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

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

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GENITAL WARTS 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 ©2003 by ICON Group International, Inc. Copyright ©2003 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., 1960Genital Warts: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83599-3 1. Genital Warts-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on genital warts. 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 GENITAL WARTS....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Genital Warts................................................................................ 4 E-Journals: PubMed Central ....................................................................................................... 13 The National Library of Medicine: PubMed ................................................................................ 14 CHAPTER 2. NUTRITION AND GENITAL WARTS ............................................................................. 47 Overview...................................................................................................................................... 47 Finding Nutrition Studies on Genital Warts .............................................................................. 47 Federal Resources on Nutrition ................................................................................................... 52 Additional Web Resources ........................................................................................................... 53 CHAPTER 3. ALTERNATIVE MEDICINE AND GENITAL WARTS ...................................................... 55 Overview...................................................................................................................................... 55 National Center for Complementary and Alternative Medicine.................................................. 55 Additional Web Resources ........................................................................................................... 63 General References ....................................................................................................................... 64 CHAPTER 4. DISSERTATIONS ON GENITAL WARTS ........................................................................ 65 Overview...................................................................................................................................... 65 Dissertations on Genital Warts ................................................................................................... 65 Keeping Current .......................................................................................................................... 66 CHAPTER 5. PATENTS ON GENITAL WARTS ................................................................................... 67 Overview...................................................................................................................................... 67 Patents on Genital Warts............................................................................................................. 67 Patent Applications on Genital Warts......................................................................................... 75 Keeping Current .......................................................................................................................... 77 CHAPTER 6. BOOKS ON GENITAL WARTS ....................................................................................... 79 Overview...................................................................................................................................... 79 Book Summaries: Federal Agencies.............................................................................................. 79 Book Summaries: Online Booksellers........................................................................................... 81 The National Library of Medicine Book Index ............................................................................. 81 Chapters on Genital Warts .......................................................................................................... 82 CHAPTER 7. MULTIMEDIA ON GENITAL WARTS ............................................................................ 85 Overview...................................................................................................................................... 85 Video Recordings ......................................................................................................................... 85 Bibliography: Multimedia on Genital Warts ............................................................................... 85 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 89 Overview...................................................................................................................................... 89 NIH Guidelines............................................................................................................................ 89 NIH Databases............................................................................................................................. 91 Other Commercial Databases....................................................................................................... 95 APPENDIX B. PATIENT RESOURCES ................................................................................................. 97 Overview...................................................................................................................................... 97 Patient Guideline Sources............................................................................................................ 97 Associations and Genital Warts................................................................................................. 108 Finding Associations.................................................................................................................. 109 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 111 Overview.................................................................................................................................... 111 Preparation................................................................................................................................. 111 Finding a Local Medical Library................................................................................................ 111 Medical Libraries in the U.S. and Canada ................................................................................. 111

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ONLINE GLOSSARIES................................................................................................................ 117 Online Dictionary Directories ................................................................................................... 119 GENITAL WARTS DICTIONARY............................................................................................. 121 INDEX .............................................................................................................................................. 153

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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 genital warts 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 genital warts, 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 genital warts, 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 genital warts. 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 genital warts, 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 genital warts. 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 GENITAL WARTS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on genital warts.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and genital warts, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “genital warts” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Hemorrhoids, Genital Warts, and other Perianal Complaints Source: JAAPA. Journal of the American Academy of Physician Assistants. 14(9): 37-39, 43-44, 47. September 2001. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Reluctance to discuss a perianal problem may cause a patient to delay seeking medical attention. Although anorectal symptoms account for 10 percent of visits to a medical provider, 80 percent of patients who have symptoms of benign anorectal disease do not seek medical attention. Yet 75 percent of Americans will be given a diagnosis of hemorrhoids during their lifetime. This article helps physician assistants learn about hemorrhoids, genital warts, and other perianal complaints and how to help

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patients who present with these complaints. The authors describe the components of a thorough rectal examination and the diagnosis and treatment of the five most common causes of perianal discomfort or pain: hemorrhoids, anal fissure, anorectal abscess, pruritus ani (itching), and condylomata acuminata (genital warts). Although most conditions prove benign, the differential diagnosis can include neoplasia (including cancer). Readers can qualify for continuing medical education credit by completing the posttest printed in the journal. 3 figures. 34 references. •

Oral Condylomata in Children Source: Archives of Pediatrics and Adolescent Medicine. 153(6): 651-654. June 1999. Summary: The incidence of condylomata acuminata in children seems to be increasing, paralleling a rising incidence reported in adults. This article reviews condylomata acuminata in children. The etiologic agent is the human papillomavirus (HPV), which causes soft, clustered, papillomatous growths of various sizes and shapes seen on moist mucosal surfaces, most frequently around the genital and rectal cases. The authors report a case series of three recent cases of children with condylomata in the oral cavity. For each of the three children described, the following observations were made: examination revealed a healthy child with no findings of warts outside the oral cavity; results of an anogenital examination were unremarkable, without signs of trauma, infection, or genital warts; and serologic tests for syphilis, hepatitis B, and HIV were negative. The authors review the cases presented, including the treatment. They note that the clinical recognition of mucosal HPV infection in a child raises all the unknowns about treatment and prognosis that accompany HPV genital infection in an adult. The additional burden for the pediatric caregiver is the concern that HPV mucosal infections in a child may be a manifestation of child sexual abuse. 5 figures. 28 references.

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

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

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Project Title: ACQUISITION & NATURAL HISTORY OF GENITAL HPV INFECTIONS Principal Investigator & Institution: Koutsky, Laura A. Professor; Epidemiology; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 15-MAY-1995; Project End 31-AUG-2005 Summary: (Adapted from the Applicant's Abstract): Human papillomaviruses (primarily HPV 16 and 18) play a central role in the development of in situ and invasive cervical cancer. Based on this observation and the well-recognized shortcomings of Pap smears, several groups have examined the use of HPV DNA testing as an adjunct to cytologic screening and found it to be cost effective. Consequently, a number of laboratories throughout the U.S. have begun offering HPV DNA tests, and in doing so, have left many clinicians and their clients with questions that currently do not have answers. Although the potential consequences of genital HPV infection are well documented, we know relatively little about the long-term implication; of a single or repeatedly positive type-specific HPV DNA test result. Furthermore, it is likely that HPV vaccines will introduced to prevent cervical cancer and, perhaps, genital warts in the future. However, knowledge of the infectivity and natural history of specific HPV types is essential for evaluating the impact and feasibility of vaccines. Much of this required knowledge is currently lacking. Since 1991, we have been studying the short term natural history of HPV in a cohort study of 600 freshman women and are now in a position to build on and extend these studies to gain an understanding of the longerterm natural history of genital HPV infection and of male to female transmission rates. Our specific aims are to l) define the natural history of genital HPV infection over ten years with respect to persistent detection of HPV DNA, SIL, genital warts, and HPV type-specific antibodies, 2) determine the prevalence, seroprevalence, and behavioral predictors of genital HPV infection among a random sample of male undergraduate students, and 3) estimate per partner and per act transmission rates of specific HPV types and define characteristics of partnerships (e.g., courtship behavior, condom use, and frequency of intercourse) and of partners (e.g., age, race, occupation, number of partners, circumcision status, and report of concurrent relationships) that affect transmission. The proposed study is likely to provide important information relevant to the development of effective HPV prevention strategies, including the synthesis of accurate and informative public health messages concerning the transmissibility of HPV and the meaning of a single or repeatedly positive HPV DNA test. Additionally, these data will provide investigators working on HPV vaccine development with information that is needed to guide the selection of appropriate target populations, outcome measures, and immunization strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CANCER CHEMOPREVENTION--ROLE OF INFECTION/IMMUNITY Principal Investigator & Institution: Loprinzi, Charles L. Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, MN 55905 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAR-2004 Summary: Over the past decade, a substantial body of data has accumulated which implicates the human papillomaviruses (HPVs) in epithelial cancers, especially cervical cancer. More recently, a new family HPV has been identified in skin cancers that are related to those found originally in patients with heritable skin cancer prone condition, epidermodysplasia verruciformis. With the advent of new chemoprevention strategies directed against each of these cancer types, it appears prudent to develop novel

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secondary endpoint biomarkers (SEBs). Accordingly, a central Theme of this project is to develop HPV-related SEBs in the context of two novel chemoprevention strategies, one of which is expressly directed against HPV infection. Two Phase II chemoprevention clinical trials are planned at the Mayo Clinic and in the North Central Cancer Treatment Group (NCCTG) member institutions, with support for protocol development, data management, and statistical analysis deriving primarily from NCCTG CCOP grants ( i.e. research base and individual institution grants). The first is a randomized pilot evaluation of topical imiquimod, and immunomodulatory agent which has proven to be safe and effective for the treatment of genital warts. This trial will be conducted on patients with recurrent and/or high-grade cervical intraepithelial neoplasia (CIN). For skin cancers. This trial will attempt to reproduce and further substantiate a previous randomized trial in the which a treatment benefit was demonstrated. Broad-range PCR techniques will be used to monitor the type-specific persistence of HPV in cervical specimens after imiquimod therapy. Similar techniques will be used to characterize the potential role of HPV in skin cancers, strategies will also be developed to determine if HPV - specific immune responses can be used as SEBs in CIN related gene expression and AP-1 expression/activity will be developed for the skin cancer chemoprevention project. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CELLULAR REGULATION OF PAPILLOMAVIRUS E1 FUNCTION Principal Investigator & Institution: Wilson, Van G. Medical Microbiol & Immunology; Texas A&M University Health Science Ctr College Station, TX 77843 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Papillomaviruses are the causative agents of cutaneous and genital warts. Infection with certain subtypes of genital papillomaviruses is the primary risk factor for cervical cancer. Currently there is no preventative vaccine and no consistently effective antiviral therapy. Development of improved treatments will require greater understanding of the properties of these viruses and their interactions with the host cell. The viral E1 protein, an origin-binding helicase essential for viral replication, is an attractive target for potential therapeutic intervention as inhibition of its function should prevent viral replication and propagation. The longterm goal of this research is to understand the structure, function, and regulation of the E1 protein, both as a eukaryotic DNA replication model and as a therapeutic target. Recent results indicate that E1 is covalently modified by addition of a SUMO-1 moiety. Sumoylation is a relatively newly discovered cellular modification system that can affect the stability, intracellular localization, and/or activity of its target substrates. E1 is sumoylated at a single lysine residue, and in the absence of sumoylation at this site E1 replication function is lost because E1 fails to accumulate in the nucleus. These results indicate that sumoylation has an important regulatory function that controls E1 nuclear localization and possibly modulates other E1 activities as well. Recenty, PIAS proteins (Protein Inhibitors of Activated Stat) were shown to SUMO ligases for some substrates, and we have shown the PIAS1 binds E1 and stimulates transient replication. Whether or not this stimulation of replication is the result of PIAS ligase activity enhancing E1 sumoylation or some other function of PIAS1 is unknown. The specific goals of this proposal are to ascertain the mechanism by which sumoylation controls nuclear accumulation, determine the consequences of sumoylation on E1 biochemical activities, and characterize the effect of PIAS proteins on papillomavirus replication and E1 sumoylation. These studies will elucidate a novel cellular regulatory mechanism for E1 function, will define the basic nuclear transport pathway(s) for E1, and will also provide

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new information about the general role that sumoylation plays in host cell nucleocytoplasmic transport. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CELLULAR TARGETS FOR PAPILLOMAVIRUS E6 ONCOPROTEINS Principal Investigator & Institution: Howley, Peter M. Professor and Chairman; DanaFarber Cancer Institute 44 Binney St Boston, MA 02115 Timing: Fiscal Year 2001 Summary: The human papillomaviruses (HPVs) are associated with specific human cancers, most notably human cervical cancer. More than 70 different HPVs have now been described and approximately 25 of these are associated with lesions of the anogenital tract. These anogenital associated HPVs can be further subdivided into two groups on the basis of the clinical lesions with which they are associated. The "low risk" HPVs (e.g. HPV-6 and HPVI l) are associated with benign genital warts or condyloma acuminata that only very rarely progress to cancers, whereas the "high risk" HPVs (e.g. HPVI6 and HPVI8) are associated with intraepithelial neoplasias that can progress to cancer. Approximately 85-90% of human cervical cancers contain and viral DNA from a "high risk" HPV type and express the HPV E6 and E7 genes. This along with independent biochemical evidence, suggests strongly that the proteins encoded by the E6 and E7 genes of the "high risk" HPVs contribute directly to carcinogenic progression in the HPV positive cancers. The E7 proteins functions in cellular transformation, at least in part. through interactions with the product of the retinoblastoma susceptibility gene, pRB, and the other pRB related "pocket proteins". The major target of the E6 oncoprotein encoded by the genital tract, cancer associated human papillomaviruses is the p53 tumor suppressor protein. However, several lines of evidence indicate that the E6 protein of the cancer associated HPVs has additional cellular targets. Furthermore, the strongly oncogenic E6 protein encoded by the bovine papillomavirus does not cause transformation by a p53 dependent pathway. The specific aims of this grant proposal are designed to examine additional targets of the papillomavirtts E6 proteins that may be important to the transformation functions of the virus and to determine how the E6 interaction may affect the function of these cellular targets. We will determine the physiologic consequence of the interaction of E6 with the focal adhesion/LIM domain proteins paxillin and hic5. We will determine the consequences of the binding of HPV16 E6 to Interferon Regulatory Factor (IRF-3). Also we will determine the relevance of the binding of E6 to specific cellular targets to its transformation and tumorigenic functions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CORE--TISSUE PROCESSING FACILITY Principal Investigator & Institution: Gaspari, Anthony A. Professor; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2001 Summary: The Tissue Processing Core will be responsible for the coordination of all aspects of dispersing human tissues for the proposed program project. The Tissue Processing Core will be composed of the Core Director, Anthony A. Gaspari, MD; Robert Rose, PhD, Glynis Scoot, MD, Consultant, and a technical associate, Ms. Carol Tanck. The Specific Aims of the core will be to: 1) Recruit subjects with external genital warts to obtain wart tissue 2) Recovery and expansion of wart-infiltrating lymphocytes for in vitro immunologic studies. 3) Processing and storage of peripheral blood lymphocytes. 4) Processing and storage of serum samples. 5) HPV Genotyping by DNA

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PCR-ELISA 6) Preparation of autologous HPV vaccine from HPV infected tissue. 7) Coordinate distribution of tissues to appropriate investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HUMAN PAPILLOMAVIRUS T AND B CELL RESPONSES Principal Investigator & Institution: Bonnez, William C.; University of Rochester Orpa Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2001 Summary: Genital human papillomavirus (HPV) infections represent the most common viral sexually transmitted disease in the United States. These functions cause conditions that include anogenital warts and cervical dysplasias. These diseases can spontaneously regress but the immunologic mechanisms that contribute to the regression are poorly characterized. The experiments in animal models strongly suggest that papillomavirusassociated diseases can be prevented by immunization with virus-like particles (VLP) derived from the major capsid protein of HPV. The present proposal will focus on clinical samples from two unique patient populations. The first is comprised of human volunteers vaccinated with the first HPV type 11 VLP vaccine. This trial is completed and lymphocytes and sera are available. A second group with clinically evident anogenital warts will be treated with autogenous vaccination to induce clinical regression. Sera, peripheral blood mononuclear cells, and most importantly, wart infiltrating lymphocytes will be available for study. These samples will be utilized to study the antigen specificity of the B and T cell populations involved in HPV- specific vaccine responses and anogenital wart regression. Specifically, the peripheral T cells responses to structural and non-structural HPV-6 and -11 proteins will be identified, and the fine specificity for the reactive proteins will be further determined. The frequency of these HPV-6 and-11 specific CD4 and CD 8 T cells will be measured in peripheral blood. Using these results as a guide, the antigenic specificity and frequency of infiltrating T lymphocytes in anogenital warts will be determined. The specific relationship between disease regression and T cell populations will be investigated. For the B cells, the capsid protein conformational and linear epitopes that are recognized by the subjects will be determined, and whether any of the linear epitopes are neutralizing will be established. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MATERNAL RISK FACTORS FOR J ORRP IN DENMARK Principal Investigator & Institution: Shah, Keerti V. Professor; Molecular Microbiol and Immun; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 04-MAY-2000; Project End 30-APR-2002 Summary: Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a childhood disease characterized by growth of benign papilloma in the respiratory tract, most frequently on the vocal fold. Some children undergo over one hundred surgical procedures to remove recurrent papillomas. JORRP is caused by perinatal mother-tochild transmission of HPV types 6 and 11 which are also responsible for genital warts. The proposed population-based, retrospective, cohort study plans to analyze data in Danish National Registries to address two specific aims: (1) to estimate the relative risk of JORRP in offspring of mothers who have condyloma during pregnancy or at delivery and to identify additional risk factors for transmission of JORRP; and (2) to examine if the above risk is reduced by cesarean delivery of the at-risk infants. Pregnancies with the diagnoses of maternal condyloma will be identified in a search of over one million

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pregnancies in Denmark in the time period 1974-1993. It is estimated that about 3,000 such pregnancies will be identified. The incidence of JORRP in children from these pregnancies will be compared with that in children from non-exposed pregnancies. Factors that may influence the transmission of JORRP (virus type in condyloma, maternal age, parity, medical intervention and others) will be identified. It is anticipated that about 15 percent of the births will be by cesarean delivery. Maternal condyloma is not an indication for cesarean delivery in Denmark. Therefore, it will be possible to examine if cesarean delivery reduces the risk of JORRP in the offspring of condylomatous women. The results of this investigation may clarify questions in the biology of JORRP and also help to identify circumstances in which cesarean delivery would be appropriate to reduce the risk of JORRP. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR GENETICS OF PAPILLOMAVIRUSES Principal Investigator & Institution: Lambert, Paul F. Professor; University of Wisconsin Madison 750 University Ave Madison, WI 53706 Timing: Fiscal Year 2001 Summary: Anogenital human papillomaviruses (HPVs) are the causative agents of the sexually transmitted disease, genital warts. A subset of these HPVs are also associated with genital cancers including cervical cancer in women and penile cancer in men. The HPV genotype 16 (HPV-16) is the HPV most frequently associated with cervical cancer. The research efforts in Dr. Lambert's laboratory are directed at characterizing the life cycle of papillomaviruses and understanding their contribution to human cancer. During the current grant period, Dr. Lambert's laboratory has 1) performed genetic and biochemical studies on E1 and E2 genes to learn further their roles in viral transcription and replication, 2) using a novel series of cervical epithelial cells harboring HPV-16 DNA, assessed the role of viral DNA integration in cervical cancer and discovered there to be a fundamental switch in viral DNA replication in the viral life cycle, and 3) using a comprehensive set of novel transgenic mouse lines expressing HPV-26 E6 and/or E7 in stratified squamous epithelium discovered that E6 and E7 can alter the growth and differentiation of squamous epithelia, E7 is sufficient to induce cancers and can act in the promotion phase of carcinogenesis, in E6 and E7 each can abrogate normal cellular responses to radiation in vivo. The goals of this proposal are to understand further the role of papillomaviral E1 and E2 proteins in the papillomavirus life cycle and to learn how the human papillomavirus type 16 oncogenes E6 and E7 contribute to cancer development and affect responsiveness of the cancers to conventional radiation treatment. The specific aims are: 1) to study the role of specific properties of the E2 proteins in viral transcription DNA replication in terminally differentiated cells, and 3) to define further the role of HPV-16 E6 and E7 in carcinogenesis. The specific aims represent logical extensions of Dr. Lambert's current research directions and make use of critical reagents generated by the Lambert laboratory during the current grant period. These studies should contribute to our further understanding of papillomaviral life cycle and the role of HPVs in anogenital cancers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PREVALENCE OF HPV IN THE ORAL CAVITY OF HIV+ INDIVIDUALS Principal Investigator & Institution: Hagensee, Michael E. Associate Professor of Clinical Medicine; Medicine; Louisiana State Univ Hsc New Orleans New Orleans, LA 70112

10 Genital Warts

Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): Human immunodeficiency virus (HIV) has infected over 33 million people worldwide leading to immune suppression from the selective depletion of CD4+ T cells. This lack of immunity results in numerous opportunistic infections with over 50% of the HIV-infected individuals developing pathology involving the oral cavity. Among the pathogens responsible for oral disease in HIV+ patients is the mucosatropic human papillomavirus (HPV). Although HPV cannot be routinely cultured, it is the most common viral sexually transmitted disease. HPV is the etiologic agent of oral and genital warts, focal epithelial hyperplasia, and a large proportion of cervical, anogenital, and oral squamous cell carcinomas. HIV co-infection leads to increased rate of HPV genital infection, increased HPV persistence, and increased rates of HPV-related pathology (cervical or anal dysplasia), which is more difficult to treat. Similarly, preliminary studies indicate that HIV co-infection leads to increases in the prevalence of oral HPV and HPV-related oral pathology including oral cancer. Surprisingly, treatment of HIV with highly active anti-retroviral therapy (HAART) has led to increases in apparent HPV-related oral warts. These warts have been large, painful, and difficult to treat. Continued use of HAART for the HIV+ patient may lead to substantial increases in the incidence of oral warts and other HPV-related oral pathology such as squamous cell carcinomas. The studies to date have been limited by the lack of or the restrictive scope of the molecular techniques used to detect HPV infection. Thus, little is known about the prevalence, site of infection and natural history of oral HPV infection. A better understanding of oral HPV infection particularly in the HIV+ co-infected individual is of paramount importance in order to prevent HPVrelated oral pathology. Preliminary data demonstrates the ability to detect oral HPV infection utilizing consensus PCR primer sets that were developed for detection of genital HPV. These techniques can be extended to detect oral HPV types. We hypothesize that a high throughput PCR-based method for detecting oral HPV types can be developed and utilized to determine the prevalence and site of oral HPV infection in a cohort of HIV+ individuals Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ROLE OF CELLULAR PROTEINS IN HPV TRANSCRIPTION Principal Investigator & Institution: Chiang, Cheng-Ming; Biochemistry; Case Western Reserve University 10900 Euclid Ave Cleveland, OH 44106 Timing: Fiscal Year 2001; Project Start 15-JAN-2000; Project End 31-DEC-2004 Summary: Human papillomaviruses (HPVs) cause a variety of human diseases including genital warts and cervical carcinomas. Replication of HPV genomes requires virus-encoded E1 and E2 proteins, whereas transcription of HPV genes is mainly regulated by E2 and cellular transcription factors. To investigate the mechanisms of HPV transcription, we have developed two cell-free transcription systems reconstituted either with individually purified general transcription factors and cofactors or with a preassembled RNA polymerase II holoenzyme and TFIID (or TBP). Interestingly, both activation and repression of the HPV E6 promoter can be recapitulated in vitro by differential amounts of E2 proteins as observed previously in transfected cells. This provides us with a unique opportunity to dissect the mechanisms of transcriptional regulation mediated by E2 and to define the role o cellular proteins in HPV transcription. The objectives in this proposal are: 1) To define the role of cellular proteins in mediating the functions of HPV E2 proteins. The observation that E2-mediated activation and repression can both occur in our highly purified transcription system reconstituted with only recombinant general transcription factors and cofactors (TBP,

Studies 11

TFIIB, TFIIE, TFIIF, and PC4) and epitope-tagged multiprotein complexes (TFIID, TFIIH, and RNA polymerase II) suggests that components of the general transcription machinery are the targets of E2-mediated regulation. To define the steps of transcription complex assembly regulated by E2 proteins, we will perform template challenge and order-of-addition experiments as well as functional recruitment assays with our cell-free transcription systems using both synthetic DNA templates containing multimerized E2binding sites and natural HPV templates containing the E6 promoter linked to the upstream regulatory region (URR). 2) To dissect the mechanism of HPV chromatin transcription mediated by various viral and cellular proteins. Since many gene-specific transcription factors and cofactors only work in the context of chromatin, we will develop an in vitro chromatin transcription system to study the mechanisms by which viral E2 and cellular enhancer-binding factors transcribe HPV chromatin. The Drosophila S190 chromatin assembly extract and purified histones will be used to assemble HPV-11 DNA templates, which will then be characterized by micrococcal nuclease digestion and Southern blotting with promoter-proximal and -distal DNA probes, and used for in vitro transcription to define the role of E2 and enhancer-binding factors in HPV chromatin transcription. These studies will uncover the role of cellular proteins in mediating E2 functions and further shed light on the molecular mechanism of HPV transcription. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STRATEGIES AGAINST HPV RELATED GENITAL DISEASES IN WOMEN Principal Investigator & Institution: Monk, Bradley J. Obstetrics and Gynecology; University of California Irvine Campus Dr Irvine, CA 92697 Timing: Fiscal Year 2001; Project Start 29-AUG-2001; Project End 30-JUN-2006 Summary: The human papillomavirus (HPV) is a significant etiologic agent in lower female genital tract neoplasia. Novel interactions with other co-carcinogens and/or immuno-deficiency lead to tumorigenesis and cancer progression. However, both the lack of adequate animal models and prospective clinical trials are impediments to the development of effective anti-HPV therapies and prevent a thorough understanding of human interactions with this virus. The objective of this proposal is to support the career development of Bradley J. Monk, M.D. Under the direction of Dr. Luis P. Villarreal, Ph.D., Dr. Monk will evaluate co-carcinogens and anti-viral agents in a recently described severe combined immunodeficiency mouse model using implanted human HPV infected epithelium, cervical intraepithelial neoplasia (CIN). Dr. Monk proposes to study the neoplastic transformation as well as the progression or regression of these cervical tissue implants. The influence of specific promoters or genotoxic compounds (e.g. hormones, nicotine) as well as novel anti-HPV agents (e.g. stimulated immune cells, anti-sense oncogenes) and nutritional supplements (e.g. indole 3-carbinol or I3C) will be studied. In addition, under the direction of Philip J. DiSaia, M.D., a Gynecologic Oncologist; Frank L. Meyskens, M.D., a Medical Oncologist with expertise in Chemoprevention; and Jeffrey S. Weber, M.D., Ph.D., a Medical Oncologist with expertise in Immunology, Dr. Monk will conduct two prospective clinical trials of novel HPV therapies. First, I3C, a compound found in cruciferous vegetables and effective in HPV related laryngeal papillomatosis, will be evaluated in patients with HPV induced genital warts in a randomized phase II trial. Second, a phase I and II study of a DNA plasmid vaccine encoding an immunogenic portion of the HPV type 16 E7 protein is planned among women with CIN. Dr. Monk will focus his career on translational research in the area of anti-HPVmodalities specifically related to female lower genital

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tract neoplasia. Mentors in Virology, Chemoprevention, Immunology and Gynecologic Oncology will allow Dr. Monk to investigate unique anti-viral agents both in the laboratory and in clinical settings with an emphasis on HPV immunity. This path will develop Dr. Monk into an independent investigator able to study anti-HPV therapies first in animals then in human chemoprevention trials. It is expected that Dr. Monk will have obtained extramural funding for both his laboratory and clinical studies by the end of the period of support requested. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STRUCTURE DETERMINATION OF PROTEINS ASSOCIATED W/ CANCER Principal Investigator & Institution: Baleja, James D.; Massachusetts Institute of Technology Cambridge, MA 02139 Timing: Fiscal Year 2001 Summary: We are determining the three-dimensional structures of several proteins associated with cancer. Certain strains of papillomavirus cause cutaneous warts, whereas several other strains are transmitted sexually and cause genital warts. Infections by roughly 50% of these strains are known to progress to cancer. Greater than 90% of cervical cancer tissue, for example, harbors papillomaviral DNA. One viral protein, the E2 protein, controls viral transcription and has an N-terminal transcriptional activation domain and a C-terminal DNA-binding domain. We are determining the structure for the DNA-binding domain from the human strain, HPV-16 and have collected the data necessary for NMR resonance assignment. A small molecular weight inhibitor for E2 from a different strain of virus (HPV-3 1) has been reported. We have repeated the structure activity relationship determination using the NMR method (SAR by NMR) for our HPV-16 E2 domain. We are also studying two peptides that interact with the E6 protein from the virus. The complex that one of these peptides makes (but not the other) promotes p53 degradation, which presumably leads to cellular proliferation. We hypothesize that since the peptides have similar amino acid sequences, they also have similar three-dimensional structures. The part from each of these peptides that interacts with E6 is observed to be alpha helical, with the amino acid residues most important for binding on one side of the structure. A third kind of protein we are studying is unrelated to papillomavirus, but is involved in many human cancers. The EH domain from RalBP1 is a protein in the Ras signaling pathway downstream from Ras. The EH domain binds calcium using a classical EF-hand motif and appears to interact with proteins associated with cellular sorting. The domain also binds peptides containing a "NPF' motif and we are determining the structure of the EH domain by itself, and in complex with a NPF containing peptide. For the EH domain, we have collected the NMR data required for structure determination. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: THE PATHOGENICITY

MECHANISMS

OF

HUMAN

PAPILLOMAVIRUS

Principal Investigator & Institution: Roman, Ann; Professor and Associate Chairman; Microbiology and Immunology; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, IN 462025167 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Human papillomaviruses (HPV) cause benign and malignant hyperproliferative disease. A woman infected with HPV 16 (a high risk HPV)

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has a 200-fold increased risk for the development of cervical cancer while one infected with HPV 6 (a low risk HPV) has a 10-fold increased risk. Notably, HPV 6 is the causative agent of the most prevalent viral sexually transmitted disease, benign hyperproliferative genital warts. Over a million new cases of this disease are diagnosed annually and almost four billion dollars in US health care costs are spent annually. HPVs replicate in the differentiated compartment of the epithelium. The viruses must, therefore, have the ability to either abrogate growth arrest that occurs when the infected cells differentiate or induce differentiated cells to re-enter the cell cycle. While an examination of the high risk viruses has been emphasized, it is imperative that we understand the mechanism of pathogenicity of the low risk viruses, clinically significant pathogens in their own right. Therefore, our focus is to define the interactions between HPV 6 and a differentiating epithelium that dictate the outcome of infection. Because of the interaction of E7 with pivotal cell cycle control proteins, E7 is likely to play a critical role in altering the intracellular environment in such a way as to promote the virus life cycle. For this reason, we have chosen to concentrate on this gene product. In Specific Aim 1 of the proposal we will establish the role of E7 in the HPV 6 life cycle. We will use the intact HPV 6 genome, with a translation termination linker in the E7 gene, to determine the necessity of 6E7 for a) episomal maintenance in primary undifferentiated keratinocytes during the non-productive stage of the life cycle, and b) the HPVmediated aberrant cellular DNA synthesis in the suprabasal cell layer of organotypic raft cultures during the productive stage of the life cycle. We will also use the raft culture to determine the sufficiency of 6E7 in altering epithelial cell growth. In Specific Aim 2 we will conduct a structure/function analysis of the 6E7 protein to identify regions of E7 pertinent to the virus life cycle. We will analyze the mutants in the context of the intact genome for their necessity in episomal maintenance in undifferentiated cells and for reprogramming suprabasal cells to enter S phase. In Specific Aim 3 we will determine the cellular targets of 6E7 relevant to the life cycle of the virus, with emphasis on the pRb family:E2F-mediated pathways. The effect of 6E7, in the context of the entire genome, on cellular gene expression during the non-productive and productive stages of the life cycle, will be determined. By conducting these experiments under physiological conditions that mimic a natural infection, we expect to make novel contributions on the activities of this important protein. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “genital warts” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for genital warts in the PubMed Central database: 3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Cervical intraepithelial neoplasia in women presenting with external genital warts. by Howard M, Sellors J, Lytwyn A. 2002 Mar 5; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=99401

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Correlation between Pretreatment Levels of Interferon Response Genes and Clinical Responses to an Immune Response Modifier (Imiquimod) in Genital Warts. by Arany I, Tyring SK, Brysk MM, Stanley MA, Tomai MA, Miller RL, Smith MH, McDermott DJ, Slade HB. 2000 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=89977

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Detection of Human Papillomavirus Types 6 and 11 in Pubic and Perianal Hair from Patients with Genital Warts. by Boxman IL, Hogewoning A, Mulder LH, Bavinck JN, ter Schegget J. 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=85134

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Detection of Multiple Human Papillomavirus Types in Condylomata Acuminata Lesions from Otherwise Healthy and Immunosuppressed Patients. by Brown DR, Schroeder JM, Bryan JT, Stoler MH, Fife KH. 1999 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=85555

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Imiquimod for the treatment of genital warts: a quantitative systematic review. by Moore RA, Edwards JE, Hopwood J, Hicks D. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=32301

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Imiquimod, a Patient-Applied Immune-Response Modifier for Treatment of External Genital Warts. by Beutner KR, Tyring SK, Trofatter KF Jr, Douglas JM Jr, Spruance S, Owens ML, Fox TL, Hougham AJ, Schmitt KA. 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=105543

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

6

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

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A comparative study of topical analgesia with a lidocaine/prilocaine cream (EMLA) and infiltration anesthesia for laser surgery of genital warts in men. Author(s): Lassus A, Kartamaa M, Happonen HP. Source: Sexually Transmitted Diseases. 1990 July-September; 17(3): 130-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2247802&dopt=Abstract

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A pharmacokinetic evaluation of 14C-labeled afovirsen sodium in patients with genital warts. Author(s): Crooke ST, Grillone LR, Tendolkar A, Garrett A, Fratkin MJ, Leeds J, Barr WH. Source: Clinical Pharmacology and Therapeutics. 1994 December; 56(6 Pt 1): 641-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7995006&dopt=Abstract

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A retrospective analysis of costs and patterns of treatment for external genital warts in The Netherlands. Author(s): van der Meijden WI, Notowicz A, Blog FB, Langley PC. Source: Clinical Therapeutics. 2002 January; 24(1): 183-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11833831&dopt=Abstract

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A study to estimate the prevalence of upper respiratory tract papillomatosis in patients with genital warts. Author(s): Clarke J, Terry RM, Lacey CJ. Source: International Journal of Std & Aids. 1991 March-April; 2(2): 114-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1646036&dopt=Abstract

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Absence from work due to treatment for genital warts. Author(s): Williams NR. Source: J Soc Occup Med. 1991 Autumn; 41(3): 117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1921339&dopt=Abstract

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Acquired vulval lymphangiomata mimicking genital warts. Author(s): Harwood CA, Mortimer PS. Source: The British Journal of Dermatology. 1993 September; 129(3): 334-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8286236&dopt=Abstract

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Acquired vulvar lymphangioma mimicking genital warts. A case report and review of the literature. Author(s): Mu XC, Tran TA, Dupree M, Carlson JA. Source: Journal of Cutaneous Pathology. 1999 March; 26(3): 150-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10235381&dopt=Abstract

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Advising patients with genital warts--a consensus approach. Author(s): McOwan AG, Broughton C, Robinson AJ. Source: International Journal of Std & Aids. 1999 September; 10(9): 619-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492431&dopt=Abstract

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Aggressive giant condyloma acuminatum associated with oncogenic human papilloma virus: a case report. Author(s): Kibrite A, Zeitouni NC, Cloutier R. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1997 April; 40(2): 143-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9126130&dopt=Abstract

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An audit of nurse treatment sessions for female patients with genital warts. Author(s): Frayne J, Tobin JM. Source: International Journal of Std & Aids. 1995 September-October; 6(5): 363. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8547421&dopt=Abstract

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An international survey of patients with genital warts: perceptions regarding treatment and impact on lifestyle. Author(s): Maw RD, Reitano M, Roy M. Source: International Journal of Std & Aids. 1998 October; 9(10): 571-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9819106&dopt=Abstract

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Anal cancer incidence: genital warts, anal fissure or fistula, hemorrhoids, and smoking. Author(s): Holly EA, Whittemore AS, Aston DA, Ahn DK, Nickoloff BJ, Kristiansen JJ. Source: Journal of the National Cancer Institute. 1989 November 15; 81(22): 1726-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2810388&dopt=Abstract

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Anal human papillomavirus infection in heterosexuals with genital warts: prevalence and relation with sexual behaviour. Author(s): Sonnex C, Scholefield JH, Kocjan G, Kelly G, Whatrup C, Mindel A, Northover JM. Source: Bmj (Clinical Research Ed.). 1991 November 16; 303(6812): 1243. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1747648&dopt=Abstract

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Analysis of human genital warts (condylomata acuminata) and other genital tumors for human papillomavirus type 6 DNA. Author(s): Gissmann L, deVilliers EM, zur Hausen H. Source: International Journal of Cancer. Journal International Du Cancer. 1982 February 15; 29(2): 143-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6277807&dopt=Abstract

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Anogenital warts of the condyloma acuminatum type in HIV-positive patients. Author(s): Rudlinger R, Grob R, Buchmann P, Christen D, Steiner R. Source: Dermatologica. 1988; 176(6): 277-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2841174&dopt=Abstract

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Antibodies to human papillomavirus type 11 virus-like particles in sera of patients with genital warts and in control groups. Author(s): Eisemann C, Fisher SG, Gross G, Muller M, Gissmann L. Source: The Journal of General Virology. 1996 August; 77 ( Pt 8): 1799-803. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8760429&dopt=Abstract

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Antibodies to papillomavirus genus-antigens in women with genital warts. Author(s): Portolani M, Mantovani G, Pietrosemoli P, Cermelli C, Boselli F. Source: Microbiologica. 1987 July; 10(3): 271-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3041183&dopt=Abstract

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Association of coexisting vaginal infections and multiple abusers in female children with genital warts. Author(s): Herman-Giddens ME, Gutman LT, Berson NL. Source: Sexually Transmitted Diseases. 1988 January-March; 15(1): 63-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3358240&dopt=Abstract

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Audits of the treatment of genital warts: closing the feedback loop. Author(s): Reynolds M, Fraser PA, Lacey CJ. Source: International Journal of Std & Aids. 1996 August-September; 7(5): 347-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8894824&dopt=Abstract

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Cervical biopsy specimens and human papilloma virus positivity in patients with external genital warts. Author(s): Akdeniz S, Yaldiz M, Akdeniz N. Source: Eur J Gynaecol Oncol. 2002; 23(5): 460-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12440827&dopt=Abstract

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Cervical epithelial abnormalities in females with and without genital warts. Author(s): Ward KA, Lowry BE, Houston JR, Maw RD. Source: International Journal of Std & Aids. 1994 September-October; 5(5): 380-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7819367&dopt=Abstract

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Cervical intraepithelial neoplasia in women presenting with external genital warts. Author(s): Howard M, Sellors J, Lytwyn A. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 March 5; 166(5): 598-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898938&dopt=Abstract

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Cervical signs of HPV infection in PAP-smear negative women with external genital warts. Author(s): Petersen CS, Thomsen HK, Sondergaard J. Source: Acta Dermato-Venereologica. 1989; 69(5): 454-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2572122&dopt=Abstract

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Cervical-vaginal and intraanal human papillomavirus infection of young girls with external genital warts. Author(s): Gutman LT, St Claire KK, Everett VD, Ingram DL, Soper J, Johnston WW, Mulvaney GG, Phelps WC. Source: The Journal of Infectious Diseases. 1994 August; 170(2): 339-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8035020&dopt=Abstract

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Characterization of human papilloma virus (H.P.V.) present in genital warts. Author(s): Staquet MJ, Viac J, Thivolet J, Chardonnet Y. Source: Archives of Dermatological Research. 1978 February 15; 261(1): 77-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=205177&dopt=Abstract

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Choosing equipment for treating genital warts in genitourinary medicine clinics. Author(s): Scoular A. Source: Genitourinary Medicine. 1991 October; 67(5): 413-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1822975&dopt=Abstract

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Choosing equipment for treating genital warts. Author(s): Ariyanayagam S, Monteiro F. Source: Genitourinary Medicine. 1992 April; 68(2): 144-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1582663&dopt=Abstract

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Circulating B and T lymphocyte subpopulations in patients with genital warts. Author(s): Mohanty KC, Scott CS, Limbert HJ, Master PS. Source: Br J Clin Pract. 1987 February; 41(2): 601-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3499927&dopt=Abstract

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Circumcision in genital warts--let us not forget! Author(s): Dogra S, Kumar B. Source: Sexually Transmitted Infections. 2003 June; 79(3): 265. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12794228&dopt=Abstract

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Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic. Author(s): Cook LS, Koutsky LA, Holmes KK. Source: Genitourinary Medicine. 1993 August; 69(4): 262-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7721284&dopt=Abstract

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Clinicopathology and immunohistochemistry of genital warts. Author(s): Sehgal VN, Koranne RV, Srivastava SB, Gupta MM, Luthra UK. Source: International Journal of Dermatology. 1988 December; 27(10): 690-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2853141&dopt=Abstract

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Colposcopic evaluation of men with genital warts. Author(s): Comite SL, Castadot MJ. Source: Journal of the American Academy of Dermatology. 1988 June; 18(6): 1274-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3385041&dopt=Abstract

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Combination of laser-therapy with 0.5% idoxuridine cream in the treatment of therapy-resistant genital warts in male patients: an open study. Author(s): Happonen HP, Lassus A, Santalahti J, Forsstrom S, Lassus J. Source: Sexually Transmitted Diseases. 1990 July-September; 17(3): 127-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2174190&dopt=Abstract

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Combined surgery and cidofovir is an effective treatment for genital warts in HIVinfected patients. Author(s): Orlando G, Fasolo MM, Beretta R, Merli S, Cargnel A. Source: Aids (London, England). 2002 February 15; 16(3): 447-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11834957&dopt=Abstract

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Combined surgical-medical treatment of genital warts in HIV positive patients. Author(s): Orlando G, Fasolo MM, Beretta R, Cargnel A. Source: Tumori. 2001 September-October; 87(5): S11-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765191&dopt=Abstract

20 Genital Warts

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Condylomata acuminata (genital warts). An epidemiologic view. Author(s): Chuang TY. Source: Journal of the American Academy of Dermatology. 1987 February; 16(2 Pt 1): 376-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3029192&dopt=Abstract

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Condylomata acuminata (genital warts): patient demographics and treating physicians. Author(s): Fleischer AB Jr, Parrish CA, Glenn R, Feldman SR. Source: Sexually Transmitted Diseases. 2001 November; 28(11): 643-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11677386&dopt=Abstract

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Continuing medical ignorance: modern myths in the management of genital warts. Author(s): Birley HD. Source: International Journal of Std & Aids. 2001 February; 12(2): 71-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11236106&dopt=Abstract

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Correlation between pretreatment levels of interferon response genes and clinical responses to an immune response modifier (Imiquimod) in genital warts. Author(s): Arany I, Tyring SK, Brysk MM, Stanley MA, Tomai MA, Miller RL, Smith MH, McDermott DJ, Slade HB. Source: Antimicrobial Agents and Chemotherapy. 2000 July; 44(7): 1869-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10858346&dopt=Abstract

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Correlation of HPV antigen and type of genital warts with atypia. Author(s): Kumar B, Gupta R, Sehgal S. Source: Genitourinary Medicine. 1991 April; 67(2): 146-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1851721&dopt=Abstract

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Counseling patients with genital warts. Author(s): Reitano M. Source: The American Journal of Medicine. 1997 May 5; 102(5A): 38-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9217661&dopt=Abstract

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Cryosurgery of genital warts. Author(s): Balsdon MJ. Source: Br J Vener Dis. 1978 October; 54(5): 352-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=709351&dopt=Abstract

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Cryotherapy compared with trichloroacetic acid in treating genital warts. Author(s): Godley MJ, Bradbeer CS, Gellan M, Thin RN. Source: Genitourinary Medicine. 1987 December; 63(6): 390-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3323028&dopt=Abstract

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Cryotherapy versus electrocautery in the treatment of genital warts. Author(s): Simmons PD, Langlet F, Thin RN. Source: Br J Vener Dis. 1981 August; 57(4): 273-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7272706&dopt=Abstract

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Current dermatologic therapy: use of interferons in genital warts. Author(s): Gross GE. Source: Journal of the American Academy of Dermatology. 1993 October; 29(4): 665. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8292155&dopt=Abstract

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Delayed presentation of patients with genital warts. Author(s): Coker DM, Ahmed-Jushuf I, O'Mahony C, Alawattegama AB. Source: Genitourinary Medicine. 1988 August; 64(4): 281. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3169761&dopt=Abstract

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Demonstration of virus particles in human genital warts. Author(s): Oriel JD, Almeida JD. Source: Br J Vener Dis. 1970 February; 46(1): 37-42. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4313975&dopt=Abstract

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Detection of human papillomavirus (HPV) in genital warts and carcinomas by DNA in situ hybridization in Chinese patients. Author(s): Chang F, Syrjanen S, Shen Q, Ji H, Syrjanen K. Source: Cytopathology : Official Journal of the British Society for Clinical Cytology. 1990; 1(2): 97-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1966324&dopt=Abstract

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Detection of human papillomavirus DNA in genital warts, cervical dysplasias and neoplasias. Author(s): Tomita Y, Kubota K, Kasai T, Sekiya S, Takamizawa H, Simizu B. Source: Intervirology. 1986; 25(3): 151-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3015831&dopt=Abstract

22 Genital Warts

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Detection of human papillomavirus DNA on the fingers of patients with genital warts. Author(s): Sonnex C, Strauss S, Gray JJ. Source: Sexually Transmitted Infections. 1999 October; 75(5): 317-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10616355&dopt=Abstract

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Detection of human papillomavirus types 6 and 11 in pubic and perianal hair from patients with genital warts. Author(s): Boxman IL, Hogewoning A, Mulder LH, Bouwes Bavinck JN, ter Schegget J. Source: Journal of Clinical Microbiology. 1999 July; 37(7): 2270-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10364596&dopt=Abstract

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Detection of human papillomavirus types 6, 11, 16 and 18 in genital warts and cervical neoplasia. Author(s): Battista C, Hillova J, Hill M, Mathe G. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 1986; 40(10): 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3034348&dopt=Abstract

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Diagnosis of child sexual abuse in children with genital warts. Author(s): Gutman LT, Herman-Giddens M, Prose NS. Source: Am J Dis Child. 1991 February; 145(2): 126-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1994675&dopt=Abstract

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Diet and genital warts: a case-control study. Author(s): Bairati I, Sherman KJ, McKnight B, Habel LA, Van den Eeden SK, Stergachis A, Daling JR. Source: Sexually Transmitted Diseases. 1994 May-June; 21(3): 149-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8073343&dopt=Abstract

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DNA hybridization studies of a case of oropharyngeal papillomatosis from a patient with genital warts. Author(s): Clarke J, Terry RM, Wells M, Lewis FA, Lacey CJ. Source: International Journal of Std & Aids. 1992 March-April; 3(2): 134-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1315158&dopt=Abstract

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DNA typing of genital warts and diagnosis of sexual abuse in children. Author(s): Osborne JP, Potter RG. Source: Lancet. 1987 October 10; 2(8563): 864. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2889069&dopt=Abstract

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DNA typing of genital warts and diagnosis of sexual abuse of children. Author(s): Fleming KA, Venning V, Evans M. Source: Lancet. 1987 August 22; 2(8556): 454. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2887753&dopt=Abstract

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Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis. Author(s): Manhart LE, Koutsky LA. Source: Sexually Transmitted Diseases. 2002 November; 29(11): 725-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438912&dopt=Abstract

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Drug treatment of common STDs: Part II. Vaginal infections, pelvic inflammatory disease and genital warts. Author(s): Woodward C, Fisher MA. Source: American Family Physician. 1999 October 15; 60(6): 1716-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10537386&dopt=Abstract

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Dual genitotropic human papillomavirus infections in genital warts. Author(s): Aznar J, Ojeda A, Torres MJ, Palomares JC, Rodriguez-Pichardo A. Source: Genitourinary Medicine. 1993 February; 69(1): 60-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8383097&dopt=Abstract

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Effect of injections of small doses of human fibroblast interferon into genital warts. A pilot study. Author(s): Scott GM, Csonka GW. Source: Br J Vener Dis. 1979 December; 55(6): 442-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=526848&dopt=Abstract

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Emerging incidence of vulval intraepithelial neoplasia in young women with genital warts. Author(s): De Silva AH, Sivapalan S, Harindra V, Roy RB. Source: Genitourinary Medicine. 1992 October; 68(5): 346-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1427815&dopt=Abstract

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Enhanced immunogenicity of a recombinant genital warts vaccine adjuvanted with monophosphoryl lipid A. Author(s): Thompson HS, Davies ML, Watts MJ, Mann AE, Holding FP, O'Neill T, Beech JT, Thompson SJ, Leesman GD, Ulrich JT. Source: Vaccine. 1998 December; 16(20): 1993-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9796056&dopt=Abstract

24 Genital Warts

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Enhancement of the innate and cellular immune response in patients with genital warts treated with topical imiquimod cream 5%. Author(s): Arany I, Tyring SK, Stanley MA, Tomai MA, Miller RL, Smith MH, McDermott DJ, Slade HB. Source: Antiviral Research. 1999 August; 43(1): 55-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10480263&dopt=Abstract

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Epidemiology of genital warts in England and Wales: 1971 to 1994. Author(s): Simms I, Fairley CK. Source: Genitourinary Medicine. 1997 October; 73(5): 365-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9534745&dopt=Abstract

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External genital warts: report of the American Medical Association Consensus Conference. AMA Expert Panel on External Genital Warts. Author(s): Beutner KR, Reitano MV, Richwald GA, Wiley DJ. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1998 October; 27(4): 796-806. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9798036&dopt=Abstract

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Female genital warts: global trends and treatments. Author(s): Gall SA. Source: Infectious Diseases in Obstetrics and Gynecology. 2001; 9(3): 149-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11516064&dopt=Abstract

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Genital warts and cervical cancer. I. Evidence of an association between subclinical papillomavirus infection and cervical malignancy. Author(s): Reid R, Stanhope CR, Herschman BR, Booth E, Phibbs GD, Smith JP. Source: Cancer. 1982 July 15; 50(2): 377-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6282442&dopt=Abstract

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Genital warts and cervical cancer. II. Is human papillomavirus infection the trigger to cervical carcinogenesis? Author(s): Reid R. Source: Gynecologic Oncology. 1983 April; 15(2): 239-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6299907&dopt=Abstract

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Genital warts and cervical cancer. III. Subclinical papillomaviral infection and cervical neoplasia are linked by a spectrum of continuous morphologic and biologic change. Author(s): Reid R, Crum CP, Herschman BR, Fu YS, Braun L, Shah KV, Agronow SJ, Stanhope CR. Source: Cancer. 1984 February 15; 53(4): 943-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6318956&dopt=Abstract

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Genital warts and cervical cancer. IV. A colposcopic index for differentiating subclinical papillomaviral infection from cervical intraepithelial neoplasia. Author(s): Reid R, Stanhope CR, Herschman BR, Crum CP, Agronow SJ. Source: American Journal of Obstetrics and Gynecology. 1984 August 15; 149(8): 815-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6205589&dopt=Abstract

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Genital warts and cervical cancer. V. The tissue basis of colposcopic change. Author(s): Reid R, Herschman BR, Crum CP, Fu YS, Braun L, Shah KV, Agronow SJ, Stanhope CR. Source: American Journal of Obstetrics and Gynecology. 1984 June 1; 149(3): 293-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6328996&dopt=Abstract

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Genital warts and cervical cancer. VI. The relationship between aneuploid and polyploid cervical lesions. Author(s): Reid R, Fu YS, Herschman BR, Crum CP, Braun L, Shah KV, Agronow SJ, Stanhope CR. Source: American Journal of Obstetrics and Gynecology. 1984 September 15; 150(2): 18999. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6089564&dopt=Abstract

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Genital warts and cervical cancer. VII. An improved colposcopic index for differentiating benign papillomaviral infections from high-grade cervical intraepithelial neoplasia. Author(s): Reid R, Scalzi P. Source: American Journal of Obstetrics and Gynecology. 1985 November 15; 153(6): 6118. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2998190&dopt=Abstract

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Genital warts and cervical neoplasia: an epidemiological study. Author(s): Franceschi S, Doll R, Gallwey J, La Vecchia C, Peto R, Spriggs AI. Source: British Journal of Cancer. 1983 November; 48(5): 621-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6688952&dopt=Abstract

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Genital warts and cervical screening. Author(s): Greenhalgh T. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 1998 January; 48(426): 919-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9604420&dopt=Abstract

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Genital warts and molluscum contagiosum. Author(s): Margolis S. Source: The Urologic Clinics of North America. 1984 February; 11(1): 163-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6369703&dopt=Abstract

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Genital warts and the need for screening. Author(s): Jayaweera DT, Ahmed IH, Bignell CJ, Rogstad KE. Source: Genitourinary Medicine. 1990 August; 66(4): 305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2391122&dopt=Abstract

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Genital warts and the need for screening. Author(s): Crawshaw SC, Haran MV. Source: Genitourinary Medicine. 1990 June; 66(3): 228-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2370070&dopt=Abstract

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Genital warts and the need for screening. Author(s): Griffiths M. Source: Genitourinary Medicine. 1989 December; 65(6): 399. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2613219&dopt=Abstract

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Genital warts and their treatment. Author(s): Beutner KR, Wiley DJ, Douglas JM, Tyring SK, Fife K, Trofatter K, Stone KM. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1999 January; 28 Suppl 1: S37-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10028109&dopt=Abstract

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Genital warts at the site of healed herpes progenitalis: the isotopic response. Author(s): Ruocco E. Source: International Journal of Dermatology. 2000 September; 39(9): 705-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11044198&dopt=Abstract

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Genital warts do not respond to systemic recombinant interferon alfa-2a treatment during cannabis consumption. Author(s): Gross G, Roussaki A, Ikenberg H, Drees N. Source: Dermatologica. 1991; 183(3): 203-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1660417&dopt=Abstract

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Genital warts in children. Author(s): Janniger CK. Source: Cutis; Cutaneous Medicine for the Practitioner. 1992 August; 50(2): 101-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1324829&dopt=Abstract

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Genital warts in children. Author(s): Herman-Giddens ME. Source: Child Abuse & Neglect. 1990; 14(3): 454-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2207815&dopt=Abstract

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Genital warts, other sexually transmitted diseases, and vulvar cancer. Author(s): Sherman KJ, Daling JR, Chu J, Weiss NS, Ashley RL, Corey L. Source: Epidemiology (Cambridge, Mass.). 1991 July; 2(4): 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1655066&dopt=Abstract

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Genital warts, papillomaviruses, and genital malignancies. Author(s): Shah KV, Buscema J. Source: Annual Review of Medicine. 1988; 39: 371-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2835929&dopt=Abstract

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Genital warts, trichomoniasis and other concurrent STIs in Scotland. Author(s): Thompson C. Source: International Journal of Std & Aids. 1997 June; 8(6): 412. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9179657&dopt=Abstract

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Genital warts. Author(s): Wiley DJ. Source: Clin Evid. 2002 June; (7): 1426-36. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12230758&dopt=Abstract

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Genital warts. Author(s): Stack WC. Source: Bmj (Clinical Research Ed.). 1990 May 19; 300(6735): 1339-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2242133&dopt=Abstract

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Genital warts. Author(s): Clofine RJ. Source: Postgraduate Medicine. 1989 November 1; 86(6): 29-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2813215&dopt=Abstract

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Genital warts. Author(s): Simmons PD. Source: International Journal of Dermatology. 1983 September; 22(7): 410-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6629603&dopt=Abstract

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Genital warts. Author(s): Oriel JD. Source: Sexually Transmitted Diseases. 1981 October-December; 8(4 Suppl): 326-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6277022&dopt=Abstract

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Genital warts. Author(s): Samarakoon S. Source: Ceylon Med J. 1999 December; 44(4): 159-61. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10895265&dopt=Abstract

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Genital warts. Author(s): Oriel JD. Source: Sexually Transmitted Diseases. 1977 October-December; 4(4): 153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=594860&dopt=Abstract

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Genital warts. Current status. Author(s): Sehgal VN, Koranne RV, Srivastava SB. Source: International Journal of Dermatology. 1989 March; 28(2): 75-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2661450&dopt=Abstract

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Genital warts. Newly discovered consequences of an ancient disease. Author(s): Peterson IM, Rao R. Source: Postgraduate Medicine. 1989 September 1; 86(3): 197-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2771837&dopt=Abstract

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Genital warts: a study of patient anxiety and information needs. Author(s): Chandler MG. Source: British Journal of Nursing (Mark Allen Publishing). 1996 February 8-21; 5(3): 174-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8696129&dopt=Abstract

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Genital warts: diagnosis, treatment, and counseling for the patient. Author(s): Steinberg JL, Cibley LJ, Rice PA. Source: Curr Clin Top Infect Dis. 1993; 13: 99-122. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7691082&dopt=Abstract

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Genital warts: incidence of associated genital infections. Author(s): Kinghorn GR. Source: The British Journal of Dermatology. 1978 October; 99(4): 405-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=708613&dopt=Abstract

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Genital warts: just a nuisance? Author(s): Sheppard S, White M, Walzman M. Source: Genitourinary Medicine. 1995 June; 71(3): 194-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7635498&dopt=Abstract

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Genital warts: molecular biology and immunology. Author(s): Tindle R. Source: Immunology and Cell Biology. 1990 February; 68 ( Pt 1): 71-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2156777&dopt=Abstract

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Genital warts: need to screen for coinfection. Author(s): Carne CA, Dockerty G. Source: Bmj (Clinical Research Ed.). 1990 February 17; 300(6722): 459. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2107904&dopt=Abstract

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Genital warts: their etiology and treatment. Author(s): Wright T. Source: Nurs Times. 1998 February 18-24; 94(7): 52-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9536735&dopt=Abstract

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Hand-genital transmission of genital warts? An analysis of prevalence data. Author(s): Fairley CK, Gay NJ, Forbes A, Abramson M, Garland SM. Source: Epidemiology and Infection. 1995 August; 115(1): 169-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7641831&dopt=Abstract

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Hemorrhoids, genital warts, and other perianal complaints. Author(s): Gerdom LE, Dixon D, Dipalma JA. Source: Jaapa. 2001 September; 14(9): 37-9, 43-4, 47. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11599281&dopt=Abstract

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High prevalence of cervical dysplasia in female consorts of men with genital warts. Author(s): Hockenstrom T, Jonassen F, Knutsson F, Lowhagen GB, Radberg T. Source: Acta Dermato-Venereologica. 1987; 67(6): 511-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2451377&dopt=Abstract

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High-grade dysplasia in genital warts from two patients infected with the human immunodeficiency virus. Author(s): Bryan JT, Stoler MH, Tyring SK, McClowry T, Fife KH, Brown DR. Source: Journal of Medical Virology. 1998 January; 54(1): 69-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9443111&dopt=Abstract

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History of genital warts in 10,838 women 20 to 29 years of age from the general population. Risk factors and association with Papanicolaou smear history. Author(s): Munk C, Svare EI, Poll P, Bock JE, Kjaer SK. Source: Sexually Transmitted Diseases. 1997 November; 24(10): 567-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9383844&dopt=Abstract

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History of genital warts in a selected population. Author(s): Daling JR, Weiss NS, Sherman KJ. Source: Lancet. 1984 January 21; 1(8369): 157-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6140456&dopt=Abstract

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Human immunodeficiency virus infection and genital warts as risk factors for anal intraepithelial neoplasia in homosexual men. Author(s): Carter PS, de Ruiter A, Whatrup C, Katz DR, Ewings P, Mindel A, Northover JM. Source: The British Journal of Surgery. 1995 April; 82(4): 473-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7613888&dopt=Abstract

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Human leukocyte interferon-alpha in cream, for the treatment of genital warts in Asian women: a placebo-controlled, double-blind study. Author(s): Syed TA, Lundin S, Cheema KM, Kahlon BM, Cheema R, Ahmad SA, Ahmad M. Source: Clin Investig. 1994 November; 72(11): 870-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7894214&dopt=Abstract

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Human papilloma virus type I purified from human genital warts. Author(s): Staquet MJ, Viac J, Bustamante R, Thivolet J. Source: Dermatologica. 1981; 162(4): 213-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6266889&dopt=Abstract

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Human papillomavirus (HPV) type distribution and serological response to HPV type 6 virus-like particles in patients with genital warts. Author(s): Greer CE, Wheeler CM, Ladner MB, Beutner K, Coyne MY, Liang H, Langenberg A, Yen TS, Ralston R. Source: Journal of Clinical Microbiology. 1995 August; 33(8): 2058-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7559948&dopt=Abstract

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Human papillomavirus infection: a potentially carcinogenic sexually transmitted disease (condylomata acuminata, genital warts). Author(s): Lucas VA. Source: Nurs Clin North Am. 1988 December; 23(4): 917-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3057472&dopt=Abstract

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Human papillomavirus types in cervical biopsy specimens from Pap-smear-negative women with external genital warts. Author(s): Petersen CS, Lindeberg H, Thomsen HK. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1991; 70(1): 69-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1650114&dopt=Abstract

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Human papillomavirus, genital warts, Pap smears, and cervical cancer: knowledge and beliefs of adolescent and adult women. Author(s): Mays RM, Zimet GD, Winston Y, Kee R, Dickes J, Su L. Source: Health Care for Women International. 2000 July-August; 21(5): 361-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261107&dopt=Abstract

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Human papillomaviruses: associations between laryngeal papillomas and genital warts. Author(s): Bennett RS, Powell KR. Source: The Pediatric Infectious Disease Journal. 1987 March; 6(3): 229-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3033592&dopt=Abstract

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Identifying and treating genital warts. Author(s): Woolley P. Source: Practitioner. 1995 September; 239(1554): 542-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7567776&dopt=Abstract

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Imiquimod for the treatment of genital warts: a quantitative systematic review. Author(s): Moore RA, Edwards JE, Hopwood J, Hicks D. Source: Bmc Infectious Diseases [electronic Resource]. 2001; 1(1): 3. Epub 2001 June 05. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11401728&dopt=Abstract

32 Genital Warts

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Imiquimod, a patient-applied immune-response modifier for treatment of external genital warts. Author(s): Beutner KR, Tyring SK, Trofatter KF Jr, Douglas JM Jr, Spruance S, Owens ML, Fox TL, Hougham AJ, Schmitt KA. Source: Antimicrobial Agents and Chemotherapy. 1998 April; 42(4): 789-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9559784&dopt=Abstract

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Imiquimod: a new immune response modifier for the treatment of external genital warts and other diseases in dermatology. Author(s): Berman B. Source: International Journal of Dermatology. 2002 May; 41 Suppl 1: 7-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12087816&dopt=Abstract

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Immunohistology of genital warts in different stages of regression after therapy with interferon gamma. Author(s): Fierlbeck G, Schiebel U, Muller C. Source: Dermatologica. 1989; 179(4): 191-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2533570&dopt=Abstract

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Immunological events in regressing genital warts. Author(s): Coleman N, Birley HD, Renton AM, Hanna NF, Ryait BK, Byrne M, TaylorRobinson D, Stanley MA. Source: American Journal of Clinical Pathology. 1994 December; 102(6): 768-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7801889&dopt=Abstract

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Impact of highly active antiretroviral therapy on clinical evolution of genital warts in HIV-infected patients. Author(s): Orlando G, Fasolo MM, Signori R, Schiavini M, Casella A, Cargnel A. Source: Aids (London, England). 1999 February 4; 13(2): 291-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10202844&dopt=Abstract

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Increase in new patients with genital warts attending STD clinics in Helsinki, 1980-6. Author(s): Lassus J, Ponka A, Haukka K, Lassus A. Source: Genitourinary Medicine. 1988 June; 64(3): 205. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3410470&dopt=Abstract

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Increased evidence of cervical cytological abnormalities in women with genital warts. Author(s): Williams OE, Alawattegama AB. Source: Genitourinary Medicine. 1992 April; 68(2): 145-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1582666&dopt=Abstract

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Increased frequency of dosing of imiquimod 5% cream in the treatment of external genital warts in women. Author(s): Trofatter KF Jr, Ferenczy A, Fife KH. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2002 February; 76(2): 191-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11818121&dopt=Abstract

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Increased incidence of cervical cytological abnormalities in women with genital warts or contact with genital warts: a need for increased vigilance? Author(s): Rowen D, Carne CA, Sonnex C, Cooper P. Source: Genitourinary Medicine. 1991 December; 67(6): 460-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1774050&dopt=Abstract

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Increased incidence of cervical cytological abnormalities in women with genital warts. Author(s): Griffiths M. Source: Genitourinary Medicine. 1992 April; 68(2): 145. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1582665&dopt=Abstract

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Increased incidence of cervical cytological abnormalities in women with genital warts. Author(s): Evans BA, Kell PD. Source: Genitourinary Medicine. 1992 April; 68(2): 145. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1582664&dopt=Abstract

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Information-giving to patients with genital warts at a genitourinary medicine clinic: a baseline assessment. Author(s): McClean H, Weaver S. Source: International Journal of Std & Aids. 2002 April; 13(4): 223-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886605&dopt=Abstract

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Initial experience in treatment of female genital warts and cervical intraepithelial neoplasia with laser. Author(s): Chua SM, Tham KF, Chew SY. Source: Singapore Med J. 1988 June; 29(3): 265-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3187579&dopt=Abstract

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Interferon alpha-2b dependent recalcitrant genital warts. Author(s): Larsen J, Petersen CS, Kroon S. Source: Dan Med Bull. 1990 August; 37(4): 374-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2245662&dopt=Abstract

34 Genital Warts

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Interferon alpha-n1 (Wellferon) for refractory genital warts: efficacy and tolerance of low dose systemic therapy. Author(s): Reichman RC, Micha JP, Weck PK, Bonnez W, Wold D, Whisnant JK, Mounts P, Trofatter KF, Kucera P, Gall SA. Source: Antiviral Research. 1988 November; 10(1-3): 41-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2852919&dopt=Abstract

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Interferon and genital warts. Author(s): Gross G. Source: Jama : the Journal of the American Medical Association. 1988 October 14; 260(14): 2066. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3138438&dopt=Abstract

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Interferon and genital warts: much potential, modest progress. Author(s): Kirby P. Source: Jama : the Journal of the American Medical Association. 1988 January 22-29; 259(4): 570-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2447298&dopt=Abstract

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Interferon for genital warts. Author(s): Stahl-Bayliss CM. Source: Clin Pharm. 1991 March; 10(3): 177. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2040124&dopt=Abstract

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Intralesional interferon alfa-2b for the treatment of genital warts. Author(s): Welander CE, Homesley HD, Smiles KA, Peets EA. Source: American Journal of Obstetrics and Gynecology. 1990 February; 162(2): 348-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2155531&dopt=Abstract

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Intralesional or topical cidofovir (HPMPC, VISTIDE) for the treatment of recurrent genital warts in HIV-1-infected patients. Author(s): Orlando G, Fasolo MM, Beretta R, Signori R, Adriani B, Zanchetta N, Cargnel A. Source: Aids (London, England). 1999 October 1; 13(14): 1978-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10513659&dopt=Abstract

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Is oral contraceptive associated with genital warts? Author(s): Ross JD. Source: Genitourinary Medicine. 1996 October; 72(5): 330-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8976847&dopt=Abstract

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Isolation and characterization of human papillomavirus type 6-specific T cells infiltrating genital warts. Author(s): Hong K, Greer CE, Ketter N, Van Nest G, Paliard X. Source: Journal of Virology. 1997 September; 71(9): 6427-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9261360&dopt=Abstract

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Isoprinosine in the treatment of genital warts. Author(s): O'Neill BB, Robins DS. Source: Cancer Detection and Prevention. 1988; 12(1-6): 497-501. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2460237&dopt=Abstract

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Latent papillomavirus and recurring genital warts. Author(s): Ferenczy A, Mitao M, Nagai N, Silverstein SJ, Crum CP. Source: The New England Journal of Medicine. 1985 September 26; 313(13): 784-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2993887&dopt=Abstract

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Lidocaine/prilocaine cream (EMLA(R)) versus infiltration anaesthesia: a comparison of the analgesic efficacy for punch biopsy and electrocoagulation of genital warts in men. Author(s): vd Berg GM, Lillieborg S, Stolz E. Source: Genitourinary Medicine. 1992 June; 68(3): 162-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1607191&dopt=Abstract

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Lymphocyte-induced angiogenesis assay--in cutaneous malignancies and cutaneous and genital warts. Author(s): Szmurlo A, Grzesik W. Source: Arch Immunol Ther Exp (Warsz). 1988; 36(1): 85-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2466452&dopt=Abstract

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Management of female genital warts with an analog of imiquimod 2% in cream: a randomized, double-blind, placebo-controlled study. Author(s): Syed TA, Ahmadpour OA, Ahmad SA, Ahmad SH. Source: The Journal of Dermatology. 1998 July; 25(7): 429-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9714974&dopt=Abstract

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Modeling the impact of treatment options in genital warts: patient-applied versus physician-administered therapies. Author(s): Langley PC, Richwald GA, Smith MH. Source: Clinical Therapeutics. 1999 December; 21(12): 2143-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10645759&dopt=Abstract

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Modern management of genital warts in women. Author(s): Winning M. Source: Prof Care Mother Child. 1994 May; 4(4): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8680165&dopt=Abstract

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Molecular cloning of viral DNA from human genital warts. Author(s): de Villiers EM, Gissmann L, zur Hausen H. Source: Journal of Virology. 1981 December; 40(3): 932-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6275126&dopt=Abstract

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Most genital warts in children should be reported as possible sexual abuse. Author(s): Alexander RC, Schor DP. Source: Journal of the American Academy of Dermatology. 1985 September; 13(3): 525-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4056127&dopt=Abstract

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My choice: Natural history of genital warts. Author(s): Mindel A. Source: Sexually Transmitted Infections. 2000 June; 76 Suppl 1: S22-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10950608&dopt=Abstract

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Natural history of genital warts. Author(s): Oriel JD. Source: Br J Vener Dis. 1971 February; 47(1): 1-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5550858&dopt=Abstract

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Natural history of genital warts. 1971. Author(s): Oriel JD. Source: Sexually Transmitted Infections. 2000 June; 76 Suppl 1: S21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10911854&dopt=Abstract

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Optimum treatment of genital warts. Author(s): Eskelinen A, Mashkilleyson N. Source: Drugs. 1987 November; 34(5): 599-603. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3319492&dopt=Abstract

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Papanicolaou smears and genital warts. Author(s): Baird PJ. Source: The Medical Journal of Australia. 1986 October 20; 145(8): 428. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3762486&dopt=Abstract

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Papanicolaou smears and genital warts. Author(s): Evans MF. Source: The Medical Journal of Australia. 1986 July 21; 145(2): 119-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3736461&dopt=Abstract

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Papillomavirus-induced genital warts in a girl--management by surgery and immunomodulating therapy. Author(s): Trobs R, Metzner G, Friedrich T, Pustowoit B, Handrick W, Nestler I. Source: Pediatric Surgery International. 1998 April; 13(4): 301-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9553198&dopt=Abstract

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Partial characterization of viral DNA from human genital warts (Condylomata acuminata). Author(s): Gissmann L, zur Hausen H. Source: International Journal of Cancer. Journal International Du Cancer. 1980 May 15; 25(5): 605-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6246010&dopt=Abstract

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Patient-applied treatment for external genital warts: the time has come. Author(s): Beutner KR. Source: The Western Journal of Medicine. 1998 October; 169(4): 227-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9795590&dopt=Abstract

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Pediatric management problems: genital warts. Author(s): Wilk-Schank S. Source: Pediatric Nursing. 1991 March-April; 17(2): 186-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1852505&dopt=Abstract

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Penile resurfacing for extensive genital warts. Author(s): Ballaro A, Webster JJ, Ralph D. Source: International Journal of Impotence Research : Official Journal of the International Society for Impotence Research. 2001 February; 13(1): 47-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11313841&dopt=Abstract

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Perianal lymphangioma circumscriptum mistaken for genital warts. Author(s): Darmstadt GL. Source: Pediatrics. 1996 September; 98(3 Pt 1): 461-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784378&dopt=Abstract

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Phase I safety and antigenicity of TA-GW: a recombinant HPV6 L2E7 vaccine for the treatment of genital warts. Author(s): Thompson HS, Davies ML, Holding FP, Fallon RE, Mann AE, O'Neill T, Roberts JS. Source: Vaccine. 1999 January; 17(1): 40-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10078606&dopt=Abstract

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Phase IIa safety and immunogenicity of a therapeutic vaccine, TA-GW, in persons with genital warts. Author(s): Lacey CJ, Thompson HS, Monteiro EF, O'Neill T, Davies ML, Holding FP, Fallon RE, Roberts JS. Source: The Journal of Infectious Diseases. 1999 March; 179(3): 612-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9952367&dopt=Abstract

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Polymerase chain reaction for monitoring human papillomavirus contamination of medical personnel during treatment of genital warts with CO2 laser and electrocoagulation. Author(s): Bergbrant IM, Samuelsson L, Olofsson S, Jonassen F, Ricksten A. Source: Acta Dermato-Venereologica. 1994 September; 74(5): 393-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7817682&dopt=Abstract

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Presence of human papilloma virus types 16 and 18 in genital warts and cervical neoplasias. Author(s): Battista C, Hillova J, Hill M, Reynes M, Mathe G. Source: Med Oncol Tumor Pharmacother. 1988; 5(1): 1-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2835559&dopt=Abstract

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Prevalence of sexual abuse in children with genital warts. Author(s): Gutman LT, St Claire K, Herman-Giddens ME. Source: The Pediatric Infectious Disease Journal. 1991 April; 10(4): 342-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1648200&dopt=Abstract

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Preventing cervical cancer by treating genital warts in men. Why male sex partners need androscopy. Author(s): Epperson WJ. Source: Postgraduate Medicine. 1990 October; 88(5): 229-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1699215&dopt=Abstract

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Preventing the spread of genital warts: using fear appeals to promote self-protective behaviors. Author(s): Witte K, Berkowitz JM, Cameron KA, McKeon JK. Source: Health Education & Behavior : the Official Publication of the Society for Public Health Education. 1998 October; 25(5): 571-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9768378&dopt=Abstract

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Prevention and therapy of genital warts. Author(s): Eron LJ. Source: Compr Ther. 1988 November; 14(11): 7-11. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3067966&dopt=Abstract

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Recombinant interferon beta gel as an adjuvant in the treatment of recurrent genital warts: results of a placebo-controlled double-blind study in 120 patients. Author(s): Gross G, Rogozinski T, Schofer H, Jablonska S, Roussaki A, Wohr C, Brzoska J. Source: Dermatology (Basel, Switzerland). 1998; 196(3): 330-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9621141&dopt=Abstract

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Recurrent respiratory papillomatosis with pulmonary cystic disease in a child, following maternal genital warts. Author(s): Sadikot RT, Andrew AC, Wilson JD, Arnold AG. Source: Genitourinary Medicine. 1997 February; 73(1): 63-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9155559&dopt=Abstract

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Reduction of cell mediated immunity in patients with genital warts of long duration. Author(s): Avgerinou G, Georgala S, Theodoridis A, Vareltzdis A, Stratigos J. Source: Genitourinary Medicine. 1986 December; 62(6): 396-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3817815&dopt=Abstract

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Relapses after treatment of external genital warts are more frequent in HIV-positive patients than in HIV-negative controls. Author(s): De Panfilis G, Melzani G, Mori G, Ghidini A, Graifemberghi S. Source: Sexually Transmitted Diseases. 2002 March; 29(3): 121-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11875372&dopt=Abstract

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Relation of p53 tumor suppressor protein expression to human papillomavirus (HPV) DNA and to cellular atypia in male genital warts and in premalignant lesions. Author(s): Ranki A, Lassus J, Niemi KM. Source: Acta Dermato-Venereologica. 1995 May; 75(3): 180-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7653176&dopt=Abstract

40 Genital Warts

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Risk factors associated with genital warts in HIV-positive Brazilian women. Author(s): Goncalves MA, Burattini MN, Donadi EA, Massad E. Source: Tumori. 2003 January-February; 89(1): 9-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729354&dopt=Abstract

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Risk factors for the acquisition of genital warts: are condoms protective? Author(s): Wen LM, Estcourt CS, Simpson JM, Mindel A. Source: Sexually Transmitted Infections. 1999 October; 75(5): 312-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10616354&dopt=Abstract

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Safety and efficacy of imiquimod 5% cream in the treatment of penile genital warts in uncircumcised men when applied three times weekly or once per day. Author(s): Gollnick H, Barasso R, Jappe U, Ward K, Eul A, Carey-Yard M, Milde K. Source: International Journal of Std & Aids. 2001 January; 12(1): 22-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11177478&dopt=Abstract

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Specific immunity to human papilloma virus (HPV) in patients with genital warts. Author(s): Viac J, Staquet MJ, Miguet M, Chabanon M, Thivolet J. Source: Br J Vener Dis. 1978 June; 54(3): 172-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=207383&dopt=Abstract

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Systemic interferon alpha-2b increases the cure rate in laser treated patients with multiple persistent genital warts: a placebo-controlled study. Author(s): Petersen CS, Bjerring P, Larsen J, Blaakaer J, Hagdrup H, From E, Obergaard L. Source: Genitourinary Medicine. 1991 April; 67(2): 99-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2032716&dopt=Abstract

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Testing the effectiveness of cryosurgery for genital warts in men. Author(s): Green AN, Smith NH, Balsdon MJ. Source: Nurs Mirror. 1978 September 21; 147(12): 26-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=250056&dopt=Abstract

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The cellular immune system in female patients with or without genital warts: a study of peripheral white blood cell components. Author(s): Opaneye AA. Source: International Journal of Std & Aids. 1999 December; 10(12): 815-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10639064&dopt=Abstract

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The health and economic burden of genital warts in a set of private health plans in the United States. Author(s): Insinga RP, Dasbach EJ, Myers ER. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 June 1; 36(11): 1397-403. Epub 2003 May 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766834&dopt=Abstract

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The impact of HIV infection and immunodeficiency on human papillomavirus type 6 or 11 infection and on genital warts. Author(s): Silverberg MJ, Ahdieh L, Munoz A, Anastos K, Burk RD, Cu-Uvin S, Duerr A, Greenblatt RM, Klein RS, Massad S, Minkoff H, Muderspach L, Palefsky J, Piessens E, Schuman P, Watts H, Shah KV. Source: Sexually Transmitted Diseases. 2002 August; 29(8): 427-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172526&dopt=Abstract

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The investigation of patients with genital warts. Author(s): Fairris GM, Statham BN, Waugh MA. Source: The British Journal of Dermatology. 1984 December; 111(6): 736-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6548927&dopt=Abstract

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The patient with refractory genital warts in the STD-clinic. Treatment failure with CO2-laser. Author(s): Larsen J, Petersen CS. Source: Dan Med Bull. 1990 April; 37(2): 194-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2111758&dopt=Abstract

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The subtypes, distribution and location of human papillomavirus DNA in genital warts and genital Bowen's disease--a study using in situ DNA.DNA hybridization. Author(s): Jee SH, Chen Y, Chang SF, Ho SW, Wu YC, Wen WN, Lu YC. Source: Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi. 1989 November; 22(4): 267-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2561558&dopt=Abstract

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The therapy of genital warts. Author(s): Dinsmore WW. Source: J Clin Hosp Pharm. 1986 December; 11(6): 381-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3029181&dopt=Abstract

42 Genital Warts

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The use of EMLA cream and 1% lidocaine infiltration in men for relief of pain associated with the removal of genital warts by cryotherapy. Author(s): Menter A, Black-Noller G, Riendeau LA, Monti KL. Source: Journal of the American Academy of Dermatology. 1997 July; 37(1): 96-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9216530&dopt=Abstract

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Therapy for genital warts. Author(s): Greene I. Source: Dermatologic Clinics. 1992 January; 10(1): 253-67. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1730171&dopt=Abstract

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Thymopentin treatment in genital warts of long duration. Author(s): Fransen L, Anthoons J, Hoogewijs G, Bolla K. Source: Cancer Detection and Prevention. 1988; 12(1-6): 503-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3052838&dopt=Abstract

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Thymus derived lymphocytes (T cells) in patients with genital warts. Author(s): Mohanty KC, Roy RB. Source: Br J Vener Dis. 1984 June; 60(3): 186-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6610454&dopt=Abstract

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Tolerance and efficacy of recombinant human interferon gamma in the treatment of refractory genital warts. Author(s): Kirby PK, Kiviat N, Beckman A, Wells D, Sherwin S, Corey L. Source: The American Journal of Medicine. 1988 August; 85(2): 183-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2840824&dopt=Abstract

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Topical anaesthesia with local anaesthetic (lidocaine and prilocaine, EMLA) cream for cautery of genital warts. Author(s): Hallen A, Ljunghall K, Wallin J. Source: Genitourinary Medicine. 1987 October; 63(5): 316-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3315960&dopt=Abstract

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Topical idoxuridine for treatment of genital warts in males. A double-blind comparative study of 0.25% and 0.5% cream. Author(s): Happonen HP, Lassus A, Santalahti J, Forsstrom S, Lassus J. Source: Genitourinary Medicine. 1990 August; 66(4): 254-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2202655&dopt=Abstract

Studies 43

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Topical imiquimod: a review of its use in genital warts. Author(s): Perry CM, Lamb HM. Source: Drugs. 1999 August; 58(2): 375-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10473026&dopt=Abstract

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Traditional therapies for the treatment of condylomata acuminata (genital warts). Author(s): Jablonska S. Source: The Australasian Journal of Dermatology. 1998 November; 39 Suppl 1: S2-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9842092&dopt=Abstract

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Treatment of external genital warts comparing cryotherapy (liquid nitrogen) and trichloroacetic acid. Author(s): Abdullah AN, Walzman M, Wade A. Source: Sexually Transmitted Diseases. 1993 November-December; 20(6): 344-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8108758&dopt=Abstract

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Treatment of external genital warts in men using 5% imiquimod cream applied three times a week, once daily, twice daily, or three times a day. Author(s): Fife KH, Ferenczy A, Douglas JM Jr, Brown DR, Smith M, Owens ML; HPV Study Group. Source: Sexually Transmitted Diseases. 2001 April; 28(4): 226-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11318254&dopt=Abstract

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Treatment of external genital warts in men with imiquimod 2% in cream. A placebocontrolled, double-blind study. Author(s): Syed TA, Hadi SM, Qureshi ZA, Ali SM, Kwah MS. Source: The Journal of Infection. 2000 September; 41(2): 148-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11023759&dopt=Abstract

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Treatment of genital warts - what's the evidence? Author(s): Wilson J. Source: International Journal of Std & Aids. 2002 April; 13(4): 216-20; Quiz 221-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886604&dopt=Abstract

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Treatment of genital warts by cryosurgery--a follow-up study. Author(s): Ong TK, Ng CS, Ratnam SS. Source: Ann Acad Med Singapore. 1980 July; 9(3): 396-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7212624&dopt=Abstract

44 Genital Warts

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Treatment of genital warts with an immune-response modifier (imiquimod). Author(s): Beutner KR, Spruance SL, Hougham AJ, Fox TL, Owens ML, Douglas JM Jr. Source: Journal of the American Academy of Dermatology. 1998 February; 38(2 Pt 1): 230-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9486679&dopt=Abstract

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Treatment vs. nontreatment of asymptomatic genital warts. Author(s): Ambrose DN. Source: American Family Physician. 1996 July; 54(1): 59, 62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8677851&dopt=Abstract

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Typing and molecular characterization of human papillomaviruses in genital warts from South African women. Author(s): Johnson JE, Dehaeck CM, Soeters R, Williamson AL. Source: Journal of Medical Virology. 1991 January; 33(1): 39-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1849982&dopt=Abstract

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Use of human papillomavirus type 6 capsids to detect antibodies in people with genital warts. Author(s): Carter JJ, Wipf GC, Hagensee ME, McKnight B, Habel LA, Lee SK, Kuypers J, Kiviat N, Daling JR, Koutsky LA, et al. Source: The Journal of Infectious Diseases. 1995 July; 172(1): 11-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7797899&dopt=Abstract

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Validity of self-reporting of episodes of external genital warts. Author(s): Wiley DJ, Grosser S, Qi K, Visscher BR, Beutner K, Strathdee SA, Calhoun B, Palella F, Detels R; Multicenter AIDS Cohort Study Group. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 July 1; 35(1): 39-45. Epub 2002 June 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060873&dopt=Abstract

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Viral sequences related to a human skin papillomavirus in genital warts. Author(s): Orth G, Favre M, Jablonska S, Brylak K, Croissant O. Source: Nature. 1978 September 28; 275(5678): 334-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=211432&dopt=Abstract

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Virus in genital warts. Author(s): Ogilvie MM. Source: British Medical Journal. 1970 January 10; 1(688): 113. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4312427&dopt=Abstract

Studies 45

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Virus that causes genital warts may also cause cervical cancer. Author(s): Mocsny N. Source: J Pract Nurs. 1992 December; 42(4): 46-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1335072&dopt=Abstract

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Vulval neurofibromatosis masquerading as genital warts. Author(s): Singh G, Wijesurendra CS, Sparks RA. Source: International Journal of Std & Aids. 1992 September-October; 3(5): 369-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1391068&dopt=Abstract

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Vulvar carcinoma in young patients and its relationship with genital warts. Author(s): Traiman P, Bacchi CE, De Luca LA, Uemura G, Nahas Neto J, Nahas EA, Pontes A. Source: Eur J Gynaecol Oncol. 1999; 20(3): 191-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10410883&dopt=Abstract

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What advice is given to patients with a new diagnosis of genital warts? Author(s): Pritchard H, Robinson AJ. Source: International Journal of Std & Aids. 1998 April; 9(4): 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9598756&dopt=Abstract

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CHAPTER 2. NUTRITION AND GENITAL WARTS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and genital warts.

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

7

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

48 Genital Warts

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

A double-blind, randomized trial of 0.5% podofilox and placebo for the treatment of genital warts in women. Author(s): Department of Obstetrics and Gynecology, Sinai Hospital, Detroit, Michigan. Source: Greenberg, M D Rutledge, L H Reid, R Berman, N R Precop, S L Elswick, R K Obstet-Gynecol. 1991 May; 77(5): 735-9 0029-7844

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A single-blind study of podophyllotoxin cream 0.5% and podophyllotoxin solution 0.5% in male patients with genital warts. Author(s): Department of Dermato-venereology, Gentofte Hospital, University of Copenhagen, Denmark. Source: Petersen, C S Agner, T Ottevanger, V Larsen, J Ravnborg, L Genitourin-Med. 1995 December; 71(6): 391-2 0266-4348

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An audit of treatment of genital warts: opening the feedback loop. Author(s): Department of Genitourinary Medicine, Leeds General Infirmary. Source: Reynolds, M Murphy, M Waugh, M A Lacey, C J Int-J-STD-AIDS. 1993 Jul-Aug; 4(4): 226-31 0956-4624

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Audits of the treatment of genital warts: closing the feedback loop. Author(s): Department of Genitourinary Medicine, Leeds General Infirmary, UK. Source: Reynolds, M Fraser, P A Lacey, C J Int-J-STD-AIDS. 1996 Aug-September; 7(5): 347-52 0956-4624

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Chromosomal changes in Chinese hamster AA8 cells caused by podophyllin, a common treatment for genital warts. Author(s): Cancer Research Laboratory, University of Auckland Medical School, New Zealand. Source: Ferguson, L R Pearson, A Mutat-Res. 1992 April; 266(2): 231-9 0027-5107

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Combination of laser-therapy with 0.5% idoxuridine cream in the treatment of therapy-resistant genital warts in male patients: an open study. Author(s): Out-Patient Department of Venereology, University Central Hospital, Helsinki, Finland. Source: Happonen, H P Lassus, A Santalahti, J Forsstrom, S Lassus, J Sex-Transm-Dis. 1990 Jul-September; 17(3): 127-9 0148-5717

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Current status of podophyllotoxin for the treatment of genital warts. Author(s): Department of Dermatology, University of California, San Francisco. Source: Beutner, K R von Krogh, G Semin-Dermatol. 1990 June; 9(2): 148-51 0278-145X

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Detection with the polymerase chain reaction of human papillomavirus DNA in condylomata acuminata treated in vitro with liquid nitrogen, trichloroacetic acid, and podophyllin. Author(s): Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL. Source: Zhu, W Y Blauvelt, A Goldstein, B A Leonardi, C Penneys, N S J-Am-AcadDermatol. 1992 May; 26(5 Pt 1): 710-4 0190-9622

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Diet and genital warts: a case-control study. Author(s): Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington 98104. Source: Bairati, I Sherman, K J McKnight, B Habel, L A Van den Eeden, S K Stergachis, A Daling, J R Sex-Transm-Dis. 1994 May-June; 21(3): 149-54 0148-5717

Nutrition 49

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Double-blind randomized clinical trial of self-administered podofilox solution versus vehicle in the treatment of genital warts. Author(s): Department of Medicine, Harborview Medical Center, University of Washington, Seattle. Source: Kirby, P Dunne, A King, D H Corey, L Am-J-Med. 1990 May; 88(5): 465-9 00029343

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Efficacy and safety of 0.5% podofilox solution in the treatment and suppression of anogenital warts. Author(s): Department of Medicine, University of Rochester School of Medicine and Dentistry, New York. Source: Bonnez, W Elswick, R K Bailey Farchione, A Hallahan, D Bell, R Isenberg, R Stoler, M H Reichman, R C Am-J-Med. 1994 May; 96(5): 420-5 0002-9343

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External genital warts: diagnosis, treatment, and prevention. Author(s): Division of Primary Care, School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095-6919, USA. [email protected] Source: Wiley, D J Douglas, J Beutner, K Cox, T Fife, K Moscicki, A B Fukumoto, L ClinInfect-Dis. 2002 October 15; 35(Suppl 2): S210-24 1537-6591

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Factors involved in clearance of genital warts. Author(s): Department of Genitourinary Medicine, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK. Source: Wilson, J D Brown, C B Walker, P P Int-J-STD-AIDS. 2001 December; 12(12): 78992 0956-4624

•

Genital warts. Author(s): Department of Pediatric Infectious Diseases, Arkansas Children's Hospital and the University of Arkansas for Medical Sciences, Little Rock, AR, USA. Source: Darville, T Pediatr-Revolume 1999 August; 20(8): 271-2 0191-9601

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Genital warts--therapy. Author(s): Department of Dermatology, Beth Israel Medical Center, New York, NY. Source: Kling, A R Semin-Dermatol. 1992 September; 11(3): 247-55 0278-145X

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Human leukocyte interferon-alpha versus podophyllotoxin in cream for the treatment of genital warts in males. A placebo-controlled, double-blind, comparative study. Author(s): Department of Clinical Physiology, University Hospital Malmo, Sweden. Source: Syed, T A Cheema, K M Khayyami, M Ahmad, S A Ahmad, S H Ahmad, S Ahmad, S A Dermatology. 1995; 191(2): 129-32 1018-8665

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Human papillomavirus infection and genital warts: update on epidemiology and treatment. Author(s): Division of STD/HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. Source: Stone, K M Clin-Infect-Dis. 1995 April; 20 Suppl 1S91-7 1058-4838

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Immunotherapy of genital warts with inosine pranobex and conventional treatment: double blind placebo controlled study. Author(s): Prince of Wales's Hospital, London. Source: Davidson Parker, J Dinsmore, W Khan, M H Hicks, D A Morris, C A Morris, D F Genitourin-Med. 1988 December; 64(6): 383-6 0266-4348

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Interferon for treatment of genital warts. Source: Anonymous Med-Lett-Drugs-Ther. 1988 July 15; 30(770): 70-2 0025-732X

50 Genital Warts

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Issues and practicalities of treating genital warts in the community. Proceedings of a round table meeting facilitated by Succinct Communications Limited. Source: Anonymous Int-J-STD-AIDS. 2001; 12 Suppl 1: 1-8 0956-4624

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Management of genital warts in women with human leukocyte interferon-alpha vs. podophyllotoxin in cream: a placebo-controlled, double-blind, comparative study. Author(s): Department of Clinical Physiology, University Hosptial Malmo, University of Lund, Sweden. Source: Syed, T A Khayyami, M Kriz, D Svanberg, K Kahlon, R C Ahmad, S A Ahmad, S A J-Mol-Med. 1995 May; 73(5): 255-8 0946-2716

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Modern management of genital warts in women. Source: Winning, M Prof-Care-Mother-Child. 1994 May; 4(4): 105-8 0964-4156

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New therapies for the treatment of genital warts. Source: Barton, S Worlidge, P Nurs-Times. 1994 May 18-24; 90(20): 38-40 0954-7762

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New treatments for genital warts less than ideal: abstract and commentary. Author(s): Department of Medicine, Indiana University School of Medicine, Indianapolis, USA. [email protected] Source: Fife, K H JAMA. 1998 June 24; 279(24): 2003-4 0098-7484

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Patient-applied podofilox for treatment of genital warts. Author(s): Department of Dermatology, University of California, San Francisco. Source: Beutner, K R Conant, M A Friedman Kien, A E Illeman, M Artman, N N Thisted, R A King, D H Lancet. 1989 April 15; 1(8642): 831-4 0140-6736

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Patients with genital warts: how are they managed by general practitioners? Author(s): Department of Genitourinary Medicine, Manchester Royal Infirmary, UK. Source: Estcourt, C S Higgins, S P Hall, J Hillier, V F Chandiok, S Woolley, P D Int-JSTD-AIDS. 1996 May-June; 7(3): 221-3 0956-4624

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Podofilox for genital warts. Source: Anonymous Med-Lett-Drugs-Ther. 1991 December 13; 33(859): 117-8 0025-732X

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Podophyllin versus scissor excision in the treatment of perianal condylomata acuminata: a prospective study. Author(s): Department of Surgery, St. Mary's Hospital, Portsmouth, UK. Source: Khawaja, H T Br-J-Surg. 1989 October; 76(10): 1067-8 0007-1323

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Podophyllotoxin in the treatment of genital warts. Author(s): University of California, San Francisco, USA. Source: Beutner, K R Curr-Probl-Dermatol. 1996; 24227-32 0070-2064

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Response to podophyllotoxin treatment of genital warts in relation to HIV-1 infection among patients in Dar es Salaam, Tanzania. Author(s): Department of Obstetrics/Gynaecology, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. Source: Kilewo, C D Urassa, W K Pallangyo, K Mhalu, F Biberfeld, G Wigzell, H Int-JSTD-AIDS. 1995 Mar-April; 6(2): 114-6 0956-4624

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Safety and efficacy of 0.5% podofilox gel in the treatment of anogenital warts. Author(s): Department of Dermatology and Microbiology, University of Texas Medical Branch, Galveston 77555, USA. Source: Tyring, S Edwards, L Cherry, L K Ramsdell, W M Kotner, S Greenberg, M D Vance, J C Barnum, G Dromgoole, S H Killey, F P Toter, T Arch-Dermatol. 1998 January; 134(1): 33-8 0003-987X

Nutrition 51

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Scissor excision plus electrocautery of anogenital warts in prepubertal children. Author(s): Department of Genitourinary Medicine, Royal Victoria Hospital, Belfast, Northern Ireland. Source: Handley, J M Maw, R D Horner, T Lawther, H Bingham, E A Dinsmore, W W Pediatr-Dermatol. 1991 September; 8(3): 243-5, 248-9 0736-8046

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Self-treatment of female external genital warts with 0.5% podophyllotoxin cream (Condyline) vs weekly applications of 20% podophyllin solution. Author(s): Department of Obstetrics and Gynecology, Falun Hospital, Sweden. Source: Hellberg, D Svarrer, T Nilsson, S Valentin, J Int-J-STD-AIDS. 1995 Jul-August; 6(4): 257-61 0956-4624

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Synthetic oligonucleotide probes for the detection of human papilloma viruses by in situ hybridisation. Author(s): Department of Bacteriology, University of Edinburgh Medical School, U.K. Source: Cubie, H A Norval, M J-Virol-Methods. 1988 July; 20(3): 239-49 0166-0934

•

The cost effectiveness of patient-applied versus provider-administered intervention strategies for the treatment of external genital warts. Author(s): University of Colorado Health Sciences Center, Denver, USA. [email protected] Source: Langley, P C Tyring, S K Smith, M H Am-J-Manag-Care. 1999 January; 5(1): 6977 1096-1860

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The cost effectiveness of treatment of genital warts with podophyllotoxin. Author(s): Department of Genitourinary Medicine, St Luke's Hospital, Bradford, West Yorkshire, UK. Source: Mohanty, K C Int-J-STD-AIDS. 1994 Jul-August; 5(4): 253-6 0956-4624

•

The cost of treating genital warts. Author(s): Health Technology Associates, Inc., Washington, District of Columbia 20005, USA. Source: Strauss, M J Khanna, V Koenig, J D Downs, S M Goldberg, S H Manyak, M J Patsner, B Int-J-Dermatol. 1996 May; 35(5): 340-8 0011-9059

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The epidemiology and treatment of anogenital warts in Singapore: a retrospective evaluation. Author(s): National Skin Centre, 1 Mandalay Road, Singapore 308205. Source: Chan, Y C Ng, K Y Chan, R K Ann-Acad-Med-Singapore. 2002 July; 31(4): 502-8 0304-4602

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The treatment of anogenital warts at home. Author(s): Chester Hospital NHS Trust. Source: Pleavin, M Nurs-Times. 2001 February 8-14; 97(6): 37-8 0954-7762

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Therapeutic approaches to genital warts. Author(s): Department of Dermatology, University of California at San Francisco, USA. Source: Beutner, K R Ferenczy, A Am-J-Med. 1997 May 5; 102(5A): 28-37 0002-9343

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Thymopentin treatment in genital warts of long duration. Author(s): Department of Microbiology and Anatomopathology, Institute of Tropical Medicine, Antwerp, Belgium. Source: Fransen, L Anthoons, J Hoogewijs, G Bolla, K Cancer-Detect-Prevolume 1988; 12(1-6): 503-9 0361-090X

52 Genital Warts

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Topical 0.3% and 0.5% podophyllotoxin cream for self-treatment of condylomata acuminata in women. A placebo-controlled, double-blind study. Author(s): Department of Clinical Physiology, Malmo General Hospital, University of Lund, Sweden. Source: Syed, T A Lundin, S Ahmad, S A Dermatology. 1994; 189(2): 142-5 1018-8665

•

Topical imiquimod: a review of its use in genital warts. Author(s): Adis International Limited, Auckland, New Zealand. [email protected] Source: Perry, C M Lamb, H M Drugs. 1999 August; 58(2): 375-90 0012-6667

•

Topical podofilox for the treatment of condylomata acuminata in women. Author(s): Department of Obstetrics and Gynecology, SUNY, Stony Brook 11794. Source: Baker, D A Douglas, J M Buntin, D M Micha, J P Beutner, K R Patsner, B ObstetGynecol. 1990 October; 76(4): 656-9 0029-7844

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Topical treatment of genital warts in men, an open study of podophyllotoxin cream compared with solution. Author(s): Department of Dermatology and Venereology, University Hospital, Uppsala, Sweden. Source: Strand, A Brinkeborn, R M Siboulet, A Genitourin-Med. 1995 December; 71(6): 387-90 0266-4348

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Traditional therapies for the treatment of condylomata acuminata (genital warts). Author(s): Department of Dermatology, Warsaw School of Medicine, Warsaw Medical Academy, Poland. Source: Jablonska, S Australas-J-Dermatol. 1998 November; 39 Suppl 1S2-4 0004-8380

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Treatment of external genital warts: a randomised clinical trial comparing podophyllin, cryotherapy, and electrodesiccation. Author(s): Division of Sexually Transmitted Diseases Centers for Disease Control, Atlanta, Georgia. Source: Stone, K M Becker, T M Hadgu, A Kraus, S J Genitourin-Med. 1990 February; 66(1): 16-9 0266-4348

•

What is the most effective treatment for external genital warts? Author(s): Department of Family Practice, Michigan State University, East Lansing, MI, USA. Source: French, Linda Nashelsky, Joan White, David J-Fam-Pract. 2002 April; 51(4): 313 0094-3509

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

Nutrition 53

•

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/

•

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

•

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

•

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

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CHAPTER 3. ALTERNATIVE MEDICINE AND GENITAL WARTS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to genital warts. At the conclusion of this chapter, we will provide additional sources.

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

A double-blind, randomized trial of 0.5% podofilox and placebo for the treatment of genital warts in women. Author(s): Greenberg MD, Rutledge LH, Reid R, Berman NR, Precop SL, Elswick RK Jr. Source: Obstetrics and Gynecology. 1991 May; 77(5): 735-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2014088&dopt=Abstract

•

A randomized trial of combination therapy with intralesional interferon alpha 2b and podophyllin versus podophyllin alone for the therapy of anogenital warts. Author(s): Douglas JM Jr, Eron LJ, Judson FN, Rogers M, Alder MB, Taylor E, Tanner D, Peets E. Source: The Journal of Infectious Diseases. 1990 July; 162(1): 52-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2192011&dopt=Abstract

56 Genital Warts

•

A review of outpatient management of female genital warts. Author(s): Jenkins HM, Riley VC. Source: Br J Clin Pract. 1980 October; 34(10): 273-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7459192&dopt=Abstract

•

A single-blind study of podophyllotoxin cream 0.5% and podophyllotoxin solution 0.5% in male patients with genital warts. Author(s): Petersen CS, Agner T, Ottevanger V, Larsen J, Ravnborg L. Source: Genitourinary Medicine. 1995 December; 71(6): 391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8566980&dopt=Abstract

•

ABC of sexually transmitted diseases. Genital warts and molluscum contagiosum. Author(s): Adler MW. Source: British Medical Journal (Clinical Research Ed.). 1984 January 21; 288(6412): 213-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6419862&dopt=Abstract

•

An audit of treatment of genital warts: opening the feedback loop. Author(s): Reynolds M, Murphy M, Waugh MA, Lacey CJ. Source: International Journal of Std & Aids. 1993 July-August; 4(4): 226-31. Erratum In: Int J Std Aids 1993 November-December; 4(6): 366. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399504&dopt=Abstract

•

Anogenital warts in patients attending the sexually transmitted diseases clinic in Ibadan, Nigeria. Author(s): Ekweozor CC, Adeyemi-Doro FA, Ashiru JO, Osoba AO. Source: Afr J Med Med Sci. 1994 December; 23(4): 311-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7653396&dopt=Abstract

•

Anogenital warts. Author(s): Blake RS. Source: The Medical Journal of Australia. 1997 June 2; 166(11): 615. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9201192&dopt=Abstract

•

Autoimplantation technique in the treatment of anogenital warts: a clinicoimmunological study. Author(s): Usman N, Udayashankar K, Subramanian S, Thyagarajan SP. Source: International Journal of Std & Aids. 1996 January-February; 7(1): 55-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8652714&dopt=Abstract

•

Chromosomal changes in Chinese hamster AA8 cells caused by podophyllin, a common treatment for genital warts. Author(s): Ferguson LR, Pearson A.

Alternative Medicine 57

Source: Mutation Research. 1992 April; 266(2): 231-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1373833&dopt=Abstract •

Comparison of podophyllotoxin and podophyllin in treatment of genital warts. Author(s): Lassus A. Source: Lancet. 1987 August 29; 2(8557): 512-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2887805&dopt=Abstract

•

Comparison of women with cervical human papillomavirus infection and genital warts. I. Some behavioural factors and clinical findings. Author(s): Hellberg D, Borendal N, Sikstrom B, Nilsson S, Mardh PA. Source: Genitourinary Medicine. 1995 April; 71(2): 88-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7744420&dopt=Abstract

•

Condylomata acuminata (anogenital warts). Author(s): Lynch PJ. Source: Clinical Obstetrics and Gynecology. 1985 March; 28(1): 142-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3886245&dopt=Abstract

•

Cryosurgery of genital warts in cases in which podophyllin treatment failed or was contraindicated. Author(s): Ghosh AK. Source: Br J Vener Dis. 1977 February; 53(1): 49-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=843897&dopt=Abstract

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Cryotherapy versus podophyllin in the treatment of genital warts. Author(s): Bashi SA. Source: International Journal of Dermatology. 1985 October; 24(8): 535-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4066094&dopt=Abstract

•

Current status of podophyllotoxin for the treatment of genital warts. Author(s): Beutner KR, von Krogh G. Source: Semin Dermatol. 1990 June; 9(2): 148-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2202410&dopt=Abstract

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Double-blind randomized clinical trial of self-administered podofilox solution versus vehicle in the treatment of genital warts. Author(s): Kirby P, Dunne A, King DH, Corey L. Source: The American Journal of Medicine. 1990 May; 88(5): 465-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2186623&dopt=Abstract

58 Genital Warts

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Efficacy and safety of 0.5% podofilox solution in the treatment and suppression of anogenital warts. Author(s): Bonnez W, Elswick RK Jr, Bailey-Farchione A, Hallahan D, Bell R, Isenberg R, Stoler MH, Reichman RC. Source: The American Journal of Medicine. 1994 May; 96(5): 420-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8192173&dopt=Abstract

•

External genital warts: diagnosis, treatment, and prevention. Author(s): Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB, Fukumoto L. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 October 15; 35(Suppl 2): S210-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353208&dopt=Abstract

•

Factors involved in clearance of genital warts. Author(s): Wilson JD, Brown CB, Walker PP. Source: International Journal of Std & Aids. 2001 December; 12(12): 789-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779368&dopt=Abstract

•

Genital warts in children. Author(s): Stringel G, Spence J, Corsini L. Source: Can Med Assoc J. 1985 June 15; 132(12): 1397-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4005728&dopt=Abstract

•

Genital warts. Author(s): Darville T. Source: Pediatrics in Review / American Academy of Pediatrics. 1999 August; 20(8): 271-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10429146&dopt=Abstract

•

Genital warts. Author(s): Catterall RD. Source: Practitioner. 1969 July; 202(213): 69. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5801945&dopt=Abstract

•

Genital warts-recent advances. Author(s): Oriel JD. Source: Clinical and Experimental Dermatology. 1982 July; 7(4): 361-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7127885&dopt=Abstract

•

Genital warts--therapy. Author(s): Kling AR.

Alternative Medicine 59

Source: Semin Dermatol. 1992 September; 11(3): 247-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1327058&dopt=Abstract •

Human leukocyte interferon-alpha versus podophyllotoxin in cream for the treatment of genital warts in males. A placebo-controlled, double-blind, comparative study. Author(s): Syed TA, Cheema KM, Khayyami M, Ahmad SA, Ahmad SH, Ahmad S, Ahmad SA. Source: Dermatology (Basel, Switzerland). 1995; 191(2): 129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8520059&dopt=Abstract

•

Human papillomavirus infection and genital warts: update on epidemiology and treatment. Author(s): Stone KM. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1995 April; 20 Suppl 1: S91-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7540876&dopt=Abstract

•

Immunotherapy of genital warts with inosine pranobex (Imunovir): preliminary study. Author(s): Mohanty KC, Scott CS. Source: Genitourinary Medicine. 1986 October; 62(5): 352-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2429908&dopt=Abstract

•

Immunotherapy of genital warts with inosine pranobex and conventional treatment: double blind placebo controlled study. Author(s): Davidson-Parker J, Dinsmore W, Khan MH, Hicks DA, Morris CA, Morris DF. Source: Genitourinary Medicine. 1988 December; 64(6): 383-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2465265&dopt=Abstract

•

Is self application of podophyllin an acceptable treatment of genital warts in men? Author(s): O'Mahony C, Coker D. Source: Genitourinary Medicine. 1989 January; 65(1): 61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2921056&dopt=Abstract

•

Management of anogenital warts (condylomata acuminata). Author(s): von Krogh G. Source: Eur J Dermatol. 2001 November-December; 11(6): 598-603; Quiz 604. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11701422&dopt=Abstract

•

Management of genital warts in women with human leukocyte interferon-alpha vs. podophyllotoxin in cream: a placebo-controlled, double-blind, comparative study.

60 Genital Warts

Author(s): Syed TA, Khayyami M, Kriz D, Svanberg K, Kahlon RC, Ahmad SA, Ahmad SA. Source: Journal of Molecular Medicine (Berlin, Germany). 1995 May; 73(5): 255-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7670929&dopt=Abstract •

New therapies for the treatment of genital warts. Author(s): Barton S, Worlidge P. Source: Nurs Times. 1994 May 18-24; 90(20): 38-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8008579&dopt=Abstract

•

New treatments for genital warts less than ideal: abstract and commentary. Author(s): Fife KH. Source: Jama : the Journal of the American Medical Association. 1998 June 24; 279(24): 2003-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9643868&dopt=Abstract

•

Patient-applied podofilox for treatment of genital warts. Author(s): Beutner KR, Conant MA, Friedman-Kien AE, Illeman M, Artman NN, Thisted RA, King DH. Source: Lancet. 1989 April 15; 1(8642): 831-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2564912&dopt=Abstract

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Patients with genital warts: how are they managed by general practitioners? Author(s): Estcourt CS, Higgins SP, Hall J, Hillier VF, Chandiok S, Woolley PD. Source: International Journal of Std & Aids. 1996 May-June; 7(3): 221-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8799786&dopt=Abstract

•

Podophyllotoxin in the treatment of genital warts. Author(s): Beutner KR. Source: Current Problems in Dermatology. 1996; 24: 227-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8743274&dopt=Abstract

•

Randomised controlled trial and economic evaluation of podophyllotoxin solution, podophyllotoxin cream, and podophyllin in the treatment of genital warts. Author(s): Lacey CJ, Goodall RL, Tennvall GR, Maw R, Kinghorn GR, Fisk PG, Barton S, Byren I; Perstop Pharma Genital Warts Clinical Trial Group. Source: Sexually Transmitted Infections. 2003 August; 79(4): 270-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902571&dopt=Abstract

•

Response to podophyllotoxin treatment of genital warts in relation to HIV-1 infection among patients in Dar es Salaam, Tanzania. Author(s): Kilewo CD, Urassa WK, Pallangyo K, Mhalu F, Biberfeld G, Wigzell H.

Alternative Medicine 61

Source: International Journal of Std & Aids. 1995 March-April; 6(2): 114-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7779923&dopt=Abstract •

Safety and efficacy of 0.5% podofilox gel in the treatment of anogenital warts. Author(s): Tyring S, Edwards L, Cherry LK, Ramsdell WM, Kotner S, Greenberg MD, Vance JC, Barnum G, Dromgoole SH, Killey FP, Toter T. Source: Archives of Dermatology. 1998 January; 134(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9449907&dopt=Abstract

•

Self-treatment of female external genital warts with 0.5% podophyllotoxin cream (Condyline) vs weekly applications of 20% podophyllin solution. Author(s): Hellberg D, Svarrer T, Nilsson S, Valentin J. Source: International Journal of Std & Aids. 1995 July-August; 6(4): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7548288&dopt=Abstract

•

The cost effectiveness of hospital-based 25% podophyllin vs home-based 0.5% podophyllotoxin in the treatment of anogenital warts. Author(s): Lewis DA, Goldmeier D. Source: International Journal of Std & Aids. 1995 May-June; 6(3): 224-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7647132&dopt=Abstract

•

The cost effectiveness of patient-applied versus provider-administered intervention strategies for the treatment of external genital warts. Author(s): Langley PC, Tyring SK, Smith MH. Source: Am J Manag Care. 1999 January; 5(1): 69-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10345969&dopt=Abstract

•

The cost effectiveness of treatment of genital warts with podophyllotoxin. Author(s): Mohanty KC. Source: International Journal of Std & Aids. 1994 July-August; 5(4): 253-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7948154&dopt=Abstract

•

The cost of treating genital warts. Author(s): Strauss MJ, Khanna V, Koenig JD, Downs SM, Goldberg SH, Manyak MJ, Patsner B. Source: International Journal of Dermatology. 1996 May; 35(5): 340-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8734656&dopt=Abstract

•

The epidemiology and treatment of anogenital warts in Singapore: a retrospective evaluation. Author(s): Chan YC, Ng KY, Chan RK.

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Source: Ann Acad Med Singapore. 2002 July; 31(4): 502-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161888&dopt=Abstract •

The treatment of anogenital warts at home. Author(s): Pleavin M. Source: Nurs Times. 2001 February 8-14; 97(6): 37-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11954248&dopt=Abstract

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Therapeutic approaches to genital warts. Author(s): Beutner KR, Ferenczy A. Source: The American Journal of Medicine. 1997 May 5; 102(5A): 28-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9217660&dopt=Abstract

•

Topical podophyllin for genital warts. Author(s): Maiti H, Haye KR. Source: Lancet. 1987 October 3; 2(8562): 795-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2889006&dopt=Abstract

•

Topical treatment of genital warts in men, an open study of podophyllotoxin cream compared with solution. Author(s): Strand A, Brinkeborn RM, Siboulet A. Source: Genitourinary Medicine. 1995 December; 71(6): 387-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8566979&dopt=Abstract

•

Treatment of anogenital warts in children with topical 0.05% podofilox gel and 5% imiquimod cream. Author(s): Moresi JM, Herbert CR, Cohen BA. Source: Pediatric Dermatology. 2001 September-October; 18(5): 448-50; Discussion 452. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11737696&dopt=Abstract

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Treatment of anogenital warts in genitourinary clinics in England and Wales. Author(s): Wardropper A, Woolley P. Source: International Journal of Std & Aids. 1992 November-December; 3(6): 439-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1286122&dopt=Abstract

•

Treatment of external genital warts: a randomised clinical trial comparing podophyllin, cryotherapy, and electrodesiccation. Author(s): Stone KM, Becker TM, Hadgu A, Kraus SJ. Source: Genitourinary Medicine. 1990 February; 66(1): 16-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2179111&dopt=Abstract

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What is the most effective treatment for external genital warts? Author(s): French L, Nashelsky J, White D. Source: The Journal of Family Practice. 2002 April; 51(4): 313. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11978251&dopt=Abstract

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

General Overview Abnormal Pap Smear Source: Healthnotes, Inc. www.healthnotes.com AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Cervical Dysplasia Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com

64 Genital Warts

Pap Smear, Abnormal Source: Integrative Medicine Communications; www.drkoop.com Sexually Transmitted Diseases Source: Integrative Medicine Communications; www.drkoop.com STDs Source: Integrative Medicine Communications; www.drkoop.com Warts Source: Healthnotes, Inc. www.healthnotes.com Warts Source: Integrative Medicine Communications; www.drkoop.com •

Herbs and Supplements Indole-3-Carbinol Source: Healthnotes, Inc. www.healthnotes.com Shiitake Alternative names: Lentinus edodes Source: Healthnotes, Inc. www.healthnotes.com

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

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CHAPTER 4. DISSERTATIONS ON GENITAL WARTS Overview In this chapter, we will give you a bibliography on recent dissertations relating to genital warts. 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 “genital warts” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on genital warts, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Genital Warts 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 genital warts. 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: •

An Assessment of College Students' Knowledge and Perception of Risk Regarding Human Papilloma Virus and Related Health Promotion Strategies for Campus Health Personnel by Boyd, Cheryl Atchley, Phd from Ohio University, 1998, 196 pages http://wwwlib.umi.com/dissertations/fullcit/9841644

•

HIV/AIDS and Five Other Leading Sexually Transmitted Diseases: Knowledge and Behavior Levels of University Freshmen (immune Deficiency, Gonorrhea, Syphilis, Herpes, Genital Warts, Chlamydia) by Roper, Robyn Lynn, Edd from Auburn University, 1994, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9503405

•

Human Papillomavirus Types 6 and 11, Genital Warts and Juvenile Onset Recurrent Respiratory Papillomatosis: Prospective Studies in the United States and Denmark by Silverberg, Michael Jonah; Phd from The Johns Hopkins University, 2002, 184 pages http://wwwlib.umi.com/dissertations/fullcit/3046564

66 Genital Warts

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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CHAPTER 5. PATENTS ON GENITAL WARTS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “genital warts” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on genital warts, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Genital Warts By performing a patent search focusing on genital warts, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted

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

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

Composition for treating Condyloma acuminata Inventor(s): Cheng; Shu Jun (Beijing, CN), Wang; De Chang (Beijing, CN), Hara; Yukihiko (Fujieda, JP) Assignee(s): Cancer Institute (Hospital), Chinese Academy of Medical Sciences (Beijing, CN), Mitsui Norin Co., Ltd. (Tokyo, JP) Patent Number: 5,795,911 Date filed: April 10, 1997 Abstract: A composition for a treatment of HPV-infected Condyloma acuminata which comprises containing tea catechin as a main component. This medication has no danger of side-effects and may be easily applied to or inserted in the infected area by the patient themselves. Excerpt(s): The present invention relates to a composition for treating Condyloma acuminata, or more specifically to a composition for treating Condyloma acuminata caused by human papiliomavirus, containing treating catechin as a main component. Condyloma acuminata is a wart detectable on the skin or mucous membrane of the genital organs of men and women, and is caused by human papilloma virus (HPV). The site of infection in men is the balanic area, coronary sulcus, foreskin, anal area, urethral meatus; and in women is the vagina, labium, anal area and urethral orifice. Clinical symptoms appear from 1-6 months, on average 3 months after infection, but usually symptoms are not noticed by the patient. This wart shows distinctive papillary or cockscomb-like tumors and has a tendency to accumulate and multiply and is usually red or reddish brown in colour. Detection of HPV in condyloma acuminata is by a method of taking tissue or a smear from the infected area and determining the DNA of the virus. According to this method the detection rate is almost 100%. Types HPV6 and 11 of the virus are the ones most commonly detected and because HPV16 has been detected in malignant squamous cell carcinoma from cancer of the penis, cancer of the cervix and Condyloma acuminata, there is a strong possibility that HPV16 is related to the malignancy of Condyloma acuminata. Web site: http://www.delphion.com/details?pn=US05795911__

•

Diagnostic peptides of human papilloma virus Inventor(s): Schoolnik; Gary K. (Palo Alto, CA), Palefsky; Joel M. (Redwood City, CA) Assignee(s): The Board of Trustees of the Leland Stanford Junior University (Palo Alto, CA) Patent Number: 5,415,995 Date filed: July 6, 1992 Abstract: A series of seventeen synthetic peptides which are capable of raising antibodies specific for certain desired human papilloma virus (HPV) are useful in diagnosis and therapy of conditions associated with HPV infection. Excerpt(s): The invention relates to vaccines and diagnostics relevant to human papilloma virus (HPV) infection. In particular, synthetic peptides corresponding to

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regions of putative peptides for types of HPV which infect the genital region raise antibodies useful in diagnosis and in protection against infection. Human papilloma virus appears to be associated with the development of cervical carcinoma, a malignant condition which appears to be preceded by several stages of cervical intraepithelial neoplasia (CIN). The association of HPV infection with CIN has long been recognized (Meisels, A., et al, Gynecol Oncol (1981) 12:5111-5123; Crum, C. P., et al, ibid (1983) 15:88-94; Syrjanen, K. J., Obstet Gynecol Surv (1984) 39:252-265). In fact, IgG reactive with a group-specific papilloma virus antigen was detected in 93% of women with cervical carcinoma and 60% of those with CIN, but not in any control subjects (Baird, P. J., Lancet (1983) 2:17-18), and the presence of HPV DNA in these lesions has been recognized by several groups. There are approximately forty different types of HPV, which are classified by DNA sequence homology using hybridization techniques. Samples having more than 50% homology, as judged by hybridization, are placed into the same type designation. The various types appear to be rather tissue specific. HPV-6, HPV-11, HPV-16, HPV-18, and HPV-31 appear to be associated with the genital tract; others appear to be associated with warts or epidermal dysplasias in other tissues. However, HPV-6 and HPV-11 are associated with condyloma type lesions, while HPV16, HPV-18 and HPV-31 are associated with cervical intraepithelial neoplasia, including invasive carcinoma. Web site: http://www.delphion.com/details?pn=US05415995__ •

Human papilloma virus anti-sense oligonucleotides Inventor(s): DiPaolo; Joseph (Bethesda, MD), Alvarez-Salas; Luis (Bethesda, MD) Assignee(s): The United States of America as represented by the Department of Health (Washington, DC) Patent Number: 6,084,090 Date filed: September 5, 1997 Abstract: Antisense oligonucleotides having phosphorothioate backbone structure and sequences complementary to nucleotides contained with residues 415 to 445 of human papilloma virus 16 (HPV-16) are disclosed. Methods of treatment using antisense oligonucleotides having phosphorothioate backbone structure and nucleotide sequences complementary to nucleotides contained with residues 415 to 445 of HPV-16 are disclosed. Excerpt(s): The present invention relates to the use of antisense oligonicleotides to inhibit a Human Papilloma virus (HPV), and specifically relates to use of antisense oligonucleotides specific for nucleotides 415 to 445 of the DNA sequence of HPV-16. Papilloma viruses are small DNA viruses that induce the hyperproliferation of epithelial cells. Approximately 70 different genotypes of human papilloma virus (HPV) have been isolated. Some HPV genotypes (e.g., 1, 2 4, and 7) have been associated with human benign squamous papillomas (warts and condylomas) and others (e.g., 16 and 18) have been associated with human neoplastic and preneoplastic lesions (DiPaolo, et al., 1993, Crit. Rev. Oncogen. 4:337-360). Surgery is commonly used for treatment of high-grade lesions due to the lack of effective alternatives. Cervical laser ablation therapy, however, does not in the long term influence the natural history of cervical human papillomavirus-associated diseases in women. Interferons have not proved an effective antiviral or anticancer treatment. Chemotherapy (e.g., cisplatin, alone or combined with other chemotherapy agents such as 5FU) has generally not proved to be effective in treatment of many cervical cancers. Moreover, most chemotherapeutic agents are

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cytotoxic, leading to toxic side effects and the development of multiple drug resistance. Therefore, there is a need for reagents than can specifically inhibit the growth of HPVassociated tumor cells, while avoiding serious toxic reactions. Web site: http://www.delphion.com/details?pn=US06084090__ •

Human papilloma virus inhibition by a hairpin ribozyme Inventor(s): Galasinski; Scott C. (Rockford, IL), Hampel; Arnold (DeKalb, IL), Siwkowski; Andrew M. (Sycamore, IL), DiPaolo; Joseph (Bethesda, MD) Assignee(s): Northern Illinois University (DeKalb, IL), United States of America as represented by the Department of Health and (Washington, DC) Patent Number: 5,683,902 Date filed: March 21, 1995 Abstract: Synthetic catalytic RNAs, i.e. ribozyme, including a hairpin portion, binding sites for binding to a human papilloma virus after viral base 419 and 434, respectively, and cleavage sites for cleaving the virus at the binding sites have been constructed. Excerpt(s): The present invention relates to an RNA catalyst, i.e. ribozyme, which cleaves Human Papilloma virus into a fragment having a 5' hydroxyl and a fragment having a 2',3' cyclic phosphate. The products of the reaction described herein resemble those resulting from the natural hydrolysis of RNA. In the United States, cervical cancer affects approximately 8.6 women per 100,000 each year. In woman, HPV-16 is frequently associated with latent infections, benign and premalignant cervical lesions (dysplasias/CIN) and half of invasive cervical carcinomas. In males, HPV-16 is associated with subclinical macular or clinical papular lesions. Bowenoid papulosis of the penis resembles carcinoma in situ. Cervical cancer, which kills at least 500,000 women worldwide each year, proceeds through progressive cellular changes from benign condylomata to high-grade dysplasias/CIN before developing into an invasive cancer. Over five billion health care dollars are spent in the United States each year on the detection and treatment of these lesions. The current policy in genitourinary clinics is surgery for high-grade lesions due to the lack of superior alternatives. Cervical laser ablation therapy does not in the long term influence the natural history of cervical human papillomavirus-associated diseases in women. Interferons, per se, have been disappointing insofar as acute viral infection is concerned, usually because treatment cannot be started in time. Therefore, it has been assumed that any benefit with interferons is due to anti-proliferative effect and not due to antiviral. Web site: http://www.delphion.com/details?pn=US05683902__

•

Human papilloma virus inhibition by anti-sense oligonucleotides Inventor(s): DiPaolo; Joseph (Bethesda, MD), Alvarez-Salas; Luis (Bethesda, MD) Assignee(s): The United States of America as represented by the Department of Health and (Washington, DC) Patent Number: 6,277,980 Date filed: April 28, 2000 Abstract: Antisense oligonucleotides having phosphorothioate backbone structure and sequences complementary to nucleotides contained with residues 415 to 445 of human

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papilloma virus 16 (HPV-16) are disclosed. Methods of treatment using antisense oligonucleotides having phosphorothioate backbone structure and nucleotide sequences complementary to nucleotides contained with residues 415 to 445 of HPV-16 are disclosed. Excerpt(s): The present invention relates to the use of antisense oligonucleotides to inhibit a Human Papilloma virus (HPV), and specifically relates to use of antisense oligonucleotides specific for nucleotides 415 to 445 of the DNA sequence of HPV-16. Papilloma viruses are small DNA viruses that induce the hyper proliferation of epithelial cells. Approximately 70 different genotypes of human papilloma virus (HPV) have been isolated. Some HPV genotypes (e.g., 1, 2, 4, and 7) have been associated with human benign squamous papillomas (warts and condylomas) and others (e.g., 16 and 18) have been associated with human neoplastic and preneoplastic lesions (DiPaolo, et al., 1993, Crit. Rev. Oncogen. 4:337-360). Surgery is commonly used for treatment of high-grade lesions due to the lack of effective alternatives. Cervical laser ablation therapy, however, does not in the long term influence the natural history of cervical human papillomavirus-associated diseases in women. Interferons have not proved an effective antiviral or anticancer treatment. Chemotherapy (e.g., cisplatin, alone or combined with other chemotherapy agents such as 5FU) has generally not proved to be effective in treatment of many cervical cancers. Moreover, most chemotherapeutic agents are cytotoxic, leading to toxic side effects and the development of multiple drug resistance. Therefore, there is a need for reagents than can specifically inhibit the growth of HPV-associated tumor cells, while avoiding serious toxic reactions. Web site: http://www.delphion.com/details?pn=US06277980__ •

Method for the treatment of psoriasis and genital warts Inventor(s): Cheng; Yung-Chi (Woodbridge, CT), Chu; Chung K. (Athens, GA) Assignee(s): Yale University (New Haven, CT), University of Georgia Research Foundation Inc. (Athens, GA) Patent Number: 6,436,948 Date filed: March 3, 2000 Abstract: The present invention relates to the use of prodrug forms of (-)-(2S,4S)-1-(2hydroxymethyl-1,3-dioxolan-4-yl)cytosine to treat psoriasis, genital warts and other hyperproliferative keratinocyte diseases such as hyperkeratosis, ichthyosis, keratoderma or lichen planus. Excerpt(s): This invention is in the area of medicinal chemistry, and in particular is (-)(2S,4S)-1-(2-hydroxymethyl-1,3-dioxolan-4-yl)cytosine (also referred to as (-)-OddC) or its derivative, and its use to treat cancer in animals, including humans. A tumor is an unregulated, disorganized proliferation of cell growth. A tumor is malignant, or cancerous, if it has the properties of invasiveness and metastasis. Invasiveness refers to the tendency of a tumor to enter surrounding tissue, breaking through the basal laminas that define the boundaries of the tissues, thereby often entering the body's circulatory system. Metastasis refers to the tendency of a tumor to migrate to other areas of the body and establish areas of proliferation away from the site of initial appearance. Cancer is now the second leading cause of death in the United States. Over 8,000,000 persons in the United States have been diagnosed with cancer, with 1,208,000 new diagnoses expected in 1994. Over 500,000 people die annually from the disease in this country. Web site: http://www.delphion.com/details?pn=US06436948__

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•

Method for treating condyloma acuminatum with interferon Inventor(s): Ganesh; Orekonde (Bloomfield Hills, MI), Stewart; William E. (Lutz, FL) Assignee(s): National Geno Sciences, Inc. (Southfield, MI) Patent Number: 5,165,921 Date filed: March 21, 1991 Abstract: A pharmaceutical composition which includes human alpha-interferon, sodium dodecyl sulfate and a pharmaceutically acceptable vehicle is described. A method of using the pharmaceutical composition as a topical therapeutic agent in the treatment of condyloma acuminata is also provided. Excerpt(s): Condyloma acuminata, commonly referred to as genital warts, are known to be benign, fibro-epithelial tumors associated with various papilloma viruses. Condyloma acuminata is a sexually-transmitted disease, the occurrence of which is increasing rapidly. Genital warts are frequently found on or near the vulva, in the vagina, and about the rectum or penis. The manifestation of genital warts begins as an itching sensation whereupon a small papule develops. Depending upon the extent of the lesion, continued itching and a discharge may occur. A number of prior art treatments are known, including the use of cryotherapy and the surgical excision of the warts. Traditional treatment modalities also include the use of podophyllin which is applied topically to the lesions. Podophyllin treatment is typically repeated at intervals of seven to fourteen days and may cause irritation of the affected area. It is known that interferons exert a broad spectrum of biological activity such as anti-viral, antiproliferative and immunomodulatory activities. Following the characterization of interferon by Isaacs and Lindeman, interferon has been the subject of intense research to determine its molecular structure and genetic basis as well as to develop processes for its synthesis and protocols for clinical applications. The exact mechanisms by which its anti-tumor, anti-viral and immune system activities occur are not fully understood. A number of references are available which detail the history and scope of interferon research such as DeMaeyer et al., "Interferons" appearing as Chapter 5 in Comparative Virology, Vol. 15, pp. 205-284, Plenum Press, N.Y., N.Y. (1979); Cantrell, "Why Is Interferon Not In Clinical Use Today" appearing in Interferon 1979, I. Gresser, ed., Vol. 1, pp. 1-28, Academic Press, London (1979); Stewart, "The Interferon System" SpringerVerlag, N.Y., N.Y. (1979); Dunnick, et al., "Clinical Trials with Exogenous Interferon," J. Infect. Diseases, 139, No. 1, pp. 109-123 (1979); and Proc. Rov. Soc. London (Ser. B), Vol. 147, pp. 256 et seq. (1957) and U.S. Pat. No. 3,699,222. Web site: http://www.delphion.com/details?pn=US05165921__

•

Methods for the treatment of psoriasis and genital warts Inventor(s): Chu; Chung K. (Athens, GA), Cheng; Yung-Chi (Woodbridge, CT) Assignee(s): Yale University (New Haven, CT), The University of Georgia Research Foundation Center (Athens, GA) Patent Number: 6,063,787 Date filed: January 26, 1998

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Abstract: The present invention relates to the use of (-)-(2S,4S)-1-(2-hydroxymethyl-1,3dioxolan-4-yl) cytosine to treat psoriasis, genital warts and other hyperproliferative keratinocyte diseases such as hyperkeratosis, ichthyosis, keratoderma or lichen planus. Excerpt(s): This invention is in the area of medicinal chemistry, and in particular is (-)(2S,4S)-1-(2-hydroxymethyl-1,3-dioxolan-4-yl)cytosine (also referred to as (-)-OddC) or its derivative, and its use to treat cancer in animals, including humans. A tumor is an unregulated, disorganized proliferation of cell growth. A tumor is malignant, or cancerous, if it has the properties of invasiveness and metastasis. Invasiveness refers to the tendency of a tumor to enter surrounding tissue, breaking through the basal laminas that define the boundaries of the tissues, thereby often entering the body's circulatory system. Metastasis refers to the tendency of a tumor to migrate to other areas of the body and establish areas of proliferation away from the site of initial appearance. Cancer is now the second leading cause of death in the United States. Over 8,000,000 persons in the United States have been diagnosed with cancer, with 1,208,000 new diagnoses expected in 1994. Over 500,000 people die annually from the disease in this country. Web site: http://www.delphion.com/details?pn=US06063787__ •

Nucleic acid probes of human papilloma virus Inventor(s): Herzog; Albert (Eppegem, BE), Cravador; Alfredo (Rhode-St-Genese, BE), Houard; Sophie (Brussels, BE), Bollen; Alex (Itterbeek, BE) Assignee(s): Ire-Celltarg S.A. (Fleurus, BE) Patent Number: 4,983,728 Date filed: July 28, 1988 Abstract: The present invention relates to probes of nucleic acids useful for detecting indifferently the various types of human papilloma virus, particularly HPV1a, HPV5, HPV6b, HPV8, HPV11, HPV16, HPV18 and HPV33, especially a probe comprising a labelled sequence of nucleic acids, characterized in that it comprises the oligomer of twelve nucleotides X-A-A-A-A-C-G-A-A-A-G-X, with X=T or U, or its complement by interchanging A and X on the one hand, C and G on the other hand. The present invention also relates to specific probes of nucleic acids for the detection of human papilloma for each of the types HPV1a, HPV5, HPV8, HPV11, HPV16, HPV18 and HPV33, as well as specific probes of sub-groups of the virus HPV16, HPV18, HPV33 or HPV16 and HPV18 only or again HPV5 and HPV8 only. Excerpt(s): The technical field of the present invention is that of probes constituted by labelled, mono-strand DNA or RNA nucleic acid sequences. Such probes are well known in the state of the art and may be obtained by various routes particularly by genetic engineering or by manual or automatic direct synthesis. These nucleic acid sequences have the property of being matched and of forming hybrids with complementary DNA sequences, as the case may be, denaturated previously, if the latter were initially bicatenary or mRNA. This denaturation can be done after incubation in a medium of high ionic strength and at high temperature or in a basic medium. These hybrids are then detectable. Web site: http://www.delphion.com/details?pn=US04983728__

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•

Nucleotide sequences useful as type specific probes, PCR primers and LCR probes for the amplification and detection of human papilloma virus, and related kits and methods Inventor(s): Laffler; Thomas G. (Libertyville, IL), Joseph; Jeffrey L. (Cherry Hill, NJ), Bouma; Stanley R. (Mundelein, IL), Marshall; Ronald L. (Zion, IL) Assignee(s): Abbott Laboratories (Abbott Park, IL) Patent Number: 5,484,699 Date filed: September 30, 1994 Abstract: Short nucleotide sequences of human papilloma virus useful for the determination of the presence and type of human papilloma virus present in a test sample. The sequences provided can be amplified by polymerase chain reaction or ligase chain reaction. The sequences provided also can be hybridized by standard slot-, dot- or replica-blot procedures. Methods and kits also are provided for the detection of human papilloma virus in a test sample and the determination of the type of human papilloma virus present in the test sample. Excerpt(s): This invention relates generally to human papilloma virus, and more particularly, relates to nucleotide sequences of short strands of human papilloma virus which can be amplified and/or used to determine the presence of human papilloma virus products in a test sample, and which also can be amplified and/or used to determine the specific type of human papilloma virus of types 6, 11, 16, 18, 31, 33 and 61 present in the test sample. Human papilloma virus (HPV) is recognized as a venereallytransmitted disease of the anogenital tract which often is associated with the pathogenesis of cervical cancer and its precursor lesions. More than 56 types of HPV have been characterized. Of these, at least 21 types infect the anogenital tract. L. Gregoire et al., J. Clin. Micro 27 (12):2660-2665(1989). These mucosotropic viruses are associated most frequently with benign condyloma or latent infections. However, the presence of HPV in premalignant lesions and invasive cancers, particularly of the cervix, may reflect the oncogenic potential of these viruses. See P. M. Howley, in Important Advances in Oncology, D. T. DeVita, Jr. et al., eds., J. B. Lippincott, Philadelphia, Pa. (1987) at pages 55-73. Certain HPV types, namely, HPV type 16 and type 18, and to a lesser extent HPV types 31, 33 and 35, are found in a high proportion of invasive cervical cancers and their metastases. However, many HPV types which infect the anogenital tract, such as HPV types 6 and 11, are found most commonly in benign condyloma and only rarely are found in invasive cancers. HPV detected in the anogenital tract can be classified broadly as low risk papilloma viruses (HPV types 6 and 11), intermediate risk papilloma viruses (HPV types 31, 33 and 35) or high risk papilloma viruses (HPV types 16 and 18), based on the association of the particular HPV type with malignancy. A. T. Lorincz et al., J. Nat'l. Cancer Inst. 79:671 (1987). Thus, the detection of the presence of HPV and the determination of the specific type of HPV can provide a diagnostic and prognostic tool useful for determining the clinical significance associated with certain HPV types. The early detection of HPV by sensitive and specific reagents and methodologies also could provide earlier therapeutic management and counseling. Web site: http://www.delphion.com/details?pn=US05484699__

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•

Variants of human papilloma virus antigens Inventor(s): Webb; Elizabeth Ann (Eltham, AU), Cox; John Cooper (Bullengarook, AU), Edwards; Stirling John (Northcote, AU), Frazer; Ian (St. Lucia, AU) Assignee(s): The University of Queensland (St. Lucia, AU), CSL Limited (Parkville, AU) Patent Number: 6,306,397 Date filed: July 23, 1999 Abstract: Variants of human papilloma virus (HPV) E6 and E7 proteins able to elicit a humoral and/or cellular immune response against HPV in a host animal but not being cell-transforming in the host animal are disclosed, and are useful in treatment or prevention of diseases or conditions involving HPV. Excerpt(s): This invention relates generally to variants of human papilloma virus (HPV) antigens, and in particular it relates to non-transforming variants of HPV antigens which are suitable for use in vaccines. The invention also extends to vaccine compositions which include these variants of HPV antigens as active immunogens, as well as to methods of use of these variants to elicit an immune response against HPV. Papillomaviruses are small DNA viruses that infect a variety of animal species. Some are associated with the development of malignancies in their natural hosts. Over 60 types of human papillomavirus (HPV) have been identified. These infect humans at a variety of body locations and are responsible for common skin warts, laryngeal papillomas, genital warts and other wart-like lesions. Genital HPV infections are particularly common and a number of HPV types, but most frequently types 6, 11, 16 and 18, infect the genital tract in both men and women. In women, HPVs infect various portions of the genital tract including the cervix. iii latency, where the only sign of infection is the presence of HPV DNA. Web site: http://www.delphion.com/details?pn=US06306397__

Patent Applications on Genital Warts As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to genital warts: •

Human papilloma virus treatment Inventor(s): Neefe, John R. (Devon, PA), Goldstone, Stephen E. (New York, NY), Winnett, Mark T. (Phoenixville, PA), Siegel, Marvin; (Blue Bell, PA), Boux, Leslie J. (Victoria, CA) Correspondence: FISH & RICHARDSON PC; 225 FRANKLIN ST; BOSTON; MA; 02110; US Patent Application Number: 20030170268 Date filed: February 13, 2003 Abstract: Disclosed is a method of treating a wart in a subject by administering to the subject a composition containing (1) a heat shock protein or an immunostimulatory

9

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

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fragment thereof, and (2) a protein of a human papilloma virus or an antigenic fragment thereof. Also disclosed is a method of treating a human papilloma virus infection in a subject infected or suspected of being infected with a human papilloma virus of a first type by administering to the subject a composition containing (1) a heat shock protein or an antigenic fragment thereof, and (2) a protein of a human papilloma virus of a second type or an antigenic fragment thereof, where the first type and second type are different. Excerpt(s): This application claims priority from U.S. Provisional Application No. 60/214,202, filed Jun. 26, 2000, the content of which is incorporated herein by reference in its entirety. This application claims priority from U.S. Provisional Application No. 60/214,202, filed Jun. 26, 2000, the content of which is incorporated herein by reference in its entirety. This application claims priority from U.S. Provisional Application No. 60/214,202, filed Jun. 26, 2000, the content of which is incorporated herein by reference in its entirety. This application claims priority from U.S. Provisional Application No. 60/214,202, filed Jun. 26, 2000, the content of which is incorporated herein by reference in its entirety. The invention relates to therapies for human papilloma virus infections. The invention relates to therapies for human papilloma virus infections. The invention relates to therapies for human papilloma virus infections. The invention relates to therapies for human papilloma virus infections. Infection with human papilloma virus (HPV) is common. HPV can be transmitted sexually, and it is estimated that 20-80% of sexually active adults have been infected. While a majority of infections are asymptomatic, infection can lead to the development of genital warts (which have a prevalence of about 1-5% among adults) and cancer of the anogenital tract. Another type of cancer, cervical cancer, is strongly associated with HPV (Frazer, Genitourin. Med. 72:398-403, 1996). HPV types 6, 11, 16, 18, 31, and 33 are often associated with an increased risk of cancer, with types 16 and/or 18 being detected in more than 90% of cervical carcinomas (van Driel et al., Ann. Med. 28:471-477, 1996). Types 6 and 11 are also associated with anogenital warts. For reviews of papilloma viruses and their associated pathologies, see Shah et al., "Chapter 66: Papillomaviruses," In: Virology, 3rd Edition, Fields et al., Eds., Raven Press, Philadelphia, pp 2077-2109, 1996, and zur Hausen, J. Natl. Cancer Inst. 92:690-698, 2000. Infection with human papilloma virus (HPV) is common. HPV can be transmitted sexually, and it is estimated that 20-80% of sexually active adults have been infected. While a majority of infections are asymptomatic, infection can lead to the development of genital warts (which have a prevalence of about 1-5% among adults) and cancer of the anogenital tract. Another type of cancer, cervical cancer, is strongly associated with HPV (Frazer, Genitourin. Med. 72:398-403, 1996). HPV types 6, 11, 16, 18, 31, and 33 are often associated with an increased risk of cancer, with types 16 and/or 18 being detected in more than 90% of cervical carcinomas (van Driel et al., Ann. Med. 28:471-477, 1996). Types 6 and 11 are also associated with anogenital warts. For reviews of papilloma viruses and their associated pathologies, see Shah et al., "Chapter 66: Papillomaviruses," In: Virology, 3rd Edition, Fields et al., Eds., Raven Press, Philadelphia, pp 2077-2109, 1996, and zur Hausen, J. Natl. Cancer Inst. 92:690-698, 2000. Infection with human papilloma virus (HPV) is common. HPV can be transmitted sexually, and it is estimated that 20-80% of sexually active adults have been infected. While a majority of infections are asymptomatic, infection can lead to the development of genital warts (which have a prevalence of about 1-5% among adults) and cancer of the anogenital tract. Another type of cancer, cervical cancer, is strongly associated with HPV (Frazer, Genitourin. Med. 72:398-403, 1996). HPV types 6, 11, 16, 18, 31, and 33 are often associated with an increased risk of cancer, with types 16 and/or 18 being detected in more than 90% of cervical carcinomas (van Driel et al., Ann. Med. 28:471-477, 1996). Types 6 and 11 are also associated with anogenital warts. For reviews of papilloma viruses and their

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associated pathologies, see Shah et al., "Chapter 66: Papillomaviruses," In: Virology, 3rd Edition, Fields et al., Eds., Raven Press, Philadelphia, pp 2077-2109, 1996, and zur Hausen, J. Natl. Cancer Inst. 92:690-698, 2000. Infection with human papilloma virus (HPV) is common. HPV can be transmitted sexually, and it is estimated that 20-80% of sexually active adults have been infected. While a majority of infections are asymptomatic, infection can lead to the development of genital warts (which have a prevalence of about 1-5% among adults) and cancer of the anogenital tract. Another type of cancer, cervical cancer, is strongly associated with HPV (Frazer, Genitourin. Med. 72:398-403, 1996). HPV types 6, 11, 16, 18, 31, and 33 are often associated with an increased risk of cancer, with types 16 and/or 18 being detected in more than 90% of cervical carcinomas (van Driel et al., Ann. Med. 28:471-477, 1996). Types 6 and 11 are also associated with anogenital warts. For reviews of papilloma viruses and their associated pathologies, see Shah et al., "Chapter 66: Papillomaviruses," In: Virology, 3rd Edition, Fields et al., Eds., Raven Press, Philadelphia, pp 2077-2109, 1996, and zur Hausen, J. Natl. Cancer Inst. 92:690-698, 2000. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with genital warts, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “genital warts” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on genital warts. You can also use this procedure to view pending patent applications concerning genital warts. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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

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

Social Diseases Source: The Serious Sides of Sex. Contact: Nevbet Company, 2843 Brownsboro Rd, Louisville, KY, 40206, (502) 897-1664. Summary: This book chapter discusses a dozen Sexually transmitted diseases (STD's), including Acquired immunodeficiency syndrome (AIDS), chancroid, chlamydia, gonorrhea, nonspecific urethritis, syphilis, vaginitis, genital herpes, This book cha, Hepatitis B, pubic lice, and scabies. Symptoms, treatment, diagnosis, and consequences for sexual partners are covered for each. The chapter also looks at public health, education, and ethical, legal, medical and psychological issues involved in STD transmission.

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•

Sexually - Transmitted Diseases Contact: Daniel Memorial Institute, Incorporated, 3725 Belfort Rd, Jacksonville, FL, 32216, (904) 448-7612. Summary: This teaching guide enables trainers to teach foster parents about sexually transmitted diseases (STDs) as they may affect the children that they will care for. The first section starts off by looking at long-term effects and general symptoms of STDs. It then provides specific symptoms, long-term effects, and treatment for a number of common STDs, including: chlamydia, genital herpes, This teaching, vaginitis, gonorrhea, syphilis, AIDS, crab lice, Hepatitis, and gastrointestinal STDs. The second section teaches caregivers how to recognize those members of the foster-care population who are at risk for STDs; that group includes infants, abused children, and sexually active youth. The third section gives guidance on dealing with STD-infected children. This section presents detailed information on AIDS, including symptoms; routes of transmission; prevention, such as condom use; and talking with children about AIDS. Myths of casual contact transmission are dispelled.

•

L'Amour ca se Protege. [C'mon. Help Keep Love Alive.] Contact: Quebec Ministere de la Sante et des Services Sociaux, 1075 Chemin Ste-Foy 15th Fl, Quebec, (418) 643-3380. Summary: This monograph provides information in a quiz format about the transmission and prevention of Sexually transmitted diseases (STD's), including Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV) infection. Other STD's it discusses include gonorrhea, syphilis, This monograp, hepatitis B, herpes, chlamydis, candida, trichomonas, and bacterial vaginitis. It also lists ways to prevent STD's and tells that they can be treated but can recur.

•

Womancare: Sexually Transmitted Diseases Contact: University of Pittsburgh, Magee - Womens Hospital, Health Center, 300 Halket St, Pittsburgh, PA, 15213-3180, (412) 641-1000. Summary: This monograph presents basic information about the spread of Sexually transmitted diseases (STD's) and their prevention with a focus on women and infants as the high-risk group. STD's which can be spread only through sexual contact, such as gonorrhea, and syphilis, are covered. Those which can also be transmitted through IVneedle sharing, blood transfusions, or the perinatal route include Acquired immunodeficiency syndrome (AIDS), hepatitis, herpes-virus group infections, plus relevant bacterial, fungal, and parasitic infections. For each disease, the causative agent, symptoms, and diagnosis is described, together with with the respective treatment, if available. Preventive measures include barrier methods of contraception, avoiding casual sexual contacts, and vaccination, in particular for hepatitis.

•

S.T.D.: Sexually transmitted diseases including HIV/AIDS Source: Hinsdale, IL: Medtext. 1992. 149 pp. Contact: Available from Medtext, 15W560 89th Street, Hinsdale, IL 60521. Telephone: (708) 325-3277. $14.95 plus $1.50 shipping and handling. Summary: This guide for adolescents describes the medical aspects of sexually transmitted diseases. It discusses methods of transmission, common symptoms, treatment, and long-term complications of chlamydia, gonorrhea, syphilis, herpes, This

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guide fo, and HIV infection. It also provides information on prevention methods, including abstinence, monogamy, and condom use.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “genital warts” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “genital warts” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “genital warts” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Clincial Management of Genital Warts by Margaret Stanley, et al (2002); ISBN: 1904218075; http://www.amazon.com/exec/obidos/ASIN/1904218075/icongroupinterna

•

Genital Warts and Contagious Cancers: The Coming Epidemic by Julie Alvey, Gary B. Sullivan (Editor); ISBN: 0899505317; http://www.amazon.com/exec/obidos/ASIN/0899505317/icongroupinterna

•

Genital Warts: Human Papillomavirus Infection by Adrian Mindel (Editor); ISBN: 0340579242; http://www.amazon.com/exec/obidos/ASIN/0340579242/icongroupinterna

•

Genital Warts: What They Are and What You Can Do About Them; ISBN: 1854482823; http://www.amazon.com/exec/obidos/ASIN/1854482823/icongroupinterna

•

Understanding Genital Warts (The Women's Health Care Series) by Patricia A. Kuper, Patricia A. Cooper; ISBN: 1880906295; http://www.amazon.com/exec/obidos/ASIN/1880906295/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “genital warts” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 10

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

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•

Treatment of genital herpes and genital warts Author: Holmes, K.; Year: 1993; 1993

•

Treatment patterns for external genital warts in Australia, 1997 Author: Streeton, C.; Year: 1997; [West Heidelberg, Vic., Australia]: National Centre for Health Program Evaluation, [1997]; ISBN: 1875677739

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

Chapter 224: Warts Source: in Freedberg, I.M., et al., eds. Fitzpatrick's Dermatology in General Medicine. 5th ed., Vol. 2. New York, NY: McGraw-Hill. 1999. p. 2484-2497. Contact: Available from McGraw-Hill Customer Services. P.O. Box 548, Blacklick, OH 43004-0548. (800) 262-4729 or (877) 833-5524. Fax (614) 759-3749 or (614) 759-3641. E-mail: [email protected]. PRICE: $395.00 plus shipping and handling. ISBN: 0070219435. Summary: This chapter provides health professionals with information on the etiology, epidemiology, pathogenesis, clinical manifestations, histopathology, diagnosis, differential diagnosis, and treatment of warts. Warts are benign proliferations of the skin and mucosa that occur from infection with papillomaviruses (PVs). The PVs comprise a large family of double stranded DNA viruses found in humans and other species. Recombinant DNA technology has identified more than 80 different human PV (HPV) genotypes. HPV types are often associated with distinct regional predilection, histopathology, and biology and are separated on this basis into cutaneous and mucosal types and those usually isolated from epidermodysplasia verruciformis (EV). Cutaneous warts include common warts, flat warts, punctuate black dots, mosaic warts, butcher's warts, anogenital warts, and bowenoid papulosis. Mucosal warts include focal epithelial hyperplasia, oral florid papillomatosis, oral condylomata acuminata, respiratory papillotosis, and cervical warts. Warts isolated from EV usually occur in childhood and are typically widespread. The source of HPV is believed to be individuals with clinical or subclinical infection, as well as infectious viruses that may be present in the environment. Nongenital warts occur frequently in children and young adults. Anogenital warts, which are uncommon in children, are transmitted between partners during sexual contact. In addition to causing lesions on the external genitalia, genital mucosal HPV types also infect the cervix. HPV infection is acquired through inoculation of virus into the epidermis through defects in the epithelium. Once a person has been infected, new warts may develop in inoculation sites over a period of weeks to months. Diagnosis of viral wart is usually made by the clinical appearance. Histologic examination may be helpful. The approach to treating warts depends on the age of the patient, the extent and duration of lesions, and the patient's immunologic status and desire for therapy. Current treatments include physical destruction of infected cells using cryotherapy, surgical excision, chemotherapeutic agents, caustics and acids, and

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immunotherapies. Research indicates that certain PV genotypes have oncogenic potential. 15 figures, 1 table, and 130 references. •

Sexually Transmitted and Bloodborne Infections Source: in Lynch, M.A. Brightman, V.J. Greenberg, M.S., eds. Burket's Oral Medicine. 9th ed. Philadelphia, PA: J.B. Lippincott Co. 1994. p. 629-724. Contact: Available from J.B. Lippincott Co. Order Fulfillment, P.O. Box 1600, Hagerstown, MD 21741. (800) 777-2295. PRICE: $79.95 plus shipping and handling. ISBN: 0397512422. Summary: This lengthy chapter, from a textbook of oral medicine, addresses sexually transmitted and bloodborne infections from the perspective of their impact on oral health. After an introductory section defining and classifying these infections, the author presents seven sections: bacterial and chlamydial sexually transmitted diseases (STDs); viral STDs; viral hepatitis; human immunodeficiency virus (HIV-1 and HIV-2) and other retrovirus infections; HIV-1 infection and AIDS; This lengthy, condyloma, acuminatum, and other papillomavirus infections; and mollusum contagiosum (MCV) infection. An appendix presents genetic analyses of strains of HIV-1 isolated from a Florida dental practitioner and his patients. Throughout the chapter, the author focuses on the oral manifestations of these infections and their management. 32 figures. 10 tables. 349 references.

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

Video Recordings An excellent source of multimedia information on genital warts is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “genital warts” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “genital warts” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on genital warts: •

Sexually Transmitted Diseases: What You Should Know Contact: Pleasantville Media, PO Box 415, Pleasantville, NY, 10570, (914) 769-1734. Summary: This video cassette presents information for teenagers on sexually transmitted diseases (STD) education and prevention. Although AIDS is the primary concern, it looks also at syphilis, gonorrhea, chlamydia, herpes, trichomoniasis, and genital warts. It provides information and dispels myths about how AIDS and other STD's are transmitted. It encourages sexual abstinence and models assertive behavior for teenagers who wish to say "no" to sexual activity.

Bibliography: Multimedia on Genital Warts The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the

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multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in genital warts (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on genital warts (for more information, follow the hyperlink indicated): •

Genital warts [slide]: (genital human papillomavirus infection). Year: 1986; Format: Slide; Washington, D.C.: National Audiovisual Center, [1986?]

•

The long-term implications of genital warts [videorecording] Source: by Thomas M. Becker; Year: 1986; Format: Videorecording; Atlanta, Ga.: Emory University, c1986

•

Venereal warts [videorecording] Source: produced and filmed by Health Education Video, Inc; Year: 1989; Format: Videorecording; Bloomington, MN: Health Education Video, [1989]

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APPENDICES

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

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

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

•

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

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

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

•

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

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

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

•

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

11

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

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•

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

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

•

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

•

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/

•

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

•

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/

•

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

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

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

•

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

•

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/

•

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

12

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

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•

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

•

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 Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “genital warts” using the “Detailed Search” option. Go directly to the following hyperlink: 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 the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “genital warts” (or synonyms) into the “For these words:” box. The following is a sample result: •

HIV Is An STD: A Guide for Integrating HIV/STD Prevention Education Contact: West Virginia Department of Health and Human Resources, Office of Epidemiology and Health Promotion, Bureau of Public Health, Surveillance and Disease Control, 350 Capitol St Rm 125, Charleston, WV, 25301, (304) 558-5358, http://www.wvdhhr.org/bph/promot.htm. Summary: The goal of this guide is to help health educators give their audiences the clear message that: sexually transmitted diseases (STDs) can be prevented, there are cures for many of them, and prevention efforts will be strengthened if STDs can be discussed openly. It provides an overview of the common STDs (HIV/AIDS, chlamydia, gonorrhea, hepatitis B, herpes simplex, human papilloma virus and genital warts; pelvic inflammatory disease; and syphilis). It lists ten specific STDs prevention messages for health educators to use along with important points to include when showing someone how to clean needles and syringes. A chapter on culturally appropriate HIV/AIDS education for Hispanics lists some cultural factors affecting outreach to members of this ethnic community. "DOs" and "DON'Ts" for health educators, practical points, ice breakers, resources and some myths and facts about STDs are also included.

•

Choosing the Best; Student Manual Contact: Project Reality, 1701 East Lake Ave Ste 371, Glenview, IL, 60025, (847) 729-3298. Summary: This is the student manual component of a middle- and senior high schoolbased AIDS and sexually transmitted disease (STD) prevention program that focusses on abstinence as the only method to prevent the sexual transmission of these diseases. The manual is divided into seven sessions; some are complemented by video and slide presentations. In the first session students identify the risks of becoming sexually active. The second session focuses on the transmission and symptoms of chlamydia, herpes, syphilis, gonorrhea, genital warts and human papilloma virus, HIV, and AIDS. Session 3 concentrates on HIV/AIDS. This curriculum takes the position that there is no such thing as safe sex, and the only way to prevent HIV infection is through abstinence and monogamy in a marriage relationship. This session also examines condom failure, safer sex messages, and the improper use of condoms. The fourth session looks at peer

Physician Resources 93

pressure to become sexually active. Session five helps the student plan for an abstinent lifestyle. Sessions 6 and seven focus on setting limits before dating and learning assertiveness and resistance skills. •

Carriers Contact: I.E. Clark, Incorporated, PO Box 246, Schulenburg, TX, 78956, (409) 743-3232. Summary: This play consists of a cast of characters, all teenagers, who have various sexually transmitted diseases (STD's), including genital warts, herpes, gonorrhea, chlamydia, and HIV. The play seeks, as its introduction says, to frighten teens with information about STD's and HIV so that they will risk rejection by their peers and avoid unsafe sex. The characters present facts about STD's and HIV, including information about transmission, symptoms, and treatment. Drug use is presented as leading to a lowering of inhibitions and a tendency to engage in unsafe sex. Condom use is discussed, but it is stressed that the only completely safe sex is no sex. The characters in this play present information about STD's and HIV, and leave it up to the viewer to make his or her own decision.

•

A Curriculum for the Church: AIDS Contact: Episcopal Diocese of Southern Ohio, AIDS Task Force, 412 Sycamore, Cincinnati, OH, 45202, (513) 421-0311. Stephen R. Sroka, Incorporated, 1284 Manor Park, Lakewood, OH, 44107, (216) 521-1766. Summary: This manual for educators is based on the text of Educator's Guide to AIDS and other STD's. It includes sections on Human immunodeficiency virus (HIV) and other sexually transmitted diseases (chlamydia, genital herpes, genital warts, gonorrhea, hepatitis, non-gonococcal urethritis, public lice, syphilis, and vaginitis). It is a classroom-ready, activity-oriented, behavioral approach. Its objectives are to help teachers describe the communicable disease chain of infection concept, identify basic STD information and attitudes needed to break the chain of infection, plan actions for persons with STD's, and analyze and practice strategies to prevent STD's and drug use. Such strategies include abstinence and responsible sexual behavior. The guide includes activity worksheets to use as reproduction masters or with the overhead projector, provides pre- and post-tests, includes suggested organization plans, and provides student activities, such as visiting a STD clinic and practicing saying no skills. AIDS materials are included, such as a reprint of the Surgeon General's Report on Acquired Immune Deficiency Syndrome, an AIDS story and worksheet, and a true-false test on myths and facts about AIDS.

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. 14 15

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

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).

94 Genital Warts

Type “genital warts” (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 3592 41 97 132 0 3862

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

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

16

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

17

The HSTAT URL is http://hstat.nlm.nih.gov/.

18 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. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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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/.

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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 genital warts can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to genital warts. 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 genital warts. 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 “genital warts”:

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•

Other guides AIDS http://www.nlm.nih.gov/medlineplus/aids.html Cervical Cancer http://www.nlm.nih.gov/medlineplus/cervicalcancer.html Chlamydia Infections http://www.nlm.nih.gov/medlineplus/chlamydiainfections.html Female Sexual Dysfunction http://www.nlm.nih.gov/medlineplus/femalesexualdysfunction.html Herpes Simplex http://www.nlm.nih.gov/medlineplus/herpessimplex.html HPV http://www.nlm.nih.gov/medlineplus/hpv.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Male Genital Disorders http://www.nlm.nih.gov/medlineplus/malegenitaldisorders.html Oral Cancer http://www.nlm.nih.gov/medlineplus/oralcancer.html Sexually Transmitted Diseases http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html Sexually Transmitted Diseases http://www.nlm.nih.gov/medlineplus/tutorials/sexuallytransmitteddiseasesloade .html Teen Sexual Health http://www.nlm.nih.gov/medlineplus/teensexualhealth.html Vaginal Cancer http://www.nlm.nih.gov/medlineplus/vaginalcancer.html Vaginal Diseases http://www.nlm.nih.gov/medlineplus/vaginaldiseases.html Vulvar Cancer http://www.nlm.nih.gov/medlineplus/vulvarcancer.html Warts http://www.nlm.nih.gov/medlineplus/warts.html

Within the health topic page dedicated to genital warts, the following was listed: •

General/Overviews Human Papilloma Virus (HPV) Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_6x_human_papilloma_virus_h pv.asp?sitearea=cri

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JAMA Patient Page: Papillomavirus Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZIEZDXQ0D &sub_cat=292 •

Coping Local HPV Support Groups Source: American Social Health Association http://www.ashastd.org/hpvccrc/hpvref.html

•

Specific Conditions/Aspects HPV (Get the Facts): External Genital Warts Source: American Social Health Association http://www.ashastd.org/hpvccrc/gw.html HPV (Get the Facts): HPV and Abnormal Cell Changes Source: American Social Health Association http://www.ashastd.org/hpvccrc/abcell.html Human Papillomaviruses and Cancer Source: National Cancer Institute http://cis.nci.nih.gov/fact/3_20.htm Laryngeal Papillomatosis: Quick Facts Source: National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov/health/voice/laryngeal.asp STD Quiz: Are You Taking Proper, Preventive Steps? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=QZ00037

•

From the National Institutes of Health Primer on HPV Source: National Cancer Institute http://newscenter.cancer.gov/BenchMarks/archives/2002_04/related_article.html

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Organizations American Cancer Society http://www.cancer.org/ American Social Health Association http://www.ashastd.org/ iwannaknow.org Source: American Social Health Association http://www.iwannaknow.org/ National Cancer Institute http://www.cancer.gov/ National Center for HIV, STD, and TB Prevention, Division of Sexually Transmitted Diseases Source: Centers for Disease Control and Prevention

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http://www.cdc.gov/nchstp/dstd/dstdp.html National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/ •

Prevention/Screening Right Way to Use a Condom Source: American Social Health Association http://www.ashastd.org/stdfaqs/condom_a.html

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Research What's New in Cervical Cancer Research and Treatment? Source: American Cancer Society http://www.cancer.org/docroot/cri/content/cri_2_4_6x_whats_new_in_cervical_c ancer_research_and_treatment_8.asp?sitearea=cri

•

Statistics HPV: Get the Facts Source: American Social Health Association http://www.ashastd.org/hpvccrc/quickfaq.html Tracking the Hidden Epidemics 2000: Human Papillomavirus (HPV) http://www.cdc.gov/nchstp/od/news/RevBrochure1pdfhpv.htm

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 genital warts. 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: •

Verrugas Genitales. [Genital Warts] Contact: Washington State Department of Health Office of STD Services, PO Box 47842, Olympia, WA, 98504-7842, http://www.doh.wa.gov/cfh/STD/default.htm. Summary: This brochure, written for the general public provides information about the human papillomavirus (HPV) and genital warts. Genital warts are caused by a subgroup of viruses called the human papillomavirus (HPV) and are transmitted from

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skin-to-skin contact during sexual intercourse. The brochure provides a description of genital warts and informs the readers that they can appear on the sex organ as well as in the throat, mouth, and anus. Warts are usually diagnosed through a visual exam, a Pap smear, and other tests if necessary. Warts can hurt if they rub against something or grow in a place where there are other infections. Individuals should not scratch their warts. Rarely, infants of mother with genital warts get warts in their throats. Warts have been linked to cervical cancer in women, making it more essential that they have their condition monitored regularly by a physician. As of the time of this writing, warts cannot be cured. Warts can be treated by freezing, using a topical medication to get rid of them during any given outbreak, or undergoing laser surgery. Individuals with genital warts should inform their sex partners about their conditions so that they too can get tested. Condoms should be used as a part of safer sex to help prevent the spread of genital warts; however, condoms are not wholly effective in this case, as warts may be spread from contact with areas not covered by the condom. Individuals can help to prevent genital warts by abstaining from sex, avoiding substance abuse, which affects decision making about sex, avoiding injection drug use, learning more about STDs in general, limiting their sex partners, talking with their partners about safer sex with condoms, and engaging in safer sex with condoms. •

50 Things You Should Know About HPV and Genital Warts: Protect Yourself Contact: Journeyworks Publishing, PO Box 8466, Santa Cruz, CA, 95061-8466, (831) 4231400, http://www.promotehealth.com. Summary: This pamphlet discusses the human papillomavirus (HPV) and genital warts. It presents fifty facts about HPV, dealing with topics such as its epidemiology, methods of transmission, treatment, and prevention.

•

Genital Warts and HPV: Sexually Transmitted Disease Contact: Education Training and Research Associates, PO Box 1830, Santa Cruz, CA, 95061-1830, (800) 321-4407, http://www.etr.org. Summary: This brochure, for the general public, discusses the sexually transmitted disease (STD), the human papillomavirus (HPV) or genital warts. The brochure describes genital warts, and discusses its causes, symptoms, diagnosis, and treatment. It recommends that individuals get checked for genital warts and other STDs during health exams, to not have sex with infected persons, and to avoid drugs and alcohol to prevent the transmission of STDs.

•

Genital Warts : What You Need to Know Contact: Education Programs Associates, Health Education Resource Center, 1 W Campbell Ave Ste 45, Campbell, CA, 95008, (408) 374-3720, http://www.cfhc.org. Summary: This brochure provides information about genital warts, which are the result of a viral sexually transmitted disease (STD), the human papillomavirus (HPV), for individuals with genital warts. The brochure discusses the symptoms, methods of transmission, treatment, and prevention. It discusses risks associated with cervical cancer in women with HPV and the risks HPV poses to pregnant women.

•

Genital Warts : Questions and Answers Contact: Planned Parenthood of Federation of America Incorporated, PO Box 4457, New York, NY, 10163-4457, (800) 669-0156, http://www.plannedparenthood.org.

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Summary: This pamphlet provides information on a strain of the sexually transmitted disease (STD), the human papilloma virus (HPV) that causes genital warts. It provides information on its transmission, treatment, prevention, diagnosis, symptoms, and what pregnant women can do to avoid transmitting this STD to their infants. •

What's It Going to Cost You? HPV [Genital Warts] Contact: Health Edco, Division of WRS Group, Inc., PO Box 21207, Waco, TX, 767021207, (254) 776-6461. Summary: This brochure, for adolescents, discusses the sexually transmitted disease (STD), human papillomavirus (HPV). HPV causes genital warts and is one of the most common STDs in the United States. The following aspects of HPV are discussed: (1) symptoms; (2) diagnosis; (3) transmission through skin-to-skin, oral, vaginal, or anal sex with an infected person; (4) prevention measures such as practicing sexual abstinence, monogamy, safer sex with condoms, and avoidance of substance abuse; (5) treatment using acids, laser surgery, and cryotherapy; (6) the financial costs for treating HPV; and (7) the possible long-term effects including cervical, anal, or penile cancer as well as sterility in women.

•

Las Verrugas Genitales: Enfermedad de Transmision Sexual. [Genital Warts and HPV: Sexually Transmitted Disease] Contact: Education Training and Research Associates, PO Box 1830, Santa Cruz, CA, 95061-1830, (800) 321-4407, http://www.etr.org. Summary: This brochure, for the general public, discusses the sexually transmitted disease (STD), the human papillomavirus (HPV) or genital warts. The brochure describes genital warts, and discusses its causes, symptoms, diagnosis, and treatment. It recommends that individuals get checked for genital warts and other STDs during health exams, to not have sex with infected persons, and to avoid drugs and alcohol to prevent the transmission of STDs.

•

Genital Warts Contact: Public Health Seattle/King County, HIV/AIDS Programs, 400 Yesler Way 3rd Fl, Seattle, WA, 98104-2615, (206) 296-4649, http://www.metrokc.gov/health/apu. Summary: This brochure, written for the general public, provides information about genital warts, which is caused by the human papillomavirus (HPV), a sexually transmitted disease (STD). HPV is the most common STD in the world, has over sixty different variations, and can be spread through unprotected sex or skin-to-skin contact. The majority of women and some men may not have any symptoms if they are infected with HPV. The brochure identifies common symptoms of HPV infection and describes the process of testing testing for HPV. HPV can be treated, but there is no cure. The brochure outlines the treatments available for this infection. Individuals should not use over-the-counter medicine on genital warts. Visible genital warts can be removed, but treatment cannot eliminate the virus, so recurrences can occur. Infected persons should never have sex while warts are visible. The brochure outlines the effects of HPV if left untreated. Pregnancy can stimulate the growth of genital warts; however, infants rarely contract this infection from their mothers during pregnancy or childbirth. Individuals can prevent or reduce their risks for HPV by practicing sexual abstinence, getting an STD check-up before having sex, using condoms during each sexual encounter, inspecting partners' genitals for symptoms, reducing their numbers of sex partners, and getting tested if symptoms occur before having sex again. The brochure provides contact

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information for services in the Seattle, Washington area from which individuals can learn more about HPV. •

What You Should Know About Genital Warts and HPVs Contact: Channing L. Bete Company Incorporated, 200 State Rd, South Deerfield, MA, 01373-0200, (800) 477-4776, http://www.channing-bete.com. Summary: This brochure provides information about the sexually transmitted disease (STD), human papillomavirus (HPV), which causes genital warts. Genital warts are caused by viruses called HPVs and can vary in shape and location. HPVs have been linked to cervical cancer, anal cancer, and other cancers in both sexes and can cause problems during pregnancy. The brochure identifies those persons who are at risk for contracting HPV and indicates that warts usually appear within a few months of infection, although certain conditions may encourage their growth at a faster rate. The symptoms of HPV are identified. Individuals who have symptoms should see a physician or go to a clinic to get tested for this infection. Genital warts can be found during a physical exam or through a Pap test or a colposcopy. A health care provider may recommend drug treatments or removal procedures to treat the condition. Persons with HPV should notify their partner(s) immediately, keep the affected area dry, wear loose clothing, be patient during the treatment process, exercise, eat healthy foods, have regular checkups, and maintain good hygiene. Because of the health risks posed by HPV, regular Pap tests are recommended for women, and other tests may be necessary for men. To prevent HPV, individuals should practice sexual abstinence or use latex condoms. The brochure briefly differentiates between genital warts and herpes and discusses possible complications during pregnancy and delivery caused by genital warts and partner communication about genital warts.

•

Some Questions and Answers About HPV and Genital Warts Contact: American Social Health Association, PO Box 13827, Research Triangle Park, NC, 27709, (919) 361-8400. Summary: This brochure provides information about the human papillomavirus (HPV), a sexually transmitted disease (STD). HPV is a group of viruses that infect the skin and can cause warts on the hands, feet, and genitals. Genital warts are growths or bumps that are on or around the sex organs of men and women. HPV can cause the growth of warts that may not be visible but that can be detected by physicians using special magnifying instruments. HPV and genital warts are generally spread by direct contact during sex with an infected person. The symptoms of genital warts and HPV include unusual bumps, growths or skin changes on or near the penis, vagina, vulva, or anus, or unusual itching, pain, or bleeding. To detect warts, doctors often pour acetic acid on the genitals to make any infected areas more visible. A Pap smear or a colposcopy can also detect warts. The brochure examines some of the many ways that genital warts are treated and states that these treatments do not cure patients and the likelihood of a recurrence of warts is high. Certain types of HPV have been linked to cervical cancer, but they are usually not the kind that cause warts. Women who are pregnant and have HPV may experience warts that grow in size and number, and warts can occasionally make delivery hard and may infect the infants' throats. Individuals can help to protect themselves from HPV by having sex with an uninfected partner and practicing safer sex with condoms. However, condoms do not guarantee safety from infection if they do not cover an infected area or if men come into contact with an infected area on a partner that touches them in an area not protected by the condom. The brochure reviews some of the common emotions felt by individuals who discover that they have HPV. The brochure

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provides contact information for services from which individuals can learn more about HPV and STDs. The brochure explains the functions and service provide by the HPV and Cervical Cancer Prevention Resource Center in conjunction with the American Social Health Association (ASHA). •

Algunas Preguntas y Respuestas Acerca del PVH y las Verrugas Genitales. [Some Questions and Answers About HPV and Genital Warts] Contact: American Social Health Association, PO Box 13827, Research Triangle Park, NC, 27709, (919) 361-8400. Summary: This brochure discusses the human papillomavirus (HPV) and genital warts and identifies those persons most likely to contract these infections. The brochure discusses HPV and genital wart symptoms, diagnosis, medical treatment, and prevention, and the relationship between HPV, genital warts, and cervical cancer.

•

Genital Warts : Sexually Transmitted Disease Contact: Education Training and Research Associates, PO Box 1830, Santa Cruz, CA, 95061-1830, (800) 321-4407, http://www.etr.org. Summary: This brochure for the general public provides information about the symptoms, appearance, diagnosis, and medical treatment of the sexually transmitted disease (STD), genital warts. The brochure describes the human papilloma virus (HPV) that causes the warts and explains the dangers of the disease if it goes untreated. The brochure lists the symptoms of genital warts for both men and women, and provides an overview of the methods used to diagnose the disease. The brochure recommends several preventive measures one can take to avoid contracting genital warts including sexual abstinence, condom use, spermicide use, STD tests, and the avoidance of drugs and alcohol. The brochure offers several suggestions about the medical treatment of genital warts.

•

STD: Sexually Transmitted Diseases - AIDS, Cervicitis, Chlamydia, Genital Warts, Gonorrhea, Herpes, PID, Syphilis, Urethritis, Vaginitis Contact: Intermedia, Incorporated, 1300 Dexter Ave, Seattle, WA, 98109, (206) 284-2995. Summary: This brochure presents general information about the warning signs and transmission of Sexually transmitted diseases (STD's) and their prevention and specific characteristics of the individual diseases in this group. Symptoms are not always present with STD's and the only way to know for sure is to have the right tests, and then the right treatment. The brochure contains a chart of the various STD's: Acquired immunodeficiency syndrome (AIDS), cervicitis, chlamydia, genital warts, gonorrhea, Herpes-virus group, pelvic inflammatory disease, syphilis, urethritis, and vaginitis, with pertinent information. For each disease it provides a definition, causative agent, mode of transmission, duration of infection, symptoms, diagnosis, treatment, and consequences if not treated. It lists steps to take when the presence of STD's is suspected.

•

HPV and Genital Warts Contact: Kansas Department of Health and Environment, Bureau of Epidemiology and Disease Prevention, HIV-STD Section, 1000 SW Jackson Ste 210, Topeka, KS, 66612-1274, (785) 296-6173, http://www.kdhe.state.ks.us/olrh/download/health_directory.pdf.

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Summary: This information sheet provides information about the human papillomavirus (HPV), the cause of genital warts. It discusses the transmission, symptoms, treatment, and prevention of HPV. •

Human Papillomavirus and Genital Warts Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of Microbiology and Infectious Diseases, 6700-B Rockledge Dr, Bethesda, MD, 20892-7630, (301) 496-1884, http://www.niaid.nih.gov. Summary: This information sheet provides information about the sexually transmitted disease (STD), the human papillomavirus (HPV) and genital warts. The information sheet discusses HPV transmission, symptoms, diagnosis, treatment, prevention, and its possible long-term effects.

•

Genital Warts/HPV Contact: Minnesota Department of Health, AIDS/STD Prevention Services Section, (651) 676-5698, http://health.state.mn.us/divs/dpc/aids-std/aids-std.htm. Summary: This fact sheet, for the general public, discusses the sexually transmitted disease (STD), the human papillomavirus (HPV): the causes of genital warts. It lists HPV symptoms; transmission methods; the long-term consequences of untreated HPV, prevention measures; and ways to treat HPV. Contact information is provided for state and national STD services.

•

Treatment of Genital Warts Source: Schaumburg, IL: American Society for Dermatologic Surgery (ASDS). 1996. 2 p. Contact: Available from American Society for Dermatologic Surgery. 930 North Meacham Road, Schaumburg, IL 60173-6016. (800) 441-2737 or (847) 330-9830. Fax (847) 330-0050. Website: www.asds-net.org. PRICE: Call '800' number or access website for single free copy. Summary: This fact sheet uses a question and answer format to provide the general public with information on genital warts, viral lesions that are less well known but more common than herpes. These warts are transmitted by sexual contact and typically occur around the genital areas, the anus, and the urinary passageways. They appear as single or multiple cauliflower-like pink or red swellings, and they can be large and protruding or flat. Other symptoms may include itching, burning, and tenderness around the affected area. The fact sheet explains why genital warts should be treated and what followup care is needed. It describes various treatments, including cryosurgery, electrosurgery, laser therapy, surgical excision, applications of liquid acid, alphainterferon, Condylox, and bleomycin. Also included are information on the American Society for Dermatologic Surgery and a source for further information.

•

Human Papilloma Virus Contact: Medical Institute for Sexual Health, PO Box 162306, Austin, TX, 78716-2306, (512) 328-6268, http://www.medinstitute.org. Summary: This brochure, for adolescents and young adults, discusses the sexually transmitted disease (STD), human papillomavirus (HPV). HPV is a virus that infects the skin and mucous membranes of humans. The brochure discusses the epidemiology of

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HPV in the United States (US). HPV is transmitted primarily through skin to skin contact or contact with infected bodily fluids during sexual activity. Typical symptoms include the development of genital warts; however, HPV can also be an asymptomatic infection. This STD can be diagnosed with a visual examination or laboratory testing. HPV is incurable, although most HPV infections resolve spontaneously. Individuals with genital warts can manage their infection with topical medications. Some of the possible long-term effects of HPV include the development of cervical, oral, vaginal, vulvar, penile, and anal cancer. The best way for individuals to protect themselves from HPV is to practice sexual abstinence until marriage because condoms have shown to be largely ineffective against the spread of HPV. •

What is HPV (Human Papilloma Viruses)? Contact: California Department of Health Services, Office of AIDS, California AIDS Clearinghouse, 1443 N Martel Ave, Los Angeles, CA, 90046-4207, (323) 845-4180, http://www.hivinfo.org/cac/cachouse.shtml. Summary: This fact sheet provides a general overview of the human papillomaviruses (HPV), a sexually transmitted disease (STD) that sometimes cause skin growths commonly referred to as genital warts or condyloma. It discusses HPV transmission, symptoms, and how to prevent contracting HIV.

The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “genital warts” (or synonyms). The following was recently posted: •

2002 national guideline for the management of anogenital warts Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3046&nbr=2272&a mp;string=genital+AND+warts Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Anal Warts Summary: This patient brochure answers basic questions about anal warts (genital warts). Source: American Society of Colon and Rectal Surgeons http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6987

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•

Genital Warts Summary: Genital warts are viral lesions that affect approximately eight million Americans per year. Lesser known but more common than herpes, genital warts are transmitted by sexual contact. Source: American Society For Dermatologic Surgery http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6740

•

Human Papillomavirus and Genital Warts Summary: A general overview of the human papillomavirus (HPV) -- the most common causes of sexually transmitted diseases (STD) and the types of HPV that can lead to genital warts. Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=121

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Information to Live By: Human Papillomavirus (HPV) Summary: Answers to basic questions about HPV viruses, types of which can cause warts on the hands and feet, genital warts, and have been linked to cervical cancer. Source: American Social Health Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4625

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Venereal (Genital) Warts Summary: Answers to common questions and concerns from consumers on venereal (genital) warts, a sexually transmitted disease. These warts are known to be caused the Human Papilloma Virus (HPV). Source: NOAH: New York Online Access to Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2213 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 genital warts. 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.

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Additional Web Sources

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

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

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

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

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

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

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

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

Associations and Genital Warts The following is a list of associations that provide information on and resources relating to genital warts: •

American Social Health Association Telephone: (919) 361-8400 Fax: (919) 361-8425 Email: [email protected] Web Site: http://www.ashastd.org Background: The American Social Health Association (ASHA) is a not-for-profit voluntary organization dedicated to stopping sexually transmitted diseases (STDs) and their harmful consequences to individuals, families, and communities. Established in 1914, ASHA provides direct patient support through the Herpes Resource Center/National Herpes Hotline and the HPV Support Group, which coordinate a network of over 100 local support groups and publish quarterly journals. ASHA also operates the National AIDS Hotline and the National STD Hotline, both under contract with the Centers for Disease Control and Prevention (CDC), as well as the FIRST STEP Hotline and Health Check Hotline, components of North Carolina's effort to improve the health and development of children in the state. In addition, ASHA advocates for increased funding for STD programs and public policies on STD control, working through its office in Washington D.C. provides leadership for the National Coalition to Fight Sexually Transmitted Diseases; and operates the Women s Health Matters program. The organization also administers the ASHA Research Fund, the only privately funded training program for STD research. ASHA s materials include an annual report, quarterly catalog, and pamphlets.

•

Sexuality Information and Education Council of the U.S Telephone: (212) 819-9770 Fax: (212) 819-9776 Email: [email protected]

Patient Resources 109

Web Site: http://www.siecus.org Background: The Sexuality Information and Education Council of the U.S. (SIECUS) is a nonprofit organization dedicated to developing, collecting, and disseminating information; promoting comprehensive education about sexuality; and advocating for the rights of individuals to make responsible sexual choices. Established in 1964, SIECUS has many different programs developed by health, education, and sexuality experts. Educational materials include a booklet entitled 'How to Talk to Your Children About AIDS,' a pamphlet entitled 'SIECUS Publications Catalog,' and a bimonthly journal entitled the 'SIECUS Report.' The organization provides appropriate referrals, encourages lobbying efforts, and supports education. SIECUS maintains the Mary S. Calderone Library, with more than 5,000 books, 2,000 journals and newsletters, and 500 sexuality and AIDS curricula. The library also has a computerized database with more than 10,000 citations.

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to genital warts. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with genital warts. 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 genital warts. 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 “genital warts” (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.

110 Genital Warts

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 “genital warts”. 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 “genital warts” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “genital warts” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

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

•

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

•

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/

23

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

Finding Medical Libraries 113

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

•

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/

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

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

•

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

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

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

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

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

•

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

•

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

•

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

•

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

Finding Medical Libraries 115

•

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

117

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 genital warts: •

Basic Guidelines for Genital Warts Genital warts Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000886.htm

•

Signs & Symptoms for Genital Warts Abnormal vaginal bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003156.htm Genital sores (female) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003222.htm Genital sores (male) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003221.htm Increased vaginal discharge Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003158.htm

118 Genital Warts

Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Vaginal discharge Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003158.htm Vulvar itch Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003159.htm •

Diagnostics and Tests for Genital Warts Pap smear Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003911.htm

•

Background Topics for Genital Warts Asymptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002217.htm Cervix Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002317.htm Condoms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/004001.htm Cryosurgery Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002322.htm Electrocauterization Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002359.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Laser therapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001913.htm Liquid nitrogen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002246.htm Penis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002279.htm Safer sex practices Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001949.htm Scrotum Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002296.htm Surgical excision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002305.htm

Online Glossaries 119

Vagina Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002342.htm Vulva Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002343.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

121

GENITAL WARTS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablate: In surgery, is to remove. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from

122 Genital Warts

which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [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] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] 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] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anionic: Pertaining to or containing an anion. [EU] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anogenital: Pertaining to the anus and external genitals. [EU] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of

Dictionary 123

which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Antiviral Agents: Agents used in the prophylaxis or therapy of virus diseases. Some of the ways they may act include preventing viral replication by inhibiting viral DNA polymerase; binding to specific cell-surface receptors and inhibiting viral penetration or uncoating; inhibiting viral protein synthesis; or blocking late stages of virus assembly. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Auditory nerve: The eight cranial nerve; also called vestibulocochlear nerve or acoustic nerve. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] 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

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whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basilar Artery: The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] Biotin: Hexahydro-2-oxo-1H-thieno(3,4-d)imidazole-4-pentanoic acid. Growth factor present in minute amounts in every living cell. It occurs mainly bound to proteins or polypeptides and is abundant in liver, kidney, pancreas, yeast, and milk.The biotin content of cancerous tissue is higher than that of normal tissue. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists

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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] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bupivacaine: A widely used local anesthetic agent. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capillary Fragility: The lack of resistance, or susceptibility, of capillaries to damage or disruption under conditions of increased stress. [NIH] Capsid: The outer protein protective shell of a virus, which protects the viral nucleic acid. [NIH]

Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Carcinoma in Situ: A malignant tumor that has not yet invaded the basement membrane of the epithelial cell of origin and has not spread to other tissues. [NIH] Cardiac: Having to do with the heart. [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]

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Catechin: Extracted from Uncaria gambier, Acacia catechu and other plants; it stabilizes collagen and is therefore used in tanning and dyeing; it prevents capillary fragility and abnormal permeability, but was formerly used as an antidiarrheal. [NIH] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [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] Cervical intraepithelial neoplasia: CIN. A general term for the growth of abnormal cells on the surface of the cervix. Numbers from 1 to 3 may be used to describe how much of the cervix contains abnormal cells. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chancroid: Acute, localized autoinoculable infectious disease usually acquired through sexual contact. Caused by Haemophilus ducreyi, it occurs endemically almost worldwide, especially in tropical and subtropical countries and more commonly in seaports and urban areas than in rural areas. [NIH] Check-up: A general physical examination. [NIH] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Cidofovir: A drug used to treat infection caused by viruses. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Circumcision: Excision of the prepuce or part of it. [NIH]

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CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Communicable disease: A disease that can be transmitted by contact between persons. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a

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bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Condyloma: C. acuminatum; a papilloma with a central core of connective tissue in a treelike structure covered with epithelium, usually occurring on the mucous membrane or skin of the external genitals or in the perianal region. [EU] Condylomata Acuminata: Sexually transmitted form of anogenital warty growth caused by the human papillomaviruses. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] 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] Control group: In a clinical trial, the group that does not receive the new treatment being

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studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Courtship: The mutual attraction between individuals of the opposite sex. [NIH] Cruciferous vegetables: A family of vegetables that includes kale, collard greens, broccoli, cauliflower, cabbage, brussels sprouts, and turnip. These vegetables contain substances that may protect against cancer. [NIH] Cryosurgery: The use of freezing as a special surgical technique to destroy or excise tissue. [NIH]

Cryotherapy: Any method that uses cold temperature to treat disease. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may

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also increase the risk of breast cancer in women who used DES. [NIH] Diagnosis, Differential: Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [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] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrodesiccation: The drying of tissue by a high-frequency electric current applied with a needle-shaped electrode. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH]

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Enhancer: Transcriptional element in the virus genome. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermodysplasia Verruciformis: An autosomal recessive trait with impaired cellmediated immunity. About 15 human papillomaviruses are implicated in associated infection, four of which lead to skin neoplasms. The disease begins in childhood with red papules and later spreads over the body as gray or yellow scales. [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [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] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]

Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flagellum: A whiplike appendage of a cell. It can function either as an organ of locomotion or as a device for moving the fluid surrounding the cell. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH]

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

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from

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health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of

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water. [NIH] Hydroxides: Inorganic compounds that contain the OH- group. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperkeratosis: 1. Hypertrophy of the corneous layer of the skin. 2a. Any of various conditions marked by hyperkeratosis. 2b. A disease of cattle marked by thickening and wringling of the hide and formation of papillary outgrowths on the buccal mucous membranes, often accompanied by watery discharge from eyes and nose, diarrhoea, loss of condition, and abortion of pregnant animals, and now believed to result from ingestion of the chlorinated naphthalene of various lubricating oils. [EU] 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] 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] Ichthyosis: Any of several generalized skin disorders characterized by dryness, roughness, and scaliness, due to hypertrophy of the stratum corneum epidermis. Most are genetic, but some are acquired, developing in association with other systemic disease or genetic syndrome. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idoxuridine: An analog of DEOXYURIDINE that inhibits viral DNA synthesis. The drug is used as an antiviral agent, particularly in the treatment of herpes simplex keratitis. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immune-response: The production of antibodies or particular types of cytotoxic lymphoid cells on challenge with an antigen. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH]

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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] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

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] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Inosine Pranobex: An alkylamino-alcohol complex of inosine used in the treatment of a variety of viral infections. Unlike other antiviral agents, it acts by modifying or stimulating cell-mediated immune processes rather than acting on the virus directly. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon Alfa-2a: A recombinant alfa interferon consisting of 165 amino acids with lysine

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at position 23 and histidine at position 34. It is used extensively as an antiviral and antineoplastic agent. [NIH] Interferon Alfa-2b: A recombinant alfa interferon consisting of 165 amino acid residues with arginine in position 23 and histidine in position 34. It is used extensively as an antiviral and antineoplastic agent. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] 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] 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] Invasive cervical cancer: Cancer that has spread from the surface of the cervix to tissue deeper in the cervix or to other parts of the body. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratitis: Inflammation of the cornea. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid

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bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lice: A general name for small, wingless, parasitic insects, previously of the order Phthiraptera. Though exact taxonomy is still controversial, they can be grouped in the orders Anoplura (sucking lice), Mallophaga (biting lice), and Rhynchophthirina (elephant lice). [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] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligase: An enzyme that repairs single stranded discontinuities in double-stranded DNA molecules in the cell. Purified DNA ligase is used in gene cloning to join DNA molecules together. [NIH] Ligase Chain Reaction: A DNA amplification technique based upon the ligation of oligonucleotide probes. The probes are designed to exactly match two adjacent sequences of a specific target DNA. The chain reaction is repeated in three steps in the presence of excess probe: (1) heat denaturation of double-stranded DNA, (2) annealing of probes to target DNA, and (3) joining of the probes by thermostable DNA ligase. After the reaction is repeated for 20-30 cycles the production of ligated probe is measured. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [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] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH]

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Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] 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] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Micrococcal Nuclease: An enzyme that catalyzes the endonucleolytic cleavage to 3'phosphomononucleotide and 3'-phospholigonucleotide end-products. It can cause hydrolysis of double- or single-stranded DNA or RNA. (From Enzyme Nomenclature, 1992) EC 3.1.31.1. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Mode of Transmission: Hepatitis A [NIH]

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Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] 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] Mononuclear: A cell with one nucleus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier

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nuclei during their decay. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] 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] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] 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] Oligonucleotide Probes: Synthetic or natural oligonucleotides used in hybridization studies in order to identify and study specific nucleic acid fragments, e.g., DNA segments near or within a specific gene locus or gene. The probe hybridizes with a specific mRNA, if present. Conventional techniques used for testing for the hybridization product include dot blot assays, Southern blot assays, and DNA:RNA hybrid-specific antibody tests. Conventional labels for the probe include the radioisotope labels 32P and 125I and the chemical label biotin. [NIH] Oncogenes: Genes which can potentially induce neoplastic transformation. They include genes for growth factors, growth factor receptors, protein kinases, signal transducers, nuclear phosphoproteins, and transcription factors. When these genes are constitutively expressed after structural and/or regulatory changes, uncontrolled cell proliferation may result. Viral oncogenes have prefix "v-" before the gene symbol; cellular oncogenes (protooncogenes) have the prefix "c-" before the gene symbol. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury.

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[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] Ovum: A female germ cell extruded from the ovary at ovulation. [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] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [NIH] Papule: A small circumscribed, superficial, solid elevation of the skin. [EU] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] 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] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perianal: Located around the anus. [EU] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU]

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Peripheral blood: Blood circulating throughout the body. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physician Assistants: Persons academically trained, licensed, or credentialed to provide medical care under the supervision of a physician. The concept does not include nurses, but does include orthopedic assistants, surgeon's assistants, and assistants to other specialists. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pneumonia: Inflammation of the lungs. [NIH] Podophyllin: Caustic extract from the roots of Podophyllum peltatum and P. emodi. It contains podophyllotoxin and its congeners and is very irritating to mucous membranes and skin. Podophyllin is a violent purgative that may cause CNS damage and teratogenesis. It is used as a paint for warts, skin neoplasms, and senile keratoses. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short

Dictionary 143

oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polyploid: An organism with more than two chromosome sets in its vegetative cells. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium hydroxide: A toxic and highly corrosive chemical used to make soap, in bleaching, and as a paint remover. It is used in small amounts as a food additive and in the preparatrion of some drugs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Prepuce: A covering fold of skin; often used alone to designate the preputium penis. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prickle: Several layers of the epidermis where the individual cells are connected by cell bridges. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] 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] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progenitalis: A group of acute infections causes by herpes simplex virus type 1 or type 2,

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characterized by the development of one or more small fluid-filled vesicles with a raised erythematous base on the skin or mucous membrane, and occurring as a primary infection or recurring because of reactivation of a latent infection. Type 1 infections usually involve nongenital regions of the body, whereas in type 2 infections the lesions are primarily seen on the genital and surrounding areas. Precipitating factors include fever, exposure to cold temperature or to ultraviolet rays, sunburn, cutaneous or mucosal abrasions, emotional stress, and nerve injury. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] 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]

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Proto-Oncogenes: Normal cellular genes homologous to viral oncogenes. The products of proto-oncogenes are important regulators of biological processes and appear to be involved in the events that serve to maintain the ordered procession through the cell cycle. Protooncogenes have names of the form c-onc. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Pruritus Ani: Intense chronic itching in the anal area. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] 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

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in a randomized trial. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] 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] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] 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] 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] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH]

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Safe Sex: Sex behavior that prevents or decreases the spread of sexually transmitted diseases or pregnancy. [NIH] Scabies: A contagious cutaneous inflammation caused by the bite of the mite Sarcoptes scabiei. It is characterized by pruritic papular eruptions and burrows and affects primarily the axillae, elbows, wrists, and genitalia, although it can spread to cover the entire body. [NIH]

Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [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] Sequence Homology: The degree of similarity between sequences. Studies of amino acid and nucleotide sequences provide useful information about the genetic relatedness of certain species. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serologic Tests: Diagnostic procedures involving immunoglobulin reactions. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexual Abstinence: Refraining from sexual intercourse. [NIH] Sexual Partners: Married or single individuals who share sexual relations. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skin Neoplasms: Tumors or cancer of the skin. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Dodecyl Sulfate: An anionic surfactant, usually a mixture of sodium alkyl sulfates, mainly the lauryl; lowers surface tension of aqueous solutions; used as fat emulsifier, wetting agent, detergent in cosmetics, pharmaceuticals and toothpastes; also as research tool in protein biochemistry. [NIH]

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Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] 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] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spermicide: An agent that is destructive to spermatozoa. [EU] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spirochete: Lyme disease. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Squamous Epithelium: Tissue in an organ such as the esophagus. Consists of layers of flat, scaly cells. [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] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH]

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Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Sulfates: Inorganic salts of sulfuric acid. [NIH] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogenesis: Production of monstrous growths or fetuses. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH]

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Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichloroacetic Acid: A strong acid used as a protein precipitant in clinical chemistry and also as a caustic for removing warts. [NIH] Trichomonas: A genus of parasitic flagellate protozoans distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [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]

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Tumorigenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH]

Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Ultraviolet Rays: That portion of the electromagnetic spectrum immediately below the visible range and extending into the x-ray frequencies. The longer wavelengths (near-UV or biotic or vital rays) are necessary for the endogenous synthesis of vitamin D and are also called antirachitic rays; the shorter, ionizing wavelengths (far-UV or abiotic or extravital rays) are viricidal, bactericidal, mutagenic, and carcinogenic and are used as disinfectants. [NIH]

Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethritis: Inflammation of the urethra. [EU] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vaccine adjuvant: A substance added to a vaccine to improve the immune response so that less vaccine is needed. [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] Vaginal Discharge: A common gynecologic disorder characterized by an abnormal, nonbloody discharge from the genital tract. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venereology: A branch of medicine which deals with sexually transmitted disease. [NIH] Venous: Of or pertaining to the veins. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH]

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Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] 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] Vulva: The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina. [NIH] Wart: A raised growth on the surface of the skin or other organ. [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]

Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

153

INDEX A Aberrant, 13, 121 Ablate, 121, 132 Ablation, 69, 70, 71, 121 Abortion, 121, 136 Abscess, 4, 121 Adjuvant, 39, 121 Adverse Effect, 121, 152 Affinity, 121, 152 Agonist, 121, 143 Alkaline, 121, 125 Alkaloid, 121, 143 Alpha Particles, 121, 149 Alternative medicine, 121 Amino acid, 12, 121, 122, 123, 124, 134, 135, 138, 141, 145, 148, 151, 155 Amino Acid Sequence, 12, 122, 123, 134 Amplification, 74, 122, 140 Anaesthesia, 35, 42, 122 Anaesthetic, 42, 122 Anal, 4, 10, 16, 30, 68, 102, 103, 106, 107, 122, 149 Anal Fissure, 4, 16, 122 Analgesic, 35, 122 Analog, 35, 122, 136 Anaphylatoxins, 122, 129 Anesthesia, 15, 122, 147 Angiogenesis, 35, 122 Animal model, 8, 11, 122 Anionic, 123, 152 Annealing, 123, 140, 146 Anorectal, 3, 123 Antibacterial, 123, 152 Antibiotic, 123, 152 Antibodies, 5, 17, 44, 68, 69, 123, 136, 137, 141, 146 Antibody, 121, 123, 128, 133, 137, 144, 152 Anticoagulant, 123, 148 Antigen, 8, 20, 69, 121, 123, 129, 136, 137 Antigen-Antibody Complex, 123, 129 Antineoplastic, 123, 125, 138, 146 Antiviral, 6, 24, 34, 69, 70, 71, 123, 136, 138 Antiviral Agents, 123, 138 Anus, 101, 103, 105, 122, 123, 138, 145, 150 Anxiety, 28, 123 Aqueous, 124, 152 Arginine, 122, 124, 138 Arterial, 124, 148 Arteries, 124, 125, 130, 141 Aseptic, 124, 153

Assay, 35, 124 Asymptomatic, 44, 76, 106, 118, 124 Auditory, 124, 141 Auditory nerve, 124, 141 Autologous, 8, 124 B Bacteria, 123, 124, 142, 146, 152, 155, 156 Base, 6, 70, 124, 130, 134, 139, 147, 154 Basement Membrane, 124, 126 Basilar Artery, 124, 141 Benign, 3, 7, 8, 12, 25, 69, 70, 71, 72, 74, 82, 124, 142, 144 Binding Sites, 11, 70, 124 Biochemical, 6, 7, 9, 124 Biological response modifier, 124, 138 Biomarkers, 6, 124 Biopsy, 17, 31, 35, 124 Biopsy specimen, 17, 31, 124 Biotin, 125, 144 Bleomycin, 106, 125 Blood Coagulation, 125, 154 Blood pressure, 125, 142, 152 Blood transfusion, 80, 125 Blood vessel, 122, 125, 127, 154, 156 Blot, 74, 125, 144 Body Fluids, 124, 125, 152, 155 Bone Marrow, 125, 137, 140, 152 Bowel, 122, 125 Branch, 50, 115, 125, 133, 141, 145, 149, 152, 157 Breakdown, 125, 131, 133 Buccal, 125, 136 Bupivacaine, 125, 140 C Calcium, 12, 125, 128 Cannabis, 27, 126 Capillary, 126 Capillary Fragility, 126 Capsid, 8, 126 Carcinogenesis, 9, 24, 126 Carcinogenic, 7, 31, 126, 138, 144, 148, 156 Carcinogens, 11, 126 Carcinoma, 45, 69, 70, 126 Carcinoma in Situ, 70, 126 Cardiac, 126, 132, 140, 142 Case report, 15, 16, 126 Case series, 4, 126 Catechin, 68, 126 Cause of Death, 71, 73, 126 Caustic, 126, 146, 155

154 Genital Warts

Cell proliferation, 126, 144 Cervical intraepithelial neoplasia, 6, 11, 14, 18, 25, 33, 69, 127 Cervix, 68, 74, 75, 82, 118, 121, 126, 127, 139 Chancroid, 79, 127 Check-up, 103, 127 Chemoprevention, 5, 11, 127 Chemotactic Factors, 127, 129 Chemotherapeutic agent, 69, 71, 82, 127 Chemotherapy, 20, 32, 69, 71, 127 Cholinergic, 127, 143 Chromatin, 11, 127 Chromosomal, 48, 56, 122, 127, 146, 151 Chromosome, 127, 146 Chronic, 127, 137, 149, 153 Cidofovir, 19, 34, 127 Circulatory system, 71, 73, 127 Circumcision, 5, 19, 127 CIS, 99, 127 Cisplatin, 69, 71, 127 Clear cell carcinoma, 128, 131 Clinical Medicine, 9, 128, 147 Clinical trial, 4, 6, 11, 52, 62, 91, 128, 130, 131, 148, 150 Cloning, 36, 128, 140 Coagulation, 125, 128, 139 Cofactor, 128, 148, 154 Collagen, 122, 124, 126, 128 Combination Therapy, 55, 128 Communicable disease, 93, 128 Complement, 73, 122, 128, 129, 134 Complementary and alternative medicine, 55, 64, 129 Complementary medicine, 55, 129 Computational Biology, 91, 129 Conception, 121, 129, 130, 153 Condoms, 23, 40, 93, 101, 102, 103, 104, 106, 118, 129 Condyloma, 7, 8, 16, 17, 68, 69, 72, 74, 83, 106, 129 Condylomata Acuminata, 4, 14, 16, 31, 43, 48, 50, 52, 59, 82, 129 Connective Tissue, 125, 128, 129, 140 Consciousness, 122, 129 Consumption, 27, 129, 151 Contamination, 38, 129 Contraception, 80, 130 Contraindications, ii, 130 Control group, 17, 130 Controlled study, 35, 40, 49, 59, 130 Conventional therapy, 130 Conventional treatment, 49, 59, 130 Coordination, 7, 130 Corneum, 130, 132, 136

Coronary, 68, 130, 141 Coronary Thrombosis, 130, 141 Corpus, 130, 145 Courtship, 5, 130 Cruciferous vegetables, 11, 130 Cryosurgery, 20, 40, 43, 57, 106, 118, 130 Cryotherapy, 21, 42, 43, 52, 57, 62, 72, 82, 102, 130 Cutaneous, 6, 12, 15, 27, 35, 48, 82, 130, 148, 151 Cyclic, 70, 130 Cytosine, 71, 73, 130 Cytotoxic, 70, 71, 130, 136 Cytotoxicity, 128, 130 D Decision Making, 101, 131 Degenerative, 131, 135 Delivery of Health Care, 131, 134 Denaturation, 73, 131, 140, 146 DES, 80, 122, 131 Diagnosis, Differential, 82, 131 Diagnostic procedure, 67, 131, 151 Diarrhoea, 131, 136 Digestion, 11, 125, 131, 140, 153 Digestive tract, 131, 153 Dilatation, 121, 131, 147 Direct, iii, 73, 103, 109, 128, 131, 150 Distal, 11, 131, 132, 149 Double-blind, 30, 35, 39, 42, 43, 48, 49, 50, 52, 55, 57, 59, 131 Drug Resistance, 70, 71, 131 Drug Tolerance, 131, 154 Dysplasia, 10, 30, 63, 132 E Effector, 128, 132 Efficacy, 34, 35, 40, 42, 49, 50, 58, 61, 132 Electrocoagulation, 35, 38, 128, 132 Electrode, 132 Electrodesiccation, 52, 62, 132 Electrolyte, 132, 147, 152 Endocrine Glands, 132 Endotoxins, 129, 132 Enhancer, 11, 132 Environmental Health, 90, 92, 132 Enzymatic, 122, 125, 129, 132, 146 Enzyme, 132, 140, 141, 146, 148, 154, 155, 157 Epidemiological, 25, 132 Epidermal, 69, 132, 139 Epidermis, 82, 130, 132, 135, 136, 139, 147 Epidermodysplasia Verruciformis, 5, 82, 132 Epidermoid carcinoma, 132, 153 Epithelial, 5, 9, 10, 13, 17, 69, 71, 72, 82, 126, 133, 135, 144 Epithelial Cells, 9, 69, 71, 133, 135

Index 155

Epithelium, 11, 13, 82, 124, 129, 133, 144 Epitope, 11, 133 Erectile, 133, 145 Esophagus, 131, 133, 153 Eukaryotic Cells, 133, 137 Extensor, 133, 149 Extracellular, 129, 133, 152 F Facial, 133, 141 Family Planning, 91, 133 Fat, 125, 133, 140, 152, 154 Fistula, 16, 133 Flagellum, 133, 155 Fold, 8, 13, 133, 147 Foramen, 133, 141 G Gas, 133, 136, 143 Gastrointestinal, 80, 133, 155 Gene, 6, 7, 11, 13, 81, 133, 134, 140, 144 Gene Expression, 6, 13, 133 General practitioner, 50, 60, 133 Genetic Code, 134, 143 Genetic Engineering, 73, 128, 134 Genetic testing, 134, 146 Genotype, 9, 134 Gestation, 134, 145 Glycine, 122, 134, 143 Gonorrhea, 65, 79, 80, 85, 92, 93, 104, 105, 134 Governing Board, 134, 147 Grade, 6, 25, 30, 69, 70, 71, 134 Graft, 134, 135 Granulocytes, 134, 157 Gravidity, 134, 144 Growth factors, 134, 144 H Health Care Costs, 13, 134, 135 Health Expenditures, 134, 135 Hemorrhage, 132, 135 Hemorrhoids, 3, 16, 29, 135 Hepatitis, 4, 79, 80, 92, 93, 135, 142, 157 Hepatocytes, 135 Hereditary, 135, 151 Heredity, 133, 135 Herpes, 26, 65, 79, 80, 82, 85, 92, 93, 98, 103, 104, 105, 107, 109, 135, 136, 147 Herpes Zoster, 135 Histidine, 135, 138 Hormone, 131, 135 Horny layer, 132, 135 Host, 6, 75, 135, 136, 151, 156 Humoral, 75, 135 Humour, 135 Hybrid, 135, 144

Hybridization, 22, 41, 69, 135, 144 Hydrogen, 124, 131, 136, 142, 143, 149 Hydrolysis, 70, 127, 136, 141, 148 Hydroxides, 136 Hydroxyproline, 122, 128, 136 Hyperkeratosis, 71, 73, 136 Hyperplasia, 10, 82, 136 Hypertrophy, 136 I Ichthyosis, 71, 73, 136 Id, 53, 63, 99, 107, 108, 114, 116, 136 Idoxuridine, 19, 42, 48, 136 Immune response, 6, 20, 24, 32, 75, 121, 123, 136, 137, 156, 157 Immune Sera, 136, 137 Immune system, 40, 72, 136, 137, 141, 156, 157 Immune-response, 32, 44, 136 Immunity, 10, 12, 39, 40, 132, 136, 137, 155 Immunization, 5, 8, 136 Immunodeficiency, 10, 11, 30, 41, 79, 80, 83, 93, 105, 137 Immunodeficiency syndrome, 79, 80, 105, 137 Immunogenic, 11, 137 Immunoglobulin, 123, 137, 152 Immunohistochemistry, 19, 137 Immunologic, 7, 8, 82, 127, 137 Immunology, 6, 11, 12, 29, 121, 137 In situ, 5, 21, 41, 51, 137 In Situ Hybridization, 21, 137 In vitro, 7, 10, 48, 137, 146 In vivo, 9, 137 Incision, 137, 138 Incubation, 73, 137 Indicative, 81, 137, 145, 156 Infarction, 130, 137, 141 Infiltrating cancer, 138, 139 Infiltration, 15, 35, 42, 138, 147 Inflammation, 135, 138, 139, 146, 151, 156 Ingestion, 136, 138 Initiation, 138, 155 Inorganic, 127, 136, 138, 153 Inosine Pranobex, 49, 59, 138 Interferon, 7, 14, 20, 23, 27, 30, 32, 33, 34, 39, 40, 42, 49, 50, 55, 59, 72, 106, 138 Interferon Alfa-2a, 27, 138 Interferon Alfa-2b, 34, 138 Interferon-alpha, 30, 49, 50, 59, 138 Intestines, 133, 138 Intracellular, 6, 13, 137, 138, 147 Intraepithelial, 7, 23, 30, 69, 138 Invasive, 5, 69, 70, 74, 136, 138, 139 Invasive cancer, 70, 74, 138, 139

156 Genital Warts

Invasive cervical cancer, 5, 74, 139 Ions, 124, 132, 136, 139, 142 K Kb, 90, 139 Keratin, 139 Keratinocytes, 13, 139 Keratitis, 136, 139 Keratolytic, 139, 146 L Labile, 128, 139 Large Intestine, 131, 138, 139, 150 Laryngeal, 11, 31, 75, 99, 139 Larynx, 139 Laser Surgery, 15, 101, 102, 139 Laser therapy, 106, 118, 139 Latency, 75, 139 Latent, 35, 70, 74, 139, 147 Leukocytes, 125, 127, 134, 138, 140 Library Services, 114, 140 Lice, 79, 80, 93, 140 Lidocaine, 15, 35, 42, 140 Life cycle, 9, 13, 140 Ligaments, 130, 140 Ligase, 6, 74, 140 Ligase Chain Reaction, 74, 140 Ligation, 140 Lipid, 23, 140 Liver, 125, 135, 140 Localization, 6, 137, 140 Localized, 127, 137, 140, 146 Loop, 17, 48, 56, 140 Lymph, 126, 127, 135, 140 Lymph node, 126, 140 Lymphatic, 138, 140, 152, 154 Lymphocyte, 18, 35, 123, 141 Lymphoid, 123, 136, 141 Lysine, 6, 138, 141 Lytic, 141, 151 M Malignancy, 24, 68, 74, 141, 144 Malignant, 12, 68, 69, 71, 73, 123, 126, 141, 142 Malignant tumor, 126, 141 Meatus, 68, 141 MEDLINE, 92, 141 Membrane, 68, 129, 133, 139, 141, 142, 147, 155 Mental, iv, 4, 90, 94, 141, 149 Mental Health, iv, 4, 90, 94, 141, 149 Meta-Analysis, 23, 141 Metabolite, 141, 147 Metastasis, 71, 73, 141 MI, 52, 72, 119, 141 Micrococcal Nuclease, 11, 141

Microorganism, 128, 142, 145, 157 Mode of Transmission, 105, 142 Modification, 6, 122, 134, 142 Molecular, 8, 10, 11, 12, 29, 36, 44, 60, 72, 91, 95, 129, 142, 155 Molecular Structure, 72, 142 Molecule, 123, 124, 129, 132, 133, 136, 142, 143, 146, 150, 155 Monitor, 6, 142, 143 Mononuclear, 8, 142 Mucosa, 82, 142 Myocardium, 141, 142 N NCI, 1, 89, 99, 127, 142 Need, 3, 26, 29, 33, 38, 70, 71, 79, 82, 85, 92, 101, 110, 142, 154 Needle Sharing, 80, 142 Neoplasia, 4, 11, 22, 23, 25, 30, 69, 142 Neoplasm, 142, 144 Neoplastic, 11, 69, 71, 142, 144 Nerve, 122, 124, 142, 147, 148, 153 Neural, 135, 142 Neurons, 143, 154 Neurotransmitter, 122, 134, 143, 154 Neutrons, 121, 143, 149 Nicotine, 11, 143 Nitrogen, 43, 48, 118, 121, 143 Nuclear, 6, 133, 143, 144 Nuclei, 121, 134, 143, 149 Nucleic acid, 73, 126, 130, 134, 135, 137, 143, 144 Nucleic Acid Hybridization, 135, 143 Nucleus, 6, 127, 130, 133, 142, 143, 149, 153 O Odds Ratio, 143, 150 Oligonucleotide Probes, 51, 140, 143 Oncogenes, 9, 11, 144, 149 Oncogenic, 7, 16, 74, 83, 144 Opportunistic Infections, 10, 144 Oral Health, 83, 144 Oral Manifestations, 83, 144 Outpatient, 56, 144 Ovum, 134, 140, 144 P Pancreas, 124, 125, 144, 155 Papilla, 144 Papillary, 68, 136, 144 Papillomavirus, 4, 6, 7, 8, 9, 10, 11, 12, 14, 16, 17, 18, 21, 22, 23, 24, 31, 35, 37, 38, 39, 41, 44, 48, 49, 57, 59, 65, 69, 70, 71, 75, 81, 83, 86, 99, 100, 101, 102, 103, 104, 105, 106, 107, 135, 144 Papule, 72, 144 Parasite, 144, 155

Index 157

Parasitic, 80, 140, 144, 155 Parity, 9, 144 Pathogen, 137, 145 Pathogenesis, 74, 82, 145 Pathologic, 124, 130, 145, 149 Pathologies, 76, 145 Patient Education, 100, 112, 114, 119, 145 Pelvic, 23, 92, 105, 145, 148 Pelvic inflammatory disease, 23, 92, 105, 145 Pelvis, 145, 156 Penis, 68, 70, 72, 103, 118, 129, 145, 147 Peptide, 12, 122, 139, 145, 148 Perianal, 3, 14, 22, 29, 37, 50, 129, 145 Perinatal, 8, 80, 145 Peripheral blood, 7, 8, 138, 145 Pharmacokinetic, 15, 145 Pharmacologic, 122, 145, 155 Phosphorus, 125, 145 Physical Examination, 127, 145 Physician Assistants, 3, 145 Physiologic, 7, 121, 145, 150 Pilot study, 23, 145 Plants, 121, 126, 146, 155, 156 Plasma, 123, 146 Plasma cells, 123, 146 Plasmid, 11, 146 Platinum, 127, 140, 146 Pneumonia, 130, 146 Podophyllin, 48, 50, 51, 52, 55, 56, 57, 59, 60, 61, 62, 72, 146 Podophyllotoxin, 48, 49, 50, 51, 52, 56, 57, 59, 60, 61, 62, 146 Polymerase, 10, 38, 48, 74, 123, 146 Polymerase Chain Reaction, 48, 74, 146 Polyploid, 25, 146 Polysaccharide, 123, 146 Posterior, 122, 124, 144, 147 Potassium, 147 Potassium hydroxide, 147 Practice Guidelines, 94, 106, 147 Precancerous, 147 Precursor, 74, 132, 147 Premalignant, 39, 70, 74, 147 Prepuce, 127, 147 Prevalence, 5, 10, 15, 16, 29, 30, 38, 76, 143, 147 Prickle, 139, 147 Probe, 73, 140, 144, 147 Procaine, 140, 147 Prodrug, 71, 147 Progenitalis, 26, 147 Progression, 7, 11, 122, 148 Progressive, 70, 131, 134, 148 Promoter, 10, 148

Prone, 5, 148 Prophylaxis, 123, 148, 156 Prospective study, 50, 148 Prostate, 124, 148, 155 Protease, 128, 148 Protein C, 8, 122, 139, 148 Protein Conformation, 8, 122, 139, 148 Protein Kinases, 144, 148 Protein S, 81, 123, 134, 148, 151 Proteolytic, 128, 148 Protocol, 6, 148 Protons, 121, 136, 149 Proto-Oncogenes, 144, 149 Protozoan, 149, 155 Proximal, 11, 131, 149 Pruritic, 149, 151 Pruritus, 4, 149 Pruritus Ani, 4, 149 Psoriasis, 71, 72, 73, 149 Public Health, 5, 39, 48, 79, 92, 94, 102, 105, 149 Public Policy, 91, 149 Pulmonary, 39, 125, 129, 149, 154 Pulse, 142, 149 Purgative, 146, 149 Purulent, 121, 149, 156 Q Quaternary, 148, 149 R Race, 5, 149 Radiation, 9, 149, 150, 153, 157 Radioactive, 136, 143, 144, 150, 156 Radioisotope, 144, 150 Randomized, 6, 11, 35, 48, 49, 55, 57, 132, 150 Randomized clinical trial, 49, 57, 150 Reactivation, 147, 150 Receptor, 123, 150 Recombinant, 10, 23, 27, 38, 39, 42, 82, 138, 150 Rectal, 4, 107, 150 Rectum, 72, 123, 131, 133, 139, 148, 150 Recur, 80, 150 Recurrence, 104, 127, 150 Refer, 1, 125, 128, 135, 140, 143, 150, 155 Refraction, 150, 152 Refractory, 34, 41, 42, 132, 150 Regimen, 132, 150 Relative risk, 8, 150 Remission, 150 Respiration, 142, 151 Retinoblastoma, 7, 151 Retrospective, 8, 15, 51, 61, 151 Retrovirus, 83, 151 Ribosome, 151, 155

158 Genital Warts

Risk factor, 6, 8, 30, 40, 148, 150, 151 S Safe Sex, 93, 151 Scabies, 79, 151 Screening, 5, 26, 100, 128, 151 Secondary tumor, 141, 151 Senile, 146, 151 Sensibility, 122, 151 Sequence Homology, 69, 151 Sequencing, 146, 151 Serologic, 4, 151 Serologic Tests, 4, 151 Serum, 7, 122, 128, 136, 151, 152 Sexual Abstinence, 85, 102, 103, 104, 106, 152 Sexual Partners, 79, 152 Shock, 75, 152, 155 Side effect, 70, 71, 121, 152, 155 Skin Neoplasms, 132, 146, 152 Sodium, 15, 72, 152 Sodium Dodecyl Sulfate, 72, 152 Solid tumor, 122, 125, 152 Somatic, 135, 152 Specialist, 110, 152 Species, 75, 82, 135, 144, 149, 151, 152, 153, 155, 157 Specificity, 8, 121, 152 Spectrum, 25, 72, 152, 156 Spermicide, 104, 153 Spinous, 132, 139, 153 Spirochete, 153, 154 Sporadic, 151, 153 Squamous, 9, 10, 68, 69, 71, 133, 153 Squamous cell carcinoma, 10, 68, 133, 153 Squamous cells, 153 Squamous Epithelium, 9, 153 Sterility, 102, 153 Stimulus, 132, 139, 153 Stomach, 131, 133, 135, 138, 153 Strand, 52, 62, 73, 146, 153 Stress, 126, 148, 153 Subacute, 137, 153 Subclinical, 24, 25, 70, 82, 137, 153 Subspecies, 152, 153 Sulfates, 152, 153 Sunburn, 148, 153 Support group, 109, 154 Suppression, 10, 49, 58, 154 Surfactant, 152, 154 Synaptic, 143, 154 Synaptic Transmission, 143, 154 Syphilis, 4, 65, 79, 80, 85, 92, 93, 104, 105, 154 Systemic, 27, 34, 40, 125, 136, 138, 154, 155 Systemic disease, 136, 154 Systemic therapy, 34, 154

T Temporal, 141, 154 Teratogenesis, 146, 154 Thermal, 143, 146, 154 Thrombin, 148, 154 Thrombomodulin, 148, 154 Thrombosis, 148, 154 Thymus, 42, 137, 140, 154 Tolerance, 34, 42, 154 Topical, 6, 15, 24, 34, 42, 43, 52, 62, 72, 101, 106, 155 Toxic, iv, 70, 71, 130, 136, 143, 146, 147, 155 Toxicology, 92, 155 Toxin, 154, 155 Transcriptase, 151, 155 Transcription Factors, 10, 144, 155 Transfer Factor, 137, 155 Transfusion, 155 Translation, 13, 122, 155 Translational, 11, 155 Transplantation, 137, 155 Trauma, 4, 155 Trichloroacetic Acid, 21, 43, 48, 155 Trichomonas, 80, 155 Trichomoniasis, 27, 85, 155 Tumor marker, 124, 155 Tumorigenic, 7, 156 Tunica, 142, 156 U Ultraviolet Rays, 148, 156 Unconscious, 136, 156 Urethra, 145, 148, 156 Urethritis, 79, 93, 104, 105, 156 Urinary, 105, 134, 156 Urine, 156 Urogenital, 134, 156 Uterus, 121, 126, 127, 130, 156 V Vaccination, 8, 80, 156 Vaccine, 5, 6, 8, 11, 23, 38, 75, 121, 148, 156 Vaccine adjuvant, 23, 156 Vagina, 68, 72, 103, 119, 127, 131, 156, 157 Vaginal, 17, 18, 23, 98, 102, 106, 117, 118, 156, 157 Vaginal Discharge, 117, 156 Vaginitis, 79, 80, 93, 104, 105, 156 Vascular, 137, 138, 156 Vegetative, 146, 156 Vein, 143, 157 Venereal, 86, 108, 154, 157 Venereology, 48, 52, 157 Venous, 135, 148, 157 Veterinary Medicine, 92, 157 Viral Hepatitis, 83, 157

Index 159

Vitro, 11, 157 Vivo, 157 Vulva, 72, 103, 119, 157 W Wart, 7, 8, 68, 75, 82, 104, 157 White blood cell, 40, 123, 140, 141, 146, 157

X Xenograft, 122, 157 X-ray, 143, 156, 157 Z Zymogen, 148, 157

160 Genital Warts

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