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

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

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MOLAR

PREGNANCY 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., 1960Molar Pregnancy: 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: 0-597-84500-X 1. Molar Pregnancy-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 molar pregnancy. 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 MOLAR PREGNANCY ................................................................................ 3 Overview........................................................................................................................................ 3 Federally Funded Research on Molar Pregnancy .......................................................................... 3 E-Journals: PubMed Central ......................................................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. NUTRITION AND MOLAR PREGNANCY ...................................................................... 31 Overview...................................................................................................................................... 31 Finding Nutrition Studies on Molar Pregnancy ......................................................................... 31 Federal Resources on Nutrition ................................................................................................... 32 Additional Web Resources ........................................................................................................... 33 CHAPTER 3. CLINICAL TRIALS AND MOLAR PREGNANCY ............................................................ 35 Overview...................................................................................................................................... 35 Recent Trials on Molar Pregnancy .............................................................................................. 35 Keeping Current on Clinical Trials ............................................................................................. 36 CHAPTER 4. BOOKS ON MOLAR PREGNANCY ................................................................................ 39 Overview...................................................................................................................................... 39 Book Summaries: Federal Agencies.............................................................................................. 39 Chapters on Molar Pregnancy ..................................................................................................... 40 CHAPTER 5. PERIODICALS AND NEWS ON MOLAR PREGNANCY .................................................. 41 Overview...................................................................................................................................... 41 News Services and Press Releases................................................................................................ 41 Academic Periodicals covering Molar Pregnancy........................................................................ 43 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 47 Overview...................................................................................................................................... 47 NIH Guidelines............................................................................................................................ 47 NIH Databases............................................................................................................................. 49 Other Commercial Databases....................................................................................................... 51 The Genome Project and Molar Pregnancy ................................................................................. 51 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 59 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 61 Overview...................................................................................................................................... 61 Preparation................................................................................................................................... 61 Finding a Local Medical Library.................................................................................................. 61 Medical Libraries in the U.S. and Canada ................................................................................... 61 ONLINE GLOSSARIES.................................................................................................................. 67 Online Dictionary Directories ..................................................................................................... 69 MOLAR PREGNANCY DICTIONARY ...................................................................................... 71 INDEX ................................................................................................................................................ 97

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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 molar pregnancy 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 molar pregnancy, 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 molar pregnancy, 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 molar pregnancy. 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 molar pregnancy, 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 molar pregnancy. 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 MOLAR PREGNANCY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on molar pregnancy.

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

Project Title: HCG ISOFORM MARKERS OF TROPHOBLASTIC MALIGNANCIES Principal Investigator & Institution: Birken, Steven; Senior Research Scientist; Obstetrics and Gynecology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): HCG is the main tumor marker for both gestational and non-gestational trophoblastic disease. After a pregnancy with partial or complete

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

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hydatidiform mole, some patients develop malignant gestational trophoblastic disease. Patients may display unexplained elevation of circulating hCG with no evidence of clinical disease and are treated solely because of their hCG marker. Other patients under treatment develop resistance to therapy or relapse as detected by the hCG marker. We propose to assess the utility of several new immunoassays for hCG isoforms, recently developed in our laboratory, as improved hCG-related tumor markers. New markers may help to identify the subpopulation of women who will require chemotherapy from those who will undergo spontaneous remission after a premalignant molar pregnancy. The new markers may also improve therapeutic care for both gestational and nongestational trophoblastic disease patients, including testicular cancers. These markers are based on four differentiating immunoassay systems to: 1.carbohydrate-related variants of hCG. 2. "nicked" forms of hCG. 3. isoforms both "nicked" and hyperglycosylated. 4. hCG and hLH beta core fragments. Most of these hCG isoforms have been shown to be structurally altered in malignancies but no assay measurement systems existed previously to quantify these isoforms. The hCG isoforms produced by healthy individuals (from pituitary) must be clearly differentiated from those isoforms produced by malignant tissues. The detection of carbohydrate-variant hCG isoforms are based on the antibody B152 (developed to choriocarcinoma-secreted hCG isoforms) which detects a differentially O-glycosylated form of hCG produced very early in pregnancy as well as in various malignancies. HCG-secreting cancers have also been reported to produce "nicked" hCG isoforms with peptide bond cleavages within the beta subunit. These will be measured by assay system (B151) in conjunction with a rapid chromatographic procedure. Choriocarcinoma and other trophoblastic cancers produce isoforms, which are both "nicked", and hyperglycosylated. These are detected by a B151 capture B152 detection assay. Systems to specifically measure urinary hCG and urinary hLH metabolites have also been developed so that hCG-related metabolites can be distinguished from normal hLH metabolites in postmenopausal women. Structural analyses will be performed to correlate isoform structures with assay measurements. 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 “molar pregnancy” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for molar pregnancy in the PubMed Central database: •

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Lack of involvement of known DNA methyltransferases in familial hydatidiform mole implies the involvement of other factors in establishment of imprinting in the

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

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

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human female germline. by Hayward BE, De Vos M, Judson H, Hodge D, Huntriss J, Picton HM, Sheridan E, Bonthron DT.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149328 •

Linkage of Two Human Pregnancy-Specific [beta]1-Glycoprotein Genes: One is Associated with Hydatidiform Mole. by Leslie KK, Watanabe S, Lei K, Chou DY, Plouzek CA, Deng H, Torres J, Chou JY.; 1990 Aug 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=54420

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Rapid RFLP screening using DNA from complete hydatidiform moles. by Litt M, Buder A, Surti U.; 1989 Jan 11; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=331583

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

“Hook effect” in complete hydatidiform molar pregnancy: a falsely low level of betaHCG. Author(s): Levavi H, Neri A, Bar J, Regev D, Nordenberg J, Ovadia J. Source: Obstetrics and Gynecology. 1993 October; 82(4 Pt 2 Suppl): 720-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7690921

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A cervical ectopic masquerading as a molar pregnancy. Author(s): Masir N, Tamby MR, Jamil MA. Source: Med J Malaysia. 2000 March; 55(1): 138-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11072500

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

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A cervical ectopic masquerading as a molar pregnancy. Author(s): Masir N, Tamby MR, Jamil MA. Source: Med J Malaysia. 2000 June; 55(2): 138-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10944911

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A false negative pregnancy test in a patient with a hydatidiform molar pregnancy. Author(s): Tabas JA, Strehlow M, Isaacs E. Source: The New England Journal of Medicine. 2003 November 27; 349(22): 2172-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14645652

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Acute pulmonary complications of molar pregnancy. Author(s): Twiggs LB, Morrow CP, Schlaerth JB. Source: American Journal of Obstetrics and Gynecology. 1979 September 15; 135(2): 18994. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=474670

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Amniography in the early diagnosis of molar pregnancy. Author(s): Weissman I, Trupin L. Source: Imj Ill Med J. 1971 September; 140(3): 201-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4398463

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Anesthetic implications of a partial molar pregnancy and associated complications. Author(s): Celeski D, Micho J, Walters L. Source: Aana Journal. 2001 February; 69(1): 49-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11759139

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Appearance of molar pregnancy 9.5 weeks after conception. Use of transvaginal ultrasound for early diagnosis. Author(s): Crade M, Weber PR. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1991 August; 10(8): 473-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1942239

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Can histopathologists reliably diagnose molar pregnancy? Author(s): Howat AJ, Beck S, Fox H, Harris SC, Hill AS, Nicholson CM, Williams RA. Source: Journal of Clinical Pathology. 1993 July; 46(7): 599-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8157742

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Case-control study of risk factors for partial molar pregnancy. Author(s): Berkowitz RS, Bernstein MR, Harlow BL, Rice LW, Lage JM, Goldstein DP, Cramer DW. Source: American Journal of Obstetrics and Gynecology. 1995 September; 173(3 Pt 1): 788-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7573245

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Central hemodynamic monitoring in a woman with acute respiratory insufficiency after evacuation of a complete molar pregnancy. A case report. Author(s): Rosen T, Sutin K, Carreno CA, Hibbett E, Funai EF. Source: J Reprod Med. 2001 October; 46(10): 916-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11725738

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Characteristics of molar pregnancy in a 12 year old. Author(s): Chapman GW Jr. Source: Journal of the National Medical Association. 1996 December; 88(12): 806-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8990807

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Choriocarcinoma of the bladder. Report of a case of primary tumor or late metastasis of a molar pregnancy. Author(s): Yishai D, Atad J, Bornstein J, Sova Y, Mecz Y, Lurie A, Lurie M, Abramovici H. Source: J Reprod Med. 1995 June; 40(6): 482-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7650666

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Circulating immune complex levels in patients with molar pregnancy. Author(s): Berkowitz RS, Lahey SJ, Rodrick ML, Rayner AA, Goldstein DP, Steele G Jr. Source: Obstetrics and Gynecology. 1983 February; 61(2): 165-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6823357

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Clinical and laboratory correlates of molar pregnancy and trophoblastic disease. Author(s): Morrow CP, Kletzky OA, Disaia PJ, Townsend DE, Mishell DR, Nakamura RM. Source: American Journal of Obstetrics and Gynecology. 1977 June 15; 128(4): 424-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=194480

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Clinical features of multiple conception with partial or complete molar pregnancy and coexisting fetuses. Author(s): Steller MA, Genest DR, Bernstein MR, Lage JM, Goldstein DP, Berkowitz RS. Source: J Reprod Med. 1994 March; 39(3): 147-54. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8035369

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Clinical presentation and management of molar pregnancy. Author(s): Sasaki S. Source: Best Practice & Research. Clinical Obstetrics & Gynaecology. 2003 December; 17(6): 885-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14614887

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Coagulation and fibrinolysis in intact hydatidiform molar pregnancy. Author(s): Tsakok FH, Koh S, Ratnam SS. Source: British Medical Journal. 1976 December 18; 2(6050): 1481-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1000261

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Coagulation and fibrinolysis in molar pregnancy. Author(s): Lopez-Llera M, de la Luz Espinosa M, Ramos JN, de Leon MD. Source: American Journal of Obstetrics and Gynecology. 1977 April 15; 127(8): 855-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=851143

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Combined tubal and molar pregnancy: case report. Author(s): Sze EH, Adelson MD, Baggish MS, Contente N. Source: American Journal of Obstetrics and Gynecology. 1988 November; 159(5): 1217-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3189455

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Comparative assay of HCG, HCT and HCS in molar pregnancy. Author(s): Tojo S, Mochizuki M, Kanazawa S. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1974; 53(4): 369-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4474790

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Complete molar pregnancy. Clinical trends at King Fahad Hospital, Riyadh, Kingdom of Saudi Arabia. Author(s): Felemban AA, Bakri YN, Alkharif HA, Altuwaijri SM, Shalhoub J, Berkowitz RS. Source: J Reprod Med. 1998 January; 43(1): 11-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9475143

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Confirmation of paternal disomy in a twin molar pregnancy. A case report. Author(s): Kirshon B, Reiter A, Adam K, Cheung SW. Source: J Reprod Med. 2000 January; 45(1): 39-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10664946

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Current management of complete and partial molar pregnancy. Author(s): Goldstein DP, Berkowitz RS. Source: J Reprod Med. 1994 March; 39(3): 139-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8035368

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Current management of molar pregnancy. Author(s): Hancock BW, Tidy JA. Source: J Reprod Med. 2002 May; 47(5): 347-54. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12063873

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Decreased aggregability of platelets in hydatidiform molar pregnancy. Author(s): Rakoczi I, Szepesi J, Gero G, Turi BS, Szigetvari I, Gati I. Source: Thrombosis Research. 1988 October 1; 52(1): 75-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3059557

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Delayed-interval delivery in a quadruplet pregnancy after intrauterine death of a partial molar pregnancy and preterm delivery. A case report. Author(s): Marinoff DN, Spitzberg EH, Chueh JT, Goldman JM, Downs T. Source: J Reprod Med. 1998 December; 43(12): 1051-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9883410

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Delivery of a severely anaemic fetus after partial molar pregnancy: clinical and ultrasonographic findings. Author(s): Hsieh CC, Hsieh TT, Hsueh C, Kuo DM, Lo LM, Hung TH. Source: Human Reproduction (Oxford, England). 1999 April; 14(4): 1122-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10221252

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Development of postmolar trophoblastic disease after partial molar pregnancy. Author(s): Goto S, Yamada A, Ishizuka T, Tomoda Y. Source: Gynecologic Oncology. 1993 February; 48(2): 165-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8428686

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Diagnosis of complete molar pregnancy by microsatellites in archival material. Author(s): Lane SA, Taylor GR, Ozols B, Quirke P. Source: Journal of Clinical Pathology. 1993 April; 46(4): 346-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8496392

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Diagnosis of molar pregnancy and persistent trophoblastic disease by flow cytometry. Author(s): Hemming JD, Quirke P, Womack C, Wells M, Elston CW, Bird CC. Source: Journal of Clinical Pathology. 1987 June; 40(6): 615-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3611391

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Diagnosis of molar pregnancy using ultrasonography: report of two cases. Author(s): Wittich AC. Source: J Am Osteopath Assoc. 1982 June; 81(10): 684-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7107342

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Diagnostic ultrasound in the detection of molar pregnancy. Author(s): Leopold GR. Source: Radiology. 1971 January; 98(1): 171-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5100050

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Distribution of major histocompatibility (HLA) antigens in chorionic villi of molar pregnancy. Author(s): Berkowitz RS, Anderson DJ, Hunter NJ, Goldstein DP. Source: American Journal of Obstetrics and Gynecology. 1983 May 15; 146(2): 221-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6846443

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Documentation of subclinical trophoblastic embolization with invasive cardiac monitoring in a woman with a molar pregnancy. A case report. Author(s): Twiggs LB, Phillips GL. Source: J Reprod Med. 1986 April; 31(4): 277-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3012083

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Early detection of persistent trophoblastic tumour by serum human chorionic gonadotrophin monitoring after molar pregnancy. Author(s): Ngan HY, Wong LC. Source: Chinese Medical Journal. 1999 March; 112(3): 260-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11593563

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Eclampsia complicating hydatidiform molar pregnancy with a coexisting, viable fetus. A case report. Author(s): Ramsey PS, Van Winter JT, Gaffey TA, Ramin KD. Source: J Reprod Med. 1998 May; 43(5): 456-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9610471

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Eclampsia in association with partial molar pregnancy and congenital abnormalities. Author(s): Slattery MA, Khong TY, Dawkins RR, Pridmore BR, Hague WM. Source: American Journal of Obstetrics and Gynecology. 1993 December; 169(6): 1625-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8267078

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Eclampsia in molar pregnancy. Author(s): Teoh ES, Tow SH. Source: J Obstet Gynaecol Br Commonw. 1967 June; 74(3): 453-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6026621

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Epidemiology of complete molar pregnancy. Author(s): Craighill MC, Cramer DW. Source: J Reprod Med. 1984 November; 29(11): 784-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6520819

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Evaluation of tumour markers in molar pregnancy. Author(s): Hegab HM, Schindler AE, Rizk M, Ramadan M. Source: Archives of Gynecology and Obstetrics. 2003 August; 268(3): 151-4. Epub 2003 March 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12942241

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Evidence for the luteal source of circulating relaxin in molar pregnancy. Author(s): Seki K, Kato K. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1987; 66(4): 319-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3425229

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Evolving concepts of molar pregnancy. Author(s): Berkowitz RS, Goldstein DP, Bernstein MR. Source: J Reprod Med. 1991 January; 36(1): 40-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1848899

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Expression of trophoblast-leukocyte common antigens and placental-type alkaline phosphatase in complete molar pregnancy. Author(s): Berkowitz RS, Umpierre SA, Johnson PM, McIntyre JA, Anderson DJ. Source: American Journal of Obstetrics and Gynecology. 1986 August; 155(2): 443-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2943162

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False positive ultrasonography diagnosis of molar pregnancy. Author(s): Levin S, Feingold M, Brook I, Glezerman M. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1981; 60(4): 435-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7282315

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Familial peripartum cardiomyopathy after molar pregnancy. Author(s): Massad LS, Reiss CK, Mutch DG, Haskel EJ. Source: Obstetrics and Gynecology. 1993 May; 81(5 ( Pt 2)): 886-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8469509

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Familial recurrent molar pregnancy: a case report. Author(s): Agarwal P, Bagga R, Jain V, Kalra J, Gopalan S. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2004 February; 83(2): 213-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14756744

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Fetal hemoglobin in women with normal and with hydatidiform molar pregnancy. Author(s): Lee JC, Hayashi RH, Shepard MK. Source: American Journal of Hematology. 1982 September; 13(2): 131-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6182794

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First trimester molar pregnancy: nonspecific ultrasonographic appearance. Author(s): Woodward RM, Filly RA, Callen PW. Source: Obstetrics and Gynecology. 1980 March; 55(3 Suppl): 31S-33S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7360446

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First-trimester serum levels of the beta-subunit of human chorionic gonadotropin in a tubal molar pregnancy. Author(s): Chase JS, Check JH, Nowroozi K, Wu CH. Source: American Journal of Obstetrics and Gynecology. 1987 October; 157(4 Pt 1): 910. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2445209

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Five years' experience with the prevention of trophoblastic tumors by the prophylactic use of chemotherapy in patients with molar pregnancy. Author(s): Goldstein DP. Source: Clinical Obstetrics and Gynecology. 1970 December; 13(4): 945-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5516580

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Genesis of molar pregnancy: neoplastic transformation of the inner cell mass with a case presentation. Author(s): Balasubramaniam UN, Salem FA, Savage EW. Source: Gynecologic Oncology. 1982 August; 14(1): 62-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7095590

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Gestational trophoblastic disease. Subsequent pregnancy outcome, including repeat molar pregnancy. Author(s): Berkowitz RS, Im SS, Bernstein MR, Goldstein DP. Source: J Reprod Med. 1998 January; 43(1): 81-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9475154

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Gray-scale findings in ectopic pregnancy resembling molar pregnancy and missed abortion. Author(s): Kadar N, Romero R. Source: Journal of Clinical Ultrasound : Jcu. 1982 October; 10(8): 403-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6816822

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Growth hormone, prolactin and chorionic somatomammotropin in normal and molar pregnancy. Author(s): Mochizuki M, Morikawa H, Kawaguchi K, Tojo S. Source: The Journal of Clinical Endocrinology and Metabolism. 1976 September; 43(3): 614-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=956347

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HCT and thyroid function in molar pregnancy. Author(s): Tojo S, Kanazawa S, Saida K, Nakamura A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1976; 55(4): 345-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=61702

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Hemodynamic observations in evacuation of molar pregnancy. Author(s): Cotton DB, Bernstein SG, Read JA, Benedetti TJ, D'Ablaing G, Miller FC, Morrow CP. Source: American Journal of Obstetrics and Gynecology. 1980 September 1; 138(1): 6-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7416207

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How long should patients be followed after molar pregnancy? Analysis of serum hCG follow-up data. Author(s): Batorfi J, Vegh G, Szepesi J, Szigetvari I, Doszpod J, Fulop V. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2004 January 15; 112(1): 95-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14687748

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Human chorionic gonadotropin follow-up in patients with molar pregnancy: a time for reevaluation. Author(s): Kohorn EI. Source: Obstetrics and Gynecology. 2003 December; 102(6): 1417. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14662242

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Human chorionic gonadotropin follow-up in patients with molar pregnancy: a time for reevaluation. Author(s): Petignat P, Boulvain M, Vassilakos P. Source: Obstetrics and Gynecology. 2003 September; 102(3): 642-3; Author Reply 643. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12962958

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Human chorionic gonadotropin follow-up in patients with molar pregnancy: a time for reevaluation. Author(s): Feltmate CM, Batorfi J, Fulop V, Goldstein DP, Doszpod J, Berkowitz RS. Source: Obstetrics and Gynecology. 2003 April; 101(4): 732-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12681878

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Human chorionic TSH (hCTSH, hCT) during normal or molar pregnancy. Author(s): Tojo S, Kanazawa S, Nakamura A, Kitagaki S, Mochizuki M. Source: Endocrinol Jpn. 1973 October; 20(5): 505-15. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4801947

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Hydatid mole with a coexisting pregnancy. Author(s): Urbanski TK, Higgins PG, Murray ML, Joffe G. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1996 November-December; 16(6): 478-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8979188

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Hydatidiform molar pregnancy in Malaysian women: a histopathological study from the University Hospital, Kuala Lumpur. Author(s): Cheah PL, Looi LM, Sivanesaratnam V. Source: Malays J Pathol. 1993 June; 15(1): 59-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8277792

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Identification of triploid trophoblast cells in peripheral blood of a woman with a partial hydatidiform molar pregnancy. Author(s): van Wijk IJ, de Hoon AC, Griffioen S, Mulders MA, Tjoa ML, van Vugt JM, Oudejans CB. Source: Prenatal Diagnosis. 2001 December; 21(13): 1142-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11787040

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Immunobiology of complete molar pregnancy and gestational trophoblastic tumor. Author(s): Berkowitz RS, Umpierre SA, Taylor-Emery S, Goldstein DP, Anderson DJ. Source: Cancer and Metastasis Reviews. 1986; 5(2): 109-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3030577

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Immunobiology of molar pregnancy and gestational trophoblastic tumors. Author(s): Berkowitz RS, Goldstein DP, Hoch EJ, Anderson DJ. Source: J Reprod Med. 1984 November; 29(11): 796-801. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6097683

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Immunohistochemical localization of interferons in human placental tissues in normal, ectopic, and molar pregnancy. Author(s): Bulmer JN, Morrison L, Johnson PM, Meager A. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 1990 March-April; 22(3-4): 109-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2115786

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Immunopathologic study of the implantation site in molar pregnancy. Author(s): Berkowitz RS, Mostoufizadeh GhM, Kabawat SE, Goldstein DP, Driscoll SG. Source: American Journal of Obstetrics and Gynecology. 1982 December 15; 144(8): 92530. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6756152

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Implantation site in complete molar pregnancy: a study of immunologically competent cells with monoclonal antibodies. Author(s): Kabawat SE, Mostoufi-Zadeh M, Berkowitz RS, Driscoll SG, Goldstein DP, Bhan AK. Source: American Journal of Obstetrics and Gynecology. 1985 May 1; 152(1): 97-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3873176

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Incidence of acute atherosis in complete molar pregnancy. Author(s): Hayati AR, Azizah A, Wahidah A. Source: Malays J Pathol. 1998 December; 20(2): 113-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10879273

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Intraoperative molar pregnancy crisis. Author(s): Robinson BJ. Source: Aorn Journal. 1994 August; 60(2): 193, 196-201. Review. Erratum In: Aorn J 1994 October; 60(4): 543. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7944318

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Localization of E-cadherin in villous, extravillous and vascular trophoblasts during intrauterine, ectopic and molar pregnancy. Author(s): Floridon C, Nielsen O, Holund B, Sunde L, Westergaard JG, Thomsen SG, Teisner B. Source: Molecular Human Reproduction. 2000 October; 6(10): 943-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11006324

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Localization of transferrin receptor in the chorionic villi of complete molar pregnancy. Author(s): Berkowitz RS, Dubey DP, Goldstein DP, Anderson DJ. Source: American Journal of Obstetrics and Gynecology. 1985 January 1; 151(1): 128-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2981470

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Malignant sequelae of molar pregnancy in Victoria. Author(s): Olesnicky G, Long AR, Quinn MA, Pepperell RJ, Horacek I, Kneale BL. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1985 February; 25(1): 7-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3862406

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Management of complete molar pregnancy. Author(s): Berkowitz RS, Goldstein DP, DuBeshter B, Bernstein MR. Source: J Reprod Med. 1987 September; 32(9): 634-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3312599

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Management of molar pregnancy. Author(s): Goldstein DP, Berkowitz RS, Bernstein MR. Source: J Reprod Med. 1981 April; 26(4): 208-12. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7218227

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Maternal death associated with hydatidiform molar pregnancy. Author(s): Tsakok FH, Koh S, Ilancheran A, Poh WK, Ratnam SS. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1983 December; 21(6): 485-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6141111

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Maternal plasma testosterone levels in molar pregnancy. Author(s): Chew PC, Goh HH, Ratnam SS. Source: British Journal of Obstetrics and Gynaecology. 1977 July; 84(7): 528-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=911710

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Methodology of molar pregnancy termination. Author(s): Schlaerth JB. Source: Clinical Obstetrics and Gynecology. 1984 March; 27(1): 192-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6423329

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Molar pregnancy after artificial homologous insemination for retrograde ejaculation. Author(s): Barriere P, Lopes P, Mollat F, Bureau L, Lerat MF. Source: Lancet. 1984 September 15; 2(8403): 635. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6147662

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Molar pregnancy after artificial insemination (donor) Author(s): Olesnicky G, Quinn M. Source: Lancet. 1984 June 9; 1(8389): 1296. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6145000

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Molar pregnancy and hyperthyroidism in a 13 year-old girl. Author(s): Panamonta O, Luanratanakorn S, Thampratankul L. Source: J Pediatr Endocrinol Metab. 2003 June; 16(5): 787-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12880130

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Molar pregnancy and living normal fetus coexisting until term: prenatal biochemical and sonographic diagnosis. Author(s): Chen FP. Source: Human Reproduction (Oxford, England). 1997 April; 12(4): 853-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9159456

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Molar pregnancy and risk for cancer in women and their male partners. Author(s): Olsen JH, Mellemkjaer L, Gridley G, Brinton L, Johansen C, Kjaer SK. Source: American Journal of Obstetrics and Gynecology. 1999 September; 181(3): 630-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10486475

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Molar pregnancy coexisting with a normal fetus: a case report. Author(s): Deaton JL, Hoffman JS, Saal H, Allred C, Koulos JP. Source: Gynecologic Oncology. 1989 March; 32(3): 394-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2920964

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Molar pregnancy in a 60-year-old woman. Author(s): Davidson SA, Gottesfeld J, La Rosa FG. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1997 January; 56(1): 53-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9049695

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Molar pregnancy in British Columbia: estimated incidence and postevacuation regression patterns of the beta subunit of human chorionic gonadotropin. Author(s): Yuen BH, Cannon W. Source: American Journal of Obstetrics and Gynecology. 1981 February 1; 139(3): 316-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7468701

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Molar pregnancy of hyperthyroidism. Author(s): Hearn MT, Nilsen KH, Court DJ, Barrett JT. Source: N Z Med J. 1976 December 8; 84(577): 433-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=190567

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Molar pregnancy presenting with hyperemesis gravidarum. Author(s): Glick MM, Dick EL. Source: J Am Osteopath Assoc. 1999 March; 99(3): 162-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10217911

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Molar pregnancy with a coexistent fetus after intracytoplasmic sperm injection. A case report. Author(s): Petignat P, Senn A, Hohlfeld P, Blant SA, Laurini R, Germond M. Source: J Reprod Med. 2001 March; 46(3): 270-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11304873

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Molar pregnancy with a coexisting fetus progressing to a viable infant. Author(s): Moini A, Riazi K. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 July; 82(1): 63-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12834943

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Molar pregnancy. Author(s): Ho MR, Baker JE. Source: The Journal of Emergency Medicine. 2002 January; 22(1): 93-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11809563

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Molar pregnancy: a case study and review. Author(s): Jonquil SG. Source: Midwifery Today Childbirth Educ. 1996 Fall; (39): 35, 38. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9016047

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Molar pregnancy: a clinical study of 347 cases. Author(s): Koetsawang A. Source: J Med Assoc Thai. 1984 February; 67(2): 73-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6330260

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Molar pregnancy: early diagnosis by ultrasound. Author(s): Wittmann BK, Fulton L, Cooperberg PL, Lyons EA, Miller C, Shaw D. Source: Journal of Clinical Ultrasound : Jcu. 1981 April; 9(4): 153-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6793633

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Molar pregnancy: presentation and diagnosis. Author(s): Kohorn EI. Source: Clinical Obstetrics and Gynecology. 1984 March; 27(1): 181-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6705310

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Molar pregnancy--associated ectopic decidua: report of a case and review of the literature. Author(s): Kularbkaew C, Yutanawiboonchai W, Pairojkul C. Source: J Med Assoc Thai. 1998 November; 81(11): 918-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9803093

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Mutations in the gene encoding the alpha-subunit of the Gs protein in molar pregnancy. Author(s): Garon G, LeHoux JG, Bessette P. Source: Endocrine. 1999 August; 11(1): 83-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10668646

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Natural history of partial molar pregnancy. Author(s): Kohorn EI. Source: Obstetrics and Gynecology. 1986 November; 68(5): 731-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3020480

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Natural history of partial molar pregnancy. Author(s): Berkowitz RS, Goldstein DP, Bernstein MR. Source: Obstetrics and Gynecology. 1985 November; 66(5): 677-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2414703

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Natural history of recurrent molar pregnancy. Author(s): Federschneider JM, Goldstein DP, Berkowitz RS, Marean AR, Bernstein MR. Source: Obstetrics and Gynecology. 1980 April; 55(4): 457-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7366903

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Neuroendocrine regulation of anterior pituitary function in patients during and after molar pregnancy. Author(s): Forsbach G, Contreras J, de Hoyos R, Martinez-Campos A. Source: Acta Endocrinol (Copenh). 1987 November; 116(3): 373-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3120449

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Nonneoplastic complications of molar pregnancy. Author(s): Twiggs LB. Source: Clinical Obstetrics and Gynecology. 1984 March; 27(1): 199-210. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6705311

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Observations on molar pregnancy in Enugu, Nigeria. Author(s): Egwuatu VE, Ozumba BC. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1989 July; 29(3): 219-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2569418

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Occurrence of molar pregnancy in patients undergoing elective abortion: comparison with other clinical presentations. Author(s): Yuen BH, Callegari PB. Source: American Journal of Obstetrics and Gynecology. 1986 February; 154(2): 273-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2418683

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Origin of choriocarcinoma in previous molar pregnancy proved by DNA analysis. Author(s): Vojtassak J, Repiska V, Zajac V, Konecna B, Korbel' M, Danihel L. Source: Neoplasma. 1996; 43(1): 57-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8843962

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Partial hydatidiform molar pregnancy presenting with severe preeclampsia prior to twenty weeks gestation: a case report and review of the literature. Author(s): Brittain PC, Bayliss P. Source: Military Medicine. 1995 January; 160(1): 42-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7746435

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Partial molar pregnancy associated with severe pregnancy-induced hypertension. Author(s): Cox SM, Klein VR. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1993 March-April; 13(2): 103-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8515300

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Partial molar pregnancy with fetal survival: an unusual example of confined placental mosaicism. Author(s): Sarno AP Jr, Moorman AJ, Kalousek DK. Source: Obstetrics and Gynecology. 1993 October; 82(4 Pt 2 Suppl): 716-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8378025

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Patterns and pitfalls in the ultrasonic diagnosis of molar pregnancy. Author(s): Lingard DA. Source: Australasian Radiology. 1982 March; 26(1): 73-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7126081

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Patterns of molar pregnancy in adolescents. Author(s): Chapman GW Jr, Thompson HC, Edwards JA. Source: Gynecologic Oncology. 1988 June; 30(2): 196-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3371744

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Persistent partial molar pregnancy. A report of uterus-preserving treatment and follow-up with magnetic resonance imaging. Author(s): Wright-Browne V, Kudelka AP, Malpica A, Edwards CL, Varma DG, Kavanagh JJ. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 1996 October; 19(5): 534-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8823486

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Plasma beta-subunit human chorionic gonadotropin assay in molar pregnancy and choriocarcinoma. Author(s): Yuen BH, Cannon W, Benedet JL, Boyes DA. Source: American Journal of Obstetrics and Gynecology. 1977 April 1; 127(7): 711-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=557901

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Plasma hormone concentrations and serum 17 beta-hydroxysteroid dehydrogenase activity in molar pregnancy. Author(s): Massart C, Le Pogamp C, Nicol M. Source: Clinical Chemistry. 1982 July; 28(7): 1474-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6952965

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Plasma testosterone in molar pregnancy: Correlation with gestational age, uterine size, theca-lutein cyst and serum HCG. Author(s): Chew PC, Ratnam SS, Goh HH. Source: British Journal of Obstetrics and Gynaecology. 1978 August; 85(8): 624-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=687543

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Post-molar trophoblastic disease following coexisting molar pregnancy and living fetus subsequent to clomiphene citrate therapy. Author(s): Grenman SE, Salmi T, Meurman L. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1990 August; 32(4): 381-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1977634

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Post-sterilization molar pregnancy in a 52 year old menopausal woman. Author(s): Roy KK, Malhotra N, Takkar D, Goel S. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2000 August; 79(8): 716-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10949243

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Prognostic characteristics of serum human chorionic gonadotropin titer regression following molar pregnancy. Author(s): Schlaerth JB, Morrow CP, Kletzky OA, Nalick RH, D'Ablaing GA. Source: Obstetrics and Gynecology. 1981 October; 58(4): 478-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7279342

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Prophylactic chemotherapy of complete molar pregnancy. Author(s): Goldstein DP, Berkowitz RS. Source: Seminars in Oncology. 1995 April; 22(2): 157-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7740316

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Prophylactic chemotherapy of patients with molar pregnancy. Author(s): Goldstein DP. Source: Obstetrics and Gynecology. 1971 December; 38(6): 817-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4331074

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Prostaglandin F2 alpha for interrupting pregnancy, managing intrauterine death and molar pregnancy and inducing labor. Author(s): de Gezelle H, Thiery M, Parewijck W, Decoster JM. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1980 January-February; 17(4): 362-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6102058

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Pulmonary embolization of trophoblastic tissue in molar pregnancy. Author(s): Kohorn EI, McGinn RC, Gee BL, Goldstein DP, Osathanondh R. Source: Obstetrics and Gynecology. 1978 January; 51(1 Suppl): 16S-20S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=618467

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Radioactive iodine-tagged albumin photoscan of molar pregnancy. Author(s): Masterson BJ, White WE. Source: American Journal of Obstetrics and Gynecology. 1966 November 15; 96(6): 896-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5927301

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Radioimmunoassay of free beta-subunit of human chorionic gonadotropin as a prognostic test for persistent trophoblastic disease in molar pregnancy. Author(s): Khazaeli MB, Hedayat MM, Hatch KD, To AC, Soong SJ, Shingleton HM, Boots LR, LoBuglio AF. Source: American Journal of Obstetrics and Gynecology. 1986 August; 155(2): 320-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3017111

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Radiology rounds. Molar pregnancy (hydatidiform mole; gestational trophoblastic disease). Author(s): McLennan MK. Source: Can Fam Physician. 1999 January; 45: 49, 61-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10889855

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Recurrent consecutive partial molar pregnancy. Author(s): Narayan H, Mansour P, McDougall WW. Source: Gynecologic Oncology. 1992 July; 46(1): 122-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1634132

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Recurrent molar pregnancy after ovulation induction and repeat ovulation induction. A case report. Author(s): Basbug M, Aygen E, Tayyar M, Kaya E, Demir I, Serin S. Source: J Reprod Med. 1997 September; 42(9): 600-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9336760

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Recurrent molar pregnancy. Author(s): Bilgin T, Esmer A, Kuckerdogan IB. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1997 May; 57(2): 185-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9184959

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Recurrent molar pregnancy: report of a case with seven consecutive hydatidiform moles. Author(s): Ozalp S, Yalcin OT, Tanir HM, Etiz E. Source: Gynecologic and Obstetric Investigation. 2001; 52(3): 215-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11598368

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Relationship of oral contraceptives and the intrauterine contraceptive devices to the regression of concentrations of the beta subunit of human chorionic gonadotropin and invasive complications after molar pregnancy. Author(s): Ho Yuen B, Burch P. Source: American Journal of Obstetrics and Gynecology. 1983 January 15; 145(2): 214-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6849356

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Reproductive experience after complete and partial molar pregnancy and gestational trophoblastic tumors. Author(s): Berkowitz RS, Goldstein DP, Bernstein MR. Source: J Reprod Med. 1991 January; 36(1): 3-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1848896

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Reproductive performance after molar pregnancy and gestational trophoblastic tumors. Author(s): Goldstein DP, Berkowitz RS, Bernstein MR. Source: Clinical Obstetrics and Gynecology. 1984 March; 27(1): 221-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6323080

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Risk factors for complete molar pregnancy from a case-control study. Author(s): Berkowitz RS, Cramer DW, Bernstein MR, Cassells S, Driscoll SG, Goldstein DP. Source: American Journal of Obstetrics and Gynecology. 1985 August 15; 152(8): 101620. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4025447

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Risk of partial and complete hydatidiform molar pregnancy in relation to maternal age. Author(s): Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 January; 109(1): 99-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11843379

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Risk of recurrent hydatidiform mole and subsequent pregnancy outcome following complete or partial hydatidiform molar pregnancy. Author(s): Sebire NJ, Fisher RA, Foskett M, Rees H, Seckl MJ, Newlands ES. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 January; 110(1): 22-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12504931

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Serum chorionic gonadotropin activity after molar pregnancy, therapeutic abortion, and term delivery. Author(s): Pastorfide GB, Goldstein DP, Kosasa TS, Levesque L. Source: American Journal of Obstetrics and Gynecology. 1974 January 15; 118(2): 293-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4809418

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Serum placental lactogen activity in patients with molar pregnancy and trophoblastic tumors--a reliable index of malignancy. Author(s): Goldstein DP. Source: American Journal of Obstetrics and Gynecology. 1971 June 15; 110(4): 583-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4325820

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Serum placental lactogen levels in patients with molar pregnancy and trophoblastic tumors. Author(s): Saxena B, Goldstein DP, Emerson K Jr, Selenkow HA. Source: American Journal of Obstetrics and Gynecology. 1968 September 1; 102(1): 11521. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4299677

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Significant clinical manifestations of molar pregnancy. Author(s): Hofmeister FJ, O'Leary W. Source: Wis Med J. 1968 October; 67(10): 509-13. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5703597

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Sonographic findings and clinical correlations in molar pregnancy. Author(s): Santos-Ramos R, Forney JP, Schwarz BE. Source: Obstetrics and Gynecology. 1980 August; 56(2): 186-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7393507

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Steroid excretion in molar pregnancy and early hormone-induced pregnancy. Author(s): Macnaughton MC, Coutts JR, Browning MC. Source: Proc R Soc Med. 1970 November; 63(11 Part 1): 1087-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5484920

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Subinvolution of the placental bed after molar pregnancy. Author(s): Khong TY, Chin MM. Source: J Reprod Med. 1996 May; 41(5): 352-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8725762

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Subsequent pregnancy experience in patients with molar pregnancy and gestational trophoblastic tumor. Author(s): Garner EI, Lipson E, Bernstein MR, Goldstein DP, Berkowitz RS. Source: J Reprod Med. 2002 May; 47(5): 380-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12063876

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Subsequent pregnancy outcome in patients with molar pregnancy and gestational trophoblastic tumors. Author(s): Berkowitz RS, Goldstein DP, Bernstein MR, Sablinska B. Source: J Reprod Med. 1987 September; 32(9): 680-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2822923

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Successful use of anti-retroviral therapy in combination with cytotoxic chemotherapy for persistent molar pregnancy: a case report. Author(s): Moodley M, Moodley J. Source: International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society. 2003 March-April; 13(2): 246-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12657133

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Termination of a molar pregnancy using mifepristone and gemeprost. Author(s): Bates A, Pinto A, Evans J. Source: British Journal of Obstetrics and Gynaecology. 1994 July; 101(7): 637-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8043548

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Termination of molar pregnancy by intramuscular administration of 15(S)-15-methylprostaglandin F2 alpha. Author(s): Keirse MJ. Source: Prostaglandins Med. 1980 May; 4(5): 333-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7403332

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The application of an immunoradiometric assay of plasma thyrotropin (TSH-IRMA) in molar pregnancy. Author(s): Berghout A, Endert E, Wiersinga WM, Touber JL. Source: J Endocrinol Invest. 1988 January; 11(1): 15-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3361074

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The changing clinical presentation of complete molar pregnancy. Author(s): Soto-Wright V, Bernstein M, Goldstein DP, Berkowitz RS. Source: Obstetrics and Gynecology. 1995 November; 86(5): 775-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7566847

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The current clinical presentation of complete molar pregnancy. Author(s): Gemer O, Segal S, Kopmar A, Sassoon E. Source: Archives of Gynecology and Obstetrics. 2000 July; 264(1): 33-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10985617

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The diagnosis and prognosis of molar pregnancy: the experience of the National Referral Centre in London. Author(s): Paradinas FJ. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1998 April; 60 Suppl 1: S57-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9833616

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The diagnosis of molar pregnancy by sonography and gross morphology. Author(s): Lindholm H, Flam F. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1999 January; 78(1): 6-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926884

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The diagnosis of molar pregnancy by ultrasound: a continuing challenge. Author(s): Berkowitz RS, Goldstein DP. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1997 January; 9(1): 4-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9060121

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The epidemiology of molar pregnancy and choriocarcinoma. Author(s): Buckley JD. Source: Clinical Obstetrics and Gynecology. 1984 March; 27(1): 153-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6705308

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The radiographic diagnosis of molar pregnancy. Report of three patients. Author(s): Zarou DM, Imbleau Y, Zarou GS. Source: Obstetrics and Gynecology. 1970 January; 35(1): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5409839

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The spermatogram of a man into a couple bearing a total molar pregnancy. Case report. Author(s): Parvulescu G. Source: Rom J Morphol Embryol. 1991 July-December; 37(3-4): 175-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1814516

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The use of a radioimmunoassay specific for human chorionic gonadotropin in patients with molar pregnancy and gestational trophoblastic disease. Author(s): Pastorfide GB, Goldstein DP, Kosasa TS. Source: American Journal of Obstetrics and Gynecology. 1974 December 15; 120(8): 10258. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4372889

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Thromboxane A2 and prostacyclin levels in molar pregnancy. Author(s): Greer IA, Walker JJ, Mclaren M, Lang GD, Serle E, Calder AA, Forbes CD. Source: British Journal of Obstetrics and Gynaecology. 1985 June; 92(6): 652. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3890938

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Thromboxane A2 and prostacyclin levels in molar pregnancy. Author(s): Roy AC, Karim SM, Kottegoda SR, Ratnam SS. Source: British Journal of Obstetrics and Gynaecology. 1984 September; 91(9): 908-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6383461

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Thyroid function in molar pregnancy. Author(s): Nagataki S, Mizuno M, Sakamoto S, Irie M, Shizume K. Source: The Journal of Clinical Endocrinology and Metabolism. 1977 February; 44(2): 254-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=402378

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Thyroid function in molar pregnancy. Author(s): Kock H, von Kessel H, Stolte L, von Leusden H. Source: The Journal of Clinical Endocrinology and Metabolism. 1966 October; 26(10): 1128-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5926071

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Timing of subsequent pregnancy following treatment of molar pregnancy. Author(s): Young RL, Sangi-Haghpeykar H, Thomakos N, Miller HJ. Source: Gynecologic and Obstetric Investigation. 1999; 48(4): 251-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10592427

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Toxemic renal disease in incomplete molar pregnancy. Author(s): Lansing M, Mandal AK. Source: Diagn Gynecol Obstet. 1982 Spring; 4(1): 45-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7042259

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Treatment of persistent trophoblastic disease later than 6 months after diagnosis of molar pregnancy. Author(s): Gillespie AM, Kumar S, Hancock BW. Source: British Journal of Cancer. 2000 April; 82(8): 1393-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10780516

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Triploid partial molar pregnancy and fetal neural tube defect detected through Down's syndrome screening. Author(s): Quintieri F, Idotta R. Source: Clin Exp Obstet Gynecol. 1996; 23(3): 181-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8894330

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Triploid partial molar pregnancy detected through maternal serum alpha-fetoprotein and HCG screening. Author(s): Harper MA, Ruiz C, Pettenati MJ, Rao PN. Source: Obstetrics and Gynecology. 1994 May; 83(5 Pt 2): 844-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7512706

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Trisomy 21 fetus co-existent with a partial molar pregnancy: case report. Author(s): Geisler JP, Mernitz CS, Hiett AK, Geisler HE, Cudahy TJ. Source: Clin Exp Obstet Gynecol. 1999; 26(3-4): 149-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10668140

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Ultrasound diagnosis of molar pregnancy. Author(s): Bean WJ, Calonje MA, Geshner J. Source: J La State Med Soc. 1975 November; 127(11): 419-20. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1240117

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Update on molar pregnancy and choriocarcinoma. Author(s): Ilancheran A, Singh P. Source: Singapore Med J. 1989 October; 30(5): 473-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2694375

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Urinary pigment-creatinine ratio in normal and molar pregnancy. Author(s): Franklin CA, Galton VA, Ingbar SH. Source: Obstetrics and Gynecology. 1971 May; 37(5): 761-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5091756

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Uterine and peripheral hematologic profiles in molar pregnancy. Author(s): Lopez-Llera M, Niz Ramos J, Espinosa ML. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1978 July-1979 August; 17(1): 63-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=39841

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Uterine visualization with Tc-99m human polyclonal immunoglobulin G scintigraphy to detect molar pregnancy. Author(s): Arka A, Stipsanelli K, Papantoniou V, Leondi A, Sampaliotou G, Zerva C, Karpathios S. Source: Clinical Nuclear Medicine. 2002 November; 27(11): 844. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12394152

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X chromosome expression in normal and molar pregnancy. Author(s): Oudejans CB. Source: Medical Hypotheses. 1984 October; 15(2): 115-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6513828

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CHAPTER 2. NUTRITION AND MOLAR PREGNANCY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and molar pregnancy.

Finding Nutrition Studies on Molar Pregnancy 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 “molar pregnancy” (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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Molar Pregnancy

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

Hydatidiform mole pregnancy trophoblast extracts differentially suppress interleukin-2-induced proliferation of human T-lymphocytes and PHA-blasts. Author(s): Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505. Source: Bennett, W A Brackin, M N McGehee, R P Cowan, B D Am-J-Reprod-Immunol. 1990 June; 23(2): 44-9 1046-7408

•

Hydatidiform mole: clinical analysis of 310 patients. Author(s): Department of Gynecologic Oncology, Dr Zekai Tahir Burak Women's Hospital, Ankara, Turkey. Source: Mungan, T Kuscu, E Dabakoglu, T Senoz, S Ugur, M Cobanoglu, O Int-JGynaecol-Obstet. 1996 March; 52(3): 233-6 0020-7292

•

Kinetic analysis of 3 beta-hydroxysteroid dehydrogenase activity in microsomes from complete hydatidiform mole. Author(s): Departamento de Bioquimica Clinica, Facultad de Ciencias Quimicas, Universidad Nacional de Cordoba, Argentina. Source: Genti Raimondi, S Olivier, N S Patrito, L C Flury, A J-Steroid-Biochem. 1990 June; 36(1-2): 149-52 0022-4731

•

Medical induction prior to surgical evacuation of hydatidiform mole: is there a greater risk of persistent trophoblastic disease? Author(s): Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden. Source: Flam, F Lundstrom, V Pettersson, F Eur-J-Obstet-Gynecol-Reprod-Biol. 1991 November 3; 42(1): 57-60 0301-2115

•

Persistent gestational trophoblastic tumor after partial hydatidiform mole. Author(s): New England Trophoblastic Disease Center, Boston, Massachusetts. Source: Rice, L W Berkowitz, R S Lage, J M Goldstein, D P Bernstein, M R GynecolOncol. 1990 March; 36(3): 358-62 0090-8258

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

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

•

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

•

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

•

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

•

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

Nutrition

33

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

35

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

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

Methotrexate Compared With Dactinomycin in Treating Patients With Gestational Trophoblastic Neoplasia Condition(s): Hydatidiform Mole; uterine choriocarcinoma; nonmetastatic gestational trophoblastic tumor; good prognosis metastatic gestational trophoblastic tumor Study Status: This study is currently recruiting patients. Sponsor(s): Gynecologic Oncology Group; National Cancer Institute (NCI); Eastern Cooperative Oncology Group Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether methotrexate is more effective than dactinomycin in treating patients with gestational trophoblastic neoplasia. PURPOSE: Randomizedphase III trial to compare the effectiveness of methotrexate with that of dactinomycin in treating patients who have gestational trophoblastic neoplasia. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003702

8

These are listed at www.ClinicalTrials.gov.

36

Molar Pregnancy

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 “molar pregnancy” (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

•

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

•

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

•

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

•

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

•

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

•

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

•

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/

•

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

•

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

•

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

•

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

Clinical Trials 37

•

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

•

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

39

CHAPTER 4. BOOKS ON MOLAR PREGNANCY Overview This chapter provides bibliographic book references relating to molar pregnancy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on molar pregnancy include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss Source: Lanham, MD: Taylor Trade Publishing/Rowman and Littlefield Publishing Group. 2000. 321 p. Contact: Available from Taylor Trade Publishing/Rowman and Littlefield Publishing Group, 4720 Boston Way, Lanham, MD 20706. (301) 459-3366, (800) 462-6420 (orders and customer service), (800) 338-4550 (Fax), [email protected] (E-mail), http://www.rlpgbooks.com (Web Site). $16.95. ISBN 0-87833-182-4. Summary: This book is intended to give women and their partners the information and reassurance they need to withstand the physical and emotional difficulties of a high-risk subsequent pregnancy. The book focuses on the kinds of issues that are of primary concern to couples who are embarking on pregnancy after miscarriage, stillbirth, or infant death. The following topics are covered: risk factors for and causes of ectopic

40

Molar Pregnancy

pregnancy, molar pregnancy, miscarriage, recurrent miscarriage, and stillbirth; tests that can determine the causes of miscarriage, recurrent miscarriage, and stillbirth; the 10 leading causes of infant death; emotional and physical factors involved in a couple's decision to attempt another pregnancy; preparing for another pregnancy, including having a preconception health checkup; how one's reproductive history will affect the next pregnancy; determining whether a couple is a good candidate for genetic counseling; what couples can do to increase their odds of conceiving quickly; how couples can tell if they have a fertility problem; the challenges of coping with infertility after pregnancy loss or infant death; the emotions a couple may experience when the pregnancy test comes back positive; components of a healthy lifestyle and what pregnant women can do to ensure the healthiest possible baby; the pros and cons of prenatal testing; coping with the unique physical and emotional challenges of a highrisk pregnancy; chronic conditions in the mother that can put the pregnancy at risk; problems that can occur during a multiple pregnancy; preparing for the birth by taking prenatal classes, writing a birth plan, and hiring a doula; pain relief options during labor; the signs of labor and the three stages of labor; what to expect during a cesarean delivery; and how to survive the emotional highs and lows that can occur after birth. The more than 100 parents who were interviewed for this book answered a series of questionnaires that focused on every aspect of pregnancy after a loss: how they decided it was time to start trying to conceive again, how they maintained their sanity when they didn't conceive as quickly as they wanted, whether they stayed with the same physician or midwife they had worked with in the past, whether they went through prenatal testing, how they coped with their fear that something also would happen to this baby, and what they did to prepare themselves for the upcoming birth. Appendixes contain a table of infant deaths and infant mortality rates for the year 1997, a directory of relevant organizations in the United States and Canada, and a directory of internet resources. Numerous references.

Chapters on Molar Pregnancy In order to find chapters that specifically relate to molar pregnancy, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and molar pregnancy 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 “molar pregnancy” (or synonyms) into the “For these words:” box.

41

CHAPTER 5. PERIODICALS AND NEWS ON MOLAR PREGNANCY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover molar pregnancy.

News Services and Press Releases One of the simplest ways of tracking press releases on molar pregnancy is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “molar pregnancy” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to molar pregnancy. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “molar pregnancy” (or synonyms). The following was recently listed in this archive for molar pregnancy: •

Risk of recurrent hydatidiform mole is low Source: Reuters Medical News Date: January 24, 2003

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Molar Pregnancy

The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “molar pregnancy” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “molar pregnancy” (or synonyms). If you know the name of a company that is relevant to molar pregnancy, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “molar pregnancy” (or synonyms).

Periodicals and News

43

Academic Periodicals covering Molar Pregnancy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to molar pregnancy. In addition to these sources, you can search for articles covering molar pregnancy that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

45

APPENDICES

47

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 Institute9: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

9

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

48

Molar Pregnancy

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

49

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.10 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:11 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

10

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

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•

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

•

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

The NLM Gateway12 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.13 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “molar pregnancy” (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 3204 31 735 0 8 3978

HSTAT14 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.15 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.16 Simply search by “molar pregnancy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

12

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

13

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). 14 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 15 16

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

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

Physician Resources

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Coffee Break: Tutorials for Biologists17 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.18 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.19 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 Molar Pregnancy In the following section, we will discuss databases and references which relate to the Genome Project and molar pregnancy. 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).20 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. 17 Adapted 18

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. 19 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. 20 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 “molar pregnancy” (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 molar pregnancy: •

Hydatidiform Mole Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=231090 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, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

Physician Resources

53

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “molar pregnancy” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database21 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 Database22 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 “molar pregnancy” (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).

21

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 22 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

55

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 molar pregnancy 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 molar pregnancy. 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 molar pregnancy. 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 “molar pregnancy”:

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Birth Defects http://www.nlm.nih.gov/medlineplus/birthdefects.html High Risk Pregnancy http://www.nlm.nih.gov/medlineplus/highriskpregnancy.html Infections and Pregnancy http://www.nlm.nih.gov/medlineplus/infectionsandpregnancy.html Pregnancy Loss http://www.nlm.nih.gov/medlineplus/pregnancyloss.html Uterine Cancer http://www.nlm.nih.gov/medlineplus/uterinecancer.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 molar pregnancy. 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: •

Early Pregnancy Loss: Miscarriage, Ectopic Pregnancy, and Molar Pregnancy Source: Washington, DC: American College of Obstetricians and Gynecologists. 1998. 6 p. Contact: Available from American College of Obstetricians and Gynecologists, Distribution Center, P.O. Box 4500, Kearneysville, WV 25430-4500. (800) 762-2264, ext. 931 (orders), (304) 725-8410, ext. 339 (orders), (800) 525-5562 (Fax), [email protected] (Email), http://www.acog.org (Web Site). $17.50 for a package of 50 brochures. Order No. AP090. Summary: This pamphet addresses the problem of early pregnancy loss, which is defined as the loss of a pregnancy before 20 weeks' gestation. Most often this kind of loss is a miscarriage, but ectopic pregnancy and molar pregnancy also can be causes of early pregnancy loss. Miscarriages occur in 15 to 20 percent of all pregnancies, and most occur in the first 13 weeks. A woman can miscarry without even being aware that she is pregnant. More than half of miscarriages in the first trimester of pregnancy are caused by abnormalities in the chromosomes of the fetus. Most chromosomal abnormalities are not inherited, but happen by chance and are not likely to occur again in a later pregnancy. Other causes of miscarriage are problems with the mother's health, such as an abnormally shaped uterus, an incompetent cervix, chronic disease, and genital tract

Patient Resources

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infections. Lifestyle factors also can cause miscarriage, notably, smoking, heavy alcohol use, and use of illegal drugs. Bleeding is the most common sign of miscarriage. When a miscarriage occurs early in pregnancy, tissue may remain in the uterus. If this happens, the tissue will have to be removed by dilation and curettage. Generally, this does not require a hospital stay. Recovery may take some time, but a woman can ovulate and become pregnant as soon as 2 weeks after an early miscarriage. Ectopic pregnancy occurs when the fertilized egg doesn't reach the uterus and begins to grow in the fallopian tube or, rarely, attaches to an ovary or other organ in the stomach. About 1 in 60 pregnancies is ectopic. Most ectopic pregnancies occur in the fallopian tube. The tube is narrow, so the pregnancy can only grow to the size of a walnut before rupture occurs. If the tube bursts it will cause major bleeding, which is why ectopic pregnancy must be treated promptly. The symptoms of ectopic pregnancy are vaginal bleeding, abdominal pain, shoulder pain, weakness, dizziness, or fainting. Treatment for ectopic pregnancy depends on the size of the pregnancy, whether the tube has ruptured, and the amount of bleeding. If the tube bursts, there will be heavy bleeding inside the stomach and emergency surgery will be required. In many cases, a ruptured tube will have to be removed. If the tubes have been left in place, there is a good chance that the woman can have a normal pregnancy in the future. But women who have experienced ectopic pregnancy are at higher risk for having another one. In molar pregnancy, the pregnancy is not an embryo but a mass of abnormal tissue. This type of pregnancy occurs in only 1 of 1,000 to 1,200 pregnancies. A genetic error causes the abnormal cells to grow. The most common symptom of this condition is vaginal bleeding during the first trimester. Other signs, an enlarged uterus or ovaries, can only be detected by a doctor. The doctor can test for molar pregnancy by analyzing the blood for a specific hormone or doing an ultrasound. Treatment for molar pregnancy is dilation of the cervix and removal of the mole. Careful followup treatment is necessary, as abnormal cells may remain. Women who have molar pregnancies should wait 6 months to a year before getting pregnant again. For many women the emotional healing after a pregnancy loss takes longer than the physical healing. They should not blame themselves for early pregnancy loss because most early losses cannot be prevented. Most women who suffer early pregnancy loss have a healthy pregnancy later. It is important that they allow enough time for physical and emotional healing before trying to get pregnant again. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “molar pregnancy” (or synonyms). The following was recently posted: •

Chlamydial urethritis and cervicitis Source: Finnish Medical Society Duodecim - Professional Association; 2001 June 5; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3401&nbr=2627&a mp;string=molar+AND+pregnancy

58

•

Molar Pregnancy

Clinical policy guidelines Source: National Abortion Federation - Professional Association; 1996 (revised 2003); 54 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3689&nbr=2915&a mp;string=molar+AND+pregnancy

•

Clinical policy: critical issues in the initial evaluation and management of patients presenting to the emergency department in early pregnancy Source: American College of Emergency Physicians - Medical Specialty Society; 2003 January; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3693&nbr=2919&a mp;string=molar+AND+pregnancy

•

Common gynecologic problems: a guide to diagnosis and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3486&nbr=2712&a mp;string=molar+AND+pregnancy

•

Diseases characterized by urethritis and cervicitis. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3236&nbr=2462&a mp;string=molar+AND+pregnancy

•

Laboratory support for the diagnosis and monitoring of thyroid disease Source: National Academy of Clinical Biochemistry - Professional Association; 2002; 125 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3522&nbr=2748&a mp;string=molar+AND+pregnancy

•

National High Blood Pressure Education Program: Working Group report on high blood pressure in pregnancy Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1990 (revised 2000 Jul); 39 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1478&nbr=704&am p;string=hydatidiform+AND+mole

Patient Resources

•

59

Recommendations for the evaluation and management of nausea and vomiting of early pregnancy Source: University of Texas at Austin School of Nursing, Family Nurse Practitioner Program - Academic Institution; 2002 May; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3228&nbr=2454&a mp;string=molar+AND+pregnancy 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 molar pregnancy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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 molar pregnancy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with molar pregnancy. 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 molar pregnancy. For more information,

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see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “molar pregnancy” (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 “molar pregnancy”. 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 “molar pregnancy” (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 “molar pregnancy” (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.23

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

23

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)24: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

24

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

Finding Medical Libraries 63

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries 65

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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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/

•

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

•

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

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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 molar pregnancy: •

Basic Guidelines for Molar Pregnancy Hydatidiform mole Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000909.htm

•

Signs & Symptoms for Molar Pregnancy Heat intolerance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003094.htm High blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Loose stools Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

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Rapid heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Restlessness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Swelling in feet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003104.htm Trembling hands Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003192.htm Unexplained weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm Vaginal bleeding in pregnancy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003264.htm •

Diagnostics and Tests for Molar Pregnancy Carotene Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003571.htm HCG (quantitative) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003510.htm Proteinuria Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003580.htm Serum HCG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003509.htm Transvaginal ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003779.htm

•

Nutrition for Molar Pregnancy Folic acid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002408.htm Protein Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002467.htm

•

Surgery and Procedures for Molar Pregnancy Abortion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002912.htm Hysterectomy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002915.htm

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Suction curettage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002912.htm •

Background Topics for Molar Pregnancy Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Benign Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002236.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Invasive Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002384.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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MOLAR PREGNANCY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Allografts: A graft of tissue obtained from the body of another animal of the same species but with genotype differing from that of the recipient; tissue graft from a donor of one genotype to a host of another genotype with host and donor being members of the same species. [NIH] Alpha-fetoprotein: AFP. A protein normally produced by a developing fetus. AFP levels are usually undetectable in the blood of healthy nonpregnant adults. An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation

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of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Antibiotics: Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] 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] 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] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the

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biological or pharmacological potency of a drug. [EU] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] 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] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blasts: Immature blood cells. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH]

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

Broad Ligament: A broad fold of peritoneum that extends from the side of the uterus to the wall of the pelvis. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] 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] Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] 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] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH]

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Checkup: A general physical examination. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Choriocarcinoma: A malignant tumor of trophoblastic epithelium characterized by secretion of large amounts of chorionic gonadotropin. It usually originates from chorionic products of conception (i.e., hydatidiform mole, normal pregnancy, or following abortion), but can originate in a teratoma of the testis, mediastinum, or pineal gland. [NIH] Chorion: The outermost extraembryonic membrane. [NIH] Chorionic Villi: The threadlike, vascular projections of the chorion which enter into the formation of the placenta. [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 Disease: Disease or ailment of long duration. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomiphene: A stilbene derivative that functions both as a partial estrogen agonist and complete estrogen antagonist depending on the target tissue. It antagonizes the estrogen receptor thereby initiating or augmenting ovulation in anovulatory women. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques

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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] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] 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] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Curette: A spoon-shaped instrument with a sharp edge. [NIH] 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] Cyst: A sac or capsule filled with fluid. [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] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Dactinomycin: An anticancer drug that belongs to the family of drugs called antitumor antibiotics. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU]

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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] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilation and curettage: D&C. A minor operation in which the cervix is expanded enough (dilation) to permit the cervical canal and uterine lining to be scraped with a spoon-shaped instrument called a curette (curettage). [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid

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and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epithelial: Refers to the cells that line the internal and external 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] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [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] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Evacuation: An emptying, as of the bowels. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetal Blood: Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the placenta. The cord blood is blood contained in the umbilical vessels at the time of delivery. [NIH] Fetoprotein: Transabdominal aspiration of fluid from the amniotic sac with a view to detecting increases of alpha-fetoprotein in maternal blood during pregnancy, as this is an important indicator of open neural tube defects in the fetus. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH]

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Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

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

Genetic Counseling: Advising families of the risks involved pertaining to birth defects, in order that they may make an informed decision on current or future pregnancies. [NIH] Genital: Pertaining to the genitalia. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational Age: Age of the conceptus. In humans, this may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis. [NIH] Gestational trophoblastic disease: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic tumor, gestational trophoblastic neoplasia, molar pregnancy, or choriocarcinoma. [NIH] Gestational trophoblastic neoplasia: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic tumor, molar pregnancy, or choriocarcinoma. [NIH]

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Gestational trophoblastic tumor: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic neoplasia, molar pregnancy, or choriocarcinoma. [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] 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] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] 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] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU]

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Histocompatibility: The degree of antigenic similarity between the tissues of different individuals, which determines the acceptance or rejection of allografts. [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] Hydatidiform Mole: A trophoblastic disease characterized by hydrops of the mesenchymal portion of the villus. Its karyotype is paternal and usually homozygotic. The tumor is indistinguishable from chorioadenoma destruens or invasive mole ( = hydatidiform mole, invasive) except by karyotype. There is no apparent relation by karyotype to choriocarcinoma. Hydatidiform refers to the presence of the hydropic state of some or all of the villi (Greek hydatis, a drop of water). [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] Hyperemesis: Excessive vomiting. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [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] Immunoradiometric Assay: Form of radioimmunoassay in which excess specific labeled antibody is added directly to the test antigen being measured. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] 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]

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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] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Interferons: Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Karyotype: The characteristic chromosome complement of an individual, race, or species as defined by their number, size, shape, etc. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA

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fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leukemia: Cancer of blood-forming tissue. [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] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]

Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [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]

Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of

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radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menarche: The establishment or beginning of the menstrual function. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesoderm: The middle germ layer of the embryo. [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

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body to another. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methyltransferases: A subclass of enzymes of the transferase class that catalyze the transfer of a methyl group from one compound to another. (Dorland, 28th ed) EC 2.1.1. [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] Mifepristone: A progestational and glucocorticoid hormone antagonist. Its inhibition of progesterone induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary Cushing syndrome. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Molar pregnancy: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic neoplasia, gestational trophoblastic tumor, or choriocarcinoma. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness,

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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] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] 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] Neonatal: Pertaining to the first four weeks after birth. [EU] 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] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Nonmetastatic: Cancer that has not spread from the primary (original) site to other sites in the body. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] 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] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and

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secrete some of the female sex hormones. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovulation Induction: Techniques for the artifical induction of ovulation. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Ovum Implantation: Endometrial implantation of the blastocyst. [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] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pineal gland: A tiny organ located in the cerebrum that produces melatonin. Also called pineal body or pineal organ. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Placental tissue: The tissue intervening between fetal blood and maternal blood in the placenta; it acts as a selective membrane regulating the passage of substances from the maternal to the fetal blood. [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

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regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] 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] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Pregnancy Tests: Tests to determine whether or not an individual is pregnant. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Primary tumor: The original tumor. [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] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or

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severity. [EU] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostaglandins F: (9 alpha,11 alpha,13E,15S)-9,11,15-Trihydroxyprost-13-en-1-oic acid (PGF(1 alpha)); (5Z,9 alpha,11,alpha,13E,15S)-9,11,15-trihydroxyprosta-5,13-dien-1-oic acid (PGF(2 alpha)); (5Z,9 alpha,11 alpha,13E,15S,17Z)-9,11,15-trihydroxyprosta-5,13,17-trien-1oic acid (PGF(3 alpha)). A family of prostaglandins that includes three of the six naturally occurring prostaglandins. All naturally occurring PGF have an alpha configuration at the 9carbon position. They stimulate uterine and bronchial smooth muscle and are often used as oxytocics. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not

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working properly. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pupil: The aperture in the iris through which light passes. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Reassurance: A procedure in psychotherapy that seeks to give the client confidence in a favorable outcome. It makes use of suggestion, of the prestige of the therapist. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxin: Hormone produced by the ovaries during pregnancy that loosens ligaments that hold the hip bones together. [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] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Reproductive History: An important aggregate factor in epidemiological studies of women's health. The concept usually includes the number and timing of pregnancies and their outcomes, the incidence of breast feeding, and may include age of menarche and menopause, regularity of menstruation, fertility, gynecological or obstetric problems, or contraceptive usage. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH]

Dictionary 91

Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] 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] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [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 Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such

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alterations. [NIH] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Sperm: The fecundating fluid of the male. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Stillbirth: The birth of a dead fetus or baby. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] 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] 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] Symphysis: A secondary cartilaginous joint. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [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] Teratoma: A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex

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characteristics. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] 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] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [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] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transvaginal ultrasound: A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An instrument is inserted into the vagina, and sound waves bounce off organs inside the pelvic area. These sound waves create echoes, which a computer uses to create a picture called a sonogram. Also called TVS. [NIH]

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Triploid: Pertaining to an organism with more than three chromosome sets in its vegetative cells. [NIH] Trophoblast: The outer layer of cells of the blastocyst which works its way into the endometrium during ovum implantation and grows rapidly, later combining with mesoderm. [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 marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urethritis: Inflammation of the urethra. [EU] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Venous: Of or pertaining to the veins. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH]

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Villous: Of a surface, covered with villi. [NIH] Villus: Cell found in the lining of the small intestine. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Zygote: The fertilized ovum. [NIH]

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INDEX A Abdomen, 71, 74, 83, 87, 92 Abdominal, 57, 71, 87 Abdominal Pain, 57, 71 Abortion, 12, 20, 24, 58, 68, 71, 75, 88 Agonist, 71, 75 Albumin, 22, 71, 88 Algorithms, 71, 73 Alkaline, 11, 71 Alkaline Phosphatase, 11, 71 Allografts, 71, 81 Alpha-fetoprotein, 29, 71, 78 Alternative medicine, 42, 71 Amino acid, 71, 72, 87, 89, 93 Amniotic Fluid, 72, 79 Anaesthesia, 72, 82 Anatomical, 72, 75, 81, 91 Anemia, 53, 72 Anions, 71, 72, 91 Antibiotics, 72, 76 Antibodies, 72, 80, 85 Antibody, 4, 72, 80, 81, 82, 84, 85, 90 Antigen, 72, 81, 82, 84, 90 Anti-infective, 72, 82 Antimetabolite, 72, 85 Antineoplastic, 72, 85 Anus, 72, 74, 75, 82 Arachidonic Acid, 72, 89 Arterial, 72, 81, 89, 92 Arteries, 72, 73, 76, 85 Artery, 72, 76, 77 Assay, 4, 8, 21, 72, 81, 90 Ataxia, 52, 53, 73, 93 Atrophy, 52, 73 B Bacteria, 72, 73, 77 Basal Ganglia, 73 Basal Ganglia Diseases, 73 Base, 73, 76, 82 Bilirubin, 71, 73 Biochemical, 17, 72, 73, 79 Biotechnology, 4, 5, 42, 49, 51, 52, 53, 73 Bladder, 7, 73, 89, 93, 94 Blastocyst, 73, 76, 77, 87, 94 Blasts, 32, 73 Blood Glucose, 73, 80 Blood pressure, 58, 67, 73, 81, 85 Blood vessel, 73, 75, 82, 84, 92, 93, 94

Body Fluids, 73, 94 Bowel, 74, 77, 92 Bowel Movement, 74, 77, 92 Branch, 65, 74, 92 Broad Ligament, 74, 78 C Carbohydrate, 4, 74 Carcinogens, 74, 86 Cardiac, 10, 74, 86 Cardiomyopathy, 11, 74 Carrier Proteins, 74, 88, 90 Case report, 7, 8, 9, 10, 11, 17, 18, 20, 23, 26, 27, 29, 74, 75 Case series, 74, 75 Cell, 12, 52, 53, 71, 73, 74, 75, 76, 77, 79, 82, 85, 86, 87, 88, 89, 90, 92, 93, 94, 95 Cell Division, 52, 73, 74, 88 Cell Size, 74, 79 Cerebellar, 73, 74, 90 Cerebral, 73, 74, 76 Cerebral Cortex, 73, 74 Cerebrum, 74, 87, 94 Cervical, 5, 6, 74, 77 Cervix, 56, 71, 74, 77 Checkup, 40, 75 Chemotherapy, 4, 12, 22, 35, 75 Chin, 25, 75, 84 Choriocarcinoma, 4, 7, 20, 21, 27, 29, 35, 75, 79, 80, 81, 85 Chorion, 75 Chorionic Villi, 10, 15, 75 Chromatin, 75, 83 Chromosomal, 56, 75 Chromosome, 30, 75, 82, 83, 94 Chronic, 40, 52, 56, 75, 77, 82, 83, 88 Chronic Disease, 56, 75 Chronic renal, 75, 88 Clinical study, 18, 75 Clinical trial, 3, 35, 36, 49, 75 Clomiphene, 21, 75 Cloning, 73, 75 Cofactor, 75, 89 Colloidal, 71, 75, 91 Colon, 52, 75, 83 Complete remission, 75, 90 Computational Biology, 49, 51, 75 Conception, 6, 7, 71, 75, 76, 78, 79, 80, 85, 88, 92

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Connective Tissue, 76, 79, 83, 84 Contraindications, ii, 76 Convulsions, 76, 77, 88 Coronary, 76, 85 Coronary Thrombosis, 76, 85 Cortisol, 71, 76 Creatinine, 29, 76 Curettage, 69, 76, 77 Curette, 76, 77 Cyclic, 76, 89 Cyst, 21, 76 Cytoplasm, 76, 83 Cytotoxic, 26, 76 Cytotoxic chemotherapy, 26, 76 D Dactinomycin, 35, 76 Decidua, 19, 76, 85, 87 Density, 76, 79, 91 Diabetes Mellitus, 76, 80 Diagnostic procedure, 42, 76 Diastolic, 76, 81 Digestion, 74, 77, 83, 92 Digestive system, 36, 77 Dilatation, 71, 77 Dilation, 57, 77 Dilation and curettage, 57, 77 Direct, iii, 77, 90 Dizziness, 57, 77 Duodenum, 77, 92 Dysplasia, 53, 77 Dystrophy, 52, 77 E Eclampsia, 10, 77, 88 Ectopic, 5, 6, 12, 14, 15, 19, 39, 56, 77 Ectopic Pregnancy, 12, 40, 56, 77 Edema, 77, 88 Ejaculation, 16, 77, 91 Elective, 20, 77 Emboli, 10, 22, 77 Embolization, 10, 22, 77 Embryo, 57, 71, 73, 77, 82, 84, 88, 92 Embryo Transfer, 77, 88 Endogenous, 77, 85 Endometrium, 76, 77, 85, 94 End-stage renal, 75, 77, 88 Environmental Exposure, 78, 86 Environmental Health, 48, 50, 78 Enzymatic, 72, 78 Enzyme, 71, 78, 88, 90 Epidemiological, 78, 90 Epithelial, 76, 78 Epithelium, 75, 78

Erythrocytes, 72, 78 Esophagus, 77, 78, 92 Essential Tremor, 52, 78 Estrogen, 75, 78, 89 Estrogen receptor, 75, 78 Evacuation, 7, 13, 32, 78 Excitation, 78, 79 F Fallopian tube, 57, 78, 93 Family Planning, 49, 78 Fat, 72, 77, 78 Fatty acids, 71, 78, 89 Fertilization in Vitro, 78, 88 Fetal Blood, 78, 87 Fetoprotein, 78 Fetus, 9, 10, 17, 18, 21, 29, 56, 71, 78, 87, 88, 92, 94 Fibrin, 78 Fibrinolysis, 8, 78 Fibrosis, 53, 79, 91 Flow Cytometry, 9, 79 Fluorescence, 79 Fluorescent Dyes, 79 Forearm, 73, 79 G Gallbladder, 71, 77, 79 Gastrin, 79, 81 Gastrointestinal, 79, 94 Gastrointestinal tract, 79, 94 Gene, 19, 53, 54, 73, 79, 86 Genetic Counseling, 40, 79 Genital, 56, 79 Germ Cells, 79, 86, 92 Gestation, 20, 56, 79, 87, 92 Gestational, 3, 12, 14, 21, 23, 24, 25, 27, 32, 35, 79, 80, 85 Gestational Age, 21, 79 Gestational trophoblastic disease, 3, 12, 23, 27, 79, 80, 85 Gestational trophoblastic neoplasia, 35, 79, 80, 85 Gestational trophoblastic tumor, 14, 23, 24, 25, 32, 35, 79, 80, 85 Gland, 80, 83, 87, 89, 91, 93 Glucocorticoid, 80, 85 Glucose, 52, 73, 76, 80 Gonadotropin, 12, 13, 17, 21, 22, 23, 24, 27, 75, 80 Governing Board, 80, 88 Grafting, 80, 81 Granulocyte, 80, 82 Growth, 13, 52, 72, 80, 84, 86, 87, 91, 93, 94

Index 99

H Haemorrhage, 71, 80 Haptens, 80, 90 Hemoglobin, 12, 72, 78, 80 Hemoglobinuria, 52, 80 Hemorrhage, 80, 92 Hepatic, 71, 80 Hereditary, 80, 90 Heredity, 79, 80 Histocompatibility, 10, 81 Homologous, 16, 81 Hormonal, 73, 81 Hormone, 13, 21, 25, 57, 76, 79, 81, 82, 85, 88, 89, 90, 92, 93 Hydatidiform Mole, 4, 5, 23, 24, 32, 35, 41, 52, 75, 81 Hydrogen, 73, 74, 81, 85 Hyperemesis, 17, 81 Hypertension, 20, 81, 88 Hyperthyroidism, 16, 17, 81 I Id, 33, 52, 57, 58, 59, 64, 66, 81 Immune system, 81, 83, 95 Immunoassay, 4, 81 Immunodeficiency, 52, 81 Immunogenic, 81, 90 Immunoglobulin, 29, 72, 81, 85 Immunologic, 79, 81 Immunoradiometric Assay, 26, 81 Immunosuppressant, 81, 85 Impairment, 73, 81, 84 Implantation, 15, 76, 81, 87 Incision, 81, 82 Indicative, 81, 94 Induction, 23, 32, 82, 87, 89 Infant Mortality, 40, 82 Infarction, 76, 82, 85 Infection, 80, 81, 82, 83, 92, 95 Infertility, 40, 82 Inflammation, 71, 79, 82, 88, 94 Interferons, 14, 82 Interleukin-2, 32, 82 Intestinal, 82, 84 Intestines, 71, 79, 82 Intracellular, 82, 89 Intramuscular, 26, 82 Invasive, 10, 23, 69, 81, 82, 83 Involuntary, 73, 78, 82, 86 Iodine, 22, 82 Ischemia, 73, 82 K Karyotype, 81, 82

Kb, 48, 82 Kidney Disease, 36, 48, 53, 83 L Lactation, 83, 89 Large Intestine, 77, 82, 83, 90, 91 Leukemia, 52, 83 Library Services, 64, 83 Ligament, 83, 89 Linkages, 80, 83 Liver, 71, 72, 77, 79, 80, 83 Liver cancer, 71, 83 Localization, 14, 15, 83 Luteal Phase, 83, 85 Lutein Cells, 83, 89 Lymph, 74, 83 Lymph node, 74, 83 Lymphocytes, 32, 72, 82, 83, 95 Lymphoid, 72, 83 Lymphoma, 52, 83 M Macrophage, 82, 83 Magnetic Resonance Imaging, 21, 83 Malabsorption, 52, 84 Malignancy, 24, 84 Malignant, 4, 15, 52, 72, 75, 82, 83, 84, 86, 92 Malignant tumor, 75, 84 Malnutrition, 71, 73, 84, 86 Mediator, 82, 84 MEDLINE, 49, 51, 53, 84 Melanocytes, 84 Melanoma, 52, 84 Membrane, 75, 84, 85, 86, 87 Menarche, 84, 90 Menopause, 84, 88, 90 Menstruation, 76, 83, 84, 90 Mental, iv, 3, 37, 48, 50, 54, 74, 75, 84, 90 Mental Disorders, 37, 84 Mercury, 79, 84 Mesenchymal, 81, 84 Mesoderm, 84, 94 Metastasis, 7, 14, 84 Metastatic, 35, 84, 91 Methotrexate, 35, 85 Methyltransferases, 4, 85 MI, 56, 69, 85 Mifepristone, 26, 85 Miscarriage, 39, 56, 85 Molecular, 15, 49, 51, 73, 76, 85, 89 Molecule, 72, 73, 78, 85, 90 Monitor, 76, 85 Monoclonal, 15, 85

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Monoclonal antibodies, 15, 85 Morphological, 77, 84, 85 Morphology, 27, 85 Motion Sickness, 85, 86 Mucosa, 85, 89 Muscle Fibers, 85 Muscular Atrophy, 52, 85 Muscular Dystrophies, 77, 86 Mydriatic, 77, 86 Myocardium, 85, 86 Myotonic Dystrophy, 52, 86 N Nausea, 67, 86 NCI, 1, 35, 36, 47, 86 Need, 39, 40, 60, 75, 86 Neonatal, 82, 86 Neoplasia, 35, 52, 86 Neoplasm, 86, 94 Neoplastic, 12, 83, 86 Nephropathy, 83, 86 Nerve, 73, 75, 84, 86, 91 Neural, 28, 78, 86 Nonmetastatic, 35, 86 Nuclei, 83, 86 Nucleus, 73, 75, 76, 83, 86, 93 O Oncogene, 52, 86 Orgasm, 77, 86 Osmotic, 71, 86, 91 Ovaries, 57, 86, 90, 91, 92 Ovary, 57, 86, 87 Ovulation, 23, 75, 83, 87 Ovulation Induction, 23, 87 Ovum, 76, 79, 87, 88, 89, 94, 95 Ovum Implantation, 87, 94 P Pancreas, 71, 77, 87, 94 Pancreatic, 52, 87 Pancreatic cancer, 52, 87 Paroxysmal, 52, 87 Partial remission, 87, 90 Parturition, 87, 89 Patient Education, 56, 62, 64, 69, 87 Pelvic, 87, 89, 93 Pelvis, 71, 74, 86, 87, 94 Penis, 77, 87 Peptide, 4, 71, 87, 89, 93 Peripheral blood, 14, 87 Phagocytosis, 82, 87 Pharmacologic, 87, 93 Physical Examination, 75, 79, 87 Physiologic, 71, 84, 87, 89, 90

Pineal gland, 75, 87 Placenta, 75, 78, 87, 88 Placental tissue, 14, 87 Plants, 80, 85, 87, 93, 94 Plasma, 16, 21, 26, 71, 72, 80, 88, 91 Plasma protein, 71, 88, 91 Platelets, 9, 88, 93 Pneumonia, 76, 88 Poisoning, 84, 86, 88 Polycystic, 53, 88 Posterior, 73, 87, 88 Postmenopausal, 4, 88 Practice Guidelines, 50, 57, 88 Precancerous, 88 Preeclampsia, 20, 88 Pregnancy Outcome, 12, 24, 25, 88 Pregnancy Tests, 79, 88 Premalignant, 4, 88 Prenatal, 14, 17, 40, 77, 88 Primary tumor, 7, 88 Progesterone, 85, 88, 89 Progressive, 75, 80, 86, 88, 94 Prolactin, 13, 89 Prostaglandin, 22, 26, 89 Prostaglandins A, 89 Prostaglandins F, 85, 89 Prostate, 52, 89, 94 Protein C, 71, 89 Protein S, 53, 73, 89 Proteins, 71, 72, 74, 75, 82, 85, 87, 88, 89, 91, 93 Proteinuria, 68, 88, 89 Psychic, 84, 90, 91 Psychotherapy, 90 Public Policy, 49, 90 Pulmonary, 6, 22, 73, 90 Pulmonary Artery, 73, 90 Pupil, 77, 86, 90 R Radioactive, 22, 81, 85, 90 Radiography, 79, 90 Radioimmunoassay, 22, 27, 81, 90 Reassurance, 39, 90 Receptor, 15, 72, 85, 90 Rectum, 72, 74, 75, 77, 83, 89, 90 Red Nucleus, 73, 90 Reductase, 85, 90 Refer, 1, 77, 83, 90 Relapse, 4, 90 Relaxin, 11, 90 Remission, 4, 90 Reproduction Techniques, 88, 90

Index 101

Reproductive History, 40, 90 Retinoblastoma, 52, 90 Retrograde, 16, 91 Risk factor, 7, 24, 39, 91 S Salivary, 77, 87, 91 Salivary glands, 77, 91 Sclerosis, 52, 91 Screening, 5, 28, 29, 75, 91 Secondary tumor, 84, 91 Secretion, 75, 83, 91 Seizures, 87, 91 Semen, 77, 89, 91 Serologic, 81, 91 Serum, 10, 12, 13, 21, 22, 24, 25, 29, 68, 71, 80, 90, 91 Serum Albumin, 90, 91 Sex Characteristics, 91, 93 Sex Determination, 53, 91 Signs and Symptoms, 90, 91 Skeleton, 89, 91 Small intestine, 77, 81, 82, 91, 94, 95 Sonogram, 91, 93 Sound wave, 91, 93 Spatial disorientation, 77, 92 Specialist, 60, 77, 92 Species, 71, 82, 85, 92 Sperm, 18, 75, 92 Spontaneous Abortion, 88, 92 Sporadic, 90, 92 Sterility, 82, 92 Sterilization, 21, 92 Stillbirth, 39, 88, 92 Stomach, 57, 71, 77, 78, 79, 81, 82, 86, 91, 92 Stool, 75, 83, 92 Stress, 76, 86, 92 Stroke, 37, 48, 92 Subclinical, 10, 82, 91, 92 Symphysis, 75, 89, 92 Synergistic, 89, 92 Systemic, 73, 82, 92 Systolic, 81, 92 T Telangiectasia, 53, 92 Teratoma, 75, 92 Testicular, 4, 92 Testis, 75, 92 Testosterone, 16, 21, 90, 92 Thalamic, 73, 93

Thalamic Diseases, 73, 93 Threshold, 81, 93 Thrombocytes, 88, 93 Thrombosis, 9, 89, 92, 93 Thyroid, 13, 28, 58, 81, 82, 93 Thyroid Gland, 81, 93 Thyroid Hormones, 93 Thyrotropin, 26, 93 Thyroxine, 71, 93 Tissue, 22, 57, 71, 72, 73, 75, 76, 77, 78, 80, 83, 84, 85, 86, 87, 88, 92, 93, 94 Toxaemia, 88, 93 Toxic, iv, 78, 93 Toxicology, 50, 93 Toxins, 72, 82, 85, 93 Trachea, 93 Transfection, 73, 93 Transvaginal ultrasound, 6, 68, 93 Triploid, 14, 28, 29, 94 Trophoblast, 11, 14, 32, 73, 94 Tuberous Sclerosis, 53, 94 Tumor marker, 3, 94 Tumour, 10, 11, 94 U Ultrasonography, 9, 11, 79, 94 Unconscious, 81, 94 Urethra, 87, 89, 94 Urethritis, 57, 58, 94 Urinary, 4, 29, 94 Urine, 73, 76, 80, 89, 94 Uterine Contraction, 71, 94 Uterus, 21, 56, 71, 74, 76, 77, 79, 80, 84, 85, 86, 88, 93, 94 V Vagina, 74, 84, 93, 94 Vaginal, 57, 68, 94 Vascular, 15, 75, 82, 87, 93, 94 Vegetative, 94 Venous, 89, 94 Veterinary Medicine, 49, 94 Villi, 81, 94, 95 Villous, 15, 95 Villus, 81, 95 Viruses, 82, 95 W White blood cell, 72, 80, 83, 95 Windpipe, 93, 95 Womb, 94, 95 Z Zygote, 76, 95

102

Molar Pregnancy

Index 103

104

Molar Pregnancy

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