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

KELOIDS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Keloids: 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: 0-597-84472-0 1. Keloids-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 keloids. 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 KELOIDS .................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Keloids........................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND KELOIDS .......................................................................................... 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Keloids.......................................................................................... 53 Federal Resources on Nutrition ................................................................................................... 54 Additional Web Resources ........................................................................................................... 55 CHAPTER 3. CLINICAL TRIALS AND KELOIDS................................................................................. 57 Overview...................................................................................................................................... 57 Recent Trials on Keloids............................................................................................................... 57 Keeping Current on Clinical Trials ............................................................................................. 58 CHAPTER 4. PATENTS ON KELOIDS ................................................................................................. 61 Overview...................................................................................................................................... 61 Patents on Keloids........................................................................................................................ 61 Patent Applications on Keloids .................................................................................................... 76 Keeping Current .......................................................................................................................... 82 CHAPTER 5. BOOKS ON KELOIDS .................................................................................................... 83 Overview...................................................................................................................................... 83 Chapters on Keloids...................................................................................................................... 83 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 89 Overview...................................................................................................................................... 89 NIH Guidelines............................................................................................................................ 89 NIH Databases............................................................................................................................. 91 Other Commercial Databases....................................................................................................... 93 The Genome Project and Keloids.................................................................................................. 93 APPENDIX B. PATIENT RESOURCES ................................................................................................. 97 Overview...................................................................................................................................... 97 Patient Guideline Sources............................................................................................................ 97 Finding Associations.................................................................................................................. 101 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 103 Overview.................................................................................................................................... 103 Preparation................................................................................................................................. 103 Finding a Local Medical Library................................................................................................ 103 Medical Libraries in the U.S. and Canada ................................................................................. 103 ONLINE GLOSSARIES................................................................................................................ 109 Online Dictionary Directories ................................................................................................... 110 KELOIDS DICTIONARY............................................................................................................. 111 INDEX .............................................................................................................................................. 157

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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 keloids 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 keloids, 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 keloids, 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 keloids. 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 keloids, 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 keloids. 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 KELOIDS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on keloids.

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

Body's Skin Frontier and the Challenges of Wound Healing: Keloids Source: JADA. Journal of the American Dental Association. 131(3): 362-365. March 2000. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. Summary: Keloids are thick, disfiguring scars that usually result from trauma to the skin induced by injuries such as burns or piercing, acne, or surgery within subpopulations of dark skinned people. This article describes keloids, wound healing, and present research on the skin as a frontier of defense for the body. Topics include the incidence and prevalence of keloids, how molecular defects contribute to keloid scarring, growth factors and keloids, and the clinical management of keloids. The clinical management of keloids in dentistry and medicine includes dressings and pressure devices,

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compression therapy, corticosteroid injections, cryosurgery, excision, radiation therapy, laser therapy, interferon therapy, and other therapies directed at collagen synthesis. The author briefly reports on current research efforts to understand and treat keloids. The contact information for two resource organizations is provided. 2 figures. 26 references. •

Keloids and Hypertrophic Scars: Review and Treatment Strategies Source: Seminars in Cutaneous Medicine and Surgery. 18(2): 159-171. June 1999. Summary: This journal article provides health professionals with information on the clinical, histopathological, and biochemical features of keloids and hypertrophic scars and on methods of treating them. Keloids and hypertrophic scars represent exuberant forms of scar formation that frequently are pruritic and painful, and occasionally form strictures. They may result in significant cosmetic disfigurement. A keloid is characterized histologically by the haphazard deposition of collagen fibers within the dermis, surrounded by a mucinous extracellular matrix with few macrophages and an abundance of eosinophils, mast cells, plasma cells, and lymphocytes. Histologically, hypertrophic scars also show increased collagen bundles. Biochemical features of keloids and hypertrophic scars include increased collagen synthesis, increased levels of certain immunoglobulins, and alterations in growth factor levels. Recent years have seen a better understanding of the molecular and biological mechanisms of keloidal scar formation, allowing for the development of more specific therapeutic options. These include surgical excision, radiotherapy, mechanical pressure, topical silicone gel sheeting, laser surgery, corticosteroid injections, cryosurgery, interferon therapy, and various pharmacological therapies. Despite these developments, keloids and hypertrophic scars remain difficult to manage. Many clinicians use several approaches in combination or sequentially. Development of a reliable animal model for keloid and hypertrophic scar formation, further molecular analysis of these lesions, and comparative analyses of fetal wound healing will significantly aid in the pursuit of better treatments. 1 figure and 141 references. (AA-M).

Federally Funded Research on Keloids The U.S. Government supports a variety of research studies relating to keloids. 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 keloids. 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 keloids. The following is typical of the type of information found when searching the CRISP database for keloids: 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: A6: HUMAN GENETICS: DNA SEQ, MOLEC GEN, POSIT MAPPING, KELOIDS, HYPERTEN, ALZ Principal Investigator & Institution: Valenzuela, Manuel S.; Meharry Medical College 1005-D B Todd Blvd Nashville, Tn 37208 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CELLULAR PATHOGENESIS

AND

MOLECULAR

BIOLOGY

OF

KELOID

Principal Investigator & Institution: Longaker, Michael T.; Professor of Surgery; Surgery; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2006 Summary: (provided by applicant) The long-term goal of this proposal is gain a better understanding of the biomolecular mechanisms underlying keloid pathogenesis. Keloids are the result of pathologic over-healing and represent a worldwide biomedical burden with approximately two billion people at risk. Keloids are not only aesthetically unattractive, but can result in functional impairments and physical deformity with many attendant fiscal, social, and psychological sequelae. In general, we propose to study the molecular biology of keloid pathogenesis using a four-pronged approach. First, we intend to employ a novel co-culture system to investigate the interactions of two important cell-types (keratinocytes and fibroblasts) believed to be critical to the formation of keloids in vivo. We will utilize mix and match combinations of normal skin-derived human keratinocytes (NHKs) or keloid-derived human keratinocytes (KHKs) with normal skin-derived human fibroblasts (NHFs) or keloid-derived human fibroblasts (KHFs). This step will allow us to isolate and focus on these four cell types and their specific interactions. Second, because keloids have a propensity to develop in areas of the body where skin stretch and movement are prevalent, we will examine the effect of equibiaxial strain on these four cell types and determine its effect on gene expression and protein synthesis. Third, we intend to make use of the strong environment for microarray analysis here at Stanford University to study the gene expression of NHKs, KHKs, NHFs, and KHFs. This powerful technology, will allow us to analyze differential gene expression on a genome-wide basis. We can, therefore, use microarray analysis to characterize the large-scale gene expression phenotypes of these four cell types in isolation as well as in coculture. Finally, we intend to use an innovative grafting technique to place cutaneous keratinocyte/acellular dermal grafts onto nude mice. We will pre-seed these grafts with either NHKs or KHKs and eventually NHFs and KHFs in mix and match combinations. In this way, we hope to create an in vivo analog to our in vitro coculture model. The central hypothesis to be tested in this proposal is that KHKs interact with KHFs in promoting keloid pathogenesis Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ECM REMODELING IN EXCESSIVE FIBROPLASIA Principal Investigator & Institution: Tuan, Tai-Lan; Assistant Professor of Research; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, Ca 90027 Timing: Fiscal Year 2004; Project Start 01-JUL-1998; Project End 31-JAN-2008 Summary: (provided by applicant): Long-term goal: To elucidate the cellular and molecular basis of excess scar formation during wound repair. This application will

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focus on the role of altered expression of plasminogen activator inhibitor-1 (PAI-1) in collagen over-production by keloidfibroblasts. Proteolytic degradation of the provisional fibrin matrix and remodeling of the newly formed collagen-containing scar tissues are essential features in injury repair. Keloids, resulting from improper wound healing, are the extreme form of skin fibrosis with unknown etiology. Using a 3dimensional fibrin gel culture system, we discovered that keloid fibroblasts are defective in fibrin degradation due to PAl-1 over-expression. In the previous granting period, we established, both in vitro and in vivo, that PAI-1 overexpression is phenotypic of keloid fibroblasts and is causal in the elevated collagen accumulation. Reducing PAI-1 activity also abolishes the elevated collagen accumulation in keloid fibroblasts (Tuan et al., Am J Pathol 2003). In addition, we demonstrated that, in vivo, PAI-1 increases as fetal mouse skin wounds transition from scarless (El5) to scarforming (E18 and after) repair, and aprotinin, a uPA/plasmin inhibitor, causes scar formation in E15 fetal skin wounds (Huang et al., WRR 2002). PAI-1 is the major inhibitor of the plasminogen activator (PA)/plasmin system. This system is central to fibrin degradation, cell adhesion and migration, and metalloproteinase (MMP) activation, which is essential in collagen turnover. Thus, we hypothesize that "PAl-1 contributes to elevated collagen accumulation in keloid fibroblasts by inhibiting MMP activation and or by modulating uPA-mediated cell adhesion". PAI-1 is a down stream target of TGF-beta, and keloid fibroblasts exhibit TGF-beta-mediated differences in matrix contraction and collagen synthesis. Thus, we also hypothesize that "an altered TGF-beta signaling pathway and or utilization of PAI-1 promoter response elements are responsible for increased PAI-1 expression in keloidfibroblasts" The established evidence and the unique experimental models will allow us to test these hypotheses through the following specific aims: Aim I: To investigate the role of PAI-1 increase in MMP- and cell adhesion-mediated collagen accumulation in keloid fibroblasts. Aim II: To determine the biological mechanism of PAI-1 increase resulting from altered TGFbeta signaling events and/or difference in PAI-1 promoter utilization in keloid fibroblasts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FIBROBLAST CD 90 EXPRESSION IN FIBROGENIC SKIN DISORDERS Principal Investigator & Institution: Hagood, James S.; Associate Professor; Pediatrics; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: (Taken from the application): Following skin injury, fibroblasts enter the wound, proliferate, and produce and reorganize connective tissue, restoring strength and function to the wounded site. If this process is disordered or excessive, fibrotic scarring results. Keloids and hypertrophic scars are painful and disfiguring examples. In scleroderma, fibrotic scarring forms in skin and other organs without prior injury, causing deformity, debilitation, and in some cases, death. The long-term goal to which the proposed research is directed is to understand how excessive fibrosis occurs and to develop new ways to prevent or treat it. Fibroblasts isolated from fibrotic tissues have many distinctive features, but it remains unclear how they acquire these features and whether all fibroblasts are equally involved. Prior investigations have defined heterogeneous features of normal rodent fibroblast subsets based on whether they express the cell surface marker Thy-l. However, to date Thy-l expression in fibrotic states has not been explored, nor has there been correlation of expression of CD90, the human Thy-l equivalent, with human 'fibroblast heterogeneity. We hypothesize that

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absence of Thy-1CD90 on the fibroblast surface correlates with a phenotype predisposed to participate in fibrotic responses, and that examination of fibrogenic lesions in human skin will demonstrate a higher proportion of fibroblasts lacking CD90 compared to normal skin. Thus, the aims of the project are: 1) to characterize fibroblast CD90 expression in hypertrophic scars. keloids, and scleroderma-affected skin in comparison to normal skin and normal scars, by immunostaining of tissue sections and cultured fibroblasts; 2) to characterize expression of type I collagen and connective tissue growth factor in sorted CD90 (-/+) and Thy-l (-/+) fibroblast populations: and to define the profile of differential gene expression in CD90 and Thv-l(-/+) subpopulations. Establishing the role of fibroblast Thy-1/CD90 expression in human fibrogenic skin diseases is likely to unlock mechanisms of fibroblast activation and lead to more effective treatments for fibrotic disorders in skin and other tissues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HYPOXIA REGULATION OF VEGF/VEGF RECEPTORS IN KELOIDS Principal Investigator & Institution: Le, Anh D.; Oral and Maxillofacial Surgery; Charles R. Drew University of Med & Sci 1621 E 120Th St Los Angeles, Ca 90059 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: We postulate that an imbalance in vascular homeostasis could contribute to a hypervascular state at the inflammatory border (erythematous) or a hypovascular state at the stable portion (classical keloid) of the keloid lesion, as observed clinically and histologically. The hypovascular or hypoxic state present at the stable portion is the key factor for induction and prolongation of the hypervascular and hyperpermeable features. These features, characteristic of the granulation tissue phenotype, are responsible for the maintenance of an enriched milieu of cytokines and growth factors for continuing support of dermal growth. Our study will focus on vascular endothelial growth factor (VEGF) as a major regulator of keloid vascular homeostasis. The proposed keloid study model will be established on three clinically distinct lesional sites--inflammatory (erythematous), stable (classical keloid) and central portion (regressing scar)--which represent the pathologic course of keloid formation. The role of transcription factor, hypoxia- inducible factor, HIF-1, and hypoxia-responsive element, HRE, in the regulation of hypoxic-induced VEGF expression at the stable portion of the keloid will be determined in correlation with the granulation tissue phenotype observed at the inflammatory border. The interaction between angiogenic stimuli, VEGF, HIF-1, and the extracellular proteases, urokinase plasminogen activator, uPA, and its inhibitor, PAI-1, will be investigated in our unique three-distinct-sites approach to elucidate the molecular basis of differential vascular formation in keloids. We hypothesize that a dysregulation in wound angiogenesis contributes to a differential distribution of vascular network, hypovascular or hypoxic at the stable portion of the lesion versus hypervascular and hyperpermeable at the inflammatory border, establishing the benign growth of the keloid phenotype. Our hypothesis will be tested using the following specific aims: 1) To confirm that VEGF/VEGF receptor(s) and uPA/PAI-1 are differentially expressed in human microvascular endothelium of keloids at the three distinct sites compared to adjacent clinically normal skin; 2) To study the effect of hypoxic stress on the expression of uPA/PAI-1 and VEGF/VEGF receptor(s), receptor affinity, biological functions including phosphorylation and in vitro angiogenic activity; 3) To study the effect of VEGF on the expression of uPA /PAI-1 and their role in keloid vascular homeostasis; and 4) To delineate the role of transcription factor, HIF-1, and HRE on hypoxia-induced VEGF expression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MINORITY PREDOCTORAL FELLOWSHIP PROGRAM Principal Investigator & Institution: Handy, Jeffrey A.; Microbiology; Meharry Medical College 1005-D B Todd Blvd Nashville, Tn 37208 Timing: Fiscal Year 2002; Project Start 01-JAN-2002 Summary: The long term goal of this laboratory is to elucidate the mechanisms underlying the formation of keloids, which are benign tumors that develop during an abnormal wound healing program. Our laboratory has reported an abnormal pattern of responses of keloid fibroblasts in vitro that may help to elucidate the underlying mechanism of abnormal growth and matrix metabolism of keloids, in vivo. In cultures derived from keloid and normal dermal fibroblasts, TGFbeta partially reverses the stimulation of DNA synthesis by EGF, PDGF, and SmC in normal, but not keloid cells. It has been reported that, in mink epithelial cells, growth inhibition by TGFbeta is linked to decreased phosphorylation of the retinoblastoma protein during Gl progression and induction of transcription of genes encoding certain inhibitors of cyclin dependent kinases. Therefore, the specific aims of the studies described herein are to 1) determine if the differential effects of TGFbeta on the response of keloid and normal fibroblasts to EGF are accompanied by differential phosphorylation of the retinoblastoma (Rb) protein, and 2) determine if these effects are accompanied by differential expression of the cyclin dependent kinase inhibitors p15 and p21. Confluent cultures from both keloid and normal fibroblasts in 1 percent serum will be exposed to either TGFbeta alone, EGF in the presence or absence of TGFbeta, or neither growth factor. Cells from each condition described will be harvested at various times for immunoblotting with antibodies against either Rb, p15 or p21. Intensity of the bands will estimate protein levels and relative electrophoretic mobility will vary with the phosphorylation status of Rb. The outcomes of these studies will contribute to an understanding of the pathology underlying the formation of keloids, the regulatory events governing cell cycle progression, and the effects of perturbation of those events on biological systems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR MECHANISMS FOR KELOID FORMATION Principal Investigator & Institution: Reichenberger, Ernst J.; Biostructure and Function; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2002; Project Start 10-SEP-1999; Project End 31-AUG-2004 Summary: The long-term goal of this study is to understand the molecular mechanisms of neoformation of dermal tissue in fibrotic diseases. To achieve this goal we began to study hereditary keloid formation. Keloids are benign tumors of the skin or cornea caused by clonal overactivity of fibroblasts during abnormal wound repair. The relatively large number of familial cases of keloid formation makes it possible to propose a genetic approach for the identification of a gene responsible for increased cell proliferation and extracellular matrix expression. We performed linkage analysis of one large family afflicted with an autosomal dominant form of hereditary keloid formation to identify the chromosomal locus of the disease gene by using polymorphic microsatellite markers covering the entire genome. We have identified a possible disease gene locus and are now in the process of establishing a high resolution map of the keloid locus by including other pedigrees that show locus homogeneity. Ideally, the interval will be restricted to less than 1-2 cM. The keloid gene will be identified by candidate gene cloning, positional candidate gene cloning, or positional cloning. We will construct a physical map of the keloid locus using YAC and cosmid clones covering this interval. Once the disease gene has been identified by mutation analysis and by co-

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segregation with the affected phenotype, studies are planned to characterize the protein product and its interactions with other genes or gene products. Depending on the nature of the keloid gene, we will plan in vitro studies of fibroblast and organ cultures as well as a mouse model that expresses the mutated gene by homologous recombination (knock-in). These studies should enable us to perform further studies on down-stream events, which are involved in the fibrosis of keloid scars. Identifying and characterizing the keloid gene product, and identifying other proteins or genes with which it interacts, will help us understand abnormal fibroblast regulation. We suggest that keloids are an excellent model for studying regulation of fibroblast activation and extracellular matrix expression during wound healing and fibrosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PILOT: KELOIDS Principal Investigator & Institution: Williams, Scott Matthew.; Associate Professor; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2004 Summary: Specific Aims: Keloids are benign collagenous tumors that develop during an exaggerated wound healing response of the skin. Even though keloids occur in less than 1% of the overall US population, they occur in 4.5% to 16% of African Americans. They have a 45-100% recurrence rate after surgical excision. While keloids are clearly familial and can have autosomal dominant or autosomal recessive modes of inheritance in some families, the gene(s) responsible have not been identified. We propose to map the gene(s) that cause keloids in African-American families by the following specific aims: 1. Ascertain and recruit individuals from African-American families with multiple affected individuals. Blood samples will be collected from as many family members as possible, both keloid formers and non-formers. DNA will be isolated from these samples for genetic analyses. 2. Test microsatellite markers for linkage to keloids. Initial analyses will focus on chromosome 14q22-23, where we have recently identified markers that appear to co-segregate with keloids in one African-American kindred. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SELECTINS AND FETAL WOUND HEALING Principal Investigator & Institution: Olutoye, Oluyinka O.; Surgery; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 31-JAN-2008 Summary: (provided by applicant): The overall objective of this project is to gain an in depth understanding into the role of selectins in the modulation of the inflammatory response following wounding in the adult and fetus. Fetal dermal wound healing is characterized by a scant inflammatory response and minimal fibrosis. Although fetal inflammatory cells are generally considered immature, an acute inflammatory response (with fibrosis) can be evoked at the site of fetal wounds by the application of diverse stimuli. Selectins are cell surface lectin molecules expressed on both leukocytes and endothelial cells that interact with their respective carbohydrate ligands to facilitate the early events of leukocyte recruitment, and thereby, contribute significantly to the inflammatory process. The contributions of these adhesion molecules to wound closure, repair and scar formation are poorly understood. This study is therefore proposed to evaluate the role of selectins in wound healing. The application will be centered on the hypothesis that the minimal inflammation noted in fetal dermal wounds is a consequence of alterations in expression of P- and E-selectin on fetal platelets and

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endothelial cells. To test this hypothesis, the relative expression of selectins on adult and fetal platelets and endothelial cells will be determined. Mice with targeted deletions of individual or combinations of selectins will be studied to determine the consequences of selectin absence on wound healing. Using the murine syngeneic fetal skin transplantation model and creating mice chimeric for selectins, the specific contributions of platelet or endothelial selectins in the inflammatory response will be elucidated. Understanding the mechanism of scarless fetal wound healing will provide alternative avenues to modulate the postnatal wound healing response. This will have implications not only in the management of complications of dermal wound healing (bum contractures, keloids, hypertrophic scars, non-healing ulcers, etc.) but also in all conditions where fibrosis is an undesired consequence, such as pulmonary fibrosis, strictures, peritoneal adhesions, hepatic fibrosis, etc. Furthermore, understanding how selectins modulate the inflammatory response in the fetus will reveal valuable information that may explain the predisposition of neonates and premature infants to infections. These may then provide opportunities to assist with the inflammatory responses in these children when they are most vulnerable. 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 “keloids” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for keloids in the PubMed Central database: •

Reduced growth-factor requirement of keloid-derived fibroblasts may account for tumor growth. by Russell SB, Trupin KM, Rodriguez-Eaton S, Russell JD, Trupin JS.; 1988 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=279596

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

A case of FG syndrome with gingival hyperplasia and keloids. Author(s): Elia M, Di Lello R, Romano C, Schepis C. Source: Pediatric Dermatology. 1995 December; 12(4): 387-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8747594

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A comparison of intralesional triamcinolone and cryosurgery in the treatment of acne keloids. Author(s): Layton AM, Yip J, Cunliffe WJ. Source: The British Journal of Dermatology. 1994 April; 130(4): 498-501. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8186117

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A comparison of spring and CO2- powered needleless injectors in the treatment of keloids with triamcinolone. Author(s): Berry RB. Source: British Journal of Plastic Surgery. 1981 October; 34(4): 458-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6794695

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A comparison of the combined effect of cryotherapy and corticosteroid injections versus corticosteroids and cryotherapy alone on keloids: a controlled study. Author(s): Yosipovitch G, Widijanti Sugeng M, Goon A, Chan YH, Goh CL. Source: The Journal of Dermatological Treatment. 2001 June; 12(2): 87-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12243664

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A controlled clinical trial of topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. Author(s): Gold MH. Source: Journal of the American Academy of Dermatology. 1994 March; 30(3): 506-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8113473

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A controlled cohort study examining the onset of hypertension in black patients with keloids. Author(s): Woolery-Lloyd H, Berman B. Source: European Journal of Dermatology : Ejd. 2002 November-December; 12(6): 581-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12459533

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A follow-up study on the treatment of keloids with triamicinolone acetonide. Author(s): Griffith BH, Monroe CW, McKinney P. Source: Plastic and Reconstructive Surgery. 1970 August; 46(2): 145-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5423478

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A new probably X-linked inherited syndrome: congenital muscular torticollis, multiple keloids cryptorchidism and renal dysplasia. Author(s): Goeminne L. Source: Acta Genet Med Gemellol (Roma). 1968 July; 17(3): 439-67. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4387470

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A protocol for the treatment of hypertrophic scars and keloids. Author(s): Nicolai JP, Bos MY, Bronkhorst FB, Smale CE. Source: Aesthetic Plastic Surgery. 1987; 11(1): 29-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3577941

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A randomized controlled trial of hydrocolloid dressing in the treatment of hypertrophic scars and keloids. Author(s): Phillips TJ, Gerstein AD, Lordan V. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1996 September; 22(9): 775-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8874525

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A technique for excising earlobe keloids. Author(s): Howell S, Warpeha R, Brent B. Source: Surg Gynecol Obstet. 1975 September; 141(3): 438. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1162577

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A technique to avoid atrophy in combined intralesional excision and steroid injection for keloids. Author(s): Patel IA, Hall PN. Source: British Journal of Plastic Surgery. 2000 March; 53(2): 174. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10878847

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A wound contraction experimental model for studying keloids and wound-healing modulators. Author(s): Kamamoto F, Paggiaro AO, Rodas A, Herson MR, Mathor MB, Ferreira MC. Source: Artificial Organs. 2003 August; 27(8): 701-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12911344

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Activation of collagen gene expression in keloids: co-localization of type I and VI collagen and transforming growth factor-beta 1 mRNA. Author(s): Peltonen J, Hsiao LL, Jaakkola S, Sollberg S, Aumailley M, Timpl R, Chu ML, Uitto J. Source: The Journal of Investigative Dermatology. 1991 August; 97(2): 240-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2071936

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Adjunct therapies to surgical management of keloids. Author(s): Berman B, Bieley HC. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1996 February; 22(2): 126-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8608373

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Aetiology and management of hypertrophic scars and keloids. Author(s): Wakelin SH, Marren P. Source: Annals of the Royal College of Surgeons of England. 1996 November; 78(6): 558. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8943647

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Aetiology and management of hypertrophic scars and keloids. Author(s): O'Sullivan ST, O'Shaughnessy M, O'Connor TP. Source: Annals of the Royal College of Surgeons of England. 1996 May; 78(3 ( Pt 1)): 16875. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8779496

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Aetiopathogenesis of keloids. Author(s): Deodhar AK. Source: Indian Journal of Medical Sciences. 1999 December; 53(12): 525-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10862278

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Alpha-naphthyl acid phosphatase activity in normal human skin and keloids. Author(s): Im MJ, Hoopes JE. Source: The Journal of Investigative Dermatology. 1971 September; 57(3): 184-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5094727

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Alterations in fibroblast alpha1beta1 integrin collagen receptor expression in keloids and hypertrophic scars. Author(s): Szulgit G, Rudolph R, Wandel A, Tenenhaus M, Panos R, Gardner H. Source: The Journal of Investigative Dermatology. 2002 March; 118(3): 409-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11874478

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Altered cytokine production in black patients with keloids. Author(s): McCauley RL, Chopra V, Li YY, Herndon DN, Robson MC. Source: Journal of Clinical Immunology. 1992 July; 12(4): 300-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1512303

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An approach to management of keloids. Author(s): Stucker FJ, Shaw GY. Source: Archives of Otolaryngology--Head & Neck Surgery. 1992 January; 118(1): 63-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1728280

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An experience in treating five hundred and one patients with keloids. Author(s): Inalsingh CH. Source: Johns Hopkins Med J. 1974 May; 134(5): 284-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4826125

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An interesting case of multiple keloids. Author(s): Gupta S. Source: Indian J Dermatol. 1973 October; 19(1): 15-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4802940

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Analysis of collagen composition in acne keloids. Author(s): Jutley JK, Ng KY, Cunliffe WJ, Layton AM, Wood EJ. Source: Biochemical Society Transactions. 1993 August; 21 ( Pt 3)(3): 303S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8224450

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Analysis of differentially expressed genes in keloids and normal skin with cDNA microarray. Author(s): Chen W, Fu X, Sun X, Sun T, Zhao Z, Sheng Z. Source: The Journal of Surgical Research. 2003 August; 113(2): 208-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957131

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Analysis of p53 gene mutations in keloids using polymerase chain reaction-based single-strand conformational polymorphism and DNA sequencing. Author(s): Saed GM, Ladin D, Olson J, Han X, Hou Z, Fivenson D. Source: Archives of Dermatology. 1998 August; 134(8): 963-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9722726

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Apoptosis, necrosis, and proliferation: possible implications in the etiology of keloids. Author(s): Appleton I, Brown NJ, Willoughby DA. Source: American Journal of Pathology. 1996 November; 149(5): 1441-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8909233

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Are keloids really “gli-loids”?: High-level expression of gli-1 oncogene in keloids. Author(s): Kim A, DiCarlo J, Cohen C, McCall C, Johnson D, McAlpine B, Quinn AG, McLaughlin ER, Arbiser JL. Source: Journal of the American Academy of Dermatology. 2001 November; 45(5): 70711. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11606920

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Association between keloids and Dupuytren's disease: case report. Author(s): Gonzalez-Martinez R, Marin-Bertolin S, Amorrortu-Velayos J. Source: British Journal of Plastic Surgery. 1995 January; 48(1): 47-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7719609

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Atypical keloids after dermabrasion of patients taking isotretinoin. Author(s): Rubenstein R, Roenigk HH Jr, Stegman SJ, Hanke CW. Source: Journal of the American Academy of Dermatology. 1986 August; 15(2 Pt 1): 2805. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3018052

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Auricular keloids: a simple method of management. Author(s): Barton RP. Source: Annals of the Royal College of Surgeons of England. 1978 July; 60(4): 324-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=666239

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Bilateral congenital corneal keloids and anterior segment mesenchymal dysgenesis in a case of Rubinstein-Taybi syndrome. Author(s): Rao SK, Fan DS, Pang CP, Li WW, Ng JS, Good WV, Lam DS. Source: Cornea. 2002 January; 21(1): 126-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11805525

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Bilateral earlobe keloids. Author(s): Cosman B, Wolff M. Source: Plastic and Reconstructive Surgery. 1974 May; 53(5): 540-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4821203

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Biochemical composition of the connective tissue in keloids and analysis of collagen metabolism in keloid fibroblast cultures. Author(s): Abergel RP, Pizzurro D, Meeker CA, Lask G, Matsuoka LY, Minor RR, Chu ML, Uitto J. Source: The Journal of Investigative Dermatology. 1985 May; 84(5): 384-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3998489

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Biologic basis for the treatment of keloids and hypertrophic scars. Author(s): Peacock EE Jr, Madden JW, Trier WC. Source: Southern Medical Journal. 1970 July; 63(7): 755-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5427162

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Bleomycin in the treatment of keloids and hypertrophic scars by multiple needle punctures. Author(s): Espana A, Solano T, Quintanilla E. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 January; 27(1): 23-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11231236

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Butterfly keloids elsewhere than presternal. Author(s): Stott W. Source: British Journal of Plastic Surgery. 1977 July; 30(3): 243. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=890204

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Button compression for keloids of the lobule. Author(s): Snyder GB. Source: British Journal of Plastic Surgery. 1974 April; 27(2): 186-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4834033

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Carbon dioxide laser ablation associated with interferon alfa-2b injections reduces the recurrence of keloids. Author(s): Conejo-Mir JS, Corbi R, Linares M. Source: Journal of the American Academy of Dermatology. 1998 December; 39(6): 103940. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9843032

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Carbon dioxide laser excision of earlobe keloids. A prospective study and critical analysis of existing data. Author(s): Stern JC, Lucente FE. Source: Archives of Otolaryngology--Head & Neck Surgery. 1989 September; 115(9): 1107-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2765229

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Carbon dioxide laser for keloids. Author(s): Lim TC, Tan WT. Source: Plastic and Reconstructive Surgery. 1991 December; 88(6): 1111. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1946769

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Classification of keloids. Author(s): Onwukwe MF. Source: J Dermatol Surg Oncol. 1978 July; 4(7): 534-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=670531

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Clinical genetics of familial keloids. Author(s): Marneros AG, Norris JE, Olsen BR, Reichenberger E. Source: Archives of Dermatology. 2001 November; 137(11): 1429-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11708945

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Coiffure keloids. Author(s): Bayles MA. Source: The British Journal of Dermatology. 1972 April; 86(4): 415-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5023900

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Collagen chain composition and collagen gene expression in acne keloids. Author(s): Jutley JK, Cunliffe WJ, Layton A, Wood EJ. Source: Biochemical Society Transactions. 1992 November; 20(4): 374S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1487034

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Collagen gene expression in keloids: analysis of collagen metabolism and type I, III, IV, and V procollagen mRNAs in keloid tissue and keloid fibroblast cultures. Author(s): Ala-Kokko L, Rintala A, Savolainen ER. Source: The Journal of Investigative Dermatology. 1987 September; 89(3): 238-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3624897

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Combination of different techniques for the treatment of earlobe keloids. Author(s): Akoz T, Gideroglu K, Akan M. Source: Aesthetic Plastic Surgery. 2002 May-June; 26(3): 184-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12140696

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Combined approach to the treatment of earlobe keloids. Author(s): Akoz T, Erdogan B, Gorgu M, Deren O. Source: Plastic and Reconstructive Surgery. 1998 March; 101(3): 857-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9500410

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Combined modalities in the management of hypertrophic scars and keloids. Author(s): Babin RW, Ceilley RI. Source: The Journal of Otolaryngology. 1979 October; 8(5): 457-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=501782

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Combined modalities in the treatment of keloids. Author(s): Goldberg HC. Source: J Med Soc N J. 1967 November; 64(11): 595-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5237631

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Combined surgery and irradiation for treatment of hypertrophic scars and keloids. Author(s): Chen HC, Ou SY, Lai YL. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1991 April; 47(4): 249-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1646674

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Combined surgical and x-ray therapy of keloids. Author(s): Greer JL, Vickers B. Source: J La State Med Soc. 1970 April; 122(4): 107-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5427581

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Comparative ultrastructure of hypertrophic scars and keloids. Author(s): Kischer CW. Source: Scan Electron Microsc. 1984; (Pt 1): 423-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6740239

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Complications of foot surgery. Wound dehiscence, hypertrophic scars, and keloids. Author(s): Wilczynski RJ. Source: Clin Podiatr Med Surg. 1991 April; 8(2): 359-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2059927

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Co-ordinate induction of collagen type I and biglycan expression in keloids. Author(s): Hunzelmann N, Anders S, Sollberg S, Schonherr E, Krieg T. Source: The British Journal of Dermatology. 1996 September; 135(3): 394-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8949432

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Corneal keloids. Author(s): LeMasters WC, Notz RG. Source: Trans Pa Acad Ophthalmol Otolaryngol. 1986; 38(1): 286-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3765007

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Corneal keloids. Author(s): O'Grady RB, Kirk HQ. Source: American Journal of Ophthalmology. 1972 February; 73(2): 206-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5015901

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Corneal keloids--a histopathological study. Author(s): Lahav M, Cadet JC, Chirambo M, Rehani U, Ishii Y. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 1982; 218(5): 256-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7095450

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Correction of keloids and finger contractures in burn patients. Author(s): Robitaille A, Halpern D, Kottke FJ, Burrill C, Payne L. Source: Archives of Physical Medicine and Rehabilitation. 1973 November; 54(11): 51520 Passim. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4748319

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Correlation between X-prolyl dipeptidyl-aminopeptidase and serum amine oxidase in serum of patients with post-burn keloids. Author(s): Nagatsu T, Iwase K, Kasahara Y, Kubono K, Sakakibara S, Aoyama H, Izawa Y. Source: Clinical Chemistry. 1979 March; 25(3): 376-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=400439

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Cryosurgery for hypertrophic scars and keloids. A preliminary report. Author(s): Pierce HE. Source: Journal of the National Medical Association. 1974 March; 66(2): 174-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4819902

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Cryotherapy in the treatment of keloids. Author(s): Muti E, Ponzio E. Source: Annals of Plastic Surgery. 1983 September; 11(3): 227-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6638822

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Cultured epithelial autografts in the treatment of extensive recalcitrant keloids. Author(s): Haas AF, Reilly DA. Source: Archives of Dermatology. 1998 May; 134(5): 549-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9606323

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Current concepts in the management of keloids. Author(s): Strahan RW, Krugman M. Source: Otolaryngologic Clinics of North America. 1972 October; 5(3): 521-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5072517

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Current developments and uses of cryosurgery in the treatment of keloids and hypertrophic scars. Author(s): Zouboulis CC, Zouridaki E, Rosenberger A, Dalkowski A. Source: Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society. 2002 March-April; 10(2): 98-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12028522

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Detection and analysis of Fas gene (exon 1-6) mutations in keloids. Author(s): Liu YB, Gao JH, Duan HJ. Source: Di Yi June Yi Da Xue Xue Bao. 2002 January; 22(1): 61-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390849

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Detection of apoptosis in keloids and a comparative study on apoptosis between keloids, hypertrophic scars, normal healed flat scars, and dermatofibroma. Author(s): Akasaka Y, Fujita K, Ishikawa Y, Asuwa N, Inuzuka K, Ishihara M, Ito M, Masuda T, Akishima Y, Zhang L, Ito K, Ishii T. Source: Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society. 2001 November-December; 9(6): 5016. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11896992

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Dietary compounds inhibit proliferation and contraction of keloid and hypertrophic scar-derived fibroblasts in vitro: therapeutic implication for excessive scarring. Author(s): Phan TT, Sun L, Bay BH, Chan SY, Lee ST. Source: The Journal of Trauma. 2003 June; 54(6): 1212-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12813346

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Direct histochemical demonstration of histamine in cutaneous mast cells: urticaria pigmentosa and keloids. Author(s): Hakanson R, Owman C, Sjoberg NO, Sporrong B. Source: Experientia. 1969 August 15; 25(8): 854-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5348555

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Discrete keloids in a lightning strike. Author(s): Resnik BI, Capland L. Source: Journal of the American Academy of Dermatology. 1994 June; 30(6): 1039-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8188875

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Downregulation of inducible nitric oxide synthase expression in keloids. Author(s): Lim TC, Moochhala SM, Tan Walter TL, Chhatwal VJ, Suhumaran S, Hon WM, Khoo HE. Source: Plastic and Reconstructive Surgery. 1996 October; 98(5): 911-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8823050

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D-Penicillamine in the treatment of keloids. Author(s): Mayou BJ. Source: The British Journal of Dermatology. 1981 July; 105(1): 87-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7020743

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Ear lobe keloids, surgical excision followed by radiation therapy: a 10-year experience. Author(s): Chaudhry MR, Akhtar S, Duvalsaint F, Garner L, Lucente FE. Source: Ear, Nose, & Throat Journal. 1994 October; 73(10): 779-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7805600

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Earlobe keloids. Author(s): Zuber TJ, DeWitt DE. Source: American Family Physician. 1994 June; 49(8): 1835-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8203321

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Ear-lobe keloids: treatment by a protocol of surgical excision and immediate postoperative adjuvant radiotherapy. Author(s): Ragoowansi R, Cornes PG, Glees JP, Powell BW, Moss AL. Source: British Journal of Plastic Surgery. 2001 September; 54(6): 504-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11513512

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Ectodermal dysplasia syndrome in siblings with true keloids, stenosis of the esophagus after operations for congenital achalasia and renovascular hypertension due to stenosis of renal artery. Author(s): Shimohashi N, Furukawa M, Yamaguchi H, Hashimoto T, Umeda F, Nawata H. Source: Intern Med. 1995 May; 34(5): 406-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7647411

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Effect of the 585 nm flashlamp-pumped pulsed dye laser for the treatment of keloids. Author(s): Paquet P, Hermanns JF, Pierard GE. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 February; 27(2): 171-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11207693

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Effects of a water-impermeable, non-silicone-based occlusive dressing on keloids. Author(s): Bieley HC, Berman B. Source: Journal of the American Academy of Dermatology. 1996 July; 35(1): 113-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8682947

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Keloids

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Effects of pharmacologic agents on human keloids implanted in athymic mice. A pilot study. Author(s): Waki EY, Crumley RL, Jakowatz JG. Source: Archives of Otolaryngology--Head & Neck Surgery. 1991 October; 117(10): 117781. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1910708

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Efficacy and safety of intralesional 5-fluorouracil in the treatment of keloids. Author(s): Gupta S, Kalra A. Source: Dermatology (Basel, Switzerland). 2002; 204(2): 130-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11937738

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Embedded foreign bodies presenting as earlobe keloids. Author(s): Saleeby ER, Rubin MG, Youshock E, Kleinsmith DM. Source: J Dermatol Surg Oncol. 1984 November; 10(11): 902-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6491029

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Enzyme activities in hypertrophic scars and keloids. Author(s): Hoopes JE, Su CT, Im MJ. Source: Plastic and Reconstructive Surgery. 1971 February; 47(2): 132-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5540789

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Enzyme activity in human scars, hypertrophic scars and keloids. Author(s): Kemble JV, Brown RF. Source: The British Journal of Dermatology. 1976 March; 94(3): 301-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1252360

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Eradication of large auricular keloids by excision, skin grafting, and intradermal injection of triamcinolone acetonide solution. Case report. Author(s): Converse JM, Stallings JO. Source: Plastic and Reconstructive Surgery. 1972 April; 49(4): 461-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4552358

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Eruptive paraneoplastic keloids. Author(s): Coppa LM, Alam M, Longley BJ, Stiller MJ. Source: Cutis; Cutaneous Medicine for the Practitioner. 1999 October; 64(4): 243-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10544878

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Erythema elevatum diutinum mimicking extensive keloids; quiz 386. Author(s): Krishnan RS, Hwang LY, Tschen JA, Subrt P, Hsu S. Source: Cutis; Cutaneous Medicine for the Practitioner. 2001 May; 67(5): 381-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11381853

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Evaluation of the late neurologic deficits accompanied by hypertrophic scars and keloids in children with elbow fractures. Author(s): Gurbuz H, Birtane M, Yalcin O. Source: Journal of Pediatric Orthopedics. 2001 September-October; 21(5): 577-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11521021

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Evaluation of various methods of treating keloids and hypertrophic scars: a 10-year follow-up study. Author(s): Darzi MA, Chowdri NA, Kaul SK, Khan M. Source: British Journal of Plastic Surgery. 1992 July; 45(5): 374-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1638291

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Experience with difficult keloids. Author(s): Lahiri A, Tsiliboti D, Gaze NR. Source: British Journal of Plastic Surgery. 2001 October; 54(7): 633-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11583502

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Expression of Bcl-2, p53, c-jun and c-fos protooncogenes in keloids and hypertrophic scars. Author(s): Teofoli P, Barduagni S, Ribuffo M, Campanella A, De Pita' O, Puddu P. Source: Journal of Dermatological Science. 1999 December; 22(1): 31-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10651227

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Expression of transforming growth factor beta 1, 2, and 3 proteins in keloids. Author(s): Lee TY, Chin GS, Kim WJ, Chau D, Gittes GK, Longaker MT. Source: Annals of Plastic Surgery. 1999 August; 43(2): 179-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10454326

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Expression of urokinase-type plasminogen activator and its receptor in keloids. Author(s): Leake D, Doerr TD, Scott G. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 December; 129(12): 1334-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14676162

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Extensive keloids following hair transplantation. Author(s): Brown MD, Johnson T, Swanson NA. Source: J Dermatol Surg Oncol. 1990 September; 16(9): 867-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2398207

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Keloids

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Facial keloids and their management. Author(s): Moreno FG, Pennington FR, Bond WR Jr, Morrison WV. Source: Ear, Nose, & Throat Journal. 1981 November; 60(11): 519-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7333220

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Facial keloids. A 15-year experience. Author(s): Lindsey WH, Davis PT. Source: Archives of Otolaryngology--Head & Neck Surgery. 1997 April; 123(4): 397-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9109787

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Facial keloids: an update on dental considerations and new management techniques. Author(s): Tatum RC, Rezai RF, Contreras J. Source: J Md State Dent Assoc. 1985 August; 28(2): 67-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3862734

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Failure of carbon dioxide laser excision of keloids. Author(s): Apfelberg DB, Maser MR, White DN, Lash H. Source: Lasers in Surgery and Medicine. 1989; 9(4): 382-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2503668

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Failure of interferon-alpha 2b in the treatment of mature keloids. Author(s): al-Khawajah MM. Source: International Journal of Dermatology. 1996 July; 35(7): 515-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8809610

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Fibronectin (FN) in hypertrophic scars and keloids. Author(s): Kischer CW, Hendrix MJ. Source: Cell and Tissue Research. 1983; 231(1): 29-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6342808

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Follow-up on treatment of hypertrophic scars and keloids with triamcinolone. Author(s): Ketchum LD, Robinson DW, Masters FW. Source: Plastic and Reconstructive Surgery. 1971 September; 48(3): 256-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5566476

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From the literature: intralesional 5-FU in the treatment of hypertrophic scars and keloids: clinical experience. Author(s): Lebwohl M. Source: Journal of the American Academy of Dermatology. 2000 April; 42(4): 677. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10727318

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Functional analyses of the stratum corneum in scars. Sequential studies after injury and comparison among keloids, hypertrophic scars, and atrophic scars. Author(s): Suetake T, Sasai S, Zhen YX, Ohi T, Tagami H. Source: Archives of Dermatology. 1996 December; 132(12): 1453-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8961874

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Gelatinase activity in keloids and hypertrophic scars. Author(s): Neely AN, Clendening CE, Gardner J, Greenhalgh DG, Warden GD. Source: Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society. 1999 May-June; 7(3): 166-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10417752

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Gene mapping and serendipity. The locus for torticollis, keloids, cryptorchidism and renal dysplasia (31430, Mckusick) is at Xq28, distal to the G6PD locus. Author(s): Zuffardi O, Fraccaro M. Source: Human Genetics. 1982; 62(3): 280-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6132873

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Glucocorticoid regulation of elastin synthesis in human fibroblasts: down-regulation in fibroblasts from normal dermis but not from keloids. Author(s): Russell SB, Trupin JS, Kennedy RZ, Russell JD, Davidson JM. Source: The Journal of Investigative Dermatology. 1995 February; 104(2): 241-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7829880

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Heterogeneity in radiosensitivity of human diploid fibroblasts from keloids and normal skins. Author(s): Ma S, Fang RH, Chang WP. Source: Cell Biology International. 1996 April; 20(4): 289-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8664852

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Histochemistry of hypertrophic scars and keloids. Author(s): Kemble JV, Brown RF. Source: Proc R Soc Med. 1974 April; 67(4): 257-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4375817

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Histomorphologic changes in keloids treated with Kenacort. Author(s): Boyadjiev C, Popchristova E, Mazgalova J. Source: The Journal of Trauma. 1995 February; 38(2): 299-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7869456

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Keloids

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Historical notes on the use of pressure in the treatment of hypertrophic scars or keloids. Author(s): Linares HA, Larson DL, Willis-Galstaun BA. Source: Burns : Journal of the International Society for Burn Injuries. 1993 February; 19(1): 17-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8435111

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HLA antigens in keloids and hypertrophic scars. Author(s): Laurentaci G, Dioguardi D. Source: Archives of Dermatology. 1977 December; 113(12): 1726. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=596911

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Hydration and occlusion treatment for hypertrophic scars and keloids. Author(s): Sawada Y, Sone K. Source: British Journal of Plastic Surgery. 1992 November-December; 45(8): 599-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1493533

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Hypertrophic scars and keloids. Author(s): Haverstock BD. Source: Clin Podiatr Med Surg. 2001 January; 18(1): 147-59. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344975

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Hypertrophic scars and keloids. Author(s): Eisenbeiss W, Peter FW, Bakhtiari C, Frenz C. Source: J Wound Care. 1998 May; 7(5): 255-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9677997

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Hypertrophic scars and keloids. Author(s): Yagi K. Source: Plastic and Reconstructive Surgery. 1992 April; 89(4): 768-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1546104

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Hypertrophic scars and keloids. Author(s): Ketchum LD. Source: Clin Plast Surg. 1977 April; 4(2): 301-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=856531

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Hypertrophic scars and keloids. A collective review. Author(s): Ketchum LD, Cohen IK, Masters FW. Source: Plastic and Reconstructive Surgery. 1974 February; 53(2): 140-54. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4590747

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Hypertrophic scars and keloids. Cause and management--current concepts. Author(s): Chait LA, Kadwa MA. Source: S Afr J Surg. 1988 September; 26(3): 95-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3055354

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Hypertrophic scars and keloids: a recurrent problem revisited. Author(s): Ellitsgaard V, Ellitsgaard N. Source: Acta Chir Plast. 1997; 39(3): 69-77. Review. Erratum In: 1997; 39(4): 112. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9439007

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Hypertrophic scars and keloids: a review and new concept concerning their origin. Author(s): Kischer CW, Shetlar MR, Chvapil M. Source: Scan Electron Microsc. 1982; (Pt 4): 1699-713. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7184146

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Hypertrophic scars and keloids: etiology and management. Author(s): Alster TS, Tanzi EL. Source: American Journal of Clinical Dermatology. 2003; 4(4): 235-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12680802

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Hypertrophic scars, keloids, and contractures. The cellular and molecular basis for therapy. Author(s): Tredget EE, Nedelec B, Scott PG, Ghahary A. Source: The Surgical Clinics of North America. 1997 June; 77(3): 701-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9194888

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Hypertrophic scars, keloids, and laryngotracheal stenosis. Author(s): Raman R, Arumainathan U, Subramaniam S, Chan L, Jalaludin MA. Source: Plastic and Reconstructive Surgery. 1999 April; 103(5): 1539. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10190465

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Immunoglobulins in hypertrophic scars and keloids. Author(s): Kischer CW, Shetlar MR, Shetlar CL, Chvapil M. Source: Plastic and Reconstructive Surgery. 1983 June; 71(6): 821-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6344114

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Immunologic associations of keloids. Author(s): Placik OJ, Lewis VL Jr. Source: Surg Gynecol Obstet. 1992 August; 175(2): 185-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1636146

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Impairment in the fatty acid composition of keloids. Author(s): Louw L, Engelbrecht AM, Cloete F, van der Westhuizen JP, Dumas L. Source: Advances in Experimental Medicine and Biology. 1997; 400B: 905-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9547645

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In search of the optimal treatment of keloids: report of a series and a review of the literature. Author(s): Lawrence WT. Source: Annals of Plastic Surgery. 1991 August; 27(2): 164-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1835334

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Increased androgen binding in keloids: a preliminary communication. Author(s): Ford LC, King DF, Lagasse LD, Newcomer V. Source: J Dermatol Surg Oncol. 1983 July; 9(7): 545-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6682867

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Increased expression of tenascin C by keloids in vivo and in vitro. Author(s): Dalkowski A, Schuppan D, Orfanos CE, Zouboulis CC. Source: The British Journal of Dermatology. 1999 July; 141(1): 50-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10417515

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Intra- and postoperative steroid injections for keloids and hypertrophic scars. Author(s): Tang YW. Source: British Journal of Plastic Surgery. 1992 July; 45(5): 371-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1638290

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Intralesional 5-fluorouracil as a treatment modality of keloids. Author(s): Nanda S, Reddy BS. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2004 January; 30(1): 54-6; Discussion 56-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14692928

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Intralesional cryosurgery using lumbar puncture and/or hypodermic needles for large, bulky, recalcitrant keloids. Author(s): Gupta S, Kumar B. Source: International Journal of Dermatology. 2001 May; 40(5): 349-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11555001

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Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids. Author(s): Har-Shai Y, Amar M, Sabo E. Source: Plastic and Reconstructive Surgery. 2003 May; 111(6): 1841-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12711943

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Intralesional injection of keloids and hypertrophic scars with the Dermo-Jet. Author(s): Vallis CP. Source: Plastic and Reconstructive Surgery. 1967 September; 40(3): 255-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6037157

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Intralesional interferon alpha-2b has no effect in the treatment of keloids. Author(s): Wong TW, Chiu HC, Yip KM. Source: The British Journal of Dermatology. 1994 May; 130(5): 683-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8204485

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Intralesional interferon gamma treatment for keloids and hypertrophic scars. Author(s): Larrabee WF Jr, East CA, Jaffe HS, Stephenson C, Peterson KE. Source: Archives of Otolaryngology--Head & Neck Surgery. 1990 October; 116(10): 115962. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2119626

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Inverse correlation between CD34 expression and proline-4-hydroxylase immunoreactivity on spindle cells noted in hypertrophic scars and keloids. Author(s): Aiba S, Tagami H. Source: Journal of Cutaneous Pathology. 1997 February; 24(2): 65-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9162737

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Keloids - the sebum hypothesis revisited. Author(s): Fong EP, Bay BH. Source: Medical Hypotheses. 2002 April; 58(4): 264-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12027517

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Keloids and diabetes in a family. Author(s): Rao KV, Sundaram A, Manjula N, Seshiah V. Source: J Assoc Physicians India. 1990 August; 38(8): 585. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2246203

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Keloids and end-stage renal disease. Author(s): Freedman BI, Morrow MA, Tuttle AB, Igwemezie BM, Rich SS, Sherertz EF. Source: Nephron. 1998 October; 80(2): 244-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9736834

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Keloids and hypertrophic scars in the foot. Author(s): Kwiecinski MG, Reinherz RP. Source: J Foot Surg. 1987 July-August; 26(4): 293-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3655193

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Keloids and hypertrophic scars of Caucasians show distinctive morphologic and immunophenotypic profiles. Author(s): Santucci M, Borgognoni L, Reali UM, Gabbiani G. Source: Virchows Archiv : an International Journal of Pathology. 2001 May; 438(5): 45763. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407473

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Keloids and hypertrophic scars. Author(s): English RS, Shenefelt PD. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1999 August; 25(8): 631-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10491047

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Keloids and hypertrophic scars. Author(s): Murray JC. Source: Clinics in Dermatology. 1994 January-March; 12(1): 27-37. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8180942

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Keloids and hypertrophic scars. Author(s): Nemeth AJ. Source: J Dermatol Surg Oncol. 1993 August; 19(8): 738-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8349914

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Keloids and hypertrophic scars. Author(s): Brody GS. Source: Plastic and Reconstructive Surgery. 1990 October; 86(4): 804. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2217605

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Keloids and hypertrophic scars. Author(s): Murray JC, Pollack SV, Pinnell SR. Source: Clinics in Dermatology. 1984 July-September; 2(3): 121-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6545764

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Keloids and hypertrophic scars: a comprehensive review. Author(s): Rockwell WB, Cohen IK, Ehrlich HP. Source: Plastic and Reconstructive Surgery. 1989 November; 84(5): 827-37. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2682703

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Keloids and hypertrophic scars: results with intraoperative and serial postoperative corticosteroid injection therapy. Author(s): Chowdri NA, Masarat M, Mattoo A, Darzi MA. Source: The Australian and New Zealand Journal of Surgery. 1999 September; 69(9): 6559. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10515339

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Keloids and hypertrophic scars: review and treatment strategies. Author(s): Urioste SS, Arndt KA, Dover JS. Source: Semin Cutan Med Surg. 1999 June; 18(2): 159-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10385284

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Keloids and neoplasms in the Rubinstein-Taybi syndrome. Author(s): Siraganian PA, Rubinstein JH, Miller RW. Source: Medical and Pediatric Oncology. 1989; 17(6): 485-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2586363

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Keloids have continuous high metabolic activity. Author(s): Ueda K, Furuya E, Yasuda Y, Oba S, Tajima S. Source: Plastic and Reconstructive Surgery. 1999 September; 104(3): 694-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10456520

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Keloids in Ibadan. Author(s): Oluwasanmi JO. Source: Trop Geogr Med. 1974 September; 26(3): 231-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4439459

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Keloids in rural black South Africans. Part 1: general overview and essential fatty acid hypotheses for keloid formation and prevention. Author(s): Louw L. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 2000 November; 63(5): 237-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11090249

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Keloids in rural black South Africans. Part 2: dietary fatty acid intake and total phospholipid fatty acid profile in the blood of keloid patients. Author(s): Louw L, Dannhauser A. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 2000 November; 63(5): 247-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11090250

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Keloids in rural black South Africans. Part 3: a lipid model for the prevention and treatment of keloid formations. Author(s): Louw L. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 2000 November; 63(5): 255-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11090251

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Keloids of the breast: mammographic findings. Author(s): Kilkenny TE, Swenson GW. Source: Ajr. American Journal of Roentgenology. 1995 April; 164(4): 1022. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7726020

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Keloids of the ear lobes in Egypt: their rarity in childhood and their treatment. Author(s): Moustafa MF, Abdel-Fattah AM. Source: British Journal of Plastic Surgery. 1976 January; 29(1): 59-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1268443

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Keloids of the earlobes: a surgical technique. Author(s): Salasche SJ, Grabski WJ. Source: J Dermatol Surg Oncol. 1983 July; 9(7): 552-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6853822

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Keloids of the external ear. Author(s): Buchwald C, Nielsen LH, Rosborg J. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 1992; 54(2): 108-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1377373

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Keloids should be treated with the traditional scalpel incision followed by steroid injection. Author(s): Thomas JR. Source: Archives of Otolaryngology--Head & Neck Surgery. 2001 September; 127(9): 1144. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11556870

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Keloids treated with excision followed by radiation therapy. Author(s): Klumpar DI, Murray JC, Anscher M. Source: Journal of the American Academy of Dermatology. 1994 August; 31(2 Pt 1): 22531. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8040405

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Keloids treated with topical injections of triamcinolone acetonide (kenalog). Immediate and long-term results. Author(s): Kiil J. Source: Scand J Plast Reconstr Surg. 1977; 11(2): 169-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=345427

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Keloids. Author(s): Berman B, Bieley HC. Source: Journal of the American Academy of Dermatology. 1995 July; 33(1): 117-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7601928

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Keloids. Author(s): Doyle-Lloyd DJ, White JA. Source: J La State Med Soc. 1991 December; 143(12): 9-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1779193

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Keloids. Author(s): Kelly AP. Source: Dermatologic Clinics. 1988 July; 6(3): 413-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3048824

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Keloids: a prospective study of 57 cases. Author(s): Sharma BC. Source: Med J Zambia. 1980 June-July; 14(4): 66-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7053006

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Keloids: a review of the literature. Author(s): Datubo-Brown DD. Source: British Journal of Plastic Surgery. 1990 January; 43(1): 70-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2178718

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Keloids: a review. Author(s): Murray JC, Pollack SV, Pinnell SR. Source: Journal of the American Academy of Dermatology. 1981 April; 4(4): 461-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7014664

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Keloids: a study of the immune reaction to sebum. Author(s): Fasika OM. Source: East Afr Med J. 1992 February; 69(2): 114-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1505385

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Keloids: an enigma of surgeons. Author(s): Daniels KB. Source: J Foot Surg. 1984 July-August; 23(4): 279-82. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6470426

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Keloids: enigma of the plastic surgeon. Author(s): Pierce HE. Source: Journal of the National Medical Association. 1979 December; 71(12): 1177-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=522181

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Keloids: peripheral and central differences in cell morphology and fatty acid compositions of lipids. Author(s): Louw L, van der Westhuizen JP, Duyvene de Wit L, Edwards G. Source: Advances in Experimental Medicine and Biology. 1997; 407: 515-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9322000

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Keloids: scar revision. Author(s): Brown LA Jr, Pierce HE. Source: J Dermatol Surg Oncol. 1986 January; 12(1): 51-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3510231

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Keloids: the natural history. Author(s): Adeyemi-Doro HO. Source: Afr J Med Med Sci. 1976 March; 5(1): 93-100. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=829712

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Keloids: time to dispel the myths? Author(s): Fong EP, Chye LT, Tan WT. Source: Plastic and Reconstructive Surgery. 1999 September; 104(4): 1199-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10654768

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Keloids--their epidemiology and treatment. Author(s): Lee CP. Source: International Journal of Dermatology. 1982 November; 21(9): 504-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7152774

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Laser treatment of hypertrophic scars and keloids. Author(s): Scholz TA, Vanderhooft SL. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1998 February; 24(2): 298-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9491132

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Laser treatment of hypertrophic scars, keloids, and striae. Author(s): Alster TS, Handrick C. Source: Semin Cutan Med Surg. 2000 December; 19(4): 287-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11149609

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Laser treatment of hypertrophic scars, keloids, and striae. Author(s): Alster TS. Source: Dermatologic Clinics. 1997 July; 15(3): 419-29. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9189679

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Laser treatment of keloids: a clinical trial and an in vitro study with Nd:YAG laser. Author(s): Abergel RP, Dwyer RM, Meeker CA, Lask G, Kelly AP, Uitto J. Source: Lasers in Surgery and Medicine. 1984; 4(3): 291-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6390045

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Linear keloids resulting from abuse of anabolic androgenic steroid drugs. Author(s): Scott MJ Jr, Scott MJ 3rd, Scott AM. Source: Cutis; Cutaneous Medicine for the Practitioner. 1994 January; 53(1): 41-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8119077

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Management of keloids and hypertrophic scars. Author(s): Tritto M, Kanat IO. Source: Journal of the American Podiatric Medical Association. 1991 November; 81(11): 601-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1784016

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Management of keloids by surgical excision and local injections of a steroid. Author(s): Singleton MA, Gross CW. Source: Southern Medical Journal. 1971 November; 64(11): 1377-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4942437

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Management of scar contractures, hypertrophic scars, and keloids. Author(s): Sherris DA, Larrabee WF Jr, Murakami CS. Source: Otolaryngologic Clinics of North America. 1995 October; 28(5): 1057-68. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8559572

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Mechanical properties of keloids in vivo during treatment with intralesional triamcinolone acetonide. Author(s): Krusche T, Worret WI. Source: Archives of Dermatological Research. 1995; 287(3-4): 289-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7598534

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Men, earrings, and keloids. Author(s): Ofodile FA. Source: Plastic and Reconstructive Surgery. 1995 August; 96(2): 495-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7624438

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Mucin-like changes in keloids. Author(s): Wolff M. Source: American Journal of Clinical Pathology. 1981 October; 76(4): 504-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7293974

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Mucin-like changes in keloids. Author(s): Santa Cruz DJ, Ulbright TM. Source: American Journal of Clinical Pathology. 1981 January; 75(1): 18-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7457425

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Multiple cell origin of traumatically induced keloids. Author(s): Moulton-Levy P, Jackson CE, Levy HG, Fialkow PJ. Source: Journal of the American Academy of Dermatology. 1984 June; 10(6): 986-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6736343

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Multiple keloids. Author(s): Curth W, McSorley J. Source: Archives of Dermatology. 1971 July; 104(1): 106-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4256259

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New concept of balloon-compression wear for the treatment of keloids and hypertrophic scars. Author(s): Kosaka M, Kamiishi H. Source: Plastic and Reconstructive Surgery. 2001 October; 108(5): 1454-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11604673

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New therapies for the management of keloids. Author(s): Poochareon VN, Berman B. Source: The Journal of Craniofacial Surgery. 2003 September; 14(5): 654-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14501323

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Non-invasive monitoring of the mechanical properties of keloids during cryosurgery. Author(s): Dobrev H. Source: Acta Dermato-Venereologica. 1999 November; 79(6): 487-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10598775

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On the nature of hypertrophic scars and keloids: a review. Author(s): Niessen FB, Spauwen PH, Schalkwijk J, Kon M. Source: Plastic and Reconstructive Surgery. 1999 October; 104(5): 1435-58. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10513931

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Outcomes of cryosurgery in keloids and hypertrophic scars. A prospective consecutive trial of case series. Author(s): Zouboulis CC, Blume U, Buttner P, Orfanos CE. Source: Archives of Dermatology. 1993 September; 129(9): 1146-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8363398

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p53 and apoptosis alterations in keloids and keloid fibroblasts. Author(s): Ladin DA, Hou Z, Patel D, McPhail M, Olson JC, Saed GM, Fivenson DP. Source: Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society. 1998 January-February; 6(1): 28-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9776848

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Painless steroid injections for hypertrophic scars and keloids. Author(s): Azad S, Sacks L. Source: British Journal of Plastic Surgery. 2002 September; 55(6): 534. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12479437

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Painless steroid injections for hypertrophic scars and keloids. Author(s): Nduka C, van Dam H, Davis K, Shibu M. Source: British Journal of Plastic Surgery. 2003 December; 56(8): 842. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14615270

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Painless steroid injections for hypertrophic scars and keloids. Author(s): Mandal A, Imran D. Source: British Journal of Plastic Surgery. 2003 January; 56(1): 79. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12706172

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Perivascular myofibroblasts and microvascular occlusion in hypertrophic scars and keloids. Author(s): Kischer CW, Thies AC, Chvapil M. Source: Human Pathology. 1982 September; 13(9): 819-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7106747

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Perpendicular suture method for earlobe keloids. Author(s): Kuwahara RT, Rasberry RD. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2000 October; 26(10): 979. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11050510

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Pilot study of the effect of postoperative imiquimod 5% cream on the recurrence rate of excised keloids. Author(s): Berman B, Kaufman J. Source: Journal of the American Academy of Dermatology. 2002 October; 47(4 Suppl): S209-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12271279

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Plastic and reconstructive surgery. Scars, hypertrophic scars, and keloids. Author(s): Davies DM. Source: British Medical Journal (Clinical Research Ed.). 1985 April 6; 290(6474): 1056-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3921108

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Posterior auricular keloids as a complication of conchal cartilage grafts in blacks. Author(s): Ofodile FA, Morrison NG. Source: Plastic and Reconstructive Surgery. 1992 August; 90(2): 340-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1631236

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Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Author(s): Ogawa R, Mitsuhashi K, Hyakusoku H, Miyashita T. Source: Plastic and Reconstructive Surgery. 2003 February; 111(2): 547-53; Discussion 554-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12560675

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Postoperative interstitial radiotherapy of keloids by iridium 192: a retrospective study of 46 treated scars. Author(s): Clavere P, Bedane C, Bonnetblanc JM, Bonnafoux-Clavere A, Rousseau J. Source: Dermatology (Basel, Switzerland). 1997; 195(4): 349-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9529555

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Postoperative irradiation in the prevention of keloids. Author(s): Levy DS, Salter MM, Roth RE. Source: Am J Roentgenol. 1976 September; 127(3): 509-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=183542

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Postoperative keloids--treat or ignore? Author(s): Wrong NM. Source: Can Med Assoc J. 1969 August 23; 101(4): 226-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5811702

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Postoperative radiotherapy of keloids: a twenty-year experience. Author(s): Caccialanza M, Piccinno R, Schiera A. Source: European Journal of Dermatology : Ejd. 2002 January-February; 12(1): 58-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11809597

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Postsurgical acrylic ear splints for keloids. Author(s): Pierce HE. Source: J Dermatol Surg Oncol. 1986 June; 12(6): 583-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3711419

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Pressure garments in the prevention and treatment of keloids. Author(s): Ng CL, Lee ST, Wong KL. Source: Ann Acad Med Singapore. 1983 April; 12(2 Suppl): 430-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6625526

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Preventing hypertrophic scarring and keloids. Author(s): Topham J. Source: J Wound Care. 1998 July; 7(7): 342. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9791363

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Prevention and treatment of earlobe keloids. Author(s): Ashbell TS. Source: Annals of Plastic Surgery. 1982 September; 9(3): 264-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7137826

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Prevention and treatment of keloids with intralesional verapamil. Author(s): D'Andrea F, Brongo S, Ferraro G, Baroni A. Source: Dermatology (Basel, Switzerland). 2002; 204(1): 60-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11834852

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Prevention of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in an office setting. Author(s): Gold MH, Foster TD, Adair MA, Burlison K, Lewis T. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 July; 27(7): 641-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11442615

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Proliferating activity of dermal fibroblasts in keloids and hypertrophic scars. Author(s): Nakaoka H, Miyauchi S, Miki Y. Source: Acta Dermato-Venereologica. 1995 March; 75(2): 102-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7604635

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Prosthetic treatment of earlobe keloids. Author(s): Sela M, Taicher S. Source: The Journal of Prosthetic Dentistry. 1984 September; 52(3): 417-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6592340

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Pseudofolliculitis barbae with keloids. Author(s): Edlich RF, Haines PC, Nichter LS, Silloway KA, Morgan RF. Source: The Journal of Emergency Medicine. 1986; 4(4): 283-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3540094

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Radiation therapy for keloids and plantar warts. Author(s): Perez CA, Lockett MA, Young G. Source: Front Radiat Ther Oncol. 2001; 35: 135-46. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11351943

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Radiation therapy in the treatment of keloids in East Africa. Author(s): Edsmyr F, Larsson LG, Onyango J, Wanguru S, Wood M. Source: Acta Radiol Ther Phys Biol. 1974 April; 13(2): 102-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4833768

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Radiation therapy in the treatment of keloids. Author(s): Tepmongkol P. Source: J Med Assoc Thai. 1978 January; 61(1): 20-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=632706

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Radiation therapy of keloids. Author(s): Amar Inalsingh CH. Source: Compr Ther. 1975 June; 1(2): 56-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1222547

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Radiotherapy for keloids. Author(s): Hoffman S. Source: Annals of Plastic Surgery. 1982 September; 9(3): 265. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7137827

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Radiotherapy in the management of keloids. Clinical experience with electron beam irradiation and comparison with X-ray therapy. Author(s): Maarouf M, Schleicher U, Schmachtenberg A, Ammon J. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2002 June; 178(6): 330-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12122789

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Radiotherapy in the treatment of keloids in East Africa. Author(s): Edsmyr F, Larson LG, Onyango J, Wanguru S, Wood M. Source: East Afr Med J. 1973 August; 50(8): 457-61. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4761218

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Recurrence rates of excised keloids treated with postoperative triamcinolone acetonide injections or interferon alfa-2b injections. Author(s): Berman B, Flores F. Source: Journal of the American Academy of Dermatology. 1997 November; 37(5 Pt 1): 755-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9366822

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Regulation of collagen gene expression in keloids and hypertrophic scars. Author(s): Friedman DW, Boyd CD, Mackenzie JW, Norton P, Olson RM, Deak SB. Source: The Journal of Surgical Research. 1993 August; 55(2): 214-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8412102

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Relief of pain and itch associated with keloids on treatment with oxpentifylline. Author(s): Wong TW, Lee JY, Sheu HM, Chao SC. Source: The British Journal of Dermatology. 1999 April; 140(4): 771-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10233352

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Results of prophylactic irradiation in patients with resected keloids--a retrospective analysis. Author(s): Wagner W, Alfrink M, Micke O, Schafer U, Schuller P, Willich N. Source: Acta Oncologica (Stockholm, Sweden). 2000; 39(2): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10859014

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Retinoic acid in the treatment of keloids. Author(s): Panabiere-Castaings MH. Source: J Dermatol Surg Oncol. 1988 November; 14(11): 1275-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3183178

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Role of HLA-DR and CD1a molecules in pathogenesis of hypertrophic scarring and keloids. Author(s): Chen D, Wang Q, Bao W, Xu S, Tang Y. Source: Chinese Medical Journal. 2003 February; 116(2): 314-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12775256

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Role of ionizing irradiation for 393 keloids. Author(s): Borok TL, Bray M, Sinclair I, Plafker J, LaBirth L, Rollins C. Source: International Journal of Radiation Oncology, Biology, Physics. 1988 October; 15(4): 865-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3182326

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Rubinstein-Taybi syndrome and spontaneous keloids. Author(s): Goodfellow A, Emmerson RW, Calvert HT. Source: Clinical and Experimental Dermatology. 1980 September; 5(3): 369-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7438534

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Rubinstein-Taybi syndrome and spontaneous keloids. Author(s): Kurwa AR. Source: Clinical and Experimental Dermatology. 1979 June; 4(2): 251-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=498578

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Rubinstein-Taybi syndrome with multiple flamboyant keloids. Author(s): Hendrix JD Jr, Greer KE. Source: Cutis; Cutaneous Medicine for the Practitioner. 1996 May; 57(5): 346-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8726717

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Rubinstein-Taybi syndrome. Cutaneous manifestations and colossal keloids. Author(s): Selmanowitz VJ, Stiller MJ. Source: Archives of Dermatology. 1981 August; 117(8): 504-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7259246

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Scanning electron microscopy of normal human scar tissue and keloids. Author(s): Hunter JA, Finlay JB. Source: The British Journal of Surgery. 1976 October; 63(10): 826-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=990706

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Scar contractures, hypertrophic scars, and keloids. Author(s): Brissett AE, Sherris DA. Source: Facial Plastic Surgery : Fps. 2001 November; 17(4): 263-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11735059

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Scars and keloids. Author(s): Murray JC. Source: Dermatologic Clinics. 1993 October; 11(4): 697-708. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8222353

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Scleroderma presenting with multiple keloids. Author(s): Akintewe TA, Alabi GO. Source: British Medical Journal (Clinical Research Ed.). 1985 August 17; 291(6493): 448-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3926234

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Self-adhesive silicone gel sheet: a treatment for hypertrophic scars and keloids. Author(s): Chuangsuwanich A, Osathalert V, Muangsombut S. Source: J Med Assoc Thai. 2000 April; 83(4): 439-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10808705

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Silicone gel in the treatment of keloids. Author(s): Murdoch ME, Salisbury JA, Gibson JR. Source: Acta Dermato-Venereologica. 1990; 70(2): 181-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1969213

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Silicone use in keloids. Author(s): Leshaw SM. Source: The Western Journal of Medicine. 1994 April; 160(4): 363-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8023490

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Single-dose electron beam irradiation in treatment and prevention of keloids and hypertrophic scars. Author(s): Lo TC, Seckel BR, Salzman FA, Wright KA. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 1990 November; 19(3): 267-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2126387

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Some observations on keloids and double control evaluation of intralesional treatment. Author(s): Ghosh P, Ganguli AC. Source: J Indian Med Assoc. 1978 March 1; 70(5): 103-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=353202

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Some observations on keloids in Indians. Author(s): Sirsat MV, Sampat MB. Source: Indian Journal of Medical Sciences. 1966 November; 20(11): 790-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5979233

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Sternal keloids: successful treatment employing surgery and adjunctive radiation. Author(s): Ship AG, Weiss PR, Mincer FR, Wolkstein W. Source: Annals of Plastic Surgery. 1993 December; 31(6): 481-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8297076

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Structure of the collagen nodule from hypertrophic scars and keloids. Author(s): Kischer CW, Brody GS. Source: Scan Electron Microsc. 1981; (Pt 3): 371-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7330586

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Studies on the immunologic aspects of keloids and hypertrophic scars. Author(s): Janssen de Limpens AM, Cormane RH. Source: Archives of Dermatological Research. 1982; 274(3-4): 259-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6187300

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Study of 1,000 patients with keloids in South India. Author(s): Ramakrishnan KM, Thomas KP, Sundararajan CR. Source: Plastic and Reconstructive Surgery. 1974 March; 53(3): 276-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4813760

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Suppression of insulin-like growth factor signalling pathway and collagen expression in keloid-derived fibroblasts by quercetin: its therapeutic potential use in the treatment and/or prevention of keloids. Author(s): Phan TT, See P, Tran E, Nguyen TT, Chan SY, Lee ST, Huynh H. Source: The British Journal of Dermatology. 2003 March; 148(3): 544-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12653748

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Surgical pearl: excision with suprakeloidal flap and radiation therapy for keloids. Author(s): Adams BB, Gloster HM. Source: Journal of the American Academy of Dermatology. 2002 August; 47(2): 307-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12140481

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Surgical treatment of keloids secondary to ear piercing. Author(s): Kelly AP. Source: Journal of the National Medical Association. 1978 May; 70(5): 349-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=702572

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Survey of informed consent for ear piercing: risk of keloids. Author(s): Gaughf CN, Pritzker AS, Davis L. Source: Pediatric Dermatology. 1996 September-October; 13(5): 430. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8893247

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Symptomatic keloids in two children. Dramatic improvement with silicone cream occlusive dressing. Author(s): Wong TW, Chiu HC, Chen JS, Lin LJ, Chang CC. Source: Archives of Dermatology. 1995 July; 131(7): 775-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7611791

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Synchronous activation of ERK and phosphatidylinositol 3-kinase pathways is required for collagen and extracellular matrix production in keloids. Author(s): Lim IJ, Phan TT, Tan EK, Nguyen TT, Tran E, Longaker MT, Song C, Lee ST, Huynh HT. Source: The Journal of Biological Chemistry. 2003 October 17; 278(42): 40851-8. Epub 2003 August 07. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12907681

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The body's skin frontier and the challenges of wound healing: keloids. Author(s): Slavkin HC. Source: The Journal of the American Dental Association. 2000 March; 131(3): 362-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10715928

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The effect of carbon dioxide laser surgery on the recurrence of keloids. Author(s): Norris JE. Source: Plastic and Reconstructive Surgery. 1991 January; 87(1): 44-9; Discussion 50-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1898535

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The intraligamental dental syringe facilitates steroid injection into hypertrophic scars and keloids. Author(s): Sagher U. Source: Plastic and Reconstructive Surgery. 1989 September; 84(3): 542. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2762418

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The local treatment of hypertrophic scars and keloids with topical retinoic acid. Author(s): Janssen de Limpens AM. Source: The British Journal of Dermatology. 1980 September; 103(3): 319-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7426429

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The microvessels in hypertrophic scars, keloids and related lesions: a review. Author(s): Kischer CW. Source: J Submicrosc Cytol Pathol. 1992 April; 24(2): 281-96. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1600518

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The protruding scars: keloids and hypertrophic diagnosis and treatment with silicongel-sheeting. Author(s): Tilkorn H, Ernst K, Osterhaus A, Schubert A, Schwipper V. Source: Polim Med. 1994; 24(1-2): 31-44. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7971533

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The risks of treating keloids with radiotherapy. Author(s): Botwood N, Lewanski C, Lowdell C. Source: The British Journal of Radiology. 1999 December; 72(864): 1222-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10703484

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The role of kilovoltage irradiation in the treatment of keloids. Author(s): Doornbos JF, Stoffel TJ, Hass AC, Hussey DH, Vigliotti AP, Wen BC, Zahra MK, Sundeen V. Source: International Journal of Radiation Oncology, Biology, Physics. 1990 April; 18(4): 833-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2108939

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The small-wave incision for long keloids. Author(s): Hyakusoku H, Ogawa R. Source: Plastic and Reconstructive Surgery. 2003 February; 111(2): 964-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12560747

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The surgical treatment of keloids. Author(s): Pollack SV, Goslen JB. Source: J Dermatol Surg Oncol. 1982 December; 8(12): 1045-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6759543

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The treatment of earlobe keloids by surgical excision and postoperative triamcinolone injection. Author(s): Shons AR, Press BH. Source: Annals of Plastic Surgery. 1983 June; 10(6): 480-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6881865

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The treatment of hypertrophic scars and keloids. Author(s): Berman B, Flores F. Source: European Journal of Dermatology : Ejd. 1998 December; 8(8): 591-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9889433

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The treatment of keloids. Author(s): Hardin JC Jr. Source: Plastic and Reconstructive Surgery. 1996 September; 98(4): 750-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8773703

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The treatment of keloids. Author(s): Ship AG. Source: Plastic and Reconstructive Surgery. 1996 September; 98(4): 750-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8773702

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The use of athymic nude mice for the study of human keloids. Author(s): Shetlar MR, Shetlar CL, Hendricks L, Kischer CW. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1985 September; 179(4): 549-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4022961

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Tissue expansion for the treatment of keloids. Author(s): Roeder JA, White SK. Source: Plastic Surgical Nursing : Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses. 1990 Fall; 10(3): 114-7, 125. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2217564

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Topical application of imiquimod 5% cream to keloids alters expression genes associated with apoptosis. Author(s): Jacob SE, Berman B, Nassiri M, Vincek V. Source: The British Journal of Dermatology. 2003 November; 149 Suppl 66: 62-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616355

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Topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. A dermatologic experience. Author(s): Gold MH. Source: J Dermatol Surg Oncol. 1993 October; 19(10): 912-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8408909

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Treating keloids with carbon dioxide lasers. Author(s): Driscoll B. Source: Archives of Otolaryngology--Head & Neck Surgery. 2001 September; 127(9): 1145. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11556871

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Treatment of earlobe keloids with carbon dioxide laser excision: a report of 16 cases. Author(s): Kantor GR, Wheeland RG, Bailin PL, Walker NP, Ratz JL. Source: J Dermatol Surg Oncol. 1985 November; 11(11): 1063-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3932493

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Treatment of earlobe keloids with surgery plus adjuvant intralesional verapamil and pressure earrings. Author(s): Lawrence WT. Source: Annals of Plastic Surgery. 1996 August; 37(2): 167-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8863976

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Treatment of keloids and hypertrophic scars with an argon laser. Author(s): Hulsbergen Henning JP, Roskam Y, van Gemert MJ. Source: Lasers in Surgery and Medicine. 1986; 6(1): 72-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3959718

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Treatment of keloids by 90Sr-90Y beta-rays. Author(s): Supe SS, Supe SJ, Rao SM, Deka AC, Deka BC. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 1991 July; 167(7): 397-402. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1858015

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Treatment of keloids by combined surgical excision and immediate postoperative Xray therapy. Author(s): Ollstein RN, Siegel HW, Gillooley JF, Barsa JM. Source: Annals of Plastic Surgery. 1981 October; 7(4): 281-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7316418

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Treatment of keloids by high-dose-rate brachytherapy: A seven-year study. Author(s): Guix B, Henriquez I, Andres A, Finestres F, Tello JI, Martinez A. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 May 1; 50(1): 167-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11316560

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Treatment of keloids by single intraoperative perilesional injection of repository steroid. Author(s): Golladay ES. Source: Southern Medical Journal. 1988 June; 81(6): 736-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3287640

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Treatment of keloids by surgical excision and immediate postoperative singlefraction radiotherapy. Author(s): Ragoowansi R, Cornes PG, Moss AL, Glees JP. Source: Plastic and Reconstructive Surgery. 2003 May; 111(6): 1853-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12711944

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Treatment of keloids with excision and postoperative X-ray irradiation. Author(s): Enhamre A, Hammar H. Source: Dermatologica. 1983; 167(2): 90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6628805

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Treatment of keloids with surgical excision and postoperative X-ray radiation. Author(s): Sallstrom KO, Larson O, Heden P, Eriksson G, Glas JE, Ringborg U. Source: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery / Nordisk Plastikkirurgisk Forening [and] Nordisk Klubb for Handkirurgi. 1989; 23(3): 211-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2617222

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Treatment of recurrent earlobe keloids. Author(s): Rauscher GE, Kolmer WL. Source: Cutis; Cutaneous Medicine for the Practitioner. 1986 January; 37(1): 67-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3948535

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Treatment of scars and keloids with a cream containing silicone oil. Author(s): Sawada Y, Sone K. Source: British Journal of Plastic Surgery. 1990 November; 43(6): 683-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2104531

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Treatment of scars and keloids. Author(s): Hirshowitz B. Source: British Journal of Plastic Surgery. 1991 May-June; 44(4): 318. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2059794

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Triamcinolone and keloids. Author(s): Epstein E. Source: The Western Journal of Medicine. 1980 September; 133(3): 257-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7415179

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Two patients with penile keloids: a review of the literature. Author(s): Gurunluoglu R, Bayramicli M, Numanoglu A. Source: Annals of Plastic Surgery. 1997 December; 39(6): 662-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9418933

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Ultrasound therapy for keloids. Author(s): Walker JJ. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1983 August 20; 64(8): 270. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6879382

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Unusual complications of triamcinolone injected keloids: tissue necrosis and systemic corticosteroid effects. Author(s): Abdel-Fattah AM. Source: British Journal of Plastic Surgery. 1976 October; 29(4): 283. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1000110

•

Use of cryotherapy in the treatment of keloids. Author(s): Rusciani L, Rossi G, Bono R. Source: J Dermatol Surg Oncol. 1993 June; 19(6): 529-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8509514

•

UVA1 for treatment of keloids. Author(s): Hannuksela-Svahn A, Grandal OJ, Thorstensen T, Christensen OB. Source: Acta Dermato-Venereologica. 1999 November; 79(6): 490. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10598777

•

Varicella causes skin pits and keloids--more reasons for the varicella vaccine. Author(s): Scheinfeld N, Cohen SR. Source: Pediatrics. 2000 July; 106(1 Pt 1): 160. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10939909

•

Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. Author(s): Palmieri B, Gozzi G, Palmieri G. Source: International Journal of Dermatology. 1995 July; 34(7): 506-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7591421

•

Why more keloids on back than on front of earlobe. Author(s): Slobodkin D. Source: Lancet. 1990 April 14; 335(8694): 923-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1970017

•

Wide spread scars, hypertrophic scars, and keloids. Author(s): Rudolph R. Source: Clin Plast Surg. 1987 April; 14(2): 253-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3581659

Studies

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Yoruban contributions to the literature on keloids. Author(s): Omo-Dare P. Source: Journal of the National Medical Association. 1973 September; 65(5): 367-72 Passim. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4582847

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

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

7

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

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

Altered posttranslational modifications of collagen in keloid. Author(s): Dental Research Center, University of North Carolina at Chapel Hill 275997455, USA. Source: Uzawa, K Marshall, M K Katz, E P Tanzawa, H Yeowell, H N Yamauchi, M Biochem-Biophys-Res-Commun. 1998 August 28; 249(3): 652-5 0006-291X

•

Implants of keloid and hypertrophic scars into the athymic nude mouse: changes in the glycosaminoglycans of the implants. Author(s): Department of Nutrition, Texas Tech University, Lubbock 79409. Source: Shetlar, M R Shetlar, C L Kischer, C W Pindur, J Connect-Tissue-Res. 1991; 26(12): 23-36 0300-8207

•

Keloid-derived fibroblasts are refractory to Fas-mediated apoptosis and neutralization of autocrine transforming growth factor-beta1 can abrogate this resistance. Author(s): Department of Plastic and Reconstructive Surgery, Hokkaido University School of Medicine, Sapporo, Japan. Source: Chodon, T Sugihara, T Igawa, H H Funayama, E Furukawa, H Am-J-Pathol. 2000 November; 157(5): 1661-9 0002-9440

•

Lysine acetylsalicylate decreases proliferation and extracellular matrix gene expression rate in keloid fibroblasts in vitro. Author(s): IBFB Institut fur. Biomedizinische Forschung und Beratung, Karl-Heine-Str. 99, Leipzig, Germany. [email protected] Source: Petri, Jean Bernhard Haustein, Uwe Frithjof Eur-J-Dermatol. 2002 May-June; 12(3): 231-5 1167-1122

•

Pentoxifylline inhibits the proliferation of human fibroblasts derived from keloid, scleroderma and morphoea skin and their production of collagen, glycosaminoglycans and fibronectin. Author(s): Department of Dermatology, University of California, Davis School of Medicine. Source: Berman, B Duncan, M R Br-J-Dermatol. 1990 September; 123(3): 339-46 0007-0963

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

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

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

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•

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to keloids; 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: •

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

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CHAPTER 3. CLINICAL TRIALS AND KELOIDS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning keloids.

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

Genetic Analysis of Familial Keloids Condition(s): Keloid Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: The purpose of this study is to identify the gene or genes responsible for keloid formation. Keloids are raised scars on the skin that form after a minor injury. A tendency to develop keloids often runs in families, suggesting a possible genetic basis. People who have had a classic (butterfly-shaped or wound-overflowing) keloid for at least one year may be eligible for this study. In addition to these probands (original participants), family members over 12 years of age who have either classic or non-classic keloids and those 18 years of age or older without keloids may participate. Probands and family members with keloids will have a medical history focusing on skin problems-particularly keloids-and a skin examination. In some cases, with the subject's permission, photos of the keloids will be taken. All participants will have 35 milliliters (about 2 tablespoons) of blood drawn for DNA (genetic) testing and for measurement of blood proteins, including cytokines, which can affect other tissues and cause scarring. Part of the blood sample will be used for additional genetic studies unrelated to keloids. The samples will be coded for confidentiality. Study Type: Observational Contact(s): see Web site below

8

These are listed at www.ClinicalTrials.gov.

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Web Site: http://clinicaltrials.gov/ct/show/NCT00008502

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “keloids” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

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

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

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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

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CHAPTER 4. PATENTS ON KELOIDS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “keloids” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on keloids, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Keloids By performing a patent search focusing on keloids, 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

9Adapted

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

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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on keloids: •

Bandage having a scar treatment pad for scar management and scar repair Inventor(s): Cox; Christopher D. (137 Whitetail Dr., Harrison City, PA 15636), Cox; Craig M. (R.D. 4, Box 271, Greensburg, PA 15601), Isenberg; Perry A. (R.D. 4, Box 271, Greensburg, PA 15601) Assignee(s): None Reported Patent Number: 6,284,941 Date filed: May 11, 1999 Abstract: A bandage for the treatment of dermal scars, keloids, wounds or abrasions by contacting the skin of the user. The bandage includes a flexible member having a first side and a second side and further having an adhesive located on the first side. A scar treatment pad such as a layer of silicone elastomer is attached by the adhesive to the first side of the flexible member. The bandage is used by placing the first side of the flexible member in contact with the skin of the user such that the layer of silicone elastomer substantially contacts a scarred area of the skin. The adhesive removably attaches the first side of the flexible member substantially in contact with an unscarred area of the skin of the user. The layer of silicone elastomer attached to the first side of the flexible member improves the cosmetic and functional aspects of the scarred area of the skin of the user. Excerpt(s): The present invention relates generally to the treatment of dermal scars, keloids, wounds and abrasions and, more particularly, to the application of silicone sheeting or silicone gel to dermal scars, keloids, wounds and abrasions for treatment thereof. It is known in the medical field to use silicone elastomer materials (hereinafter referred to as "silicone") for the treatment of dermal scars and keloids. Silicone is known to soften scar tissue and improve the cosmetic as well as functional aspects of dermal scars and keloids. In addition, recent research indicates that certain silicone compounds promote wound healing and decrease scarring. Although the biological mechanism for the therapeutic aspects of silicone when applied to the skin is not completely understood, it is known in the art that the therapeutic benefits are derived independently of the pressure applied to the scar surface. One prior art device that has made use of the beneficial aspects of silicone when applied to the skin is disclosed in U.S. Pat. No. 5,759,560 to Dillon. The Dillon patent discloses silicone thermoplastic sheeting for scar treatment. In particular, the Dillon patent discloses a composite structure that includes a surface layer of silicone elastomeric material applied to one side of a thermoplastic splinting material. The splinting material is shaped to fit the geometric form of the skin of the patient so that the surface layer of silicone is in uniform contact with the skin of the patient. The resulting silicone thermoplastic sheeting is in the form of a hard thermoplastic splint having the surface layer of silicone on one side and is intended to be repeatedly applied to the skin of the patient. The silicone thermoplastic sheeting material disclosed by the Dillon patent is not very userfriendly because of its hard form. The silicone thermoplastic sheeting material cannot be worn, typically, when the patient engages in ordinary daily activities because of its immobilizing nature. Web site: http://www.delphion.com/details?pn=US06284941__

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•

Composition for the control of wound scar production Inventor(s): Lee; Raphael C. (Chicago, IL) Assignee(s): Massachusetts Institute of Technology (cambridge, Ma) Patent Number: 5,902,609 Date filed: October 25, 1996 Abstract: This invention pertains to a composition for controlling wound scar production containing a calcium antagonist and a protein synthesis inhibitor. The method can be used to minimize wound scars, such as hypertrophic wound healing disorders keloids and burn scar contractures in humans or other mammals, particularly those individually prone to excesssive scarring Calcium antagonist treatment can also be used to control diseases associated with excessive scarring. such as cirrhosis of the liver, constructive pericarditis Dupuytren's disease of the hand, plantar fibrosis of the foot, and various other fibromatoses. Excerpt(s): The ability to heal by forming scars is essential for mammalian systems to survive wounding after injury. Normally, wound healing is a continuous process extending over a one-to-two-year period The process can be conceptually divided into three fundamentally distinct stages. The first stage is an intensely degradative phase called the inflammatory stage It occurs immediately after injury and provides a leans to remove the damaged tissues and foreign matter from the wound. Two-to-three days later, as fibroblasts from the surrounding tissue move into the wound, the repairing process enters its second stage, the proliferation and matrix synthesis stage. The fibroblasts in the wound proliferate and actively produce macromolecular such as collagen and proteoglycans, which are secreted into the extracellular matrix. The newlysynthesized collagen fibrils are cross-linked by lysyl oxidase and provide structural integrity to the wound. During this stage, fibroblasts also contract the intact collagen in order to reduce the surface area of the wound. This second stage lasts about three weeks. In the final, remodeling stage, the previous randomly-organized collagen fibril is aligned in the direction of mechanical tension and becomes more organized so that the mechanical strength of the wound area can be increased. The repair process is accomplished when the chemical and physical barrier functions of the skin are restored. Normal wound healing follows a well-regulated course. However, imbalances may cause abnormal scars to form. For example if the biosynthetic phase continues longer than necessary or degradation of collagen decreases, hypertrophic scars may form. These scars cause problems ranging from aesthetic deformity to severe limitation of motion. Hypertrophic scars more frequently occur among children and adolescents, suggesting that growth factors may influence the development of this type of scar. Hypertrophic scars are especially common in patients who have burns or wounds that heal by secondary intention. Another type of excess scar is the keloid. In this disorder, the cells appear to lace sensitivity to normal feedback signals. They are larger than hypertrophic scars and grow in an unregulated way, tending to invade normal tissue surrounding the wound. They rarely disappear spontaneously and often recur after surgical excision. The management of these scars remains a major unsolved clinical problem. Web site: http://www.delphion.com/details?pn=US05902609__

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Keloids

Control of wound scar production Inventor(s): Lee; Raphael C. (Chicago, IL) Assignee(s): Arch Develop. (chicago, Il), Massachusetts Institute of Technology (cambridge, Ma) Patent Number: 5,569,678 Date filed: February 1, 1994 Abstract: This invention pertains to a method for controlling wound scar production by administering a calcium antagonist, alone or in a combination with or followed by a steroid, to the wound site. The method can be used to minimize wound scars, such as hypertrophic wound healing disorders, keloids and burn scar contractures in humans or other mammals, particularly those individually prone to excesssive scarring. Excerpt(s): The ability to heal by forming scars is essential for mammalian systems to survive wounding after injury. Normally, wound healing is a continuous process extending over a one-to-two-year period. The process can be conceptually divided into three fundamentally distinct stages. The first stage is an intensely degradative phase called the inflammatory stage. It occurs immediately after injury and provides a means to remove the damaged tissues and foreign matter from the wound. Two-to-three days later, as fibroblasts from the surrounding tissue move into the wound, the repairing process enters its second stage, the proliferation and matrix synthesis stage. The fibroblasts in the wound proliferate and actively produce macromolecules, such as collagen and proteoglycans, which are secreted into the extracellular matrix. The newlysynthesized collagen fibrils are cross-linked by lysyl oxidase and provide structural integrity to the wound. During this stage, fibroblasts also contract the intact collagen in order to reduce the surface area of the wound. This second stage lasts about three weeks. In the final, remodeling stage, the previous randomly-organized collagen fibril is aligned in the direction of mechanical tension and becomes more organized so that the mechanical strength of the wound area can be increased. The repair process is accomplished when the chemical and physical barrier functions of the skin are restored. Normal wound healing follows a well-regulated course. However, imbalances may cause abnormal scars to form. For example, if the biosynthetic phase continues longer than necessary or degradation of collagen decreases, hypertrophic scars may form. These scars cause problems ranging from aesthetic deformity to severe limitation of motion. Hypertrophic scars more frequently occur among children and adolescents, suggesting that growth factors may influence the development of this type of scar. Hypertrophic scars are especially common in patients who have burns or wounds that heal by secondary intention. Another type of excess scar is the keloid. In this disorder, the cells appear to lack sensitivity to normal feedback signals. They are larger than hypertrophic scars and grow in an unregulated way, tending to invade normal tissue surrounding the wound. They rarely disappear spontaneously and often recur after surgical excision. The management of these scars remains a major unsolved clinical problem. Existing therapy for hypertrophic scars and keloids includes surgery, mechanical pressure, steroids, x-ray irradiation and cryotherapy. There are many disadvantages associated with each of these methods. Surgical removal of the scar tissue is often incomplete and can result in the development of hypertrophic scars and keloids at the incision and suture points. Steroid treatments are unpredictable and often result in depigmentation of the skin. X-ray therapy is the only predictably effective treatment to date; however, because of its potential for causing cancer, it is not generally recommended or accepted.

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Web site: http://www.delphion.com/details?pn=US05569678__ •

External tissue expansion device for breast reconstruction, male pattern baldness and removal of nevi and keloids Inventor(s): Ger; Ralph (Lake Success, NY), Oddsen; Robert (Centerport, NY) Assignee(s): Progressive Surgical Products (westbury, Ny) Patent Number: 6,254,624 Date filed: October 6, 1999 Abstract: An external tissue expansion device applies constant continuous low grade force to skin to obtain additional tension free skin and subcutaneous tissue prior to a surgical procedure. The device consists of two suture plates each being laminated structure of steel and an adhesive attached foam cushion. On the each end of one suture plate is a housing that contains a constant force spring placed over a post. The ends of the constant force spring protrude from the housing and there is a hook attached to the end of the constant force spring. On each end of the other suture plate there is a housing, with a opening that can accept the hook of the opposite suture plate. These suture plates are constructed so that they can be manually shaped to conform to the topography of the body part to be corrected and are attached to skin near the defect to be corrected prior to a surgical procedure. When the hooks from one suture plate are inserted into the openings of the housing of the other suture plate, the constant force springs pulls the suture plates together and over a time period stretches and expands skin and subcutaneous tissue external from the suture plates and accumulates this additional tension free skin and subcutaneous tissue in the opening between the two suture plates. This invention further provides a method to permit breast reconstruction without the use of any prosthesis, whereby a surgeon expands a breast mound of the patient's own body tissue at a specific location consisting of tension free skin and subcutaneous tissue and shapes this breast mound into a breast. Excerpt(s): This invention is in the field of medical devices and techniques of tissue expansion that are used by plastic and general surgeons to obtain additional tension free skin and subcutaneous tissue prior to a surgical procedure to correct a defect or to cover an implantable prosthesis. Such surgical procedures include breast augmentation and breast reconstruction after mastectomy, removal of a nevus or keloid, removal of malignant or benign lesions, improvement of cosmetic appearance and other plastic reconstructive procedures of the body that require tension free skin and subcutaneous tissue without distortion of nearby body structures. Also the new invention can be used in new surgical procedures to correct male pattern baldness and for breast reconstructive surgery and removal of nevus, hypertrophic scars or keloids. It is a surgical axiom that wound tension should be avoided at all costs. In surgical procedures a certain amount of skin may be excised and easily closed but there is a point beyond which closure results in wound tension or the wound cannot be closed resulting in a deficit of skin. Skin tension is of particular importance in wound healing because a highly stressed wound environment delays wound healing. A wound sutured closed under tension will result in maximum scarring. Wound tension is also one of the factors for initiation of a keloid or hypertropic scar. For the plastic surgeon the qualitative end result is one of the most crucial factors in reconstructive surgery. The attention to minute details can be the difference between success and failure for plastic surgical procedures where cosmetic appearance is a critical factor. Tension free skin is especially important in facial areas or when skin coverage is required to cover a prosthesis.

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Wounds closed under tension can create distortions of nearby facial features such as eyelids, lips, etc., create wide displeasing scars or result in exposure of an implantable prosthesis. The physician has three surgical means to obtain additional tension free skin namely: (A) skin grafts, (B) free flaps and (C) internally placed tissue expansion devices. Web site: http://www.delphion.com/details?pn=US06254624__ •

Facilitation of keloid healing with CM101/GBS toxin Inventor(s): Abramovitch; Rinat (Mordechai, IL), Hellerqvist; Carl G. (Brentwood, TN), Neeman; Michal (Mazkeret Batya, IL), Wamil; Barbara D. (Nashville, TN) Assignee(s): Vanderbilt University (nashville, Tn), Yeda Research & Development Ltd. (rehovot, Il) Patent Number: 6,569,838 Date filed: October 7, 1998 Abstract: The present invention includes a means of treating a patient having a keloid. Specifically, the invention includes a method for excising the keloid and administering a GBS toxin isolated from Group B.beta.-hemolytic Streptococcus bacteria. Excerpt(s): This invention relates to the facilitation of wound healing in patients, by minimizing scarring and accelerating healing. This invention also relates to the reduction of wound-related tumor progression. The normal process of healing a skin wound that has been surgically induced or is the result of trauma involves formation of a blood clot and, often, a scab. More particularly, first intention, or primary healing, generally occurs at clean incisions, whereas second intention, or secondary healing, occurs where wound edges are far apart. The protein fibrin holds the edges of the skin surrounding the wound together and the scab seals the wound and staves off infection. While an inflammatory response brings increased numbers of blood cells to the area to aid in the repair process, epithelial tissue regenerates and capillaries grow from blood vessels at the edges of the wound. The capillaries revascularize the area of the wound and contribute to the formation of granulation tissue which, in turn, causes scarring. Granulation tissue begins to form in the wound site and fills the site approximately five days after wound induction. Granulation tissue contains new collagen, fibroblasts, new blood vessels and inflammatory cells, especially macrophages (E. Rubin and J. L. Farber, Pathology, Lippincott, publ., pp. 85-95 (1994)). After seven to ten days, the wound has regained only 10% of the tissue's original strength. Web site: http://www.delphion.com/details?pn=US06569838__

•

Gas or gel-filled silicone cushion for treatment of keloid and hypertrophic scars Inventor(s): Har-Shai; Yaron (Haifa, IL), Hirshowitz; Bernard (Haifa, IL), Lindenbaum; Ella (Haifa, IL) Assignee(s): Life Medical Sciences, Inc. (edison, Nj) Patent Number: 5,895,656 Date filed: October 18, 1996 Abstract: The present invention relates to the treatment of keloid and hypertrophic scars by covering the scar with a gas-or gel-filled cushion made of smooth or textured silicone sheeting. It relates particularly to a cushion in the form of a hollow bag filled with

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completely dry air, inert gel or an inert gas. The invention also relates to a silicone sheeting cushion enclosing silicone beads, polymeric pieces or bodies made of polyfluoroethylene sheeting or a related polymer which produces a negative static charge or, preferably, a silicone sponge or hydrophobic gel, most preferably silicone gel. Excerpt(s): This invention relates to the treatment of keloid and hypertrophic scars by covering the scar with a gas or gel-filled cushion made of silicone sheeting. It relates particularly to a cushion in the form of a hollow bag filled with completely dry air or an inert gas or gel. The invention also relates to a silicone sheeting cushion enclosing silicone beads, polymeric pieces or bodies made of TEFLON sheeting or a related polymer which produces a negative static electrical charge or, preferably, a silicone sponge or gel. Keloid and hypertrophic scars appear on the skin after injury or acne or spontaneously in the shape of a hard bump or swelling which usually causes much distress, both aesthetic and functional, besides pain, it causes both itching and burning sensations and can become a lifelong problem unless medically treated. Silicone gel or occlusive sheeting is widely used at present for the treatment of hypertrophic and keloid scars without any scientific explanation as to its mode of action. See, Ahn, et al., Surgery, 106:781-787 (1989), Mercer N. S. G., Br J Plast Surg, 42:83-87, (1989); Perkins, et al., Burns, 9:201-204, (1982); Quinn K. J., Burns, 13 ›Suppl!S33-S40, (1987); Quinn, et al., Burns, 12:102-108, (1985); Sawada and Sone, Br J Plast Surg, 43:683-688, (1990); and Ohmori, S., Aesth. Plast Surg 12:95-99, (1988). With this treatment, softening and flattening of the scar was experienced after from 7 to 12 months of continuous covering of the scar. Professor B. Hirshowitz and other researchers recently noted that rubbing contact with silicone sheeting creates a static electric field which, they believe, acts on the scar, prompting its reversal to normal tissue. See, Hirshowitz, et al., Eur J Plast Surg., 16:5-9, 1993). Web site: http://www.delphion.com/details?pn=US05895656__ •

Human cardiac/brain tolloid-like protein Inventor(s): Arleth; Anthony J (Hatfield, PA), Elshourbagy; Nabil A. (West Chester, PA), Li; Xiaotong (Devon, PA), Willette; Robert N (Pottstown, PA) Assignee(s): Smithkline Beecham Corporation (philadelphia, Pa) Patent Number: 6,008,017 Date filed: December 16, 1997 Abstract: HC/BTLP polypeptides and polynucleotides and methods for producing such polypeptides by recombinant techniques are disclosed. Also disclosed are methods for utilizing hC/BTLP polypeptides and polynucleotides in the design of protocols for the treatment of restenosis, atherosclerosis, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), benign prostatic hypertrophy (BPH), nephritis, fibrosis, glomerulonephritis, gliosis, cirrhosis and anomalies of wound healing, such as keloids among others, and diagnostic assays for such conditions. Excerpt(s): This invention relates to newly identified polynucleotides, polypeptides encoded by them and to the use of such polynucleotides and polypeptides, and to their production. More particularly, the polynucleotides and polypeptides of the present invention relate to the astacin protein family, hereinafter referred to as human cardiac/brain tolloid-like protein (hC/BTLP). The invention also relates to inhibiting or activating the action of such polynucleotides and polypeptides. The hC/BTLP gene appears to possess all of the important protein domains present in the bone

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morphogenetic protein (BMP)-1/procollagen C-proteinase (PCP) protein. Members of the astacin family of metalloproteinases, such as BMP-1, have previously been linked to cell differentiation and pattern formation during development through a proposed role in the activation of latent growth factors of the TGF-.beta. superfamily. In addition, recent findings indicate that BMP-1 is identical to PCP, which is a metalloproteinase involved in the synthesis of matrix collagen. This observation suggests that a functional link may exist between astacin metalloproteinases, growth factors and cell differentiation and pattern formation during development, as well as fibrotic processes characterized by the accumulation of matrix collagen. Nucleotide and amino acid sequence homologues suggest that hC/BTLP, like BMP-1, possesses PCP activity. PCP activity is one of the essential enzymatic steps required for the extracellular production of insoluble collagen fibrils from soluble procollagen. However, mouse mammalian tolloid-like protein is the most closely related homologue of hC/BTIP. Mouse mammalian tolloid-like protein and BMP-1 are distinct gene products with differential tissue distribution. Based on cross-species comparisons, the regulation and distribution of hC/BTIP would be expected to be distinct from BMP-1. Indeed, mouse mammalian tolloid-like protein exhibits a unique tissue distribution when compared to BMP-1. Thus, the selective inhibition of matrix collagen accumulation is important in highly localized fibrotic disorders, e.g., gliosis associated with neurotrauma and ventricular fibrosis associated with congestive heart failure. This indicates that the astacin protein family has an established, proven history as therapeutic targets. Web site: http://www.delphion.com/details?pn=US06008017__ •

Keloid treating agent Inventor(s): Nakata; Masanori (Odawara, JP), O'ya; Hidejiro (Kyoto, JP), Tanaka; Masaya (Kobe, JP) Assignee(s): Kanebo, Ltd. (tokyo, Jp) Patent Number: 5,128,375 Date filed: January 24, 1991 Abstract: A keloid treating agent comprising as an active ingredient ethanolamine or a pharmaceutically acceptable salt thereof which is useful for the treatment of keloid such as true keloid, cicatrical keloid, hypertrophic scar, etc. Excerpt(s): The present invention relates to a keloid treating agent comprising as an essential active ingredient ethanolamine or a pharmaceutically acceptable salt thereof. Keloid includes true keloid, cicatrical keloid, hypertrophic scar, etc. which are classified depending on the cause and symptoms thereof. Ethanolamine or a pharmaceutically acceptable salt thereof has been used in the medical field as a sclerosing agent for sclerotherapy of esophageal varices (cf. Byoin Yakkyoku Seizai (Preparation in the medicine room of hospital), 2nd Edition, issued by Yakujinipposha in 1986, page 56). It is also known that ethanolamine or a pharmaceutically acceptable salt thereof has an antiulcer activity (cf. Japanese Patent First Publication (Kokai) No. 57520/1988). However, it has never been known that ethanolamine or a pharmaceutically acceptable salt thereof is useful for the treatment of keloid. Web site: http://www.delphion.com/details?pn=US05128375__

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Lotion-based sulfur preparation for skin treatment Inventor(s): Boyce; Reginald D. (2882 Hosta Dr., Charlotte, NC 28269), Phillips; David L. (1054 White Plains Rd., Charlotte, NC 28213) Assignee(s): None Reported Patent Number: 5,716,606 Date filed: August 24, 1995 Abstract: A topical composition for treatment of dermatitic conditions, particularly keloids and hypertrophic scars, is provided which comprises sulfur of at least approximately forty weight percent in a spreadable carrier base. Excerpt(s): The present invention relates generally to preparations for treating the skin and, more particularly, to a preparation for treatment of the skin that contains a high concentration of sulfur. Sulfur is known to have properties that aid in the treatment of dermatitic conditions. It is employed in various forms for its germicidal, fungicidal, and keratolytic actions. However, current applications of sulfur to treat dermatitic conditions maintain a very low weight percentage of sulfur in the composition. For example, Fostex Medicated Cover-up, manufactured by Westwood, is an acne cream that contains only two percent sulfur. Liquimat, manufactured by Owen/Allercreme, is a lotion for treatment of acne that contains only five percent sulfur. Xerac, manufactured by Person & Covey, is a gel for the treatment of acne that contains only four percent of a microcrystalline sulfur. While these compositions do provide for treatment of dermatitic conditions, they use relatively small percentages of sulfur. In U.S. Pat. No. 4,520,012, issued to Alfonsi, flowers of sulfur, also known as sublimed sulfur, is used in a composition for topical application to improve hair growth. The Alfonsi patent uses a concentration of sulfur of between one and three weight percent and teaches away from the use of any greater concentration of sulfur by stating that greater concentrations do not result in improvement of the effectiveness of the composition. Web site: http://www.delphion.com/details?pn=US05716606__

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Method for the prevention and treatment of scars with enzymes Inventor(s): Pinnell; Sheldon R. (Durham, NC) Assignee(s): Biospecifics, NV (curacao, An) Patent Number: 4,645,668 Date filed: March 27, 1985 Abstract: The method for preventing and for treating mammalian cicatrices such as keloids, acne scars, hypertrophic scars, wrinkles, cellulite and neoplastic fibrosis which comprises intra-dermal injection of effective amounts of a pharmacologically suitable solution of the enzymes collagenase, elastase, papain, plasminogen activator, plasmin, mast cell protease or lysosomal hydrolase, individually, and one or more of such enzymes in combination with the enzyme hyaluronidase. Excerpt(s): Collagen is the major structural constituent of mammalian organisms and makes up a large portion of the total protein content of skin and other parts of the animal body. In humans, it is particularly important in the wound healing process and in the process of natural aging. Various skin traumas such as burns, surgery, infection and accident are often characterized by the erratic accumulation of fibrous tissue rich in collagen and having increased proteoglycan content. In addition to the replacement of

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the normal tissue which has been damaged or destroyed, excessive and disfiguring deposits of new tissue sometimes form during the healing process. The excess collagen deposition has been attributed to a disturbance in the balance between collagen synthesis and collagen degradation. Keloids are tumors or connective tissue consisting of highly hyperplastic masses which occur in the dermis and adjacent subcutaneous tissue in certain susceptible individuals, most commonly following trauma. The known therapies for keloids have had limited success and they frequently can recur in the site after surgical removal. Hypertrophic scars are unsightly masses which can result from burns or other injuries to the skin. Such scars are usually permanent and resistant to known methods of therapy. Web site: http://www.delphion.com/details?pn=US04645668__ •

Method for the selective dissolution of cancer cells using a composition derived from the photosynthetic system of plants and mammalian embryonic tissue Inventor(s): Lofflmann; Adolf (Munchner Strasse 7, 8000 Munich 70, DE) Assignee(s): None Reported Patent Number: 5,516,754 Date filed: January 24, 1994 Abstract: By the combined use of an agent which selectively dissolves tumor cells and which contains a protein fraction which has oxygen-liberating action and which is derived from the photosynthetic system of plants, together with a further agent which inhibits the proteases of the cancer cells and which has been obtained by means of extraction of embryonic tissue or maternal uterus tissue from placentals, it is possible to selectively dissolve the tumor by means of this agent without damaging the healthy organism. When used on its own, the abovementioned plant-derived agent shows an activity in the treatment of inflammatory processes and is also suitable for the aftertreatment of scars, keloids and damage caused by ionizing rays. Excerpt(s): The invention relates to the use of certain substances which are illustrated below in greater detail, based on a novel concept in medical science, as an active substance in pharmaceuticals, in particular for the selective dissolution (destruction) of cancer cells (malign tumor cells), but also for combating inflammatory processes, and for the treatment of hypertrophic scars and keloids. The present invention is based on considerations that one of the reasons why scientific attempts to date to understand and combat cancer may have remained so unsatisfactory is because the underlying idea that the phenomenon of cancer is causally linked to the cell nucleus has blurred focusing on fundamentally novel, promising concepts. Cancer cells differ from healthy cells by a series of properties, and successful cancer therapy should, if possible, be orientated towards these properties which distinguish cancer cells from healthy cells so as to be able to choose a therapy route which selectively only targets cancer cells, or selectively only damages cancer cells. However, numerous known methods in cancer therapy do not meet these requirements since, like most cytostatic agents and rays, for example, they do not selectively act on cancer tissue, but also damage normal healthy tissue. A method for destroying tumors, which is known from the literature, is described in Nachr. Chem. Tech. Lab. 33 (1985), No. 7 "Lokalisierung und Therapie von Tumoren mit Porphyrinen [Tumor localization therapy with porphyrins]", H. Vandenbergh and P. Cornaz. This method combines injections with a haematoporphyrin derivative with redlight irradiation. The present invention is based on the known observation that cancer cells differ from healthy cells in that they have an "anoxemic metabolism" which is

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characterized by the occurrence of aerobic glycolysis. Starting from this medical fact, the consideration was that therapy which, in a targeted manner, aims at the cell respiration of cancer cells, which differs from that of healthy cells, can selectively damage the former without simultaneously attacking healthy cells. However, when this concept was pursued, it emerged that further peculiarities of cancer cells compared with normal cells have to be taken into account if therapy is to be successful, and that valuable model hypotheses can be put forth if the cancer cell is regarded as a cell which, in total, mimics embryonic behavior (embryonic encoding). However, the properties exhibited by cancer cells similar to embryonic cells, include not only the anoxemic cell metabolism, but also the fact that proteases are active, which imparts the ability of "incipient digestion" of body tissue (maternal uterus tissue or healthy tissue of the cancer patient) to the cancer cells and to the embryonic cells. Web site: http://www.delphion.com/details?pn=US05516754__ •

Method for the treatment of scars and keloids Inventor(s): Reinmuller; Johannes (Gustav-Frcytag-Strasse 27, 65189 Wiesbaden, DE) Assignee(s): None Reported Patent Number: 5,731,298 Date filed: August 15, 1994 Abstract: A method and a pharmaceutical composition for non-topical wound, scar and keloid treatment is described which contains cross-linked glycosaminoglycans and conventional pharmaceutical auxiliary and/or carrier substances. The pharmaceutical composition is preferably administered intralesionally e.g. by injection in the form of a gel containing water. The cross-linked glycosaminoglycans are also suitable for use as cosmetics and skin care products. Excerpt(s): This is in an application under 35 U.S.C.sctn.371 of PCT/EP92/02990 having an international filing date of Dec. 24, 1992. The invention concerns a pharmaceutical composition for the treatment of wounds, scars and keloids. Excess new growth of scar tissue occurs in many people during healing of skin wounds. In medical terminology this new formation of tissue is referred to as cicatricial hypertrophy or as keloid in severe cases. These are unpredictable reactions during wound healing caused by a predisposition. Up to now the reasons for excess cicatrisation are not known. Thus at present there is also no scientifically based causal method of treatment. Web site: http://www.delphion.com/details?pn=US05731298__

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Method for topical treatment of scars with protein kinase C inhibitors Inventor(s): Crandall; Wilson T (P.O. Box 346, Verona, VA 24482) Assignee(s): Crandall; Wilson T (defiance, Va) Patent Number: 6,306,383 Date filed: August 31, 2001 Abstract: This invention relates to the topical treatment of keloids, hypertrophic scars and burn scars by the use of a selected protein kinase c inhibitor and an effective penetrating agent selected from lecithin organogel or poloxamer 407 lecithin organogel. The protein kinase c inhibitors may be selected from sphingosine, sphinganine,

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phytosphingosine, N-Acetylsphingosine, N-Hexanoylsphingosine, Octanoylsphingosine, curcumin, tetrahydrocurcumin, curcuminoids or apigenin.

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Excerpt(s): The present invention is related to a process and composition for topically inhibiting Protein Kinase C. More particularly, the present invention relates to topically applying the composition disclosed herein in order to treat the affected skin or underlying structures of humans and animals. Protein kinase C inhibitors have been shown effective in vitro and in a limited fashion orally, but not efficacious when used topically. What is needed is a topical composition which is safe and cost effective. Mukhtar in Pharmacology of the Skin describes the communication between cells as being mediated by different biomolecules, such as hormones. These so called primary messengers bind to specific receptors on the cell surface. The binding of a primary messenger to its receptor conveys a certain information to the cell which is subsequently transduced through the membrane by a chain of signaling. This process involves various membrane structures and leads to the activation of an enzyme located at the intracellular side of the membrane. The stimulated enzyme generates a second messenger which evokes the cellular response; in most cases, by the activation of other enzymes. By these steps, the initial extracellular signal is converted into an intracellular signal. This process is called signal transduction. Protein kinases regulate cellular responses by phosphorylation of substrate proteins (eg. receptors or enzymes) and thereby alter their state of activity. In the case of the inositide cascade, PKC mainly performs this reaction. Sphingosine dose-dependently inhibits PKC, but also binds to calmodulin (CaM) function and therefore inhibits CaM function. Keratinocyte intercellular adhesion molecule-1 (ICAM-1) is thought to be involved in dermal lymphocyte infiltration. The PKC activating phorbol ester, PMA has been reported to induce the expression of ICAM-1 in normal human keratinocytes. This effect can be blocked by a PKC inhibitor and suggests that PKC might play a regulatory role in ICAM-1 expression. Web site: http://www.delphion.com/details?pn=US06306383__ •

Method of promoting wound healing and scar regression Inventor(s): Grumet; Martin (New York, NY) Assignee(s): Andrx Pharmaceuticals, Inc. (fort Lauderdale, Fl) Patent Number: 5,532,275 Date filed: December 7, 1994 Abstract: A novel method of treating wounds has been discovered that is based on the system and/or topically administration of an effective amount, of para-amino benzoic acid or its derivatives, to a patient who has a wound, the healing of the wound will be promoted and scar formation will be reduced. In addition, it has been discovered that by systemically and/or topically administering an effective amount of para-amino benzoic acid or its derivatives, to a patient who has scar tissue or keloids, the scar tissue and/or keloid tissue will regress and/or soften to allow the skin in the area of the scar or keloid to become more flexible. Excerpt(s): This invention relates to a method of treating wounds, which are caused by trauma or by surgical procedures, to promote healing and reduce scarring. In addition the invention also provides a method for softening and/or reducing the severity of preexisting scars and keloids. In the prior art, wound treatment has been based on restoring the integrity of skin by use of sutures, staples or various adhesive closures.

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Systemic and local anti-infectives have been used to treat and prevent infections which are caused by microscopic flora. To promote wound healing, topical preparations of oil soluble vitamins such and Vitamin A, D and E have been applied to healing wounds but the efficacy of these treatments has not been established by controlled clinical studies. Para-amino benzoic acid has been used in the treatment of Peyronie's disease and in the treatment of scleroderma where it has anti-fibrotic activity. It has been discovered that by systemically and/or topically administering an effective amount, of para-amino benzoic acid or its derivatives, to a patient who has a wound, the healing of the wound will be promoted and scar formation will be reduced. In addition, it has been discovered that by systemically and/or topically administering an effective amount of para-amino benzoic acid or its derivatives, to a patient who has scar tissue or keloids, the scar tissue and/or keloid tissue will regress and/or soften to allow the skin in the area of the scar or keloid to become more flexible. Web site: http://www.delphion.com/details?pn=US05532275__ •

Surgical skin closure Inventor(s): Romero-Sierra; Cesar Aurelio (Bath, CA), Tanner; Joseph A. (Ottawa, CA) Assignee(s): Canadian Patents and Development Limited (ottawa, Ca) Patent Number: 4,038,989 Date filed: May 7, 1976 Abstract: A therapeutic device for skin lesions is provided in which adhesively coated flexible strips are stuck to skin on opposed sides of the lesion, aligned to prevent lateral displacement of the skin and drawn together by flaps to close the skin over the lesion. This device allows the lesion to heal without the formation of keloids. The flaps may be pulled around the side bars of a buckle member to draw the flexible strips to close skin over the lesion, and then the flaps stuck to the flexible strips to hold the skin closing the lesion. For surgical incisions a transparent, removable cover may be on the folded back flaps, and the surgical incision made through the transparent, removable cover, markings on the strips may be used to align them, and the lesion may be closed by sticking the flaps together in face-to-face relation. Excerpt(s): This invention relates to a therapeutic device for skin lesions. It has already been proposed by Claude Kawchitch in an article "No-Scar Surgery Zip-Fastener", in The Medical Technologist, Volume 4, No. 4, April, 1974, to provide a surgical zip (slide) fastener to eliminate operation scars and close a wound quickly and securely and heal a wound in a faster manner than with conventional, surgical stitching. After the surgeon has pencilled the surgical cutting line on the skin, a foundation stage of the zip fastener in the form of a self-adhesive, translucent ribbon is stuck over the pencilled line so that the two ends of the line protrude as cutting guides. The self-adhesive, translucent ribbon, which has extra strong adhesive on its silicone-rubber underside, is filled with cellular foam and is capped with a perforated nylon top layer. Protruding hooks are provided on the nylon and are used later to attach the ribbon to a concertina spring forming the zip (slide) fastener. With the self-adhesive ribbon stuck over the pencilled line the surgeon cuts through the self-adhesive, translucent ribbon along the pencilled line and into the flesh. When it is time to close the wound the surgeon pushes the two cut edges together and then stretches the concertina spring so that it narrows, clasps it to the nylon hooks, sticks both ends of the spring to the skin with adhesive plaster and the wound is neatly fastened together without the conventional, surgical stitching.

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Web site: http://www.delphion.com/details?pn=US04038989__ •

Synducin mediated modulation of tissue repair Inventor(s): Bernfield; Merton (Boston, MA), Gallo; Richard L. (Natick, MA) Assignee(s): Children's Medical Center Corporation (boston, Ma) Patent Number: 5,654,273 Date filed: September 22, 1994 Abstract: The membrane permeating antibacterial peptide, PR-39, previously found only in the intestine, was purified from wound fluid and shown to possess syndecan-1 and syndecan-4 inductive activity specifically in mesenchymal cells. This is a newly recognized function that defines peptide containing syndecan-inducing activity, and that are known as synducins. Therefore a molecule with both antimicrobial and synducin activities is deposited in wounds where it can simultaneously reduce infection and influence the action of growth factors, matrix components, and other cellular effectors involved in wound repair. Synducins, including PR-39, and derivatives thereof, is therefore useful in the modulation of wound healing, as well as other disorders involving mesenchymal cells and cell surface molecular interaction, including metastatic disease, angiogenesis, restenosis, stasis or decubitis ulcers, and prevention of keloids. Excerpt(s): This invention is generally in the area of modulation wound repair using a peptide inducer of syndecan expression. Complex cellular behaviors such as those resulting in wound repair are influenced by a variety of soluble growth factors, cytokines, and insoluble extracellular matrix components. To exert their effects, many of these effector molecules must bind to the heparan sulfate chains that are at the surface of nearly all adherent cells (Ruoslahti and Yamaguchi, Cell, 64:867 (1991)). For example, interaction with cell surface heparan sulfate is required for cells to respond to the growth factors FGF-2 (Rapraeger, et al., Science, 252:1705 (1991); Yayon, et al. Cell, 64:841 (1991)) and HB-EGF (Higashiyama, et al., J. Cell Bio., 122:933-940 (1993)), and to the matrix component fibronectin (Guan, et al. Cell Reg., 2:951 (1991); Woods, et al., Molec. Biol. Cell, 4:605 (1993)). Indeed, Guan, et al. (1991); Bernfield, et al., in Annu. Rev. Cell Biol., G. E. Palade, B. M. Alberts, J. A. Spudich, Eds. (Annual Reviews Inc., Palo Alto, Calif., 1992), 8:365-393); Jalkanen, et al., Trends in Glyco-science and Glycotech, 5:107 (1993); G. David, FASEB J., 7:0123 (1993); and A. C. Rapraeger, Curr. Opin. Cell Biol., 5:844 (1993)) have proposed that cell surface heparan sulfate, which is derived mostly from the four members of the syndecan family of transmembrane proteoglycans (G. David, et al., J. Cell Biol., 111:3165 (1990)), acts together with specific signaling receptors to mediate the cellular response to such effectors. Changes in the abundance of cell surface heparan sulfate probably regulates the action of these effector molecules, yet it is not known how the amount of heparan sulfate at the cell surface is controlled. Cell surface heparan sulfate mediates the activity of several growth factors, extracellular matrix components, proteases and other cellular effectors involved in wound repair. Syndecan-1, a major transmembrane heparan sulfate proteoglycan, is induced transiently on mesenchymal cells during the repair of skin wounds. Accordingly, induction of syndecan-1 can influence this process. Syndecan-1 induction can trigger cellular behaviors such as proliferation and migration that are involved in wound repair due to its ability to bind and thus augment the action of heparin-binding growth factors, including FGF-2, HB-EGF, and PDGF-AB, each found in repairing wounds. Cell surface syndecan-1 can also bind fibronectin, thrombospondin, tenascin and the fibrillar collagens. Accordingly, its induction can contribute to the effects of these extracellular

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matrix components that are involved in wound repair. Thus, the induction of syndecan1 by PR-39 may mediate growth factor responsiveness and the changes in cell proliferation, migration, and adhesion that must take place for wound repair to proceed. Web site: http://www.delphion.com/details?pn=US05654273__ •

Topical formulation of alkyl-, phenyl-pyridone Inventor(s): Scheiwe; Max Werner (Maulburg, DE), Yamauchi; Shitotomo (Tokyo, JP) Assignee(s): Mepha AG (aesch, Ch) Patent Number: 6,492,395 Date filed: May 23, 2001 Abstract: A pharmaceutically acceptable topical formulation for the treatment and/or prevention of skin ailments, more particularly of fibriotic nature such as fibriotic lesional tissues, contiguous warts, contact dermatitis, and keloids, and to assist the healing of burns after surgery, comprising as active ingredient a substituted pyridone of the formula: n-(R.sup.1)-R.sup.2 -2-(1H)pyridone or a pharmaceutically acceptable salt or ester thereof, where R.sup.1 is selected from methyl, ethyl, propyl, carboxyl and a carboxymethyl or carboxyethyl ester group, R.sup.2 is selected from phenyl, methylphenyl, ethylphenyl, propylphenyl, and a carboxyphenyl or carboxyethylphenyl ester group, and n is 3, 4 or 5, together with an excipient, characterized in that the excipient comprises, one or more plasticisers, one or more antioxidants, one or more gelforming agents and sufficient pH adjusting agent to bring the pH of the formulation to a value from 4 to 8. The preferred active ingredient is 5-methyl-1-phenyl-2-(1H)pyridone (Pirfenidone). Excerpt(s): or a pharmaceutically acceptable salt or ester thereof, where R.sup.1 is selected from methyl, ethyl, propyl, carboxyl and a carboxymethyl or carboxyethyl ester group, R.sup.2 is selected from phenyl, methylphenyl, ethylphenyl, propylphenyl, and a carboxyphenyl or carboxyethylphenyl ester group, and n is 3, 4 or 5 (position of substitution). The preferred active ingredient is Pirfenidone (CAS 53179-13-8, 5-methyl1-phenyl-2-(1H)-pyridone). As described in U.S. Pat. No. 5,310,562 and EP 0 383 591, Pirfenidone has a broad spectrum of applications in the prevention and treatment of fibrotic diseases, especially for the reparation and prevention of fibrotic lesional tissues, contiguous warts, contact dermatitis, keloids, fibrosis of the lung, fibrosis of the prostate, sclerosis, the healing of burns after surgery and Alzheimer disease. Although the possibility of topical application is mentioned, there is no description of any specific formulation. The application of active ingredients of the class mentioned, (hereafter called alkyl,phenyl pyridones) e.g. Pirfenidone for e.g. the treatment of burns and keloids may possibly be carried out using a solution or a suspension of the agent in aqueous or oily excipient such as emulsions, creams, ointments, gels, microemulsions, liquid emulsions, nanocapsule suspensions, liposome formulations, lotions and the like; however, an ointment, cream or gel formulation is preferable because of their soothing effect and easy application. Because these formulations are used in the treatment of humans they are considered to be pharmaceutical preparations, and as thus have to be proven to be physically and chemically stable before they are permitted on the market. For this reason, each formulation must undergo a stability test. Without the necessary data on stability and shelf life, the formulation cannot be approved by any health authority. Web site: http://www.delphion.com/details?pn=US06492395__

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Treatment of skin disorders Inventor(s): Nagler; Arnon (Jerusalem, IL), Pines; Mark (Rehovot, IL) Assignee(s): Hadasit Medical Research Services and Development Company Ltd (jerusalem, Il) Patent Number: 6,211,188 Date filed: February 11, 1997 Abstract: An effective treatment for skin disorders characterized by abnormal skin cell behavior, including a pharmaceutically effective amount of Halofuginone. Skin disorders which can be treated include keloids, hypertrophic scars, psoriasis, acne, seborrhea and alopecia. Halofuginone can reduce or eliminate clinical symptoms of these disorders, as well as substantially prevent the formation of keloids and hypertrophic scars. Excerpt(s): The present invention relates to a method and a composition for the treatment of skin disorders and, more particularly, to a method and a composition for the treatment and prevention of psoriasis, hypertrophic scars and keloids. Keloids are benign fibrotic tumors which are believed to arise from the reticular dermis. They are characterized by increased tissue fibrosis and collagen deposition [Friedman, D. W. et al., J. Surg. Res., Vol. 55, p. 214-222, 1993]. Keloids usually first appear when a patient is between the ages of 10 and 30 years, and are often associated with trauma. They occur most commonly on the upper back, anterior chest, shoulders and ear lobes. Keloids are especially frequently seen in patients of African or Asian descent. Hypertrophic scars are somewhat related to keloids, in that they are also characterized by increased tissue fibrosis and collagen deposition [Friedman, D. W. et al., J. Surg. Res., Vol. 55, p. 214-222, 1993]. Furthermore, hypertrophic scars are also most often seen in patients of African and Asian descent [Rockwell, W. B. et al., Plastic and Recon. Surg., Vol. 84, p 827-835, 1989]. Although there are certain differences between hypertrophic scars and keloids, such as a lower fibroblast density in keloids than in hypertrophic scars, a common mechanism is believed to underlie both conditions. Specifically, a geneticallydetermined aberration of the metabolism of melanocyte-stimulating hormone (MSH) is believed to be responsible for both hypertrophic scars and keloids [Rockwell, W. B. et al., Plastic and Recon. Surg., Vol. 84, p. 827-835, 1989]. Thus, both hypertrophic scars and keloids represent the effects of genetically abnormal behavior of skin cells. Web site: http://www.delphion.com/details?pn=US06211188__

Patent Applications on Keloids As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to keloids:

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

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Attenuation of fibroblast proliferation Inventor(s): Cauchon, Elizabeth; (Ile Perrot, CA), Denholm, Elizabeth M.; (Pointe Claire, CA), Silver, Paul J.; (Spring City, PA) Correspondence: Patrea L. Pabst; Arnall Golden & Gregory, Llp; 2800 One Atlantic Center; 1201 West Peachtree Street; Atlanta; GA; 30309-3450; US Patent Application Number: 20020102249 Date filed: December 1, 2000 Abstract: Highly purified and specific glycosaminoglycan degrading enzymes, chondroitinase B and chondroitinase AC, are used to treat fibroproliferative diseases. The enzymatic removal of chondroitin sulfate B (dermatan sulfate), and to a lesser extent, chondroitin sulfate A or C, from cell surfaces effectively decreases growth factor receptors on the cells and thereby decreases the cell proliferative response to such growth factors. In addition, removal of chondroitin sulfates reduces secretion of collagen, one of the major extracellular matrix components. Through the combined inhibition of fibroblast proliferation and collagen synthesis, treatment with chondroitinase B or chondroitinase AC decreases the size of fibrous tissue found in psoriasis, scleroderma, keloids, pulmonary fibrosis and surgical adhesions. Excerpt(s): The present invention is a method and composition using chondroitinase B and chondroitinase AC, glycosaminoglycan degrading enzymes, to inhibit the formation of fibrotic tissue. This application claims priority to U.S. Ser. No. 60/168,518, filed Dec. 2, 1999. Proteoglycans on the cell surface and in the extracellular matrix contain variable glycosaminoglycan chains, which include heparan sulfate and chondroitin sulfates A, B, or C. While some proteoglycans contain only one type of glycosaminoglycan, others contain a mixture of heparan and chondroitin sulfates (Jackson et. al., Physiol. Rev. 71:481-530,1991). Extracellular proteoglycans form a structural framework for cells and tissues, and together with cell-associated proteoglycans, have major functions in regulating cell adhesion, migration, and proliferation. The functions of proteoglycans and their component parts have been extensively studied, with much of the emphasis on the roles of heparin and heparan sulfate on cell metabolism (Kjellen, L., and Lindahl, U. (1991) Ann. Rev. Biochem. 60:443-475; Vlodavsky, et al. (1995) Thrombosis Haemostasis 74:534-540; Yayon, et al. (1991) Cell 64:841-848)). Much less is known about the biological activities of proteoglycans containing chondroitin sulfate glycosaminoglycans, and in particular, their effects on cell proliferation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Compounds for blocking androgen receptors Inventor(s): Mamana, John P.; (McLean, VA) Correspondence: Mcguirewoods Llp; 1750 Tysons Boulevard, Suite 1800; Mclean; VA; 22102; US Patent Application Number: 20030153627 Date filed: January 9, 2003 Abstract: Compounds used to block non-essential androgen receptors are described. In particular, cyclohexenone compounds containing an alkyl group may be used in the treatment of conditions mediated by the blocking of non-essential androgen receptors

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such as acne, male patterned baldness, keloids, skin-wrinkling, and osteoarthritis. The cyclohexenone compound may be administered orally, topically, or internally. Excerpt(s): This application claims priority to and is related to U.S. Provisional Application No. 60/346,545, filed Jan. 9, 2002, herein incorporated by reference in its entirety. The present invention is directed to compounds that are useful for treating conditions mediated by blocking non-essential androgen receptors in a patient. It is well know that androgen plays a significant role in causing a variety of conditions such as acne and male patterned baldness. Other conditions that are thought to be related to androgen include keloids, adhesions, elastin synthesis, wrinkling effects, and osteoarthritis. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Human fibrotic responses to surgery and methods of treatment Inventor(s): Spencer, E Martin; (San Francisco, CA) Correspondence: E Martin Spencer; 505 Ortega Street; San Francisco; CA; 94122; US Patent Application Number: 20020107185 Date filed: December 9, 2000 Abstract: This invention is a method for selectively preventing an unwanted fibrotic response in humans after surgery or injury using therapeutic amounts of human insulinlike growth factor binding protein-4 (IGFBP-4) that has been modified to resist the enzymatic action of the natural IGFBP-4 protease in tissues. Surgical procedures in the abdomen, pelvis, thorax, and spinal column frequently initiate the formation of fibrous adhesions between organs. Collagen is the principal constituent of fibrous adhesions. These abnormal connections may interfere with the normal function of the organs involved, cause pain, and require additional surgical procedures, which frequently induces more adhesion formation. Surgical incisions and burns may directly initiate a process in tissues that stimulates excess fibrous tissue and results in hypertrophic scars or keloids that are disfiguring and/or interfere with function. At times a decreased fibrotic response is required by plastic surgeons for cosmetic reasons and by ophthalmologists for glaucoma patients to maintain patency of holes created in the sclera (sclerectomy) to filter fluid from the anterior chamber of the eye. Insulin-like growth factor-I (IGF-I) is one of the components that stimulates the adhesion process and wound repair. Lowering the level of IGF-I in the body significantly impairs wound healing and the synthesis of collagen. Lowering the level of IGF-I in the specific site of the body at which adhesions are undesirable significantly impairs the formation of adhesions and decreases the fibrotic response in wounds. IGFBP-4 inhibits the formation of fibrous tissue by binding and inactivating IGF-I. The protease resistant, modified IGFBP-4 is superior to the natural IGFBP-4 for this purpose. Excerpt(s): This invention relates to the fibrotic response in humans resulting from surgery or trauma and methods to inhibit this response. Normal wound healing consists of a coordinated series of reactions that restore the integrity of the tissue. The stages are: Hemostasis, inflammation, proliferation, matrix formation, and remodeling. Hunt T. K., "Wound healing: Disorders of repair, in" Fundamentals of Wound Management in Surgery, (Chirurgeocom 1976). After hemostasis is achieved, granulocytes appear followed by macrophages. Macrophages are critical to healing and direct the subsequent events by the production of cytokines, polypeptides and proteins that regulate cellular functions. Fibroblasts proliferate into the wound and synthesize collagen (fibrous

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tissue), the major component of the matrix of the wound. This is followed closely by angiogenesis, which is the proliferation and in-growth of blood vessels. Subsequently, in the case of cutaneous wounds, epithelial cells on the edge proliferate and cover the wound. The final stage is remodeling which includes modification of the collagen tissue and contraction of the wound scar. IGF-I stimulates most of the phases of wound healing, especially the activity of macrophages and fibroblasts, which proliferate and synthesize collagen, elastin and proteoglycans. Spencer, et al., "Somatomedins: Do they play a pivotal role in wound healing?," Growth Factors and Other Aspects of Wound Healing: Biological and Clinical Implications, 103-116, (1988); Steenfos, et al., "Insulinlike Growth Factor 1 has a Major Role in Wound Healing," Surgical Forum, 68-70, (1989); Mueller, et al., "The role of IGF-I and IGFBP-3 in wound healing," in Modern Concepts of Insulin-like Growth Factors, ed. Spencer E. M. (Elsevier 1991) pp. 185-192; Karey K. P. and Sirbasku D., "Human platelet-derived mitogens. II. Subcellular localization of insulinlike growth factor I to the alpha-granule and release in response to thrombin," Blood, 74, 1093-100, (1989); Suh, et al., "Insulin-like growth factor-I reverses the impairment of wound healing induced by corticosteroids in rats," Endocrinology, 131, 2399-403, (1992); Mueller, et al., "The effect of insulin-like growth factor I on wound healing variables and macrophages in rats," Archives Of Surgery, 129, 262-5, (1994). Adhesions are defined as abnormal fibrous connections between organs. They consist principally of collagen. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Lectins as anti-fibrotic agents Inventor(s): Cantor, Jerome Owen; (Brooklyn, NY), Shteyngart, Bronislava; (Brooklyn, NY) Correspondence: Jerome O. Cantor, MD; 242 92nd Street; Brooklyn; NY; 11209; US Patent Application Number: 20030216300 Date filed: May 12, 2003 Abstract: The subject invention is directed to the treatment of tissue fibrosis by administration of an effective amount of lectin. Fibrosis herein refers to the accumulation of extracellular matrix constituents that occurs following trauma, inflammation, tissue repair, immunological reactions, cellular hyperplasia, and neoplasia. Examples of tissue fibrosis include, but are not limited to, pulmonary fibrosis, cirrhosis of the liver, skin scars and keloids, adhesions, fibromatosis, atherosclerosis, and amyloidosis. The treatment is intended for a variety of mammals, including humans. Excerpt(s): Lectins bind to carbohydrate moieties, e.g. acetylglucosamine, that are ubiquitous in the mammalian extracellular matrix. This suggests the possibility that lectins may be used to coat the matrix and limit further binding of collagen, elastin, and other connective tissue components to carbohydrate groups. The aggregation of large amounts of matrix constituents, as occurs in fibrosis, may therefore be subject to limitation by the introduction of lectins. This hypothesis was tested in our laboratory. Elastic fiber matrix prepared from cultured rat lung mesothelial cells (1,2) was first treated with tomato lectin (lycopersicon esculentum), then covered with hyaluronan (HA), which normally protects the matrix from degradation by elastases. It was found that lectin treatment abolished the protective effect of HA and facilitated breakdown of the elastic fiber matrix by elastase. Since the binding of HA to the elastic fibers is analogous to fibrosis in that it involves deposition of new matrix material (HA) over

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existing matrix, the addition of lectin may provide a means of counteracting this process and preventing the formation of scar tissue. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

METHOD IF TREATING KELOIDS Inventor(s): BROWN, SANDRA; (SOUTHFIELD, MI) Correspondence: Thomas E Anderson; Gifford Krass Sprinkle; Anderson & Citkowski; 280 North Old Woodward Suite 400; Birmingham; MI; 48009 Patent Application Number: 20010038846 Date filed: May 10, 1999 Abstract: Disclosed is a method for treating keloid scaring. The method includes application of a concentrated solution of glycolic acid in the range of 20-70% by weight to the skin for a period of time sufficient to promote atrophy of the scar. After a sufficient time, the tissue is washed with soap and water to remove the acid and loosen tissue. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/085,165, filed May 12, 1998. Keloids are raised, hard, generally irregularly shaped scars which form on the skin as a result of trauma including burns, lacerations, abrasions, cryosurgery, vaccinations, and the like. Keloids are characterized by the presence of thick bands of acellular, eosinophilic collagen therein, and are thought to form as a result of a defective healing process. Keloids can occur in people of any race, but are more common in black people. In some instances, keloids can produce severe physical and psychological symptoms. Keloids are prone to bleeding and itching, and can be extremely sensitive to touch so that contact with clothing, or even water, can produce excruciating pain. Keloids can be highly disfiguring, and their untreatable nature has caused some patients to become recluses or even commit suicide. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Pharmaceutical composition Inventor(s): Santana Ribeiro, Cristiano Alberto; (Sao Paulo, BR) Correspondence: Larson & Taylor, Plc; 1199 North Fairfax Street; Suite 900; Alexandria; VA; 22314; US Patent Application Number: 20030161821 Date filed: February 25, 2003 Abstract: The present invention refers to a new pharmaceutical composition applicable to any form, specially gel, cream and cream gel, liquid, spray, aerosol and lyophilized, used for treating colagenoses and fibrotic pathologies, such as keloids, hypertrophic scars, vasculophatic dermopaniculosis and the Dupuytren disease. The pharmaceutical composition of the present invention is of topical application, non-toxic, featuring debridant and anti-inflammatory action with a high rate of penetration through the skin.The pharmaceutical composition of the present invention comprises in it's formulation more than 0.01% of Papaine.

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Excerpt(s): The present invention refers to a new pharmaceutical composition to be used in any form most notably gel, cream and cream gel, liquid, spray, aerosol, lyophilized used for treating colagenoses and fibrotic pathologies, such as keloids, hypertrophic scars, vasculophatic dermopaniculosis and the Dupuytren disease. The pharmaceutical composition of the present invention is of topical application, non-toxic, featuring debridant and anti-inflammatory action with a high penetration rate through the skin. The pharmaceutical composition of the present invention is of topical application, nontoxic, featuring debridant and anti-inflammatory action with a high penetration rate through the skin. The skin permeability varies according to the region of the body, being the skin folds and the face those that present the highest absorption rate. A product applied over the skin will present a longer period of contact and percutanial absorption. 3) absence of permeability. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Treatment and prevention of abnormal scar formation in keloids and other cutaneous or internal wounds or lesions Inventor(s): Benya, Paul D.; (Los Angeles, CA), Tuan, Tai-Lan; (Fullerton, CA), Warburton, David; (La Canada, CA) Correspondence: Perkins Coie Llp; Post Office Box 1208; Seattle; WA; 98111-1208; US Patent Application Number: 20040043026 Date filed: May 13, 2003 Abstract: The present invention relates to findings that reducing the activity of Plasminogen Activator Inhibitor-1 (PAI-1) suppresses an excessive deposition of collagen which is known as a cause for the formation of abnormal scars. These abnormal scars include but are not limited to keloids, adhesions, hypertrophic scars, skin disfiguring conditions, fibrosis, fibrocystic conditions, contractures, and scleroderma, all of which are associated with or caused by an excessive deposit of collagen in a wound healing process. Accordingly, aspects of the present invention are directed to the reduction of PAI-1 activity to decrease an excessive accumulation of collagen, prevent the formation of an abnormal scar, and/or treat abnormal scars that result from an excessive accumulation of collagen. The PAI-1 activity can be reduced by PAI-1 inhibitors which include but are not limited to PAI-1 neutralizing antibodies, diketopiperazine based compounds, tetramic acid based compounds, hydroxyquinolinone based compounds, Enalapril, Eprosartan, Troglitazone, Vitamin C, Vitamin E, Mifepristone (RU486), and Spironolactone to name a few. Another aspect of the present invention is directed to methods of measuring PAI-1 activity in a wound healing process and determining the propensity of the formation of an abnormal scar. Excerpt(s): This application claims the benefit of U.S. Provisional Application No.60/380,696, filed May 13, 2002, which is hereby incorporated by reference in its entirety including drawings as fully set forth herein. The present invention relates to the treatment or prevention of abnormal scar formation. Specifically, the present invention relates to the reduction of the activity of plasminogen activator inhibitor-1 to decrease an excessive deposit of collagen in a wound healing process that causes abnormal scars including keloids, hypertrophic scars, adhesions, and other cutaneous or internal wounds or lesions. Wound healing is a continuous process commonly divided into four separate phases: 1) coagulation, 2) inflammation, 3) migration and proliferation, and 4) remodeling.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with keloids, 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 “keloids” (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 keloids. You can also use this procedure to view pending patent applications concerning keloids. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON KELOIDS Overview This chapter provides bibliographic book references relating to keloids. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on keloids include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Chapters on Keloids In order to find chapters that specifically relate to keloids, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and keloids 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 “keloids” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on keloids: •

Diseases of the External Ear and Tympanic Membrane Source: in Jafek, B.W.; Stark, A.K., eds. ENT Secrets: Questions You Will Be Asked On Rounds, In the Clinic, In the OR, On Exams. Philadelphia, PA: Hanley and Belfus. 1996. p. 34-39. Contact: Available from Hanley and Belfus. Medical Publishers, 210 South 13th Street, Philadelphia, PA 19107. (800) 962-1892 or (215) 546-7293; Fax (215) 790-9330; http://www.hanleyandbelfus.com. PRICE: $35.95 plus shipping and handling. ISBN: 1560531592. Summary: This chapter on diseases of the external ear and tympanic membrane is from a book that utilizes a question and answer format to review details of the specialty of otorhinolaryngology (ear, nose and throat, or ENT). Topics covered include the parts of the auricle (outer ear), complications of an auricular hematoma (untreated), management of auricular hematoma, perichondritis of the auricle, keratitis obturans, signs and symptoms of frostbite to the external auricle, otitis externa, differences

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between exostoses and auditory canal osteoma, malignant otitis externa, otomycosis, Ramsay Hunt syndrome (herpes zoster otiticus), microtia (small external ear), aural atresia, keloids, cerumen (earwax) impaction and its removal, removal of foreign bodies from the ear canal (generally in children), abnormal signs of the tympanic membrane (eardrum), causes of traumatic eardrum perforations, Prussak's space, chronic otitis media and eardrum perforations, three layers of the tympanic membrane, patching an eardrum perforation, myringerosclerosis, and bullous myringitis. The chapter focuses on helping readers acquire the vocabulary required to discuss these diseases of the external ear and tympanic membrane. 2 figures. 1 table. 6 references. •

Chapter 207: Noncancerous Skin Growths Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 6 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who have noncancerous skin growths with information on the symptoms and treatment of moles, atypical moles, skin tags, lipomas, angiomas, pyogenic granulomas, seborrheic keratoses, dermatofibromas, keratoacanthomas, and keloids. Moles are usually dark skin growths that vary in size, may be flat or raised, may be smooth or rough, or may have hairs growing from them. Moles are harmless and do not need to be removed unless they change. Atypical moles, which are flat or raised dark skin growths, may appear anywhere on the body. People who have atypical moles, especially those with a family history of melanoma, must have the moles examined at least once a year for any changes that might indicate malignant melanoma. Skin tags are soft, small, flesh colored or slightly darker skin flaps that usually occur on the neck, in the armpits, or in the groin. They can be removed by freezing them with liquid nitrogen or cutting them off. Lipomas are soft deposits of fatty material that grow under the skin and cause round or oval lumps. Lipomas are not cancers, and they rarely become cancerous. Bothersome lipomas may be removed by surgery or liposuction. Angiomas are collections of abnormally dense blood or lymph vessels that cause red or purple skin discolorations. Angiomas include port wine stains, strawberry marks, cavernous hemangiomas, spider angiomas, and lymphangiomas. Port wine stains are flat pink, red, or purplish discolorations that are present at birth. They are physically harmless, but may be psychologically harmful. These birthmarks can be covered with cosmetic cream or removed with a laser. Strawberry marks are raised, bright red areas that range in size from small to large. Oral prednisone may be taken to shrink them. Cavernous hemangiomas are raised red or purplish areas composed of abnormal, enlarged blood vessels. Treatment options include oral prednisone, electrocoagulation, or surgical removal. Spider angiomas are bright red areas with a central reddish or purplish spot with slender projections. They are common in pregnant women and women taking oral contraceptives. The central blood vessel can be destroyed by electrocoagulation. Lymphagiomas are bumps caused by a collection of enlarged lymphatic vessels. Treatment is not usually needed, but they can be removed surgically. Pyogenic granulomas, which usually occur after injury to the skin, are scarlet, brown, or blue black slightly raised areas caused by increased capillary growth and tissue swelling. They can be removed surgically or by electrocoagulation. Seborrheic keratoses are brown, black, or flesh colored growths that can appear anywhere on the body. Treatment is usually not needed, but they can be removed by freezing them with liquid

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nitrogen or by cutting them out. Dermatofibromas are small red to brown bumps that are caused by an accumulation of fibroblasts. They do not require treatment unless they become bothersome or enlarged; then they can be surgically removed. Keratoacanthomas, which resemble squamous cell carcinoma, are round, firm, usually flesh colored growths that have an unusual central crater filled with a pasty material. They can be treated surgically or with injections of corticosteroids or fluorouracil. Keloids are growths of fibrous tissue that form over areas of injury or surgical wounds. Monthly injections of corticosteroids may flatten them somewhat.

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APPENDICES

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

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

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

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

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

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

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

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

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

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

11

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

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•

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

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

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

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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

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

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

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

•

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

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

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

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

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•

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

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

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “keloids” (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 1742 26 213 0 14 1995

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 “keloids” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

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

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

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

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Keloids In the following section, we will discuss databases and references which relate to the Genome Project and keloids. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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

Keloids Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=148100

•

Torticollis, Keloids, Cryptorchidism, and Renal Dysplasia Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=314300 Genes and Disease (NCBI - Map)

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

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

•

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

•

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

•

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

•

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

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

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

•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “keloids” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “keloids” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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

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Other guides Acne http://www.nlm.nih.gov/medlineplus/acne.html African American Health http://www.nlm.nih.gov/medlineplus/africanamericanhealth.html Breast Reconstruction http://www.nlm.nih.gov/medlineplus/breastreconstruction.html Cardiomyopathy http://www.nlm.nih.gov/medlineplus/cardiomyopathy.html Cleft Lip and Palate http://www.nlm.nih.gov/medlineplus/cleftlipandpalate.html Plastic and Cosmetic Surgery http://www.nlm.nih.gov/medlineplus/plasticandcosmeticsurgery.html Scars http://www.nlm.nih.gov/medlineplus/scars.html Skin Aging http://www.nlm.nih.gov/medlineplus/skinaging.html Skin Diseases http://www.nlm.nih.gov/medlineplus/skindiseases.html

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

General/Overviews What Is a Scar Source: American Academy of Dermatology http://www.aad.org/pamphlets/whatsina.html

•

Treatment Dermabrasion Source: American Society for Dermatologic Surgery http://www.asds-net.org/Patients/FactSheets/patients-Fact_Sheetdermabrasion.html FDA Approves Reconstructive Surgery Product for Patients with Severe Scarring Source: Food and Drug Administration http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01148.html Laser Applications Source: American Society for Dermatologic Surgery http://www.asds-net.org/Patients/FactSheets/patients-Fact_Sheet-lasers.html Scar Revisions: Surgical Treatment for Scars Source: American Society of Plastic Surgeons http://www.plasticsurgery.org/public_education/procedures/ScarRevision.cfm

Patient Resources 99 Understanding Facial Scar Treatment: Surgery of Facial Scars Source: American Academy of Facial Plastic and Reconstructive Surgery http://www.facial-plastic-surgery.org/patient/procedures/facial_scar.html •

Specific Conditions/Aspects Acne Scarring Source: American Academy of Dermatology http://www.derm-infonet.com/acnenet/scarring.html Innovations in Scar Management Offer Encouraging News for African American Plastic Surgery Patients Source: American Society of Plastic Surgeons http://www.plasticsurgery.org/news_room/press_releases/Innovations-in-ScarManagement-Offer-Encouraging-News-for-African-American-Plastic-SurgeryPatients.cfm Keloids Source: InteliHealth http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10640.html Keloids and Hypertrophic Scars Source: American Osteopathic College of Dermatology http://www.aocd.org/skin/dermatologic_diseases/keloids_and_hypert.html

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Children Answers to Common Questions about Scars Source: Cleft Palate Foundation http://www.cleftline.org/publications/scars.htm Story on Scars Source: Nemours Foundation http://kidshealth.org/kid/watch/er/scars.html

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Organizations American Academy of Dermatology http://www.aad.org/ American Society for Dermatologic Surgery http://www.asds-net.org/ American Society of Plastic Surgeons http://www.plasticsurgery.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

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Pictures/Diagrams Before and After Treatment Photos: Acne Scars Source: American Society for Dermatologic Surgery http://www.asds-net.org/Patients/BeforeandAfter/Before-After-acne_scars.html

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Teenagers Can Acne Scars Be Removed? Source: Nemours Foundation http://kidshealth.org/teen/your_body/skin_stuff/acne_scars.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on keloids. 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: •

Keloids and Hypertrophic Scars Source: Kirksville, MO: American Osteopathic College of Dermatology (AOCD). 2001. 2 p. Contact: Available online from American Osteopathic College of Dermatology. 1501 East Illinois Street, P.O. Box 7525, Kirksville, MO 63501. (800) 449-2623 or (660) 665-2184. Fax (660) 627-2623. E-mail: [email protected]. Website: www.aocd.org/skin/dermatologic_diseases/ index.html. Summary: This fact sheet provides people who have keloids and those who have hypertrophic scars with information on the features, symptoms, and treatment of these scars. Keloids are raised, reddish nodules that can develop following a skin injury. They can develop on any part of the body, but the upper chest, shoulders, and upper back are prone to keloid formation. Symptoms include skin pigmentation, itchiness, redness, unusual sensations, and pain. Initial treatment involves injecting long acting cortisone into the keloid once a month. Other treatments include cryosurgery, surgical excision, laser therapy, and x ray therapy. Cryosurgery works well for keloids that are small and occur on lightly pigmented skin. Although laser treatment is very good at improving skin texture and color, it does not always flatten out the keloid. Surgical excision followed by x ray treatments to the site is used for severe cases. Keloids may often be prevented by using a pressure dressing, silicone gel pad, or paper tape over an injury. Recurrences are common, especially among people who have a family history of keloids. Hypertrophic scars, which look similar to keloids, do not get as big as keloids, and they may fade over time. 2 figures.

Patient Resources 101 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 keloids. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

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

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

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

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

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

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

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

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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 “keloids” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “keloids”. 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 “keloids” (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 “keloids” (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.25

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

25

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)26: •

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

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

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

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

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

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

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California: Gateway Health Library (Sutter Gould Medical Foundation)

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

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

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

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

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

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

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

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

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

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

•

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

26

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

Finding Medical Libraries 105

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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

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

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

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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 keloids: •

Basic Guidelines for Keloids Keloids Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000849.htm

•

Signs & Symptoms for Keloids Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Pruritus Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Skin lesion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm

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Telangiectasia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003284.htm •

Diagnostics and Tests for Keloids Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm BUN Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003474.htm Punch biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003840.htm Skin biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003840.htm

•

Background Topics for Keloids Burns Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000030.htm Cryotherapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002322.htm Wound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000043.htm Wounds Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000043.htm

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

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

•

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

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

•

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

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KELOIDS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Ablate: In surgery, is to remove. [NIH] Ablation: The removal of an organ by surgery. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylglucosamine: The N-acetyl derivative of glucosamine. [NIH] Acid Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.2. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Keloid: A type of acneiform disorder in which secondary pyogenic infection in and around pilosebaceous structures ends in keloidal scarring. It manifests as persistent folliculitis of the back of the neck associated with occlusion of the follicular orifices. It is most often encountered in black or Asian men. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH]

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Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

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] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form

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proteins. [NIH] Amino-terminal: The end of a protein or polypeptide chain that contains a free amino group (-NH2). [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] 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] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [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] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anomalies: Birth defects; abnormalities. [NIH] Anterior chamber: The space in front of the iris and behind the cornea. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [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 which they interact only with the antigen that induced their synthesis in cells of the

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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] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Argon: A noble gas with the atomic symbol Ar, atomic number 18, and atomic weight 39.948. It is used in fluorescent tubes and wherever an inert atmosphere is desired and nitrogen cannot be used. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH]

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Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Articular: Of or pertaining to a joint. [EU] Aseptic: Free from infection or septic material; sterile. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] 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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU]

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Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomolecular: A scientific field at the interface between advanced computing and biotechnology. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process. [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 Proteins: Proteins that are present in blood serum, including serum albumin, blood coagulation factors, and many other types of proteins. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a

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network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Blotting, Western: Identification of proteins or peptides that have been electrophoretically separated by blotting and transferred to strips of nitrocellulose paper. The blots are then detected by radiolabeled antibody probes. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breast reconstruction: Surgery to rebuild a breast's shape after a mastectomy. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bullous: Pertaining to or characterized by bullae. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calmodulin: A heat-stable, low-molecular-weight activator protein found mainly in the

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brain and heart. The binding of calcium ions to this protein allows this protein to bind to cyclic nucleotide phosphodiesterases and to adenyl cyclase with subsequent activation. Thereby this protein modulates cyclic AMP and cyclic GMP levels. [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] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] 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] Causal: Pertaining to a cause; directed against a cause. [EU] Cavernous Hemangioma: Proptosis, oedema of the conjunctiva and eyelid, together with paralysis of the oculomotor cranial nerves. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH]

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Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cerumen: The yellow or brown waxy secretions produced by vestigial apocrine sweat glands in the external ear canal. [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] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]

Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chymopapain: A cysteine endopeptidase isolated from papaya latex. Preferential cleavage at glutamic and aspartic acid residues. EC 3.4.22.6. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] Cicatrix: The formation of new tissue in the process of wound healing. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other

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medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clot Retraction: Retraction of a clot resulting from contraction of platelet pseudopods attached to fibrin strands that is dependent on the contractile protein thrombosthenin. Used as a measure of platelet function. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a 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] Coculture: The culturing of normal cells or tissues with infected or latently infected cells or tissues of the same kind (From Dorland, 28th ed, entry for cocultivation). It also includes culturing of normal cells or tissues with other normal cells or tissues. [NIH] 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] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] 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] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH]

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Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [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] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] 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] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cranial Nerves: Twelve pairs of nerves that carry general afferent, visceral afferent, special afferent, somatic efferent, and autonomic efferent fibers. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [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] Cryptorchidism: A condition in which one or both testicles fail to move from the abdomen,

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where they develop before birth, into the scrotum. Cryptorchidism may increase the risk for development of testicular cancer. Also called undescended testicles. [NIH] Curcumin: A dye obtained from tumeric, the powdered root of Curcuma longa Linn. It is used in the preparation of curcuma paper and the detection of boron. Curcumin appears to possess a spectrum of pharmacological properties, due primarily to its inhibitory effects on metabolic enzymes. [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] Cyclin: Molecule that regulates the cell cycle. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytostatic: An agent that suppresses cell growth and multiplication. [EU] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Decubitus Ulcer: An ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time. The bony prominences of the body are the most frequently affected sites. The ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depigmentation: Removal or loss of pigment, especially melanin. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action

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that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] 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] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] 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] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Dose-rate: The strength of a treatment given over a period of time. [NIH] Duct: A tube through which body fluids pass. [NIH] Dysgenesis: Defective development. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eardrum: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active

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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] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Emulsions: Colloids of two immiscible liquids where either phase may be either fatty or aqueous; lipid-in-water emulsions are usually liquid, like milk or lotion and water-in-lipid emulsions tend to be creams. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH]

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Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. 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] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Ethanolamine: A viscous, hygroscopic amino alcohol with an ammoniacal odor. It is widely distributed in biological tissue and is a component of lecithin. It is used as a surfactant, fluorimetric reagent, and to remove CO2 and H2S from natural gas and other gases. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Exostoses: Benign hypertrophy that projects outward from the surface of bone, often containing a cartilaginous component. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and

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in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [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] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibril: Most bacterial viruses have a hollow tail with specialized fibrils at its tip. The tail fibers attach to the cell wall of the host. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibrotic tissue: Inflamed tissue that has become scarred. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Folliculitis: Inflammation of follicles, primarily hair follicles. [NIH] Frostbite: Damage to tissues as the result of low environmental temperatures. [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gamma-interferon: Interferon produced by T-lymphocytes in response to various mitogens and antigens. Gamma interferon appears to have potent antineoplastic, immunoregulatory and antiviral activity. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body

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through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gingival Hyperplasia: A pathological increase in the depth of the gingival crevice surrounding a tooth at the gum margin. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Gliosis: The production of a dense fibrous network of neuroglia; includes astrocytosis, which is a proliferation of astrocytes in the area of a degenerative lesion. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the

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body. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Gonadal: Pertaining to a gonad. [EU] 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] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [NIH] Granule: A small pill made from sucrose. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granulomas: Small lumps in tissues caused by inflammation. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH]

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Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heparan Sulfate Proteoglycan: A substance released by astrocytes, which is critical in stopping nervous fibers in their tracks. [NIH] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] 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] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH]

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Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homodimer: Protein-binding "activation domains" always combine with identical proteins. [NIH]

Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hyaluronidase: An enzyme that splits hyaluronic acid and thus lowers the viscosity of the acid and facilitates the spreading of fluids through tissues either advantageously or disadvantageously. [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] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] 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] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypervascular: Having a large number of blood vessels. [NIH] Hypodermic: Applied or administered beneath the skin. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and

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disposal of foreign ("non-self") material which enters the body. [NIH] Immunoblotting: Immunologic methods for isolating and quantitatively measuring immunoreactive substances. When used with immune reagents such as monoclonal antibodies, the process is known generically as western blot analysis (blotting, western). [NIH]

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] 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] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an 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]

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] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH]

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Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Intercellular Adhesion Molecule-1: A cell-surface ligand with a role in leukocyte adhesion and inflammation. Its production is induced by gamma-interferon and it is required for neutrophil migration into inflamed tissue. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon Alfa-2b: A recombinant alfa interferon consisting of 165 amino acid residues with arginine in position 23 and histidine in position 34. It is used extensively as an antiviral and antineoplastic agent. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Involution: 1. A rolling or turning inward. 2. One of the movements involved in the gastrulation of many animals. 3. A retrograde change of the entire body or in a particular organ, as the retrograde changes in the female genital organs that result in normal size after delivery. 4. The progressive degeneration occurring naturally with advancing age, resulting

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in shrivelling of organs or tissues. [EU] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iridium: A metallic element with the atomic symbol Ir, atomic number 77, and atomic weight 192.22. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keloid: A sharply elevated, irregularly shaped, progressively enlarging scar resulting from formation of excessive amounts of collagen in the dermis during connective tissue repair. It is differentiated from a hypertrophic scar (cicatrix, hypertrophic) in that the former does not spread to surrounding tissues. [NIH] 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]

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Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kinetic: Pertaining to or producing motion. [EU] Lacerations: Torn, ragged, mangled wounds. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] 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] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Lobule: A small lobe or subdivision of a lobe. [NIH]

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Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mastectomy: Surgery to remove the breast (or as much of the breast tissue as possible). [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] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological

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color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesothelial: It lines the peritonealla and pleural cavities. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH]

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Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU]

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Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroglia: The non-neuronal cells of the nervous system. They are divided into macroglia (astrocytes, oligodendroglia, and schwann cells) and microglia. They not only provide physical support, but also respond to injury, regulate the ionic and chemical composition of the extracellular milieu, participate in the blood-brain and blood-retina barriers, form the myelin insulation of nervous pathways, guide neuronal migration during development, and exchange metabolites with neurons. Neuroglia have high-affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitters, but their role in signaling (as in many other functions) is unclear. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neutralization: An act or process of neutralizing. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] 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] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the

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subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Otorhinolaryngology: That branch of medicine concerned with medical and surgical treatment of the head and neck, including the ears, nose and throat. [EU] Outer ear: The pinna and external meatus of the ear. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

P53 gene: A tumor suppressor gene that normally inhibits the growth of tumors. This gene is altered in many types of cancer. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Papain: A proteolytic enzyme obtained from Carica papaya. It is also the name used for a purified mixture of papain and chymopapain that is used as a topical enzymatic debriding

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agent. EC 3.4.22.2. [NIH] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [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] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptic Ulcer Hemorrhage: Bleeding from a peptic ulcer. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericarditis: Inflammation of the pericardium. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Peripheral blood: Blood circulating throughout the body. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH]

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Phenyl: Ingredient used in cold and flu remedies. [NIH] Phorbol: Class of chemicals that promotes the development of tumors. [NIH] Phorbol Esters: Tumor-promoting compounds obtained from croton oil (Croton tiglium). Some of these are used in cell biological experiments as activators of protein kinase C. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylates: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] 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]

Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the

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vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Plastic surgeon: A surgeon who specializes in reducing scarring or disfigurement that may occur as a result of accidents, birth defects, or treatment for diseases. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] 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 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] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be

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infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] 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] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] 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] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] 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] Procollagen: A biosynthetic precursor of collagen containing additional amino acid sequences at the amino-terminal ends of the three polypeptide chains. Protocollagen, a precursor of procollagen consists of procollagen peptide chains in which proline and lysine have not yet been hydroxylated. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH]

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Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Prone: Having the front portion of the body downwards. [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] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein 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 Kinase C: An enzyme that phosphorylates proteins on serine or threonine residues in the presence of physiological concentrations of calcium and membrane phospholipids. The additional presence of diacylglycerols markedly increases its sensitivity to both calcium and phospholipids. The sensitivity of the enzyme can also be increased by phorbol esters and it is believed that protein kinase C is the receptor protein of tumor-promoting phorbol esters. EC 2.7.1.-. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]

Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or

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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] 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] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH] Punctures: Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures. [NIH] Pupil: The aperture in the iris through which light passes. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Pyridones: Pyridine derivatives with one or more keto groups on the ring. [NIH] Quercetin: Aglucon of quercetrin, rutin, and other glycosides. It is widely distributed in the plant kingdom, especially in rinds and barks, clover blossoms, and ragweed pollen. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH]

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Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] 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] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] 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] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal Artery: A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters. [NIH]

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Renovascular: Of or pertaining to the blood vessels of the kidneys. [EU] Resected: Surgical removal of part of an organ. [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] Response Elements: Nucleotide sequences, usually upstream, which are recognized by specific regulatory transcription factors, thereby causing gene response to various regulatory agents. These elements may be found in both promotor and enhancer regions. [NIH]

Reticular: Coarse-fibered, netlike dermis layer. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoblastoma Protein: Product of the retinoblastoma tumor suppressor gene. It is a nuclear phosphoprotein hypothesized to normally act as an inhibitor of cell proliferation. Rb protein is absent in retinoblastoma cell lines. It also has been shown to form complexes with the adenovirus E1A protein, the SV40 T antigen, and the human papilloma virus E7 protein. [NIH]

Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Rutin: 3-((6-O-(6-Deoxy-alpha-L-mannopyranosyl)-beta-D-glucopyranosyl)oxy)-2-(3,4dihydroxyphenyl)-5,7-dihydroxy-4H-1-benzopyran-4-one. Found in many plants, including buckwheat, tobacco, forsythia, hydrangea, pansies, etc. It has been used therapeutically to decrease capillary fragility. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Scalpel: A small pointed knife with a convex edge. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior five-

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sixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Sclerotherapy: Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Seborrhea: Hypersecretion of sebum with excessive oily secretion from the sweat glands. [NIH]

Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [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

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the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH] Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Skin Care: Maintenance of the hygienic state of the skin under optimal conditions of cleanliness and comfort. Effective in skin care are proper washing, bathing, cleansing, and the use of soaps, detergents, oils, etc. In various disease states, therapeutic and protective solutions and ointments are useful. The care of the skin is particularly important in various occupations, in exposure to sunlight, in neonates, and in decubitus ulcer. [NIH] Skin graft: Skin that is moved from one part of the body to another. [NIH] Skin Pigmentation: Coloration of the skin. [NIH] Skin Transplantation: The grafting of skin in humans or animals from one site to another to replace a lost portion of the body surface skin. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] 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

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distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splint: A rigid appliance used for the immobilization of a part or for the correction of deformity. [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] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

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Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] 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] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Sulfates: Inorganic salts of sulfuric acid. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sulfuric acid: A strong acid that, when concentrated is extemely corrosive to the skin and mucous membranes. It is used in making fertilizers, dyes, electroplating, and industrial explosives. [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]

Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH]

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Symphysis: A secondary cartilaginous joint. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] 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] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus

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refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tissue Expansion: Process whereby tissue adjacent to a soft tissue defect is expanded by means of a subcutaneously implanted reservoir. The procedure is used in reconstructive surgery for injuries caused by trauma, burns, or ablative surgery. [NIH] Topical: On the surface of the body. [NIH] Torticollis: Wryneck; a contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transforming Growth Factor beta: A factor synthesized in a wide variety of tissues. It acts synergistically with TGF-alpha in inducing phenotypic transformation and can also act as a negative autocrine growth factor. TGF-beta has a potential role in embryonal development, cellular differentiation, hormone secretion, and immune function. TGF-beta is found mostly as homodimer forms of separate gene products TGF-beta1, TGF-beta2 or TGF-beta3. Heterodimers composed of TGF-beta1 and 2 (TGF-beta1.2) or of TGF-beta2 and 3 (TGFbeta2.3) have been isolated. The TGF-beta proteins are synthesized as precursor proteins. [NIH]

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]

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Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Triamcinolone Acetonide: An esterified form of triamcinolone. It is an anti-inflammatory glucocorticoid used topically in the treatment of various skin disorders. Intralesional, intramuscular, and intra-articular injections are also administered under certain conditions. [NIH]

Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor suppressor gene: Genes in the body that can suppress or block the development of cancer. [NIH] Tympanic membrane: A thin, tense membrane forming the greater part of the outer wall of the tympanic cavity and separating it from the external auditory meatus; it constitutes the boundary between the external and middle ear. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [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] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Varicella: Chicken pox. [EU] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the

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body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] 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] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] 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]

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157

INDEX 3 3-dimensional, 6, 111, 144 A Abdomen, 78, 111, 117, 121, 128, 132, 134, 139, 140, 150, 151, 152 Abdominal, 111, 139, 140, 146 Ablate, 111, 124 Ablation, 16, 111 Acetylcholine, 111, 138 Acetylglucosamine, 79, 111 Acid Phosphatase, 13, 111 Acne, 3, 11, 14, 17, 67, 69, 76, 78, 98, 99, 100, 111, 133 Acne Keloid, 11, 14, 17, 111 Acne Vulgaris, 111, 133 Acrylonitrile, 111, 147 Acute renal, 111, 129 Adenovirus, 111, 147 Adhesions, 10, 77, 78, 79, 81, 111 Adjuvant, 21, 48, 111 Adrenal Cortex, 111, 121, 143 Adrenal Glands, 112, 113, 146 Adverse Effect, 112, 133, 149 Aerobic, 71, 112 Aerosol, 80, 81, 112, 151 Affinity, 7, 112, 115, 138 Algorithms, 112, 116 Alkaline, 112, 113, 117 Allylamine, 112 Alopecia, 76, 112 Alpha Particles, 112, 145 Alternative medicine, 112 Amine, 19, 112, 129 Amino Acid Sequence, 68, 112, 113, 125, 143 Amino Acids, 112, 140, 142, 144, 148, 151 Amino-terminal, 113, 143 Ammonia, 112, 113, 151 Amyloidosis, 79, 113 Anabolic, 35, 113 Anaesthesia, 113, 131 Analog, 5, 113, 126 Analogous, 79, 113, 142, 153 Anaplasia, 113 Anatomical, 113, 115, 131, 134, 148 Androgenic, 35, 113 Androgens, 111, 113, 121 Anemia, 95, 113

Angiogenesis, 7, 74, 79, 113 Animal model, 4, 113 Annealing, 113, 142 Anomalies, 67, 113, 152 Anterior chamber, 78, 113, 133 Antiallergic, 113, 121 Antibacterial, 74, 113, 150 Antibiotic, 113, 150 Antibodies, 8, 81, 113, 114, 128, 131, 135, 137, 141, 146 Antibody, 112, 114, 117, 128, 130, 131, 133, 137, 145, 146, 150, 155 Anticoagulant, 114, 144 Antigen, 112, 113, 114, 130, 131, 147 Anti-infective, 73, 114, 149 Anti-inflammatory, 80, 81, 114, 121, 127, 143, 154 Anti-Inflammatory Agents, 114, 121 Antimetabolite, 114, 126 Antimicrobial, 74, 114, 122 Antineoplastic, 114, 121, 126, 132 Antioxidants, 75, 114 Antiviral, 114, 126, 132 Anus, 114, 115, 117 Aorta, 114, 146, 155 Apoptosis, 14, 20, 37, 47, 54, 114 Aqueous, 75, 114, 115, 122, 124, 134 Arginine, 114, 132, 138 Argon, 48, 114 Arrhythmia, 114, 155 Arterial, 112, 114, 130, 144, 152 Arteries, 114, 115, 116, 117, 121, 136 Arterioles, 115, 117, 118 Articular, 115, 139, 154 Aseptic, 115, 139 Astrocytes, 115, 127, 129, 138 Ataxia, 94, 95, 115, 152 Atresia, 84, 115 Atrium, 115, 154 Atrophy, 12, 80, 94, 95, 115 Atypical, 15, 84, 115 Auditory, 84, 115, 123, 135, 154 Aural, 84, 115 Auricular, 15, 22, 38, 83, 115 B Bacteria, 66, 113, 114, 115, 136, 150, 153, 154 Bacterium, 115, 129

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Basal Ganglia, 115 Basal Ganglia Diseases, 115 Base, 14, 69, 115, 122, 133 Basement Membrane, 116, 126 Basophils, 116, 128, 134 Benign, 7, 8, 9, 65, 67, 76, 116, 125, 137, 138, 140, 146, 155 Benign tumor, 8, 116 Benzoic Acid, 72, 73, 116 Bile, 116, 126, 131, 134, 150 Biochemical, 4, 14, 15, 17, 114, 116, 134, 139 Biological response modifier, 116, 132 Biological therapy, 116, 128 Biomolecular, 5, 116 Biopsy, 110, 116 Biotechnology, 10, 91, 93, 94, 95, 96, 116 Bladder, 116, 144, 154 Blood Coagulation, 116, 117, 152 Blood Coagulation Factors, 116 Blood pressure, 116, 130 Blood Proteins, 57, 116 Blot, 117, 131 Blotting, Western, 117, 131 Bone Marrow, 117, 135, 137, 149 Boron, 117, 122 Bowel, 117, 123, 132, 140, 151 Bowel Movement, 117, 123, 151 Brachytherapy, 48, 117, 132, 133, 145, 155 Bradykinin, 117, 138 Branch, 107, 117, 135, 139, 140, 146, 149 Breakdown, 79, 117, 123, 126 Breast reconstruction, 65, 117 Bronchial, 117, 129 Bronchitis, 117, 119 Bullous, 84, 117 Burns, 3, 26, 63, 64, 67, 69, 75, 78, 80, 110, 117, 153 Burns, Electric, 117 C Calcium, 63, 64, 117, 118, 144, 149, 155 Calcium channel blocker, 117, 155 Calmodulin, 72, 117 Capillary, 84, 117, 118, 147, 155 Carbohydrate, 9, 79, 118, 121, 142 Carbon Dioxide, 24, 45, 47, 48, 118, 122, 147 Carcinogenic, 118, 132, 143, 150 Carcinogens, 118, 139 Carcinoma, 118 Cardiac, 67, 112, 118, 137, 150 Cardiomyopathy, 98, 118

Case report, 15, 22, 118, 120 Case series, 37, 118, 120 Causal, 6, 71, 118 Cavernous Hemangioma, 84, 118 Cell Adhesion, 6, 77, 118 Cell Cycle, 8, 118, 122 Cell Death, 114, 118, 137 Cell Differentiation, 68, 118, 149 Cell Division, 94, 115, 118, 119, 128, 136, 141, 148 Cell proliferation, 8, 75, 77, 119, 147, 149 Cell Respiration, 71, 119, 147 Cell Survival, 119, 128 Cellulose, 119, 141 Cerebellar, 115, 119, 146 Cerebral, 115, 119 Cerebrospinal, 119, 135, 150 Cerebrospinal fluid, 119, 135, 150 Cerebrum, 119, 154 Cerumen, 84, 119 Cervical, 119, 153 Cholesterol, 116, 119, 150 Chondroitin sulfate, 77, 119 Chromatin, 114, 119, 125 Chromosomal, 8, 119 Chromosome, 9, 119, 128, 134, 148 Chronic, 67, 84, 94, 111, 119, 124, 131, 134, 142, 145, 148, 151 Chronic Obstructive Pulmonary Disease, 67, 119 Chronic renal, 119, 142 Chymopapain, 119, 139 Cicatricial, 71, 119 Cicatrix, 119, 133 Clinical study, 119, 121 Clinical trial, 4, 35, 57, 58, 91, 120, 121, 144, 146 Cloning, 8, 116, 120 Clot Retraction, 120, 141 Coagulation, 81, 116, 120, 129, 134 Coculture, 5, 120 Cofactor, 120, 144, 152 Collapse, 117, 120 Colloidal, 120, 148, 151 Computational Biology, 91, 93, 120 Conception, 120, 126 Congestive heart failure, 67, 68, 120 Conjugated, 116, 120, 137 Conjunctiva, 118, 120 Connective Tissue, 6, 15, 70, 79, 117, 120, 121, 126, 128, 133, 135, 136, 144 Connective Tissue Cells, 120, 121

Index 159

Contact dermatitis, 75, 121 Contraindications, ii, 121 Controlled clinical trial, 11, 121 Controlled study, 11, 121 Cornea, 8, 15, 113, 121, 128, 133, 148 Corneum, 25, 121, 125 Coronary, 121, 136 Coronary Thrombosis, 121, 136 Cortex, 115, 121, 146 Corticosteroid, 4, 11, 31, 50, 121, 143 Cortisone, 100, 121, 143 Cranial, 118, 121, 138, 139 Cranial Nerves, 118, 121 Crossing-over, 121, 146 Cryosurgery, 4, 11, 19, 20, 28, 37, 80, 100, 121 Cryotherapy, 11, 19, 29, 50, 64, 110, 121 Cryptorchidism, 12, 25, 94, 121 Curcumin, 72, 122 Cutaneous, 4, 5, 20, 22, 29, 35, 42, 49, 79, 81, 121, 122 Cyclic, 118, 122, 128, 138, 142 Cyclin, 8, 122 Cysteine, 119, 122, 151 Cytokine, 14, 122 Cytoplasm, 114, 116, 122, 125, 128, 137 Cytostatic, 70, 122 Cytotoxic, 122, 146, 149 D Databases, Bibliographic, 91, 122 Decarboxylation, 122, 129 Decubitus, 122, 149 Decubitus Ulcer, 122, 149 Degenerative, 122, 127, 139 Deletion, 114, 122 Denaturation, 122, 142 Density, 76, 122, 139 Depigmentation, 64, 122 Depolarization, 122, 149 Dermal, 5, 7, 8, 9, 40, 62, 69, 72, 122 Dermatitis, 122 Detergents, 122, 149 Diagnostic Imaging, 123, 145 Diagnostic procedure, 61, 123 Diastolic, 123, 130 Diffusion, 123, 131 Digestion, 71, 116, 117, 123, 132, 134, 140, 151 Digestive system, 58, 123 Digestive tract, 123, 149, 150 Diploid, 25, 123, 141 Direct, iii, 20, 78, 123, 146

Dissociation, 112, 123, 133 Distal, 25, 123, 145 Dose-dependent, 72, 123 Dose-rate, 48, 123 Duct, 123, 131, 147, 151 Dysgenesis, 15, 123 Dysplasia, 12, 21, 25, 94, 95, 123 Dyspnea, 123, 145 Dystrophy, 94, 123 E Eardrum, 84, 123 Edema, 121, 123, 134, 139 Effector, 74, 111, 123 Efficacy, 22, 73, 124 Elastin, 25, 78, 79, 120, 124 Electrocoagulation, 84, 120, 124 Electrolyte, 121, 124, 136 Electrons, 115, 124, 133, 139, 145, 146 Embryo, 118, 124, 131, 142 Emollient, 124, 139 Emphysema, 119, 124 Emulsions, 75, 124 Endothelial cell, 9, 124, 152 Endothelium, 7, 124, 138, 142 Endothelium, Lymphatic, 124 Endothelium, Vascular, 124 Endothelium-derived, 124, 138 End-stage renal, 29, 119, 124, 142 Enhancer, 124, 147 Environmental Exposure, 124, 139 Environmental Health, 90, 92, 124 Enzymatic, 68, 77, 78, 117, 124, 129, 139, 142 Enzyme, 22, 69, 72, 111, 123, 124, 125, 128, 130, 139, 141, 142, 144, 149, 151, 152, 155 Eosinophilic, 80, 125 Eosinophils, 4, 125, 128, 134 Epidermal, 125, 133, 135, 155 Epidermis, 121, 125, 133, 143 Epidermoid carcinoma, 125, 150 Epithelial, 8, 19, 66, 79, 125, 140 Epithelial Cells, 8, 79, 125 Epithelium, 116, 124, 125, 133 Erythema, 22, 109, 121, 125, 154 Erythrocytes, 113, 117, 125, 146 Esophageal, 68, 125, 148 Esophageal Varices, 68, 125, 148 Esophagus, 21, 115, 123, 125, 140, 151 Essential Tremor, 94, 125 Ethanolamine, 68, 125 Excipient, 75, 125 Exon, 20, 125

160

Keloids

Exostoses, 84, 125 Extensor, 125, 145 External-beam radiation, 125, 133, 145, 155 Extracellular, 4, 7, 8, 45, 54, 63, 64, 68, 72, 74, 77, 79, 115, 120, 121, 125, 126, 138 Extracellular Matrix, 4, 8, 45, 54, 63, 64, 74, 77, 79, 120, 121, 125, 126 Extracellular Space, 125, 126 Extraction, 70, 126 Extravasation, 126, 129 F Facial, 24, 42, 65, 99, 126, 135 Family Planning, 91, 126 Fat, 117, 121, 122, 126, 134, 148, 149, 151 Fetus, 9, 126, 154 Fibril, 63, 64, 126 Fibrin, 6, 66, 116, 120, 126, 141, 152 Fibrinogen, 126, 141, 152 Fibroblasts, 5, 6, 8, 10, 20, 25, 37, 40, 44, 54, 63, 64, 66, 78, 85, 121, 126 Fibronectin, 24, 54, 74, 126 Fibrosis, 6, 9, 63, 67, 68, 69, 75, 76, 79, 81, 95, 112, 126, 145, 148 Fibrotic tissue, 6, 77, 126 Flatus, 126, 127 Fluorouracil, 22, 28, 85, 126 Folliculitis, 111, 126 Frostbite, 83, 126 Fungistatic, 116, 126 G Gallbladder, 111, 123, 126 Gamma Rays, 126, 145, 146 Gamma-interferon, 126, 132 Gas, 66, 67, 113, 114, 118, 123, 125, 126, 130, 138, 151 Gastric, 127, 129, 140, 148 Gastrin, 127, 130 Gels, 75, 127 Gene, 5, 7, 8, 9, 13, 17, 20, 25, 41, 54, 57, 67, 95, 96, 111, 116, 127, 139, 147, 148, 153 Gene Expression, 5, 7, 13, 17, 41, 54, 95, 127 Genetic Engineering, 116, 120, 127 Genetic testing, 127, 142 Genetics, 17, 25, 127 Genital, 127, 132 Genotype, 127, 140 Gingival Hyperplasia, 11, 127 Gland, 111, 121, 127, 135, 139, 141, 144, 148, 151 Gliosis, 67, 68, 127

Glomerular, 127 Glomeruli, 127 Glomerulonephritis, 67, 127 Glomerulus, 127, 137 Glucocorticoid, 25, 127, 143, 154 Glucose, 94, 119, 127, 128, 129, 132, 147 Glucuronic Acid, 127, 129 Glutamic Acid, 128, 143 Glycine, 116, 128, 148 Glycolysis, 71, 128 Glycoprotein, 126, 128, 152 Glycosaminoglycan, 77, 119, 128 Gonadal, 128, 150 Governing Board, 128, 143 Grade, 65, 128 Graft, 128, 130 Grafting, 5, 128, 149 Granulation Tissue, 7, 66, 128 Granule, 79, 128 Granulocytes, 78, 128, 149, 155 Granulomas, 84, 128 Groin, 84, 128 Growth factors, 3, 7, 63, 64, 68, 74, 77, 128 Guanylate Cyclase, 128, 138 H Haploid, 128, 141 Haptens, 112, 128 Heart failure, 128, 139, 145 Hematoma, 83, 129 Heme, 129, 137, 142 Hemoglobin, 113, 125, 129, 142 Hemoglobin A, 129, 142 Hemoglobinuria, 94, 129 Hemolytic, 66, 129 Hemorrhage, 124, 129, 151 Hemorrhoids, 129, 148 Hemostasis, 78, 129 Heparan Sulfate Proteoglycan, 74, 129 Heparin, 74, 77, 129 Hepatic, 10, 129 Hereditary, 8, 129, 147 Heredity, 111, 127, 129 Herpes, 84, 129 Herpes Zoster, 84, 129 Heterogeneity, 6, 25, 112, 129 Histamine, 20, 129, 130 Histidine, 129, 130, 132 Homeostasis, 7, 130 Homodimer, 130, 153 Homologous, 9, 121, 130, 148, 152 Hormonal, 115, 121, 130

Index 161

Hormone, 76, 121, 127, 130, 132, 143, 149, 153 Host, 126, 130 Hyaluronidase, 69, 130 Hydrogen, 112, 115, 118, 122, 130, 136, 138, 139, 145 Hydrophobic, 67, 123, 130 Hydroxylysine, 120, 130 Hydroxyproline, 120, 130 Hygienic, 130, 149 Hyperplasia, 79, 130 Hypertension, 11, 21, 130, 153 Hypertrophy, 67, 71, 125, 130 Hypervascular, 7, 130 Hypodermic, 28, 130 Hypoxia, 7, 130, 152 I Id, 55, 94, 101, 106, 108, 130 Immune function, 130, 153 Immune response, 111, 114, 121, 128, 130, 131, 151, 155 Immune system, 116, 130, 131, 135, 154, 155 Immunoblotting, 8, 131 Immunodeficiency, 94, 131 Immunoglobulins, 4, 27, 131 Immunologic, 27, 44, 131, 146 Immunology, 14, 111, 112, 131 Immunosuppressant, 126, 131 Impaction, 84, 131 Impairment, 28, 79, 115, 131, 136 Implant radiation, 131, 132, 133, 145, 155 In vitro, 5, 6, 7, 8, 9, 20, 28, 35, 54, 72, 131, 142 In vivo, 5, 6, 8, 28, 36, 129, 131 Incision, 32, 46, 64, 73, 131, 132, 145 Indicative, 131, 140, 154 Induction, 7, 8, 18, 66, 74, 113, 131 Infarction, 121, 131, 136 Infection, 66, 69, 74, 111, 115, 116, 130, 131, 135, 151, 154, 155 Infiltration, 72, 127, 131 Informed Consent, 44, 131 Infusion, 132, 148 Inhalation, 112, 132 Initiation, 65, 132, 144, 153 Insulin, 44, 78, 79, 132 Insulin-dependent diabetes mellitus, 132 Insulin-like, 44, 78, 79, 132 Intercellular Adhesion Molecule-1, 72, 132 Interferon, 4, 16, 24, 29, 41, 126, 132 Interferon Alfa-2b, 16, 41, 132

Interferon-alpha, 24, 132 Internal radiation, 132, 133, 145, 155 Interstitial, 38, 117, 126, 132, 133, 137, 155 Intestinal, 132, 135 Intestine, 74, 117, 132, 134 Intracellular, 72, 131, 132, 138, 149 Intramuscular, 132, 154 Intrinsic, 112, 116, 132 Invasive, 37, 132 Involuntary, 115, 125, 132, 137 Involution, 29, 132 Ionization, 133 Ionizing, 42, 70, 112, 124, 133, 146 Ions, 115, 118, 123, 124, 130, 133, 144 Iridium, 38, 133 Iris, 113, 121, 133, 145 Irradiation, 18, 38, 41, 42, 43, 46, 49, 64, 70, 133, 155 Ischemia, 115, 122, 133 Isotretinoin, 15, 133 J Joint, 115, 133, 139, 152 K Kb, 90, 133 Keloid, 3, 4, 5, 6, 7, 8, 9, 10, 15, 17, 20, 31, 32, 37, 44, 54, 57, 63, 64, 65, 66, 67, 68, 71, 72, 73, 80, 100, 133 Keratin, 133, 148 Keratinocytes, 5, 72, 133 Keratitis, 83, 133 Keratolytic, 69, 133 Keto, 134, 145 Kidney Disease, 57, 58, 90, 95, 134 Kidney Failure, 124, 134 Kinetic, 133, 134 L Lacerations, 80, 134 Large Intestine, 123, 132, 134, 146, 149 Laser Surgery, 4, 45, 134 Laser therapy, 4, 100, 134 Latent, 68, 134, 143 Lectin, 9, 79, 134 Lesion, 7, 73, 109, 127, 134, 135, 154 Leukemia, 94, 134 Leukocytes, 9, 116, 117, 125, 128, 132, 134, 137 Library Services, 106, 134 Ligament, 134, 144 Ligands, 9, 134 Linkage, 8, 9, 134 Lipid, 32, 124, 132, 134 Liposome, 75, 134

162

Keloids

Liquor, 134, 145 Liver, 63, 79, 111, 113, 116, 123, 125, 126, 127, 129, 134, 143 Lobe, 21, 134 Lobule, 16, 134 Localization, 13, 70, 79, 135 Localized, 68, 113, 129, 131, 135, 139, 141, 148, 154 Locomotion, 135, 141 Lumbar, 28, 135, 150 Lumbar puncture, 28, 135, 150 Lymph, 84, 119, 124, 135 Lymph node, 119, 135 Lymphatic, 84, 124, 131, 135, 136, 139, 149, 150, 152 Lymphatic system, 135, 149, 150, 152 Lymphocyte, 72, 114, 135 Lymphoid, 114, 128, 135 Lymphoma, 94, 135 Lysine, 54, 130, 135, 143 M Malabsorption, 94, 135 Malignant, 65, 84, 94, 114, 135, 137, 146 Malnutrition, 115, 135, 137 Mastectomy, 65, 117, 135 Meatus, 123, 135, 139, 154 Mediate, 74, 135 Medical Records, 135, 147 MEDLINE, 91, 93, 95, 135 Melanin, 122, 133, 135 Melanocytes, 135, 136, 138 Melanoma, 84, 94, 136 Membrane, 72, 74, 83, 84, 115, 120, 122, 123, 136, 140, 141, 144, 149, 154 Mental Disorders, 59, 136 Mesenchymal, 15, 74, 136 Mesothelial, 79, 136 Metastasis, 136 Metastatic, 74, 136 Methionine, 136, 151 MI, 80, 110, 136 Microbiology, 8, 115, 136 Microscopy, 42, 116, 136 Migration, 6, 74, 77, 81, 132, 136, 138 Mineralocorticoids, 111, 121, 136 Mitochondrial Swelling, 136, 137 Mitosis, 114, 136 Mobility, 8, 136 Modification, 79, 127, 136 Molecular, 3, 4, 5, 7, 8, 27, 74, 91, 93, 116, 117, 120, 126, 129, 136, 141, 147

Molecule, 74, 114, 115, 119, 122, 123, 124, 128, 134, 136, 139, 144, 146, 149 Monoclonal, 131, 133, 137, 145, 155 Monoclonal antibodies, 131, 137 Monocytes, 134, 137 Morphology, 34, 137 Mucinous, 4, 137 Mucus, 137 Muscle Fibers, 137 Muscular Atrophy, 94, 137 Muscular Dystrophies, 123, 137 Myocardium, 136, 137 Myoglobin, 137, 142 Myotonic Dystrophy, 94, 137 N NCI, 1, 58, 89, 137 Necrosis, 14, 50, 114, 131, 136, 137 Need, 3, 83, 84, 102, 112, 119, 137 Neoplasia, 79, 94, 137 Neoplasm, 137, 140 Neoplastic, 69, 113, 135, 137 Nephritis, 67, 137 Nephropathy, 134, 137 Nerve, 115, 138, 139, 143, 148, 151, 153 Nervous System, 94, 111, 128, 138, 139, 151 Neuroglia, 127, 138 Neurologic, 23, 138 Neutralization, 54, 138 Neutrons, 112, 133, 138, 145 Neutrophil, 132, 138 Nevus, 65, 138 Nitric Oxide, 20, 138 Nitrogen, 84, 112, 113, 114, 138, 154 Nuclear, 115, 124, 126, 137, 138, 147 Nucleic acid, 138 Nucleus, 70, 114, 115, 116, 119, 122, 125, 126, 137, 138, 145, 151, 152 O Oculomotor, 118, 138 Oedema, 118, 138 Ointments, 75, 139, 149 Oncogene, 15, 94, 139 Opacity, 122, 139 Optic Nerve, 139, 148 Organ Culture, 9, 139 Osteoarthritis, 78, 139 Otitis, 83, 139 Otitis Media, 84, 139 Otorhinolaryngology, 83, 139 Outer ear, 83, 139 Oxidation, 114, 139

Index 163

P P53 gene, 14, 139 Pancreas, 111, 123, 132, 139 Pancreatic, 94, 139 Pancreatic cancer, 94, 139 Papain, 69, 139 Papilloma, 140, 147 Paralysis, 118, 140 Paroxysmal, 94, 140 Particle, 134, 140, 153 Pathogenesis, 5, 42, 140 Pathologic, 5, 7, 114, 116, 121, 140, 145 Pathologic Processes, 114, 140 Pathologies, 80, 81, 140 Patient Education, 100, 104, 106, 110, 140 Pelvic, 140, 144 Peptic, 140, 148 Peptic Ulcer, 140, 148 Peptic Ulcer Hemorrhage, 140, 148 Peptide, 74, 133, 140, 142, 143, 144 Perforation, 84, 140 Perfusion, 130, 140, 153 Pericarditis, 63, 140 Pericardium, 140 Peripheral blood, 132, 140 Peritoneal, 10, 139, 140 Peritoneum, 140 Pharmaceutical Preparations, 75, 119, 140 Pharmacologic, 22, 140, 153 Phenotype, 7, 9, 140 Phenyl, 75, 141 Phorbol, 72, 141, 144 Phorbol Esters, 141, 144 Phospholipases, 141, 149 Phospholipids, 126, 141, 144 Phosphorus, 117, 141 Phosphorylates, 141, 144 Phosphorylation, 7, 8, 72, 141 Photocoagulation, 120, 141 Physiologic, 123, 141, 146 Pigment, 122, 135, 136, 137, 141 Pilot study, 22, 38, 141 Pituitary Gland, 121, 141 Plants, 70, 118, 127, 134, 137, 141, 142, 147, 153, 154 Plasma, 4, 114, 124, 126, 128, 129, 134, 136, 141, 144, 148, 153 Plasma cells, 4, 114, 128, 141 Plasmin, 6, 69, 141 Plasminogen, 6, 7, 23, 69, 81, 141 Plasminogen Activators, 141 Plastic surgeon, 34, 65, 78, 142

Platelet Activation, 142, 149 Platelet Aggregation, 138, 142 Platelets, 9, 138, 142, 152 Pleural, 136, 139, 142 Pollen, 142, 145 Polycystic, 95, 142 Polymerase, 14, 142, 144 Polymerase Chain Reaction, 14, 142 Polymorphic, 8, 142 Polymorphism, 14, 142 Polypeptide, 112, 113, 120, 126, 137, 141, 142, 143, 144, 155 Polysaccharide, 114, 119, 128, 142, 144 Porphyrins, 70, 142 Port, 84, 142, 143 Port-a-cath, 143 Posterior, 38, 115, 133, 139, 143, 147 Postnatal, 10, 143 Postoperative, 21, 28, 31, 38, 39, 41, 46, 48, 49, 143 Postsynaptic, 143, 149 Potentiation, 143, 149 Practice Guidelines, 92, 143 Precursor, 123, 124, 141, 143, 144, 153, 154 Predisposition, 10, 71, 143 Prednisolone, 143 Prednisone, 84, 143 Prevalence, 3, 143 Prickle, 133, 143 Procollagen, 17, 68, 143 Progesterone, 143, 150 Progression, 8, 66, 113, 143 Progressive, 65, 118, 119, 128, 132, 137, 139, 142, 143, 145 Proline, 29, 120, 130, 143 Promoter, 6, 143 Promotor, 144, 147 Prone, 63, 64, 80, 100, 144 Prospective study, 16, 33, 144 Prostate, 75, 94, 144 Prosthesis, 65, 144 Protease, 69, 78, 144 Protein Binding, 144, 153 Protein C, 69, 112, 133, 144 Protein Conformation, 112, 133, 144 Protein Kinase C, 71, 72, 144 Protein S, 5, 63, 95, 116, 144 Proteoglycan, 69, 144 Proteolytic, 6, 126, 139, 141, 144 Prothrombin, 144, 152 Protocol, 12, 21, 144 Protons, 112, 130, 133, 145

164

Keloids

Proximal, 123, 145 Pruritic, 4, 145 Pruritus, 109, 145 Psoriasis, 76, 77, 145 Public Policy, 91, 145 Publishing, 3, 10, 145 Pulmonary, 10, 77, 79, 116, 125, 134, 145, 151, 154 Pulmonary Fibrosis, 10, 77, 79, 145 Punctures, 16, 145 Pupil, 121, 145 Pyogenic, 84, 111, 145 Pyridones, 75, 145 Q Quercetin, 44, 145 R Race, 80, 136, 145 Radiation, 4, 21, 33, 40, 42, 44, 46, 48, 49, 111, 124, 125, 126, 132, 133, 145, 146, 155 Radiation therapy, 4, 21, 33, 40, 44, 111, 125, 132, 133, 145, 155 Radioactive, 130, 131, 132, 133, 137, 138, 145, 146, 155 Radioimmunotherapy, 146 Radiolabeled, 117, 133, 145, 146, 155 Radiotherapy, 4, 21, 38, 39, 40, 41, 43, 46, 49, 117, 133, 145, 146, 155 Randomized, 12, 124, 146 Reagent, 125, 146 Receptor, 7, 13, 23, 72, 114, 144, 146, 149 Recombinant, 67, 132, 146 Recombination, 9, 146 Rectum, 114, 117, 123, 126, 127, 134, 144, 146 Recur, 63, 64, 70, 146 Recurrence, 9, 16, 38, 41, 45, 146 Red blood cells, 125, 129, 146, 147 Red Nucleus, 115, 146 Refer, 1, 129, 135, 138, 146 Refraction, 146, 150 Refractory, 54, 124, 146 Regimen, 124, 146 Remission, 146 Renal Artery, 21, 146 Renovascular, 21, 147 Resected, 41, 147 Respiration, 118, 147 Response Elements, 6, 147 Reticular, 76, 147 Retinoblastoma, 8, 94, 147 Retinoblastoma Protein, 8, 147 Retrograde, 132, 147

Retrospective, 38, 41, 147 Retrospective study, 38, 147 Rigidity, 141, 147 Risk factor, 144, 147 Rubber, 73, 111, 147 Rutin, 145, 147 S Salivary, 123, 139, 147 Salivary glands, 123, 147 Saponins, 147, 150 Scalpel, 32, 147 Sclera, 78, 120, 147 Scleroderma, 6, 43, 54, 73, 77, 81, 148 Sclerosis, 75, 94, 148 Sclerotherapy, 68, 148 Screening, 120, 148 Scrotum, 122, 148, 152 Sebaceous, 148 Sebaceous gland, 148 Seborrhea, 76, 148 Sebum, 29, 34, 111, 148 Secretion, 77, 111, 121, 129, 132, 136, 137, 148, 153 Segregation, 9, 146, 148 Seizures, 140, 148 Semen, 144, 148 Sequencing, 14, 142, 148 Serine, 144, 148 Serous, 124, 148 Serum, 8, 19, 116, 136, 148 Serum Albumin, 116, 148 Sex Determination, 95, 148 Shock, 148, 153 Side effect, 112, 116, 148, 153 Signal Transduction, 72, 149 Signs and Symptoms, 83, 146, 149 Silicon, 46, 149 Silicon Dioxide, 149 Skin Care, 71, 149 Skin graft, 22, 66, 149 Skin Pigmentation, 100, 149 Skin Transplantation, 10, 149 Small intestine, 130, 132, 149 Smooth muscle, 112, 121, 129, 149, 151 Soaps, 149 Soft tissue, 117, 149, 153 Solid tumor, 113, 149 Specialist, 101, 149 Species, 68, 136, 137, 145, 149, 151, 153, 155 Specificity, 112, 150, 153 Spectrum, 75, 122, 150

Index 165

Sperm, 113, 119, 142, 150, 152 Spinal tap, 135, 150 Spinous, 125, 133, 150 Spleen, 113, 135, 150 Splint, 62, 150 Sporadic, 147, 150 Squamous, 85, 125, 150 Squamous cell carcinoma, 85, 125, 150 Squamous cells, 150 Stasis, 74, 150 Steel, 65, 150 Steroid, 12, 28, 32, 35, 37, 45, 48, 64, 121, 147, 150 Stimulant, 129, 150 Stimulus, 115, 151, 152 Stomach, 111, 123, 125, 127, 130, 140, 149, 150, 151 Stool, 131, 134, 151 Strand, 14, 142, 151 Stress, 7, 143, 147, 151, 154 Stroke, 59, 90, 151 Styrene, 147, 151 Subacute, 131, 151 Subclinical, 131, 148, 151 Subcutaneous, 65, 70, 123, 139, 151 Subspecies, 149, 151 Substance P, 148, 151 Substrate, 72, 151 Sulfates, 77, 151 Sulfur, 69, 136, 151 Sulfuric acid, 151 Suppression, 44, 121, 151 Surfactant, 125, 151 Suspensions, 75, 151 Sweat, 119, 148, 151 Sweat Glands, 119, 148, 151 Symphysis, 144, 152 Synaptic, 149, 152 Systemic, 50, 73, 113, 114, 116, 131, 133, 139, 143, 145, 148, 152, 155 Systolic, 130, 152 T Telangiectasia, 95, 110, 152 Teratogenic, 133, 152 Testicles, 121, 148, 152 Testicular, 122, 152 Thalamic, 115, 152 Thalamic Diseases, 115, 152 Thermal, 123, 138, 142, 152 Thigh, 128, 152 Thorax, 78, 111, 135, 152 Threonine, 144, 148, 152

Threshold, 130, 152 Thrombin, 79, 126, 142, 144, 152 Thrombocytes, 142, 152 Thrombolytic, 141, 152 Thrombomodulin, 144, 152 Thrombosis, 77, 144, 148, 151, 152 Thymus, 135, 152 Tinnitus, 139, 152 Tissue Distribution, 68, 153 Tissue Expansion, 65, 153 Topical, 4, 11, 33, 39, 45, 47, 69, 71, 72, 73, 75, 80, 81, 133, 139, 149, 153 Torticollis, 12, 25, 94, 153 Toxic, iv, 80, 81, 124, 151, 153 Toxicology, 92, 153 Toxins, 114, 127, 131, 137, 146, 153 Trace element, 117, 149, 153 Transcription Factors, 147, 153 Transduction, 149, 153 Transfection, 116, 153 Transforming Growth Factor beta, 23, 153 Transplantation, 23, 119, 153 Trauma, 3, 20, 25, 66, 70, 72, 76, 78, 79, 80, 115, 137, 152, 153 Trees, 147, 154 Triamcinolone Acetonide, 22, 33, 36, 41, 154 Tryptophan, 120, 154 Tuberous Sclerosis, 95, 154 Tumor suppressor gene, 139, 147, 154 Tympanic membrane, 83, 154 U Ulcer, 122, 128, 140, 154 Unconscious, 130, 154 Ureters, 146, 154 Urethra, 144, 154 Urine, 116, 129, 154 Urokinase, 7, 23, 154 Urticaria, 20, 154 Uterus, 70, 71, 119, 143, 154 V Vaccine, 50, 111, 145, 154 Varicella, 50, 154 Varicose, 148, 154 Varicose vein, 148, 154 Vascular, 7, 112, 124, 128, 131, 138, 139, 142, 154 Vascular endothelial growth factor, 7, 154 Vasodilator, 117, 129, 154 Veins, 117, 125, 135, 154, 155 Venous, 129, 139, 144, 154 Ventricle, 152, 154, 155

166

Keloids

Ventricular, 68, 155 Venules, 117, 118, 124, 155 Verapamil, 39, 48, 155 Vertigo, 139, 155 Vesicular, 129, 155 Veterinary Medicine, 91, 155 Viral, 153, 155 Virus, 124, 127, 132, 147, 153, 155 Viscosity, 130, 155 Vitro, 129, 155 Vivo, 5, 6, 155 W Warts, 40, 75, 155

White blood cell, 114, 134, 135, 137, 138, 141, 155 Womb, 154, 155 X Xenograft, 113, 155 X-ray, 18, 41, 48, 49, 64, 126, 133, 138, 145, 146, 155 X-ray therapy, 18, 41, 48, 64, 133, 155 Y Yeasts, 140, 155 Z Zymogen, 144, 155

Index 167

168

Keloids