Pericardium, 79, 85 Perimenopausal, 24, 32, 80 Peritoneal, 14, 80 Peritoneum, 80 Pharmacologic, 66, 80, 85 Physiologic, 65, 71, 77, 80, 81, 82 Physiology, 72, 74, 80 Placenta, 67, 80, 81 Plants, 73, 76, 80, 83, 85 Plasma, 4, 14, 16, 65, 73, 80, 85 Plasma protein, 4, 65, 80 Plasmid, 13, 80
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Endometrial Biopsy
Pneumonia, 70, 80 Postmenopausal, 11, 15, 16, 24, 25, 26, 30, 32, 33, 36, 80 Practice Guidelines, 48, 80 Precancerous, 9, 69, 80 Predictive factor, 29, 80 Premalignant, 80 Premenopausal, 24, 27, 81 Prenatal, 53, 72, 81 Prenatal Care, 53, 81 Preoperative, 25, 81 Private Practice, 18, 81 Procaine, 76, 81 Progesterone, 7, 13, 14, 15, 16, 24, 29, 53, 81, 84 Progression, 8, 9, 66, 81 Propofol, 28, 81 Prospective study, 6, 17, 81 Prostaglandin, 78, 81 Prostate, 67, 81, 86 Protein Binding, 81, 85 Proteins, 7, 66, 68, 69, 78, 79, 80, 81, 83, 85 Protocol, 5, 8, 82 Protons, 65, 82 Psammoma bodies, 30, 82 Psychiatry, 5, 82 Public Policy, 47, 82 Pupil, 70, 71, 78, 82 Q Quiescent, 9, 82 R Radiation, 53, 73, 82, 86 Radioactive, 75, 78, 82 Randomized, 6, 10, 11, 13, 26, 71, 82 Randomized clinical trial, 6, 11, 82 Receptor, 7, 67, 82 Rectal, 39, 82 Rectum, 67, 73, 76, 81, 82 Recurrence, 6, 69, 82 Reductase, 67, 82 Refer, 1, 69, 78, 82 Regimen, 8, 71, 82 Relative risk, 7, 82 Reliability, 29, 83 Remission, 82, 83 Retina, 83 Rheumatoid, 78, 83 Rheumatoid arthritis, 78, 83 Risk factor, 81, 82, 83 Risk patient, 8, 83 Rod, 4, 83
S Saline, 28, 83 Saponins, 83, 84 Screening, 24, 69, 83 Secretion, 76, 78, 83 Secretory, 9, 30, 83 Segmentation, 8, 83 Selective estrogen receptor modulator, 83, 85 Sensibility, 66, 83 Serology, 13, 83 Serum, 15, 24, 65, 69, 83 Shock, 6, 83 Side effect, 10, 65, 67, 84, 85 Small intestine, 74, 76, 84 Sodium, 12, 74, 78, 84 Sonogram, 84, 86 Sound wave, 84, 86 Specialist, 54, 71, 84 Species, 84, 85, 86 Specificity, 65, 84, 85 Spleen, 66, 77, 84 Sterility, 12, 14, 15, 16, 17, 18, 19, 20, 22, 24, 25, 27, 29, 30, 31, 75, 84 Steroid, 4, 7, 67, 83, 84 Stomach, 65, 73, 74, 76, 79, 84 Stress, 53, 83, 84 Stroma, 4, 84 Stromal, 4, 7, 17, 72, 84 Stromal Cells, 7, 84 Subacute, 75, 84 Subclinical, 75, 85 Suction, 21, 85 Superovulation, 5, 85 Supplementation, 10, 65, 85 Support group, 53, 85 Systemic, 53, 66, 68, 75, 85 Systemic lupus erythematosus, 53, 85 T Tachycardia, 67, 85 Tachypnea, 67, 85 Tamoxifen, 9, 17, 28, 30, 83, 85 Testicular, 67, 85 Thyroid, 53, 85 Tissue, 6, 9, 13, 22, 53, 66, 67, 68, 69, 70, 72, 74, 75, 76, 77, 78, 79, 80, 83, 84, 85 Tissue Distribution, 6, 85 Topical, 31, 32, 85 Toxic, iv, 53, 85 Toxicology, 48, 85 Toxins, 66, 75, 85 Trachea, 85
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Transplantation, 72, 85 Transvaginal ultrasound, 11, 23, 86 Tumor marker, 67, 86 Type 2 diabetes, 9, 86 U Ulcer, 78, 86 Ultrasonography, 15, 27, 30, 32, 33, 86 Urinary, 14, 17, 86 Urine, 68, 86 Uterus, 4, 8, 53, 69, 70, 71, 72, 75, 77, 79, 81, 86 V Vaccine, 65, 82, 86 Vagina, 69, 75, 77, 86 Vaginal, 7, 10, 11, 16, 33, 52, 86
Vascular, 18, 75, 80, 86 Vein, 78, 86 Veterinary Medicine, 47, 86 Vitro, 7, 18, 86 Vivo, 4, 86 W White blood cell, 66, 77, 78, 86 Windpipe, 85, 86 Womb, 86 X Xenograft, 66, 86 X-ray, 70, 73, 78, 86 Z Zygote, 70, 87
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Endometrial Biopsy
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Endometrial Biopsy
