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

AMNIOTIC FLUID 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., 1960Amniotic Fluid: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00056-3 1. Amniotic Fluid-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 amniotic fluid. 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 AMNIOTIC FLUID ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Amniotic Fluid.............................................................................. 6 E-Journals: PubMed Central ....................................................................................................... 28 The National Library of Medicine: PubMed ................................................................................ 29 CHAPTER 2. NUTRITION AND AMNIOTIC FLUID ............................................................................ 77 Overview...................................................................................................................................... 77 Finding Nutrition Studies on Amniotic Fluid............................................................................. 77 Federal Resources on Nutrition ................................................................................................... 79 Additional Web Resources ........................................................................................................... 80 CHAPTER 3. ALTERNATIVE MEDICINE AND AMNIOTIC FLUID ...................................................... 81 Overview...................................................................................................................................... 81 National Center for Complementary and Alternative Medicine.................................................. 81 Additional Web Resources ........................................................................................................... 87 General References ....................................................................................................................... 87 CHAPTER 4. DISSERTATIONS ON AMNIOTIC FLUID ........................................................................ 89 Overview...................................................................................................................................... 89 Dissertations on Amniotic Fluid.................................................................................................. 89 Keeping Current .......................................................................................................................... 90 CHAPTER 5. PATENTS ON AMNIOTIC FLUID ................................................................................... 91 Overview...................................................................................................................................... 91 Patents on Amniotic Fluid........................................................................................................... 91 Patent Applications on Amniotic Fluid ..................................................................................... 115 Keeping Current ........................................................................................................................ 126 CHAPTER 6. BOOKS ON AMNIOTIC FLUID .................................................................................... 127 Overview.................................................................................................................................... 127 Book Summaries: Federal Agencies............................................................................................ 127 Chapters on Amniotic Fluid....................................................................................................... 128 CHAPTER 7. PERIODICALS AND NEWS ON AMNIOTIC FLUID....................................................... 131 Overview.................................................................................................................................... 131 News Services and Press Releases.............................................................................................. 131 Academic Periodicals covering Amniotic Fluid ......................................................................... 133 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 137 Overview.................................................................................................................................... 137 NIH Guidelines.......................................................................................................................... 137 NIH Databases........................................................................................................................... 139 Other Commercial Databases..................................................................................................... 141 APPENDIX B. PATIENT RESOURCES ............................................................................................... 143 Overview.................................................................................................................................... 143 Patient Guideline Sources.......................................................................................................... 143 Finding Associations.................................................................................................................. 145 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 147 Overview.................................................................................................................................... 147 Preparation................................................................................................................................. 147 Finding a Local Medical Library................................................................................................ 147 Medical Libraries in the U.S. and Canada ................................................................................. 147 ONLINE GLOSSARIES................................................................................................................ 153 Online Dictionary Directories ................................................................................................... 154

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AMNIOTIC FLUID DICTIONARY ........................................................................................... 155 INDEX .............................................................................................................................................. 225

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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 amniotic fluid 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 amniotic fluid, 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 amniotic fluid, 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 amniotic fluid. 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 amniotic fluid, 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 amniotic fluid. 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 AMNIOTIC FLUID Overview In this chapter, we will show you how to locate peer-reviewed references and studies on amniotic fluid.

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

Prenatal and Postnatal Flavor Learning by Human Infants Source: Pediatrics. 107(6): [6 p.]. June 2001. Contact: Available from American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (888) 227-1773. Fax (847) 434-8000. E-mail: [email protected]. Website: www.pediatrics.org. Full text of this article is available at www.pediatrics.org/cgi/content/full/107/6/e88. Summary: Flavors from a woman's diet during pregnancy are transmitted to amniotic fluid and swallowed by the fetus. Consequently, the types of food eaten by women during pregnancy and, hence, the flavor principles of their culture may be experienced by the infants before their first exposure to solid foods. Some of these same flavors will later be experienced by infants in breast milk, a liquid that also comprises flavors that

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directly reflect the foods, spices, and beverages eaten by the mother. This article reports on a study that tested the hypothesis that experience with a flavor in amniotic fluid or breast milk modifies the infants' acceptance and enjoyment of similarly flavored foods at weaning. The results demonstrated that the infants who had exposure to the flavor of carrots in either amniotic fluid or breast milk behaved differently in response to that flavor in a food base than did nonexposed control infants. Specifically, previously exposed infants exhibited fewer negative facial expressions while feeding a carrot flavored cereal compared with the plain cereal, whereas control infants whose mothers drank water (rather than carrot juice) during pregnancy and lactation exhibited no such difference. The authors discuss how these very early flavor experiences may provide the foundation for cultural and ethnic differences in cuisine. 2 figures. 2 tables. 34 references. •

Pregnancy in a Patient with Goodpasture Syndrome and Renal Transplantation Source: American Journal of Perinatology. 13(2): 79-80. February 1996. Contact: Available from Thieme Medical Publishers, Inc. 381 Park Avenue South, New York, NY 10016. (800) 782-3488. Summary: Patients with Goodpasture syndrome have classically had decreased fertility and associated pregnancy wastage. Renal transplantation can increase the likelihood of successful pregnancy. This article presents the case of a patient with Goodpasture syndrome who carried a pregnancy into the third trimester and had a good neonatal outcome. However, she developed superimposed preeclampsia with subsequent graft rejection. Goodpasture syndrome is the clinical triad of pulmonary hemorrhage, glomerulonephritis, and autoantibody to glomerular basement membrane antigen. The patient did relatively well throughout the first two trimesters, except for anemia with decreased hematocrit to 25 percent. Weekly fetal surveillance was initiated at 28 weeks' gestation with reassuring nonstress tests and amniotic fluid volume. At 33 weeks' gestation, the patient developed worsening hypertension and proteinuria. Labor was induced for superimposed preeclampsia. She progressed uneventfully and delivered a 1700g female with Apgar scores of 5 and 8; the baby did well and was discharged to home at 2 weeks of life. The patient's postpartum course was uneventful, and antihypertensive medications were changed to clonidine and nifedipine. The patient had poor compliance with followup and presented 3 months postpartum with worsening hypertension; she reported noncompliance with medications. Her serum creatinine was 7.2 mg per dL, and a repeat renal biopsy demonstrated changes consistent with chronic rejection. An arteriovenous fistula was created and hemodialysis was begun. The authors conclude that renal transplantation has made pregnancy more likely for patients with chronic renal disease. Potential problems include recurrence of disease in the graft, graft rejection, worsening of the underlying disease, and possible fetal risks due to the multitude of medications required for these patients. In the patient reported in this article, poor compliance with followup and medication was probably a more significant contributor to renal failure than was the preeclampsia. 5 references. (AA-M).

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Pregnancy in Renal Transplant Recipients Source: Transplantation Proceedings. 32(8): 2611-2612. December 2000. Contact: Available from Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010. (212) 633-3730. Website: www.elsevier.com.

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Summary: This article briefly reports on the authors' experiences of patients who become pregnant after receiving a renal (kidney) transplant. The authors note that pregnancy usually has no important early effect on renal function in this setting if plasma creatinine is below 1.5 milligrams per deciliter and hypertension (high blood pressure) is well controlled. The authors reviewed the pregnancies that occurred in renal transplant recipients on their hospital unit in Oporto, Portugal. Between 1983 and 1999, 953 renal transplantations were performed; in that same period, 15 pregnancies occurred in 15 renal transplant recipients, two of which were twins. All patients had received cadaveric transplants. The authors compared these 15 patients to a control group of patients who received the paired kidney. The study and control groups were similar in terms of cause for renal failure, immunosuppression, and serum creatinine level at time of pregnancy. One of these pregnancies was still in course with 34 weeks of gestational time (at time of publication), without complications. The other 14 gestations resulted in 12 live children, one perinatal death, and three abortions in the first trimester. Maternal complications were preeclampsia in two cases, nephrotic proteinuria (protein in the urine) in once case, acute pyelonephritis (kidney infection) in one case, and polyhydramnius (excess amniotic fluid) in one case. One child had intrauterine growth retardation, another was small for gestational time, and two had pulmonary (lung) prematurity. Graft failure occurred in three patients during pregnancy. In once case, there was complete recovery after delivery; one patient developed acute rejection and continuous decline in renal function with graft loss; and in the third case, there was progression of chronic transplant nephropathy. There were no statistically significant differences in relation to mortality (13.3 percent in study group versus 33.3 percent in control group) and graft loss (20 percent in study group versus 13.3 percent in control group) between the two groups. The authors conclude that successful pregnancy is possible and well tolerated for most transplant recipients. Preterm delivery and intrauterine growth retardation occurred more frequently in these patients, but there is not a higher risk for malformations. In cases of good graft function and in the absence of hypertension, pregnancy does not adversely affect graft function or survival. 13 references. •

What's Best for Baby?: Researchers Seek Optimal Method of Hearing Screening Source: Advance for Speech-Language Pathologists [and] Audiologists. 7(9): 3, 4. March 3, 1997. Contact: Available from Merion Publications, Inc. 650 Park Avenue, Box 61556, King of Prussia, PA 19406-0956. (800) 355-1088 or (610) 265-7812. Summary: This article explores the methods of screening hearing in infants. The author reports on a recent discovery concerning the impact of external and middle ear conditions on the ability to measure responses. During the first 48 hours of life, newborns run the risk of having amniotic fluid in their middle ears and vernix in their external ear canals (vernix is a white material that covers newborns and sometimes gets into their ear canals). Another big problem to overcome in neonatal testing is noise. For otoacoustic emission (OAE) testing, it is baby noises (breathing, heartbeat, movement, and sucking) that make the testing response harder to detect. Other topics covered include the signal to noise ratio, determining the objectives by which the infant 'passes' the hearing test, separating children at risk for significant hearing loss, reasons why hearing screening can be unsuccessful, follow up testing for infants determined to be at risk for hearing loss, and usage of ABR (automated brainstem response) testing versus OAE. The article concludes with the contact information for the researcher interviewed. (AA-M).

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Therapeutic Approaches in Obstructive Uropathy Source: Seminars in Nephrology. (18)6: 652-658. November 1998. Contact: Available from W.B. Saunders Company. Periodicals Department. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This article presents the authors summary of therapeutic approaches to the most common forms of congenital obstructive uropathy: bladder outlet obstruction and unilateral hydronephrosis due to ureteropelvic junction (UPJ) obstruction. Therapy for obstructive uropathy is largely determined by whether the obstruction involves one or both kidneys, and by the age of the patient. In the infant and child, obstructive uropathy is almost always due to a congenital malformation of the ureter, bladder, or urethra. Ultrasonographic prenatal diagnosis has permitted early detection and even fetal intervention for posterior urethral valves, although this form of treatment is still considered experimental. More important to the affected infant than optimal renal development is the prevention of pulmonary hypoplasia (underdeveloped lungs), which is a consequence of fetal oliguria (inability to form and pass urine) and oligohydramnios (a small amount or absence of amniotic fluid). Congenital UPJ obstruction is generally unilateral (only on one side), and although there is controversy regarding the timing of surgical correction, current evidence favors early pyeloplasty. In the adult, obstructive nephropathy is often acquired, with ureteral obstruction usually a consequence of nephrolithiasis (kidney stones). Removal of the stone can be accomplished surgically or by lithotripsy. Bladder outlet obstruction is usually secondary to prostatic hyperplasia, which may progress slowly, allowing a delay in surgical intervention. Neurogenic bladder may require intermittent catheterization or cholinergic therapy; those with hypertonic bladder may benefit from anticholinergics. Regardless of the patient's age, prompt and accurate diagnosis is essential to planning an optimal strategy for the management of obstructive uropathy. 1 figures. 2 tables. 49 references. (AA-M).

Federally Funded Research on Amniotic Fluid The U.S. Government supports a variety of research studies relating to amniotic fluid. 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 amniotic fluid. 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 amniotic fluid. The following is typical of the type of information found when searching the CRISP database for amniotic fluid: 2

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

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Project Title: ACTH INFUSION INTO RHESUS MONKEY FETUS LEADS TO PREMATURE LABOR & DELIVERY Principal Investigator & Institution: Haluska, George J.; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002 Summary: The activation of the hypothalamic-pituitary-adrenal axis in fetal sheep is the primary initiator of parturition; however, this same mechanism has not been proven to be important in primate parturition. To determine if adrenocorticotropic hormone (ACTH) can induce premature parturition in primates, we infused ACTH (0.1 U in 30 min, every 2 hrs; n=7) beginning on day 135 of pregnancy (term=167 days) until delivery occurred. A control group of animals (n=3) received saline vehicle infusions. All animals were surgically instrumented with fetal and maternal vascular and amniotic fluid catheters, fetal ECG and myometrial EMG electrodes. Uterine activity (UA) and fetal ECG were recorded continuously. The results of ACTH and vehicle infusion are listed in the following table (values are mean + SEM) * = P<0.05 (t-test) ACTH vs Vehicle Begin Infusion (day of preg) Onset Nocturnal UA (days) Days to Delivery Delivery (Day of Pregnancy) ACTH (n=6) 135.3 + 0.6 6.3 + 0.8 15.2 + 1.3 149.7 + 1.3 Vehicle (n=3) 135.7 + 1.8 24.7 + 2.7* 27.6 + 3.2* 163.3 + 1.5* One ACTH-treated animal was delivered by cesarean section at 165 days of pregnancy after prolonged labor and dystocia and was excluded from the data set. Mean (+ SEM) maternal and fetal steroid changes in ACTHtreated animals *=P<0.005 (Rank Sum Test) (n=6) Fetal Cortisol (ng/ml) Fetal DHEASulfate (?g/ml) Fetal Androstene-dione (ng/ml) Fetal Estrone (pg/ml) Maternal Estradiol (pg/ml) Baseline 79 + 11 0.4 +.08 0.8 + 0.2 97 + 27 360 + 45 Labor 276 + 48* 6.6 + 3.1* 7.4 + 1.7* 519 + 170* 877 + 187* We conclude that infusion of ACTH into the fetal circulation activates fetal adrenal steroid biosynthesis causing increased secretion of glucocorticoids and androgens leading to increased estrogen and cortisol production and pre-term delivery in rhesus monkeys. FUNDING NIH HD06159, HD18185 PUBLICATIONS None Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: REGULATION

AMNION

STRUCTURAL

INTEGRITY--ONTOGENY

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Principal Investigator & Institution: Macdonald, Paul C.; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2003 Summary: The long-range goals are to (i) define the ontogeny and regulation of interstitial collagen formation in the amnion, (ii) explore the relationship between the regulation of amnion mesenchymal cell replication and the capacity for interstitial procollagen synthesis/processing in these unique cells, (iii) define selected collagen-related characteristics of the "dependent" portion of the fetal membranes; and (iv) explore the cause of increased risk for pre-term premature rupture of the fetal membranes in pregnancies of women who smoke cigarettes. It has been established that the interstitial collagens of the amnion zona compacta (the principal source of fetal membrane tensile strength) are synthesized exclusively in the widely dispersed mesenchymal cells of this avascular tissue. The greatest apparent capacity for interstitial collagen synthesis in amnion occurs early in pregnancy; beginning as early as 12-14 weeks gestation, the apparent capacity for pro-collagen synthesis/processing in amnion declines abruptly, perhaps in parallel with the decrease in the density of mesenchymal cells in this tissue. Studies are described to ascertain if the decline in the apparent capacity for interstitial

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collagen formation in amnion is related to a decreasing density of amnion mesenchymal or, rather, is the result of a decreased in the capacity for collagen formation in the mesenchymal cells per se. The final step in collagen formation involves the cross-linking of collagen fibrils which establish tensile strength and resistance to degradation by nonspecific proteases. The initial reaction in collagen cross-linking is catalyzed by lysyl oxidase (LOX), a copper (Cu/2+)-dependent enzymes. The specific activity of LOX in amnion also declines strikingly after 12-14 weeks gestation. In approximately 25% of amnions examined during the third trimester, LOX enzyme activity is very low or undetectable, much lower than would be expected from the level of immunoreactive LOS protein in the same tissue. This finding of low LOX activity/per unit LOX protein is suggestive of an amnion mesenchymal cell-specific Cu/2+ deficiency. Studies are described to evaluate the hypothesis that cadmium in amniotic fluid (AF) (from maternal blood in women who smoke) acts upon amnion epithelial cells to induce the formation of metallothioneins (MT), which are metal binding proteins. Increased levels of MT in AF/amnion epithelial cells could sequester Cu?2+ and prevent its transfer to the mesenchymal cells, the site of LOX enzyme synthesis, creating a mesenchymal cellspecific Cu/2+ deficiency in pregnancies of women who, themselves, are not Cu/2+ deficient. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CORE--CYTOGENETICS Principal Investigator & Institution: Olson, Susan B.; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002 Summary: The Cytogenetics Core is of major significance to the success of Projects 1,2, 3 and the Core C Repository. Its expertise draws on 32 years of experience of the Research and Clinical Cytogenetics Laboratories at Oregon Health Sciences University. These laboratories are recognized internationally for the highest standards of academic cytogenetics excellence. Together, they have a staff of 14 technologists and research associates studying approximately 2,500 blood, bone marrow, solid tumor, amniotic fluid, chorionic villus and other solid tissue samples annually. Through their early efforts of test development, and more recently as the Cytogenetics Core for the current program project grant, these combined laboratories have become a national resource for Fanconi anemia testing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CORE--HUMAN TISSUE AND BIOLOGICAL FLUIDS LABORATORY Principal Investigator & Institution: Casey, M Linette.; Associate Professor; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2003 Summary: SUBPROJECT ABSTRACT NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEVELOPMENT PSYCHOPHARMACOLOGY Principal Investigator & Institution: Newport, Donald J.; Assistant Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002; Project Start 01-JUL-2001; Project End 30-JUN-2006

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Summary: (Provided by applicant): Recent studies of perinatal psychiatric treatment have focused almost exclusively upon antidepressants. However, the introduction of anticonvulsants and atypical antipsychotics, which do not impede ovulation, has provided new treatment alternatives for women with bipolar disorder, schizophrenia, and other psychiatric illnesses. The presentation of these disorders often occurs during the childbearing years; however, clinical reproductive safety data for these medications (and those in development) is limited and slow to accumulate. As such, there is an urgent need for data defining both obstetrical outcome and functional CNS exposure for these compounds. The current study combines a naturalistic clinical investigation with detailed animal studies to provide novel obstetrical outcome data and a scientific basis for comparing CNS effects of individual medications. The clinical study includes prospective documentation of anticonvulsant and atypical antipsychotic exposures, assessment of placental passage via collection of umbilical cord blood, lactational exposure via collection of breast milk and serum of nursing infants, and prenatal exposure via collection of amniotic fluid in the event of amniocentesis. Pediatric records will be obtained annually to monitor child developmental milestones. Considering the difficulty of quantifying human brain exposure, the clinical study is complemented with an animal study using the rat as a model to study infant CNS exposure. Administering a fixed dose of an atypical antipsychotic or anticonvulsant to both pregnant and newly delivered breast-feeding dams, offspring CNS exposure will be determined by comparing medication levels in maternal brain and blood with concentrations in offspring brain, blood, and other tissues. The functional impact of CNS exposure will be assessed by ex-vivo serotonin and dopamine transporter and receptor analysis. This study moves beyond the exclusive focus of previous studies upon antidepressants to include atypical antipsychotics and anticonvulsants, and provides the first glimpse into infant CNS exposure. Such information will be relevant to clinical decision-making as psychiatrists endeavor to treat severe peripartum illness while minimizing infant exposure. These study procedures will furthermore be applicable to future research investigating other classes of psychotropic medications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENTAL EXPRESSION OF G-CSF IN THE PLACENTA Principal Investigator & Institution: Calhoun, Darlene A.; Pediatrics; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2002; Project Start 15-DEC-1997; Project End 30-NOV-2002 Summary: (Adapted from applicant's description): The proposal consists of six Specific Aims and the experiments that will achieve these aims. The aims are: 1. To determine the location(s) of G-CSF-R in the human placenta, at various stages of development, 2. To determine the function(s) of G-CSF in the human placenta, 3. To determine the location(s) of G-CSF production in the human placenta, at various stages development, 4. To determine the effect(s) of human intra-amniotic infection on placental production of G-CSF-R and G-CSF, 5. To quantify transplacental passage of G-CSF during term and preterm pregnancy in rats, and 6. To quantify transplacental passage of G-CSF during term and preterm normal and infected human gestations. The results will help clarify the location and function of placental G-CSF and G-CSF-R during human development, in health and during intra-amniotic infection, and the basic mechanistic events central to the pathogenesis of preterm labor and early-onset neonatal bacterial infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Amniotic Fluid

Project Title: DIAGNOSTIC PROTEOMIC PROFILES FOR ANEUPLOIDY Principal Investigator & Institution: Reddy, Ashok; Proteogenix, Inc. 614 Sw 11Th Ave, Ste 400 Portland, or 97205 Timing: Fiscal Year 2004; Project Start 01-MAR-2004; Project End 31-AUG-2004 Summary: (provided by applicant): We propose to develop new, efficient and reliable non-invasive methods for the diagnosis of chromosomal aneuplodies. At present, the definitive diagnosis of chromosomal aneuploidies follows a two-step process: maternal screening and, if the results are positive, maternal amniocentesis with fetal karotyping. There are significant limitations to both first- and second-semester screening tests. It is clear that the detection rate for both screening methods gives a false impression of the overall accuracy of current screening tests, with the sensitivity and specificity of the tests resulting in too many false-positive results, thus exposing many pregnancies to an unnecessary 0.5%-1.0% risk of miscarriage. Furthermore, chromosomal analysis of amniotic fluid cells is a labor-intensive and time-consuming procedure, taking up to two weeks. More reliable tests are, therefore, necessary to improve the detection of chromosomal aneuploidies using maternal serum in order to reduce the unacceptably high false-positive rate of maternal screening and to increase the speed and efficiency of diagnosis from amniotic fluid following amniocentesis. We hypothesize that there are proteomic profiles present in the amniotic fluid or serum of mothers carrying fetuses with aneuploidies that can be utilized to develop a sensitive and specific diagnostic test that can replace the current generation of analytical choices. In this phase I application, we propose to identify, analyze, and validate proteomic profiles that consistently and reliably predict the presence of aneuploidy. We will employ a multi-pronged approach that involves surface-enhanced laser desorption-ionization/time-of-flight (SELDI-TOF), 2-dimensional gel electrophoresis, and isotope-coded affinity tagging (ICAT) techniques to identify proteins and peptides that are differentially expressed in amniotic fluid and/or maternal serum. Candidate biomarkers will be unambiguously identified by tandem mass spectrometry. The data obtained in this initial phase will provide the foundation for the development of a sensitive and specific high-throughput mass spectrometry-based diagnostic test. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECT DEVELOPMENT

OF

CHRONIC

INFECTION

ON

PLACENTAL

Principal Investigator & Institution: Boggess, Kim A.; Obstetrics and Gynecology; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 13-MAR-2003; Project End 28-FEB-2006 Summary: (provided by applicant): Periodontal disease is a chronic, polymicrobial oral infection that affects up to 50% of pregnant women. This oral infection has recently been associated with adverse pregnancy outcome. Pregnant women with active chronicoral infection have a three to five-fold increased risk for spontaneous miscarriage, preeclampsia, and small-for-gestational age infants. The mechanisms by which chronic maternal oral infection disrupts normal pregnancy is unknown, although there are animal and human data to demonstrate systemic dissemination of oral pathogens to the maternal and fetal circulation, and to the placenta. Maintenance of normal pregnancy is predicated by normal placentation and placental development. This application seeks to study the mechanisms that chronic maternal oral infection could affect pregnancy outcome. The purpose of this investigation is to develop a rabbit model to study the

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effects of chronic maternal infection with oral pathogens on fetal growth and placental development. The hypothesis of this application is that chronic maternal infection with oral pathogens results in translocation of these pathogens to the utero-placental unit, altering maternal-placental interaction at the time of implantation, thus impairing fetal growth. Redundancy exists at the maternal-fetal interface that protects against maternal complement activation and inflammation, which allows normal embryo attachment and placental invasion. Chronic maternal infection with oral pathogens may alter the balance necessary to allow normal placental development to occur. In Specific Aim 1, a model of chronic maternal infection with oral pathogens, distant from the uterus, will be developed in the rabbit and used to measure the effect on fetal growth. In Specific Aim 2, maternal and fetal protective factors that allow normal implantation will be characterized in the rabbit, and placental inflammation and maternal immune tolerance will be compared between rabbits chronically infected with oral pathogens and those uninfected. The presence or absence of biomarkers of inflammation and immune tolerance within the placenta will be correlated with recovery or oral pathogens from the placenta and newborn weight. Understanding of these mechanisms may assist in the development of interventions to protect the fetus and placenta from damage as a result of chronic maternal infection with oral pathogens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF CLOLSTRUM ON GUT MATURATION AND HOST DEFENSE Principal Investigator & Institution: Walker, W Allan.; Director; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 01-MAY-1979; Project End 31-DEC-2006 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ETIOLOGY, HORMONAL CRITERIA OF 3 BETA HSD DEFICIENCY Principal Investigator & Institution: Pang, Songya; Professor; Pediatrics; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 01-JUN-1998; Project End 30-NOV-2004 Summary: (adapted from the applicants abstract) The clinical spectrum of 3bhydroxysteroid dehydrogenase (3b-HSD) deficiency (def) congenital adrenal hyperplasia (CAH) ranges from the severe form manifesting ambiguous genitalia, saltwasting, and hypogonadism to the less severe form manifesting premature pubarche (PP), pubertal onset hirsutism and menstrual disorder. Three hypotheses are advanced in this proposal: 1) Hormonal diagnosis (Dx) for the mild late-onset variant of 3b-HSD def, mild or severe, may reveal hormonal criteria which differ from the past published criteria for diagnosing the late-onset disorder; 2) Study of adrenal (Ad) 3b-HSD activity in carriers for 3b-HSD def may support or exclude the existence of an Ad 3b-HSD isoenzyme; and 3) The hormonal features of mildly decreased Ad 3b-HSD activity, leading to late-onset disorder in the past, may be associated with the insulin resistance of polycystic ovary syndrome (PCOS). We propose 5 specific aims: 1) the hormonal criteria via genotypic proof for mild to severe 3b-HSD def by a) analysis of the type II 3b-HSD gene encoding Ad and gonadal 3b-HSD in patients with various clinical/hormonal spectra of decreased Ad 3b-HSD activity; b) characterizing the mutant gene function in vitro, and c) correlating the genotype to hormonal/clinical phenotype of mild and severe variants of 3b-HSD def; 2) Ad 3b-HSD activity in the

12

Amniotic Fluid

carriers of 3b-HSD def by a) identifying hormonal profiles in family members of patients with the 3b-HSD gene mutations b) comparing Ad hormonal profiles in carriers to the genotype; 3) prenatal diagnosis of 3b-HSD CAH in fetuses at risk by a) type II 3b-HSD gene analysis from amniotic and the proband's cells, b) hormonal analysis of amniotic fluid, c) fetal outcome verification; 4) association between the hormonal marker of mildly decreased Ad 3b-HSD activity and the insulin resistance of PCOS by examining A0 insulin sensitivity (SI) in the patients and control subjects, b) comparing SI to the Ad/ovarian components of androgen secretion; 5) long term outcome by periodic examinations of growth, maturation of H-P-O axis sensitivity and Ad 3b-HSD activity hormonally in girls with PP and the hormonal marker of mildly decreased Ad 3b-HSD activity. The proposed study will help to define the hormonal criteria essential to accurately diagnose patients with variants of 3b-HSD def CAH, examine the potential existence of an Ad 3b-HSD isoenzyme, verify accuracy of prenatal Dx of 3b-HSD def, and determine whether the hormonal features of mildly decreased Ad 3b-HSD activity are associated with insulin resistance and are a marker of PCOS from childhood to adulthood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EXPERIMENTAL MODEL PREMATURITY

FOR CHORIOAMNIONITIS

AND

Principal Investigator & Institution: Gravett, Michael G.; Chief; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-SEP-1997; Project End 31-MAY-2006 Summary: Prematurity is the leading cause of neonatal morbidity and mortality in the United States. Intrauterine infections are an important, and potentially treatable cause of prematurity, and are associated with increased risk of neonatal white matter lesions of the brain and cerebral palsy. However, the mechanisms by which infection leads to prematurity and/or cerebral palsy remain speculative and treatment strategies untested largely because humans cannot be longitudinally studied following infection. We propose to use chronically instrumented pregnant rhesus monkeys at 120-130 day gestation with experimental intrauterine infection, as previously described (Gravett et al, Am J Obstet and Gynecol; 171:1660-1667,1994) to study the temporal and quantitative relationships among infection, cytokines, prostaglandins, steroid hormones, cytokine antagonists, preterm labor, and neonatal white matter lesions of the brain in order to develop effective interventional strategies. After postoperative stabilization in a tether, we will; (1) inoculate Group B Streptococci (GBS) into the amniotic fluid to establish intrauterine infection and preterm labor. Uterine contractility will be continuously monitored and periodic samples of amniotic fluid and maternal and fetal blood (1-4 cc) will be obtained for assays of eicosanoids, steroid hormones, cytokines, matrix metalloproteinases and for microbial studies; (2) utilize antibiotics with and without potent inhibitors of proinflammatory cytokine production (dexamethasone,IL-10) o prostaglandin production (indomethacin) to ascertain the most effective intervention to down-regulate the cytokine/prostaglandin cascade and associated uterine activity; (3) infuse proinflammatory cytokine IL-1beta into the amniotic cavity through indwelling catheters in the absence of infection. Prior to infusion of IL-1beta in the absence of infection, specific novel proinflammatory cytokine inhibitors (IL-1ra and sTNF-R1 PEG) will be used to identify other potentially useful immunomodulators. Samples of the decidua, fetal membranes, tissues, and brain will be obtained at cesarean section for microbiologic, histopathologic studies, immunohistochemistry for cytokines, localization and quantitation of mRNA for cytokines and PGHS-2. Fetal brain will be

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examined for increased apoptosis associated with white matter lesions. Leukocytes in amniotic fluid and tracheal aspirates will be assessed by flow cytometry Postpartum, the mother will be treated with appropriate antibiotics to eradicate the GBS from the genital tract and returned to the colony. These studies will clarify the pathophysiology of infection-associated preterm labor and will suggest effective interventional strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FEASIBILITY OF PRENATAL SCREENING FOR SLO SYNDROME Principal Investigator & Institution: Haddow, James E.; Vice President and Medical Director; Foundation for Blood Research Box 190, 69 Rte 1 Scarborough, Me 04070 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: This study aims to evaluate the efficacy of routinely identifying Smith-LemliOpitz Syndrome (SLOS) prenatally. This serious inherited metabolic disorder (birth prevalence 1:20,000) is characterized by moderate to severe mental retardation and congenital anomalies. Two circumstances now make it possible to carry out the proposed intervention trial. First, the cause of SLOS is now known to be a defect in the conversion of 7-dehydrocholesterol to cholesterol. This discovery makes it possible to confirm the diagnosis biochemically by measuring cholesterol precursors in the serum of affected individuals and in amniotic fluid. Secondly, the array of maternal serum analytes currently measured routinely to screen for Down syndrome in 2,000,000 U.S. pregnancies annually includes unconjugated estriol (uE3). This analyte requires cholesterol as a precursor, and its concentration in maternal serum is lower when the fetus has SLOS. The major barrier to identifying SLOS prenatally is the absence of sound screening methodology that takes into account the detection rate, the false positive rate, and the prevalence. The investigators have developed a model, based on actual data from SLOS pregnancies, and propose to test it in 1,000,000 pregnancies in which maternal serum uE3 (and other) measurements are currently being done routinely. The screening false positive rate is projected to be 0.2 percent, the detection rate 57 percent, and the odds of being affected given a positive result 1:70. These rates all compare favorably with routine prenatal screening tests. Diagnostic testing in amniotic fluid is highly reliable and will correctly identify the affected and unaffected pregnancies. In the proposed trial, the investigators will introduce this SLOS model into several major U.S. prenatal screening centers, and develop informational materials for both physicians and patients. Diagnostic testing will be provided by participating expert laboratories. It will also be possible, for the first time, to determine whether SLOS diagnostic studies can be carried out in maternal urine, rather than amniotic fluid, thereby avoiding invasive procedures. The study will also aid in refining prevalence estimates by race and ethnicity, and will determine whether several rare disorders in the cholesterol biosynthetic pathway would be detectable. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: FETAL MEMBRANE CELL INTERACTIONS, ANATOMICAL RELATIONSHIPS, AND FUNCTIONS Principal Investigator & Institution: Head, Judith R.; Professor; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2003 Summary: The long-range goal is to define morphological, structural, and functional interactions among cells of the fetal membranes that contribute to the maintenance of the physical integrity of this tissue. Selected studies of this project are coordinated with

14

Amniotic Fluid

those designed to define the ontogeny of interstitial pro-collagen synthesis/processing in amnion. An alternative approach to most previous studies is proposed; viz, an investigation of the region of the fetal membranes most prone to rupture, i.e., the membranes immediately over the internal cervical os ("dependent" membranes) prior to membrane rupture. Focusing on the amnion, the cellular and structural changes that may be involved in spontaneous rupture during labor and those that may create greater vulnerability for premature rupture (PT-PROM) will be defined. The amnion is an important physical/physiological barrier. but in some pregnancies during labor, leukocytes migrate into and sometimes through the fetal membranes to accumulate in the amniotic fluid (AF). Yet, surprisingly little is known about this process, including the origin of the cells, and the route and mechanisms of transmigration. We propose 3 specific aims. The goal of Aim 1 is to define, by anatomical and morphological analyses, the changes in cells, cellular relationships, and collagen structure in the amnion of the dependent membranes during gestation by immunohistochemistry, electron microscopy, and confocal laser scanning microscopy applied to both conventional sections and whole tissue examined en face. The goal of Aim 2 is to conduct similar analyses of changes related to labor, and in pregnancies in which there is increased risk of premature rupture, viz., maternal smoking. The goal of Aim 3 is to define the origin of leukocytes with the fetal membranes and AF, the capacity of these cells to produce inflammatory cytokines, and the role of the amnion in providing the chemotactic signals that promote leukocyte migration. Leukocytes in AF and tissues from pregnancies with male fetuses will be analyzed for the Y chromosome by in situ hybridization. Chemotaxis assays will be conducted to define the capacity of amnion tissue and isolated cells to produce chemokines in response to relevant stimuli (IL-1, LPS, phagocytosis, cadmium, and hypoxia) and the ability of leukocytes to transmigrate amnion tissue under various conditions. The findings of these studies should provide important new information to clarify selected aspects of amnion function for which there are significant clinical implications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FETO-MATERNAL APPLICATIONS

DNA/RNA

TRAFFICKING:BIOLOGY

&

Principal Investigator & Institution: Bianchi, Diana W.; Professor & Chief; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2004; Project Start 01-DEC-2003; Project End 30-NOV-2008 Summary: (provided by applicant): The overall goal of the proposed project is to understand the biology of feto-maternal cell-free DNA and RNA trafficking, and to use the knowledge gained to develop novel prenatal diagnostic applications. The overall hypothesis to be tested is that cell-free fetal DNA and mRNA in the maternal circulation and amniotic fluid originates from specific fetal tissue sources and contains unique fetal gene sequences that can be used for prenatal diagnosis of genetic and developmental disorders. Evidence thus far indicates that significant amounts of cell-free DNA, and to a lesser degree, RNA, circulate within the serum and plasma of pregnant women. These nucleic acids have a short half-life and are cleared within hours of delivery of the fetus or newborn. There is also a significant amount of cell-free fetal DNA and RNA present in the amniotic fluid. Currently, little is known about the tissue of origin of these nucleic acid sequences and how they are produced. Specific aim 1 of the project is to use cell-free fetal DNA in maternal plasma, archived serum samples, and amniotic fluid supernatants as sources of clinical material to develop new clinical tests that could improve existing noninvasive assays to determine the risk of fetal aneuploidy or single

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gene disorders such as congenital adrenal hyperplasia (CAH). To date clinical applications have focused on detection and quantitation of uniquely fetal sequences as an indication of pregnancy complications. A major limitation has been that many of these analyses have been limited to male fetuses, which carry a Y chromosome. Thus, specific aim 2 is to use uniquely fetal mRNA gene sequences for the identification and quantitation of fetal nucleic acids in maternal plasma, independent of fetal gender. We will examine if increased or decreased gene expression, as measured by circulating mRNA sequences in maternal blood, can be used to noninvasively detect fetal aneuploidy or other complications of pregnancy. In aim 3 we will determine the tissue of origin of the circulating nucleic acids by amplifying specific genes of hematopoietic, placental, and fetal origin. We will also use cell-free mRNA present in amniotic fluid to examine gene expression via microarrays. We will examine differences between fetuses due to gestational age and different pathologies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FUSOBACTERIUM NUCLEATUM IN AMNIOTIC FLUID INFECTION Principal Investigator & Institution: Han, Yiping W.; Periodontics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2004 Summary: (provided by applicant): Preterm birth (PTB) is the number one cause of infant mortality and morbidity. Amniotic fluid (AF) infections are prevalent in PTB. One hypothesis to explain this is that the organisms originate from the vagina and ascend into the uterus. However, some organisms from AF appear to be of oral origin. One of the most frequently isolated species from AF, Fusobacterium nucleatum, is highly prevalent in periododontal plaques and infections. F. nucleatum is capable of invading human gingival epithelial and umbilical cord vein endothelial cells. Preliminary studies revealed that haematogenous infection of. F nucleatum induced pregnancy complications in mice. Therefore, it is reasonable to speculate that the hematogenous route of transmission may also occur in humans. To test this possibility, we aim to investigate the source of the F. nucleatum infection in AF. AF samples will be collected via amniocentesis from 400 patients in preterm labor with intact fetal membranes at a gestational age of < 32 weeks. Vaginal, blood, and subgingival plaque samples from these patients will also be collected. AF infections by all bacteria and by F. nucleatum, along with the control urogenital species, Ureaplasma urealyticum, will be examined by polymerase chain reactions (PCR) using primers specific for the conserved and hypervariable regions of 16S ribosomal RNA, respectively. Once F.nucleatum is identified in AF, the vaginal, blood, and plaque samples of the same patient will be examined by PCR. in addition, since F. nucleatum is highly heterogeneous, in order to clearly identify the source of infection, F. nucleatum will be isolated and identified to the subspecies level and differentiated by DNA fingerprinting. The results from this pilot study will enable subsequent investigation into the mechanism of infection, identifying virulent strains of AF-associated F. nucleatum for diagnostic purposes, and intervention studies aimed at reducing the incidence of preterm birth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENOMICS OF HUMAN FETAL MORPHOGENESIS Principal Investigator & Institution: Manson, Jeanne M.; Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 191044399 Timing: Fiscal Year 2002; Project Start 17-SEP-2002; Project End 30-JUN-2005

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Amniotic Fluid

Summary: (provided by applicant): Recent technological advances in genomics, including the sequencing of the genome in humans and several laboratory model species, provide valuable information on similarities in the number and organization of genes among species. An important finding is that many developmental components and processes involved in organization of the body plan are shared across phyla. In particular, the homeobox (HOX) genes are important in developmental patterning, and are involved in establishing cell identities along the anterior-posterior axis of all higher metazoans. Because HOX genes are conserved across phyla and have been well described in the fruitfly, roundworm, zebra fish and the mouse, it is possible to identify related human sequences. Sequence variations in human fetal HOX genes have yet to be systematically evaluated for their relationship to human fetal survival and developmental defects. The goals of the proposed research are to establish a bank of human fetal tissues and to evaluate selected HOX genes known to control morphogenesis in laboratory models. Chorionic villus samples can be collected as early as 10 to 12 weeks and amniotic fluid samples at 16 to 20 weeks of human pregnancy. When collected in a clinical setting, these samples can be linked to pregnancy outcome through ultrasound findings and results of routine obstetrical care. A data base can be developed to catalog the spectrum and allelic frequencies of polymorphisms in HOX genes during normal development, and to determine whether sequence variations are associated with fetal lethality and/or dysmorphogenesis. Accomplishment of these goals will require the interaction of molecular epidemiologists, obstetricians, developmental toxicologists, molecular biologists and statisticians. The investigators for this proposal collectively represent these areas of expertise and have a history of working together in molecular epidemiology research and graduate teaching focused on the study of developmental defects. Interdisciplinary collaborations will be enhanced by participation of investigators in a seminar series on Molecular, Epidemiology of Developmental Defects. In addition, investigators will collaborate in establishing a tissue bank of human fetal tissues and in conducting a pilot project on the relationship between sequence variations in human HOX genes and developmental defects. The primary goal of this proposal is to provide a framework for interdisciplinary collaboration of investigators to foster research in the area of gene-environment interactions in the etiology of human developmental defects. The specific aims are to: (1) establish an interdisciplinary team of investigators with expertise in the areas of molecular epidemiology, obstetrics, developmental toxicology, environmental health sciences, molecular biology and biostatistics; (2) establish a bank of human fetal tissues consisting of chorionic villus samples and amniocytes and to develop a database to link these samples to clinical information on pregnancy outcome; (3)identify allelic frequencies of polymorphisms in selected HOX genes from human fetal DNA collected at different times in gestation from pregnancies with clinically normal outcomes; and (4) evaluate whether specific polymorphisms in these genes are associated with fetal lethality and/or dysmorphogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HOMEOSTATIC CONTROL OF AMNIOTIC FLUID VOLUME Principal Investigator & Institution: Davis, Lowell E.; Professor; Physiology and Pharmacology; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 01-JUN-2000; Project End 31-MAY-2005 Summary: (Adapted from the Investigator's Abstract) Experiments will be performed on fetal sheep of known gestational ages. Indwelling fetal catheters, flow sensors and amniotic and allantoic fluid catheters will be placed during sterile surgeries under

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17

general anesthesia. Hypotheses to be tested include: (l) Urine production, although variable, detracts from, rather than contributes to the control of amniotic fluid volume. (2) Neither lung fluid production, nor drinking of amniotic fluid are necessary for an adequate homeostatic response to abnormal production of amniotic fluid. (3) Fetal swallowing may contribute to amniotic fluid volume regulation even if not necessary in sheep. (4) Reabsorption of amniotic fluid is largely insensitive to electrolyte load. (5) Neither the crystalloid osmotic gradient nor the oncotic gradient between amniotic fluid and fetal plasma are involved in volume regulation. (6) The quantity that is being regulated is amniotic fluid volume, rather than intrauterine volume. (7) The absorptive mechanism permits passage of large quantities of macromolecules, such as plasma albumin, even in the absence of drinking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HYPOXIA EFFECTS ON AMNIOTIC FLUID VOLUME Principal Investigator & Institution: Brace, Robert A.; Professor; Reproductive Medicine; University of California San Diego La Jolla, Ca 920930934 Timing: Fiscal Year 2002; Project Start 01-JUL-1998; Project End 30-APR-2004 Summary: Normal amounts of amniotic fluid must be present in order for the fetus to grow and develop normally. Oligohydramnios (too little amniotic fluid) occurs in approximately 5 percent of human pregnancies and is responsible for many emergency cesarean sections, in utero fetal deaths due to cord compression, and neonatal deaths due to respiratory distress. Although it is widely assumed that fetal hypoxia causes oligohydramnios, the effects of hypoxia on amniotic fluid volume have not been studied experimentally. Indirect evidence suggests that fetal hypoxia may actually cause polyhydramnios (too much amniotic fluid) rather than oligohydramnios. The proposed studies will determine the effects of hypoxia on amniotic fluid volume in fetal sheep and explore the mechanisms of these effects. The overall hypothesis is that fetal hypoxia produces polyhydramnios and that fetal hypoxia in combination with placental insufficiency causes oligohydramnios. In Specific Aim number 1, fetal hypoxia will be produced by progressive fetal anemia (anemic hypoxia). The hypothesis is that there will be a threshold at which a large increase in amniotic fluid volume occurs and this is dependent upon elevated fetal plasma lactate and arginine vasopressin levels. In Specific Aim number 2, the fetus will be made hypoxic by reducing the inspired oxygen content of the mother (hypoxic hypoxia). The hypothesis is that polyhydramnios will develop and the associated mechanisms are the same as occur during anemic hypoxia. In Specific Aim number 3, the fetus will be made hypoxic by repeated microsphere embolizations of the umbilical circulation. The hypothesis is that this combination of fetal hypoxia and placental insufficiency will produce oligohydramnios. For each of these Specific Aims, the associated mechanisms will be studied by monitoring fetal urine production, fetal swallowing, lung liquid secretion, and the volume of amniotic fluid absorbed via the intramembranous pathway. Specific changes in each of these four flows are hypothesized for each method of creating fetal hypoxia. We expect the changes in amniotic fluid volume to be accurately predicted from the four measured flows. Overall, the proposed studies are important because they will dramatically improve our understanding of amniotic fluid volume regulation in the fetus under normoxic and hypoxic conditions. This is relevant clinically because an increased understanding of the mechanisms which regulate amniotic fluid volume should lead to better therapies for maintaining normal amniotic fluid volumes during human pregnancy and this would help reduce fetal and neonatal morbidity and mortality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Amniotic Fluid

Project Title: OFFSPRING

IMPRINT

OSMOREGULATION/MATERNALLY-DEHYDRATED

Principal Investigator & Institution: Desai, Mina; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 905022052 Timing: Fiscal Year 2003; Project Start 15-MAY-2003; Project End 31-MAR-2008 Summary: (provided by candidate): Pregnancy evokes marked physiologic adaptations in the composition and volume of fluid compartments. During human and rat pregnancy, maternal blood volume increases and plasma osmolality decreases. Failure to adequately "reset" maternal plasma osmolality or exposure to maternal plasma hypertonicity, as a result of hyperemesis, exercise or dehydration, results in increased fetal plasma osmolality, which stimulates fetal arginine vasopressin (AVP) secretion, causing reduced amniotic fluid (AF) volume. Conversely, induced maternal plasma hypotonicity reduces fetal plasma osmolality, increases fetal urine flow, reduces fetal swallowing and increases AF volume in sheep and humans. More importantly, chronic in utero plasma tonicity alterations imprint newborn rat and human osmoregulation and renal responses including AVP synthesis and secretion, and possibly blood pressure. The imprinting of osmoregulation may increase the susceptibility of the newborn and/or adult to water/electrolyte imbalance, hypertension and coronary heart disease. It is also possible that the imprinted osmoregulation may have intergenerational effects such that the female offspring may not appropriately reset their plasma osmolality and adequately expand their plasma volume during their subsequent pregnancies. Our preliminary studies of rats indicate that maternal dehydration during pregnancy results in hypernatremia and hypertonicity in the newborn. We hypothesize that maternal dehydration alters basal plasma tonicity in newborn and adult offspring, as a result of: (1) an elevated osmoregulatory set-point of the central osmoreceptor nuclei, and altered cellular volume regulation or (2) reduced basal AVP mRNA and synthesis, and AVP secretion in response to osmotic stimuli, and/or (3) reduced AVPinduced renal antidiuresis. We propose to examine central and peripheral mechanisms for the imprinting of the AVP-osmoregulatory system. We will determine the molecular and cellular mechanism(s) and peripheral renal AVP receptor changes. Finally, we will delineate the critical period during which imprinting of the AVP/osmoregulatory pathway occurs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INDUCTION OF CERVICAL RIPENING W/ INTERLEUKIN 8 IN PREGNANT RHESUS MONKEYS Principal Investigator & Institution: Novy, Miles J.; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002 Summary: Interleukin-8 (IL-8) is a cytokine that induces selective neutrophil chemotaxis and activation. Progesterone inhibits and antiprogestins stimulate production of IL-8 by chorion and decidua. Cervical ripening is associated with an influx of inflammatory cells into the cervix but the role of IL-8 in primate parturition remains to be established. To investigate the role of IL-8 in cervical ripening, we administered purified, human fibroblast-derived IL-8 intravaginally in 3 pregnant monkeys beginning at 137-9 days of gestation (term = 167 days) at a dose of 150 ng/kg. The cervix was evaluated by a modified Bishop=s Score. IL-8 was administered in vehicle (2.5% HPC with 300 ?l Evans Blue solution) by inserting a 1.0 or 3.0 ml syringe into the vaginal vault. Amniocentesis was performed at intervals to determine changes in amniotic fluid prostaglandins (PGs)

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and cytokines. After a recovery period of 4-5 days, a second dose of IL-8 (300 ng/kg) was administered. Res ults The effect of graded doses of intravaginal IL-8 on Modified Bishop=s Scores (mean ? SEM) is summarized in the table below. Two out of three animals showed an increase in amniotic fluid IL-8 concentrations but there were no changes in amniotic fluid PGE2 or PGF2?. One animal delivered after the second dose of IL-8. Dose 0 hours 24 hours 48 hours 72 hours 150 ng/kg 0.6 ? 0.3 5.6 ? 0.3* 5.0 ? 1.2* 5.3 ? 0.3* 300 ng/kg 2.0 ? 1.0 4.0 ? 3.0 6.5 ? 0.5* *different from time 0 hrs at P<0.05 (ttest). Conclusion Intravaginal application of purified human fibroblast-derived IL-8 induces significant cervical ripening in late pregnant rhesus monkeys. FUNDING NIH HD06159, Toray Industries Inc PUBLICATIONS Haluska GJ, Naruto M, Ida N, Cook MJ, Novy MJ. Induction of cervical ripening with interleukin-8 (IL-8) in pregnant rhesus monkeys. In Society for Gynecological Investigation Program and Abstracts 45th Annual Meeting (held in Atlanta, GA, March 11-14, 1998), p 190A (abstract #T615). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HOMEOSTASIS

MATERNAL

DEHYDRATION--FETAL/AMNIOTIC

FLUID

Principal Investigator & Institution: Ross, Michael G.; Professor and Chair; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 905022052 Timing: Fiscal Year 2002; Project Start 01-APR-1989; Project End 31-MAR-2004 Summary: Amniotic fluid (AF) is an essential accompaniment of normal pregnancy, necessary for fetal movement, growth and development. Oligohydramnios, or reduced AF volume, occurs in 8 to 38 percent of all pregnancies. The majority of oligohydramnios patients have no identifiable medical or antepartum complication and only 7 percent of cases have associated fetal malformations. However, oligohydramnios is often associated with conditions of chronic fetal stress, such as intrauterine growth retardation, preeclampsia and postterm pregnancy. These conditions, together with the direct effect of reduced AF volume, results in significant perinatal morbidity and mortality. Increasing AF volume in laboring patients with oligohydramnios improves fetal outcome, though this generally requires rupture of fetal membranes. However, our studies demonstrate that modulation of AF production (fetal urine flow) and AF resorption (fetal swallowing and intramembranous flow) may be utilized to increase AF volume in patients with intact membranes. We have developed a novel model to increase AF volume utilizing maternal administration of the arginine vasopressin (AVP) antidiuretic agonist [desamino, D-Arg8]-AVP (DDAVP). Our studies in the ovine model indicate that maternal hydration and DDAVP induces maternal and fetal plasma hyponatremia, marked increases in fetal urine flow, reduced fetal swallowing and expansion of AF volume. Our human studies have supported the clinical utility of these interventions. Despite these promising results, critical issues of efficacy and safety of DDAVP therapy for both the mother and fetus must be resolved prior to clinical use. Firstly, in studies of efficacy, we will determine the minimum level of maternal hyponatremia which induces and maintains fetal fluid responses, and examine the effects of alterations in placental osmolality gradients. Long term studies will examine the effects of hyponatremia on ovine AF volume, maternal plasma volume and umbilical and uterine blood flows in both normal and oligohydramnios ovine pregnancies. Secondly, in studies of fetal safety, we will determine if fetal brain edema and/or loss of brain electrolytes are induced by hyponatremia. As AVP has important fetal fluid and cardiovascular regulatory roles, we will determine the effect of hyponatremia on fetal osmotic and non- osmotic stimulated AVP secretion. Finally, as permanent imprinting of AVP synthesis and secretion regulatory systems may occur in

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Amniotic Fluid

response chronic tonicity alterations in newborn rats, we will examine the effects of chronic tonicity alterations on fetal AVP transcription and translation. Physiologic assessments will focus on measurements of fetal fluid exchange and fetal plasma and AF volume and composition. Endocrine and molecular assessments will include determination of fluid regulatory hormones and hypothalamic AVP mRNA and pituitary AVP contents, utilizing our newly developed ovine 130 bp cDNA probe and solution and in situ hybridization techniques. The goal of this project is to determine critical efficacy and fetal safety issues central to maternal DDAVP treatment, prior to widespread clinical use in human pregnancies with oligohydramnios. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF FETAL MEMBRANE RUPTURE Principal Investigator & Institution: Strauss, Jerome F.; Professor; Obstetrics and Gynecology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 30-SEP-1996; Project End 31-AUG-2006 Summary: Premature rupture of the fetal membranes is a major cause of maternal morbidity and premature birth. Studies performed during the past funding period implicate increased expression of matrix metalloproteinases (MMP), particularly collegenases and gelatinases in the normal as well as the preterm rupture of the fetal membranes (PROM). We now propose to test hypotheses regarding mechanisms that induce and amplify expression of MMPs in the fetal membranes; and the role of genetic variation in MMP genes in increasing the risk of preterm premature rupture (PPROM). We will determine whether proteolytic fragments of fibronectin induce MMP expression in human amnion cells in vitro; define the receptor(s) and signal transduction cascade underlying this response; identify active fibronectin proteolytic fragments in cervicovaginal secretions and amniotic fluid and correlate their presence with preterm birth. Our primary hypothesis is that fetal fibronectin is more than a marker of impending parturition and that proteolytic fragments of this protein act as signaling molecules in the fetal membranes, inducing expression of MMPs and thus promoting the degradation of the fetal membrane extracellular matrix. We will explore the association of genetic variation in the MMP-1 (collagenase) and MMP-9 (gelatinase) genes with increased risk of PPROM. We will determine whether specific polymorphisms augment MMP promoter activity and gene expression in human amnion cells. The hypothesis to be tested is that genetic variation in MMP gene promoter regions influences the level of MMP expression. We will then determine in a case-control study whether alleles linked to increased MMP expression are more prevalent in PPROM. The hypothesis to be tested is that genetic factors governing extracellular matrix metabolism in the fetal membranes are linked to risk of PPROM. The proposed studies have the potential to reveal novel biochemical and genetic risk factors for PPROM and preterm birth, and to identify molecular mechanisms of PPROM that could be exploited for therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOUSE MODEL FOR AMNIOTIC FLUID VOLUME REGULATION Principal Investigator & Institution: Cheung, Cecilia Y.; Professor; Reproductive Medicine; University of California San Diego La Jolla, Ca 920930934 Timing: Fiscal Year 2002; Project Start 15-JUL-2001; Project End 30-JUN-2004 Summary: (provided by applicant): A comprehensive understanding of the control of amniotic fluid volume is of major clinical importance. We have previously identified a

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vascular pathway within the fetal membranes for the transfer of fluid from the amniotic compartment into the fetal blood. This pathway is constituted by a network of microvessels on the surface of the placenta and, in sheep, within the amnion and chorion as well. We hypothesize that vascular endothelial growth factor (VEGF) is the determining factor for the absorptive capacity of this intramembranous pathway, thus an important regulator of amniotic fluid volume. In the present application, we propose to develop a mouse model of polyhydramnios and oligohydramnios. The model will be generated using targeted suppression or induction of VEGF gene expression in the fetal membranes and placenta. The advantage of the mouse model is that, it allows the study of the role of VEGF in intramembranous absorption by genetic manipulation. Three specific aims are proposed. Specific Aim 1 proposes to produce polyhydramnios by suppression of VEGF gene expression using a VEGE antisense sequence and oligohydramnios by over-expression of VEGF in the fetal membranes and placenta. Abnormalities in fetal lung development due to amniotic fluid volume changes will be studied. Specific Aim 2 will investigate the proliferation of microvessels in the amnion, chorion and placenta of pregnant mice with polyhydramnios or oligohydramnios. The change in amniotic fluid volume in relation to intramembranous microvessel density and VEGF gene expression will be correlated. Specific Aim 3 will examine fetal and postnatal growth patterns in the polyhydramniotic or oligohydramniotic models, and explore the development of blood pressure disorders in adulthood. The overall hypothesis is that in the pregnant mouse, alterations in amniotic fluid volume can be induced by genetic manipulation of the VEGF gene thus generating models for polyhydramnios and oligohydramnios. The proposed study is an innovative approach to understanding amniotic fluid volume regulation. The models of polyhydramnios and oligohydramnios allow investigation of fetal and postnatal growth and developmental defects due to abnormal amniotic fluid volume in utero. Results from these studies will be important for diagnosis and treatment of amniotic fluid volume disorders during pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEURONAL MECHANISM OF FETAL SWALLOWING Principal Investigator & Institution: El-Haddad, Mostafa A.; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 905022052 Timing: Fiscal Year 2002; Project Start 11-MAR-2002; Project End 28-FEB-2005 Summary: (Provided by Applicant): Fetal swallowing activity is markedly different from the adult, as spontaneous fetal swallowing occurs markedly higher rate when compared to spontaneous adult drinking. This high rate of fetal swallowing is critical for the regulation of amniotic fluid. Disordered fetal swallowing has been associated with both a decrease and increase in amniotic fluid volume. Both conditions are associated with a significant increase in perinatal morbidity and mortality, and limited treatment modalities are currently available. The mechanisms underlying the high rate of fetal swallowing have not been previously explored. Understanding these mechanisms may facilitate the discovery of an effective and safe treatment for amniotic fluid disorders via regulation of fetal swallowing, potent reducing perinatal morbidity and mortality. Behavioral studies in the adult rat have demonstrated important roles for the central angiotensin II (AngII) receptor subtype I (ATI), glutamate N-methyl-D-aspartate receptor subtype 1 (NMDA-NR1), and neuronal nitric oxide synthase (nNOS) in the regulation of stimulated, though not basal adult drinking. Our behavioral studies in the ovine fetus are the first to demonstrate an important role for nitric oxide (NO) in regulating both spontaneous and stimulated fetal swallowing. Moreover, our

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Amniotic Fluid

preliminary data suggest AngII and NMDA receptors are also involved in the regulation of fetal swallowing. We hypothesize that the very high rate of spontaneous fetal swallowing is regulated similarly to stimulated adult drinking, both requiring upregulation of AngII, glutamate, and NO pathway within the dipsogenic neurons to maintain high rate of neuronal firing. We also hypothesize that the fundamental difference in the rate of spontaneous swallowing between the fetus and adult is due to overexpression of the above receptors and enzyme within the dipsogenic neurons of the fetus. Furthermore, we hypothesize that the negative feedback mechanism between the receptor and its ligand observed in the adult in response to osmotic stimulation, is not functional in the fetus. To prove these hypothesis, we perform both in vivo and in vitro studies in the ovine fetus and ewe. First, utilizing an in vivo ovine model of fetal swallowing, we will expand our current physiological behavioral studies to determine the role of selective AngII receptors (type I and type 2) and n-NOS in fetal swallowing. Second, utilizing qualitative in vitro techniques (immunohistochemistry and in-situ hybridization), we will determine the anatomical localization of ATI, AT2 and NMDA receptors, and nNOS enzyme within the dipsogenic centers of both the fetus and mother. Third, we will utilize western and northern blotting to determine the quantitative differences between the fetus and the mother in the expression ofAT1, AT2 and NMDA receptors, and nNOS enzyme under basal and stimulated conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NONHEMATOPOIETIC DEVELOPMENTAL FUNCTIONS OF EPO Principal Investigator & Institution: Juul, Sandra E.; Assistant Professor; Pediatrics; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 16-JUL-2001; Project End 30-JUN-2005 Summary: Erythropoietin receptors are present on intestinal cells of the human fetus and neonate. Cells in contact with the developing intestinal lumen are exposed to erythropoietin (Epo) in swallowed amniotic fluid prenatally, and in human milk postnatally. When infants are born prematurely this exposure to Epo is interrupted. Pilot studies suggest that Epo may enhance the growth and development of neonatal intestine, and may also protect the neonatal intestine from injury. We hypothesize that Epo has an important role in the growth and development of the gastrointestinal tract, and that Epo will improve neonatal intestinal survival following injury. A combination of animal models will be used to test this hypothesis. The role of Epo in early intestinal development will be determined by studying intestinal growth in the presence and absence of Epo using Epo and Epo receptor knockout mouse models. These null mutation are, however, lethal at day 13.5 of gestation, so neonatal rats will be used for experiments designed to determine the effects of Epo in the post-natal intestine. Two experimental paradigms will be used. The first will be dam-raised neonatal rats, which receive Epo enterally via gavage, or parenterally, by SQ injection. These experiments will allow us to quantify the effects of exogenous Epo during normal development in a nursing pup, and to determine whether the route of administration is important. To determine the effect of mothers milk in conjunction with Epo, we will artificially rear rat pups using gastrostomy feedings of rat milk substitute to which specific total daily doses of Epo are added. As mothers' milk alone may be an important factor in bowel development, both experimental paradigms are important in evaluating the effects of Epo in the GI tract. To determine the effects of Epo on bowel injury, rat pups will be exposed to cold stress plus hypoxia in the presence or absence of Epo. It will be determined whether Epo protects the bowel from such injury, the timing of such protection, whether the route of administration is important, and the dose-response

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curve of such response in the presence and absence of mothers' milk. We feel these experiments will provide important specific insights into the regulation of neonatal intestinal growth and injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PARAXANTHINE AND REPRODUCTIVE EFFECTS OF CAFFEINE Principal Investigator & Institution: Bracken, Michael B.; Professor and Head; Epidemiology and Public Health; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2003; Project Start 01-AUG-1987; Project End 31-DEC-2004 Summary: (provided by applicant): Epidemiologic studies of antenatal caffeine consumption and adverse pregnancy outcomes have produced conflicting results. Most prior studies relied on self-reported caffeine consumption as a measure of caffeine exposure. However, caffeine metabolism and clearance greatly affect internal dose and, subsequently, fetal dose and consumption data may not provide a valid assessment of caffeine exposure. Because only 2.0% of caffeine is excreted as such in urine, there is considerable opportunity for error in estimating caffeine exposure using urinary caffeine levels. Paraxanthine, theophylline, and theobromine are primary metabolites of caffeine in humans and readily detected in body fluids. These metabolites may provide more reliable estimates of the biologically effective internal dose of caffeine. The specific aims of this application are: 1) to examine associations between intra-uterine growth retardation, preterm delivery, and birthweight with fetal caffeine exposure as estimated by cord blood serum paraxanthine; 2) to examine associations between serum paraxanthine, urinary caffeine, other metabolites, and self-reported caffeine intake; 3) to develop statistical models to determine the most precise predictive factors of caffeine exposure. We will link the analysis of serum caffeine metabolites with data previously collected on a large cohort of pregnant women (n=1775). Trained research assistants administered a baseline interview that included detailed questions on caffeine and decaffeinated beverage consumption, demographics, pregnancy history, medical history, tobacco and alcohol use, physical activity, use of nutritional supplements, and other reproductive risk factors. All women were asked to provide a urine sample at a baseline interview and cord blood was routinely collected and stored. In addition, women were randomly assigned to provide urine samples at 20, 28 or 36 weeks gestation. Medical records were abstracted to obtain information on obstetrical outcomes. The proposed work would conduct detailed biomarker analyses on samples collected from this cohort to provide a more complete understanding of effects of caffeine exposure on perinatal outcomes from a more accurate estimate of fetal exposure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PRENATAL SCHIZOPHRENIA

INFECTION,

BRAIN

DEVELOPMENT

AND

Principal Investigator & Institution: Gilmore, John H.; Professor; Psychiatry; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: (adapted from applicant's abstract): The causes of schizophrenia remain elusive, though there is strong evidence that pre- and perinatal complications, including prenatal exposure to infection, increase the risk of a person ultimately developing schizophrenia. In spite of their etiological importance, not only for schizophrenia, but

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Amniotic Fluid

also for other neurodevelopmental diseases (including lissencephaly, neural tube defects, autism, and mental retardation), the mechanisms by which clinical pre- and perinatal risk factors such as infection alter the developing brain have remained largely unstudied. It is hypothesized that pro-inflammatory cytokines, including interleukinlbeta (IL-1B), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-A), generated by the maternal, and/or placental immune system in response to infection play a key role in the association between prenatal infection and schizophrenia. Amniotic fluid and fetal cord blood levels of cytokines are increased in human pregnancies complicated by infection. IL-1B, IL-6, and TNF-A can all be neurotoxic to developing cortical neurons; the actions of cytokines on developing neurons are consistent with abnormalities of cortical neuron number, size, and "connectivity" found in the brains of patients with schizophrenia. There is also evidence that cytokines regulate more classic neurotrophic factors. The goal of this research is to characterize cytokine (IL-1B, IL-6, TNF-A) and neurotrophic factor [brain derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), nerve growth factor (NGF)] responses to prenatal infection and to study cytokine regulation of cortical neuron development. A clinical study of amniotic fluid obtained at amniocentesis from human pregnancies with and without prior exposure to infection will be used to determine cytokine and neurotrophic factor response to prenatal infection. Pre-clinical studies in a rat model of early infection (E. coli lipopolysaccaride exposure) will investigate the regulation of cytokine and neurotrophic factor (BDNF, NT-3, NGF) protein in the developing cortex. In addition, in vitro primary cell culture techniques will be used to study cytokine regulation of embryonic cortical neuron survival, growth, and synapse formation. These studies will provide a better understanding of how this clinically important risk factor for schizophrenia and other neurodevelopmental disorders can alter cortical neuron development, and may ultimately provide a rational basis on which to develop preventative treatment strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROCINE MODEL FOR ENDOCRINE DISRUPTING CHEMICALS Principal Investigator & Institution: Ryan, Peter; Mississippi State University P. O. Box 6156 Mississippi State, Ms 39762 Timing: Fiscal Year 2002; Project Start 26-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Disruption or modification of endocrine homeostasis during development by agricultural pesticides possessing estrogen-like or estrogen disruptive activities has been suggested on me basis of reports of abnormal sexual development observed in wildlife species and rodent animal models. Of great concern is the impact these types of environmental contaminants may have on human health, in particular, the effects of exposure on fetal development during organogenesis or differentiation of the endocrine and nervous systems. However, the lack of an ideal animal model to examine potential adverse effects in humans resulting from in utero exposure has hampered progress in this area. Typical laboratory rodents are not ideal models for human reproductive physiology. Thus, the primary goal of this study is to develop the pregnant pig as a novel animal model for investigating the impact of in utero exposure to estrogenic and non-estrogenic endocrine-active agricultural pesticides on sexual dimorphism in humans. The rationale for selecting the pig, as opposed to the traditional rodent model, is based on the fact that porcine physiology is remarkably similar to that of humans with particular regard to the reproductive and endocrine systems. In addition, a need exists to test the predictive value of amniotic fluid as a useful surrogate marker of fetal exposure to environmental contaminants during critical

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stages of development. Xenobiotics and naturally occurring compounds that mimic endogenous hormones have been found in human serum, breast milk and umbilical cord blood, but these fluids are not good indices of in utero contamination. Exposure estimation is often the weakest link in assessing risks to human health posed by environmental contaminants. Since amniocentesis is a relatively routine procedure performed during human pregnancy, the pig makes sampling of amniotic fluid feasible, which would be difficult to perform in the rodent model without compromising pregnancy. We propose that the pregnant pig will serve as a physiologically representative animal model for investigating the impact and mechanisms ofaction of endocrine disruptive chemicals on human sexual development. Moreover, we hypothesize that high concentration of agricultural pesticides containing amniotic fluid will be associated with aberrant reproductive development and lower birth weight of piglets. To undertake these goals, we have formulated the following two specific aims: 1) we will a) verify that the pregnant pig is a suitable animal model for assessing the impact of in utero exposure to endocrine-disruptive chemicals on sexual development, and b) test the usefulness of monitoring amniotic fluid for endocrine disruptive chemical exposure for hazard assessment. 2) we will use the pregnant pig model to investigate the endocrine disruptive potential of in utero exposure to two agricultural pesticides with known estrogen-like or estrogen disruptive activities (e.g., atrazine and methoxychlor) leading to reproductive developmental side effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF PERINATAL LUNG GENE EXPRESSION BY OXYGEN Principal Investigator & Institution: Joyce-Brady, Martin; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 30-JUN-2007 Summary: (provided by applicant): The P02 of amniotic fluid is about 26 mm Hg at late term. At birth, the lung fills with ambient air which has a P02 of about 150mmHg. This sudden change in the oxygen environment of the lung results in a transiently altered redox state that is particularly intense in lung epithelial cells. We propose that this altered redox state, in part buffered by induction of antioxidant defenses during late fetal life, is also a "physiologic" stimulus for induction of additional antioxidant genes and genes associated with postnatal development of the lung. Using a suppression subtractive hybridization screen of fetal and newborn lung, we found 65 clones that represent genes potentially associated with events related to postnatal lung development. Our hypothesis is also supported by recent observations and by our own preliminary data in normal mice and in a mouse model of impaired glutathione metabolism we have developed. The GGT enu1 mouse displays altered expression of a number of genes that we propose are induced by redox stress related to impaired glutathione metabolism. Our preliminary data identifies a subset of these genes and of genes induced at birth that share a common redox-sensitive regulatory site in their promoters. We propose to study perinatal lung and epithelial cell redox state as well as lung and epithelial cell gene expression in the GGT enu1 mouse with decreased glutathione availability, and a glutathione peroxidase over-expressing mouse with excess glutathione availability. We will use reverse engineering techniques to identify lung and epithelial cell genes that are coordinately linked to redox state and use bioinformatic algorithms to identify potential shared regulatory elements in those genes. The function of these elements will be tested with in vitro DNA gel shift and footprint

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Amniotic Fluid

assays. The reversible nature of redox state and of gene expression and the link to identified regulatory regions will be determined in our mouse models. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE SIGNIFICANCE OF AN ANTENATAL NUCHAL CORD Principal Investigator & Institution: Clapp, James F.; Professor; Reproductive Biology; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: The long range goal of this proposal is to evaluate the potential short- and long-term physiological and developmental effects of an antenatal nuchal cord in the human fetus. The specific aims for the initial funding period are to determine if the presence of an asymptomatic antenatal nuchal cord has clinical significance and, if so, are any ancillary findings of potential value in formulating a management plan. The null hypotheses to be tested are: (1) the presence of a nuchal cord is a random transient event during intrauterine life; (2) the presence of a nuchal cord prior to labor does not produce evidence of fetal stress or alter either short- or long-term fetal outcome:(3) the specific anatomical arrangement is unrelated to either persistence or neurodevelopmental performance between 6 months and 5 years of age; and (4) biophysical and/or biochemical characteristics of fetuses with antenatal nuchal cords are not predictive of neurodevelopmental performance between 6 months and 5 years of age. Three hundred and thirty low risk pregnant women carrying singletons will be recruited at 18-22 weeks gestation. They will undergo a non- stress test, a biophysical profile, velocimetry, a routine level I ultrasound and determination of cord position using color flow Doppler at 24-26, 30- 32 and 36-38 weeks gestation and the clinical course and outcome of the pregnancy and labor will be monitored by a member of the study team. Both the subject and her physician will be blinded to all but the morphometric findings unless the other test results suggest that fetal compromise may exist. Specific attention will be directed towards the incidence of clinical intervention for the indication of fetal distress, presence or absence of meconium, the fetal heart rate pattern, birth weight for gestational age, nuchal cord at birth, Apgar scores, amniotic fluid erythropoeitin and umbilical artery blood gasses. Infant follow-up will include an intracranial ultrasound on the fifth day of life and morphometric and neurodevelopmental assessments at 6 months, one, two and five years of age. There is evidence in experimental animals and in the human during labor that cord entanglement decreases umbilical blood flow, produces changes in the fetal heart rate pattern and may result in morbidity and mortality. It also appears t the incidence of nuchal cord prior to labor in the human fetus is equivalent to that found at birth. The question is should the ancillary finding of an antenatal nuchal cord on ultrasound exam be a cause for clinical concern. This proposal will provide data that should answer the question. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TWIN-TWIN TRANSFUSION SYNDROME TRIAL Principal Investigator & Institution: Crombleholme, Timothy M.; Attending Surgeon; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 191044399 Timing: Fiscal Year 2002; Project Start 24-SEP-2001; Project End 31-MAY-2006 Summary: (provided by applicant): The twin twin transfusion syndrome (TTTS) is the most common serious complication of monochorionic twin gestations, affecting between 4 and 35% of monochorionic twin pregnancies each year in the United States. The TTTS

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accounts for 17% of all perinatal mortality associated with twin gestations. Standard therapy in the United States has been limited to serial amnioreduction which appears to improve the overall outcome but has had little impact on the more severe end of the spectrum in TTTS. In addition, survivors of TTTS treated by serial amnioreduction have an 18 to 26% incidence of significant neurologic and cardiac morbidity. Selective fetoscopic laser photocoagulation of chorioangiopagus has emerged as an alternative treatment strategy in TTTS with comparable survival to serial amnioreduction in nonrandomized, non- prospective clinical studies. The superiority of fetoscopic laser treatment of TTTS remains unproven. In our preliminary data we have observed enhanced survival with selective fetoscopic laser photocoagulation in pregnancies with TTTS that had already failed serial amnioreduction or rnicroseptostomy. We hypothesize that treatment of the underlying chorioangiopagus by selective fetoscopic laser photocoagulation will not only improve the survival of twins but will reduce the incidence of neurologic, cardiac, and developmental sequelae of TTTS. We propose to test this hypothesis by a prospective randomized multicenter trial to compare serial amnioreduction with selective fetoscopic laser photocoagulation. In. the course of this study we will address the following specific aims: 1) To demonstrate that selective laser photocoagulation of chorioangiopagus in severe tETS results in significantly improved survival of twins compared to aggressive serial amnioreduction therapy. Survival of recipients and donors, both within the same pregnancy and overall survival to 30 days after birth will be examined; 2) To demonstrate that selective laser photocoagulation results in significantly improved cardiac, neurologic, and developmental outcomes in survivors of severe TTTS compared to survivors treated by aggressive serial amnioreduction. This will be a multicenter prospective randomized clinical trial with patients randomized either to serial amnioreduction at one of 16 participating centers or selective fetoscopic laser surgery at one or two participating centers. The fetal echocardiograms will be reviewed in a blinded fashion to evaluate cardiac morbidity and response to treatment. Similarly, prenatal ultrasounds, as well as ultrasounds and MRI s obtained in the first week of life and after 4 weeks, will be reviewed in a blinded fashion to evaluate the neurologic morbidity and distinguish prenatal from perinatal events. Long-term neurodevelopmental outcome will be evaluated by the NIGH]) Neonatal Network at 18 to 22 months of age. The overall goal of the study is to improve the outcomes of twins with TTTS by determining which treatment for TTTS has a better survival as well as cardiac, neurologic, and developmental outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VITAMIN A EFFECTS ON ALVEOLAR FORMATION Principal Investigator & Institution: Albertine, Kurt H.; Professor; Pediatrics; University of Utah Salt Lake City, Ut 84102 Timing: Fiscal Year 2002; Project Start 01-SEP-1999; Project End 31-JUL-2003 Summary: Impaired alveolar formation is associated with chronic lung disease (CLD) of prematurity (bronchopulmonary dysplasia or BPD) or prolonged drainage of amniotic liquid (oligohydramnios). The mechanisms by which alveolar formation is inhibited with both diseases remain unclear, and treatment strategies to reduce their incidence or severity have achieved modest success at best. We have developed a model of BPD in lambs that reproduces the pathophysiology and pathology of this disease, including impairment of alveolar formation. The lambs are delivered prematurely and mechanically ventilated for 3-4 wks. Their lungs have impaired growth of alveolar secondary crests (septa), resulting in reduced numbers of alveoli. Alveolar capillaries do not grow into the abnormal secondary crests. These pathological changes are associated

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Amniotic Fluid

with respiratory insufficiency. Our immunohistochemical, biochemical, and molecular analysis suggest that extracellular matrix components and growth factor expression are adversely affected (elastin gene expression is upregulated; elastic fiber and proteoglycan accumulation are excessive; vascular endothelial growth factor protein expression is reduced). Preliminary studies suggest that these changes can be reversed by daily parenteral administration of vitamin A (retinol). How these changes occur is not known and is the basis of our grant application. We propose to study the regulation of alveolar formation, including the role of retinoids, in our lamb model of BPD, and in a fetal lamb model of oligohydramnios that will allow us to investigate the regulation of alveolar formation in utero. Paired preterm and fetal lambs, respectively, will be treated with or without retinoids daily to test 3 hypotheses: (1) retinoids will reverse the impaired alveolar formation by regulating the expression of growth factors that promote mesenchymal, endothelial, and epithelial development such that more normal alveolar septation occurs; (2) retinoids will have an early effect (postnatal days 3-4) on extracellular matrix components and growth factors that are likely to be involved with development of distal airspace mesenchyme, endothelium, and epithelium; and (3) retinoids will reverse arrest of alveolar formation and lung hypoplasia during fetal development in utero by augmenting the expression of growth factors that promote mesenchymal, endothelial, and epithelial development. This work should provide important insights into the molecular mechanisms that contribute to impairment of alveolar formation in 2 large-animal, chronic models of 2 important pediatric diseases. The experiments also should help establish the molecular basis for the potentially therapeutic benefit of retinoids. 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 “amniotic fluid” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for amniotic fluid in the PubMed Central database: •

3 4

Cultured human amniotic fluid cells characterized with antibodies against intermediate filaments in indirect immunofluorescence microscopy. by Virtanen I, von Koskull H, Lehto VP, Vartio T, Aula P.; 1981 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=370931

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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•

Detection of group B streptococcal antigens in amniotic fluid of rhesus monkeys. by Hemming VG, London WT, Smith LP, Curfman BL, Fischer GW, Sever JL.; 1983 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=272813

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Direct analysis of amniotic fluid cells by multiplex PCR provides rapid prenatal diagnosis for Duchenne muscular dystrophy. by Simard LR, Gingras F, Labuda D.; 1991 May 11; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=329469

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Human amniotic fluid cells grown in a hormone-supplemented medium: suitability for prenatal diagnosis. by Chang HC, Jones OW, Masui H.; 1982 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=346765

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Leptotrichia amnionii sp. nov., a Novel Bacterium Isolated from the Amniotic Fluid of a Woman after Intrauterine Fetal Demise. by Shukla SK, Meier PR, Mitchell PD, Frank DN, Reed KD.; 2002 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=130742

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Maternal Thyroid Function is the Major Determinant of Amniotic Fluid 3,3[prime prime or minute],5[prime prime or minute]-Triiodothyronine in the Rat. by El-Zaheri MM, Vagenakis AG, Hinerfeld L, Emerson CH, Braverman LE.; 1981 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=370673

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Prenatal Diagnosis of Congenital Human Cytomegalovirus Infection in Amniotic Fluid by Nucleic Acid Sequence-Based Amplification Assay. by Revello MG, Lilleri D, Zavattoni M, Furione M, Middeldorp J, Gerna G.; 2003 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153931

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Quantification of Human Cytomegalovirus DNA in Amniotic Fluid of Mothers of Congenitally Infected Fetuses. by Revello MG, Zavattoni M, Furione M, Baldanti F, Gerna G.; 1999 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=85563

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Real-Time PCR Quantification of Human Cytomegalovirus DNA in Amniotic Fluid Samples from Mothers with Primary Infection. by Gouarin S, Gault E, Vabret A, Cointe D, Rozenberg F, Grangeot-Keros L, Barjot P, Garbarg-Chenon A, Lebon P, Freymuth F.; 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=130652

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 6

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

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

Abnormal amniotic fluid volume as a screening test prior to targeted ultrasound. Author(s): Blackwell SC, Hassan SS, Berry SM, Treadwell MC, Zador I, Wolfe HM. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2003 November; 9(11): Mt119-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14586286

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Amniotic fluid and maternal serum leptin levels in pregnant women who subsequently develop preeclampsia. Author(s): Chan TF, Su JH, Chung YF, Hsu YH, Yeh YT, Jong SB, Yuan SS. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 May 1; 108(1): 50-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694970

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Amniotic fluid as a novel source of mesenchymal stem cells for therapeutic transplantation. Author(s): In 't Anker PS, Scherjon SA, Kleijburg-van der Keur C, Noort WA, Claas FH, Willemze R, Fibbe WE, Kanhai HH. Source: Blood. 2003 August 15; 102(4): 1548-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900350

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Amniotic fluid beta-endorphin: a prognostic marker for gastroschisis. Author(s): Akgur FM, Olguner M. Source: Journal of Pediatric Surgery. 2004 March; 39(3): 506-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15017580

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Amniotic fluid beta-endorphin: a prognostic marker for gastroschisis. Author(s): Akgur FM, Olguner M. Source: Journal of Pediatric Surgery. 2004 February; 39(2): 248-9. Corrected and Republished In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14966756

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Amniotic fluid distribution for predicting perinatal outcome in prelabor rupture of membranes at term. Author(s): Kundavi KM, Kekre AN, Seshadri L. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 April; 81(1): 49-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676394

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Amniotic fluid embolism as cause of death in a car accident--a case report. Author(s): Rainio J, Penttila A. Source: Forensic Science International. 2003 November 26; 137(2-3): 231-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14609662

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Amniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass. Author(s): Stanten RD, Iverson LI, Daugharty TM, Lovett SM, Terry C, Blumenstock E. Source: Obstetrics and Gynecology. 2003 September; 102(3): 496-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12962931

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Amniotic fluid embolism during late term termination of pregnancy. Author(s): Shojai R, Chau C, Boubli L, D'Ercole C. Source: Prenatal Diagnosis. 2003 November; 23(11): 950-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634988

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Amniotic fluid embolism with involvement of the brain, lungs, adrenal glands, and heart. Author(s): Balazic J, Rott T, Jancigaj T, Popovic M, Zajfert-Slabe M, Svigelj V. Source: International Journal of Legal Medicine. 2003 June; 117(3): 165-9. Epub 2003 May 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12732931

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Amniotic fluid embolism. Exploring this rare but typically fatal condition. Author(s): Davis D. Source: Awhonn Lifelines / Association of Women's Health, Obstetric and Neonatal Nurses. 2003 April-May; 7(2): 126-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12735221

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Amniotic fluid embolus: a review of the research literature. Author(s): Fahy KM. Source: Aust J Midwifery. 2001 March; 14(1): 9-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12759986

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Amniotic fluid human chorionic gonadotrophin and alpha-fetoprotein levels in pregnancies conceived after assisted reproduction. Author(s): Hui PW, Lam YH, Tang MH, Ng EH, Yeung WS, Ho PC. Source: Prenatal Diagnosis. 2003 June; 23(6): 484-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12813762

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Amniotic fluid index in normal pregnancy: an assessment of gestation specific reference values among Indian women. Author(s): Khadilkar SS, Desai SS, Tayade SM, Purandare CN. Source: The Journal of Obstetrics and Gynaecology Research. 2003 June; 29(3): 136-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12841695

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Amniotic fluid index measured with the aid of color flow Doppler. Author(s): Zlatnik MG, Olson G, Bukowski R, Saade GR. Source: J Matern Fetal Neonatal Med. 2003 April;13(4):242-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854924

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Amniotic fluid inflammatory proteins and digestive compounds profile in fetuses with gastroschisis undergoing amnioexchange. Author(s): Burc L, Volumenie JL, de Lagausie P, Guibourdenche J, Oury JF, Vuillard E, Sibony O, Blot P, Saizou C, Luton D. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2004 April; 111(4): 292-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15008761

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Amniotic fluid insulin levels and fetal abdominal circumference at time of amniocentesis in pregnancies with diabetes. Author(s): Schaefer-Graf UM, Kjos SL, Buhling KJ, Henrich W, Brauer M, Heinze T, Dudenhausen JW, Vetter K. Source: Diabetic Medicine : a Journal of the British Diabetic Association. 2003 May; 20(5): 349-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12752482

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Amniotic fluid levels of immunoreactive monocyte chemotactic protein-1 increase during term parturition. Author(s): Esplin MS, Romero R, Chaiworapongsa T, Kim YM, Edwin S, Gomez R, Gonzalez R, Adashi EY. Source: J Matern Fetal Neonatal Med. 2003 July;14(1):51-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14563093

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Antimicrobial peptides in amniotic fluid: defensins, calprotectin and bacterial/permeability-increasing protein in patients with microbial invasion of the amniotic cavity, intra-amniotic inflammation, preterm labor and premature rupture of membranes. Author(s): Espinoza J, Chaiworapongsa T, Romero R, Edwin S, Rathnasabapathy C, Gomez R, Bujold E, Camacho N, Kim YM, Hassan S, Blackwell S, Whitty J, Berman S, Redman M, Yoon BH, Sorokin Y. Source: J Matern Fetal Neonatal Med. 2003 January;13(1):2-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12710851

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Are amniotic fluid alpha-fetoprotein levels influenced by the gender in twin pairs? Author(s): Sharony R, Drugan A, Amiel A, Grinshpun-Cohen J, Markov S, Fejgin MD. Source: Fetal Diagnosis and Therapy. 2003 July-August; 18(4): 281-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12835590

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Beta-endorphin in amniotic fluid in normal and hypertensive gestations: relationship with maternal blood pressure parameters. Author(s): Mauri A, Serri F, Angioni G, Paoletti AM, Melis GB. Source: Gynecologic and Obstetric Investigation. 1992; 34(3): 151-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1427415

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beta-Glucuronidase deficiency: identification of an affected fetus with simultaneous sampling of chorionic villus and amniotic fluid. Author(s): Chabas A, Guardiola A. Source: Prenatal Diagnosis. 1993 June; 13(6): 429-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8372067

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Big endothelin in plasma and amniotic fluid. Author(s): Chou J, Wang YN, Chang D, Chang JK, Avila C, Romero R. Source: Journal of Cardiovascular Pharmacology. 1991; 17 Suppl 7: S430-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1725402

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Bile acid metabolism in early life: studies of amniotic fluid. Author(s): Nakagawa M, Setchell KD. Source: Journal of Lipid Research. 1990 June; 31(6): 1089-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2373959

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Bile acids in amniotic fluid: promising metabolites for the prenatal diagnosis of peroxisomal disorders. Author(s): Stellaard F, Kleijer WJ, Wanders RJ, Schutgens RB, Jakobs C. Source: Journal of Inherited Metabolic Disease. 1991; 14(3): 353-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1770790

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Bilirubin in amniotic fluid does not interfere with the Abbott TDx FLM II assay. Author(s): Cariappa R, Parvin CA, Gronowski AM. Source: Clinical Chemistry. 2003 June; 49(6 Pt 1): 986-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12766006

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Binding of corticotropin-releasing hormone (CRH) in maternal and fetal plasma and in amniotic fluid. Author(s): Salminen-Lappalainen K, Laatikainen T. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1990 December 31; 195(1-2): 57-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2093479

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Biochemical and immunochemical identification of the fetal polypeptides of human amniotic fluid during the second trimester of pregnancy. Author(s): Prado VF, Reis DD, Pena SD. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 1990; 23(2): 121-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2207440

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Biochemical composition of amniotic fluid and extraembryonic coelomic fluid in the first trimester of pregnancy. Author(s): Campbell J, Wathen N, Macintosh M, Cass P, Chard T, Mainwaring Burton R. Source: British Journal of Obstetrics and Gynaecology. 1992 July; 99(7): 563-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1525096

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Biochemical markers of trisomy 21 in amniotic fluid. Author(s): Spencer K, Muller F, Aitken DA. Source: Prenatal Diagnosis. 1997 January; 17(1): 31-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9021826

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Biochemical profile of amniotic fluid for the assessment of fetal and renal development. Author(s): Oliveira FR, Barros EG, Magalhaes JA. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2002 February; 35(2): 215-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11847525

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Biophysical profile as a predictor of amniotic fluid culture results. Author(s): Gauthier DW, Meyer WJ, Bieniarz A. Source: Obstetrics and Gynecology. 1992 July; 80(1): 102-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1603477

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Biovar diversity of Ureaplasma urealyticum in amniotic fluid: distribution, intrauterine inflammatory response and pregnancy outcomes. Author(s): Kim M, Kim G, Romero R, Shim SS, Kim EC, Yoon BH. Source: Journal of Perinatal Medicine. 2003; 31(2): 146-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12747231

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Blood and amniotic fluid contact sustained by obstetric personnel during deliveries. Author(s): Panlilio AL, Welch BA, Bell DM, Foy DR, Parrish CM, Perlino CA, Klein L. Source: American Journal of Obstetrics and Gynecology. 1992 September; 167(3): 703-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1530027

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Blood contamination of amniotic fluid after amniocentesis in relation to placental location. Author(s): Giorlandino C, Gambuzza G, D'Alessio P, Santoro ML, Gentili P, Vizzone A. Source: Prenatal Diagnosis. 1996 February; 16(2): 180-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8650131

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Brain natriuretic peptide is present in the human amniotic fluid and is secreted from amnion cells. Author(s): Itoh H, Sagawa N, Hasegawa M, Okagaki A, Inamori K, Ihara Y, Mori T, Ogawa Y, Suga S, Mukoyama M, et al. Source: The Journal of Clinical Endocrinology and Metabolism. 1993 April; 76(4): 907-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8473404

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Broad-spectrum bacterial rDNA polymerase chain reaction assay for detecting amniotic fluid infection among women in premature labor. Author(s): Hitti J, Riley DE, Krohn MA, Hillier SL, Agnew KJ, Krieger JN, Eschenbach DA. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 June; 24(6): 1228-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9195088

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Change of adrenomedullin concentrations in plasma and amniotic fluid, and human placental adrenomedullin expression with advancing gestation. Author(s): Kanenishi K, Kuwabara H, Ueno M, Sato C, Sakamoto H, Hata T. Source: Placenta. 2001 February-March; 22(2-3): 244-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11170830

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Changes in cytokine (IL-8, IL-6 and TNF-alpha) levels in the amniotic fluid and maternal serum in patients with premature rupture of the membranes. Author(s): Zhang W, Wang L, Zhao Y, Kang J. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2000 April; 63(4): 311-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10820910

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Chemotactic activity for polymorphonuclear leukocytes: meconium versus meconium-stained amniotic fluid. Author(s): Yamada T, Matsubara S, Minakami H, Kohmura Y, Hiratsuka M, Sato I. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 2000 November; 44(5): 275-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11125788

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Clinicopathology conference: infant with meconium-stained amniotic fluid, poor Apgar scores, hypoxia, and respiratory problems. Author(s): Theophilopoulos D, Plaza M, Gilbert-Barness E, Pomerance HH. Source: Pediatric Pathology & Molecular Medicine. 2001 May-June; 20(3): 209-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11491096

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Collagenase-3 (MMP-13) in fetal membranes and amniotic fluid during pregnancy. Author(s): Fortunato SJ, LaFleur B, Menon R. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 2003 February; 49(2): 120-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12765351

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Comparability of the amniotic fluid index and single deepest pocket measurements in clinical practice. Author(s): Magann EF, Chauhan SP, Bofill JA, Martin JN Jr. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2003 February; 43(1): 75-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755354

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Comparative study of the asparagine-linked sugar chains of human lipocalin-type prostaglandin D synthase purified from urine and amniotic fluid, and recombinantly expressed in Chinese hamster ovary cells. Author(s): Manya H, Sato Y, Eguchi N, Seiki K, Oda H, Nakajima H, Urade Y, Endo T. Source: Journal of Biochemistry. 2000 June; 127(6): 1001-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10833268

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Comparison of the amniotic fluid index with gray-scale and color Doppler ultrasound. Author(s): Goldkrand JW, Hough TM, Lentz SU, Clements SP, Bryant JL, Hodges JA. Source: J Matern Fetal Neonatal Med. 2003 May;13(5):318-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12916682

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Concentrations of soluble Fas in maternal serum and amniotic fluid during uncomplicated pregnancies. Author(s): Malamitsi-Puchner A, Sarandakou A, Papagianni V, Protonotariou E, Tziotis J, Botsis D. Source: Journal of the Society for Gynecologic Investigation. 2003 April; 10(3): 158-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699879

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Concentrative relationship between polymorphonuclear elastase and urinary trypsin inhibitor in amniotic fluid. Author(s): Akutsu H, Iwama H. Source: Archives of Gynecology and Obstetrics. 2000 April; 263(4): 156-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10834321

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Congenital cytomegalovirus infection in twin pregnancies: viral load in the amniotic fluid and pregnancy outcome. Author(s): Lazzarotto T, Gabrielli L, Foschini MP, Lanari M, Guerra B, Eusebi V, Landini MP. Source: Pediatrics. 2003 August; 112(2): E153-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12897321

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Congenital HCMV infection: a collaborative and comparative study of virus detection in amniotic fluid by culture and by PCR. Author(s): Gouarin S, Palmer P, Cointe D, Rogez S, Vabret A, Rozenberg F, Denis F, Freymuth F, Lebon P, Grangeot-Keros L. Source: Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology. 2001 April; 21(1): 47-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11255097

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Continuous hemodiafiltration for disseminated intravascular coagulation and shock due to amniotic fluid embolism: report of a dramatic response. Author(s): Kaneko Y, Ogihara T, Tajima H, Mochimaru F. Source: Intern Med. 2001 September; 40(9): 945-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11579962

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Correlation among amniotic fluid index (AFI), cesarean section rate, and labor length in inducted pregnancies beyond 41 weeks' gestation with unfavorable cervix. Author(s): Rizzo N, Farina A, Santarsiero G, Morano D, Vitarelli M, Caramelli E, Carinci P, Bovicelli L. Source: American Journal of Perinatology. 2000; 17(6): 319-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11144315

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Correlation between amniotic fluid glucose concentration and amniotic fluid volume in pregnancy complicated by diabetes. Author(s): Dashe JS, Nathan L, McIntire DD, Leveno KJ. Source: American Journal of Obstetrics and Gynecology. 2000 April; 182(4): 901-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10764470

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Correlation of elevated leptin levels in amniotic fluid and maternal serum in neural tube defects. Author(s): Basbug M, Serin IS, Ozcelik B, Kula M, Basbug EM, Tutus A. Source: Obstetrics and Gynecology. 2003 March; 101(3): 523-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12636957

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C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis. Author(s): Yoon BH, Romero R, Shim JY, Shim SS, Kim CJ, Jun JK. Source: J Matern Fetal Neonatal Med. 2003 August;14(2):85-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14629087

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Cytogenetic aspects of the Canadian early and mid-trimester amniotic fluid trial (CEMAT). Author(s): Winsor EJ, Tomkins DJ, Kalousek D, Farrell S, Wyatt P, Fan YS, Carter R, Wang H, Dallaire L, Eydoux P, Welch JP, Dawson A, Lin JC, Singer J, Johnson J, Wilson RD. Source: Prenatal Diagnosis. 1999 July; 19(7): 620-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10419609

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Cytokine concentrations in the amniotic fluid during parturition at term: correlation to lower uterine segment values and to labor. Author(s): Kemp B, Winkler M, Maas A, Maul H, Ruck P, Reineke T, Rath W. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2002 October; 81(10): 938-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12366484

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Cytokine levels in midtrimester amniotic fluid in normal pregnancy and in the prediction of pre-eclampsia. Author(s): Heikkinen J, Mottonen M, Pulkki K, Lassila O, Alanen A. Source: Scandinavian Journal of Immunology. 2001 March; 53(3): 310-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11251890

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Decreased amniotic fluid index in low-risk pregnancy. Author(s): Kreiser D, el-Sayed YY, Sorem KA, Chitkara U, Holbrook RH Jr, Druzin ML. Source: J Reprod Med. 2001 August; 46(8): 743-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11547649

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Decreased laboratory testing for lecithin-to-sphingomyelin ratio and phosphatidylglycerol after fetal lung maturity assessment from lamellar body count in amniotic fluid. Author(s): Ross GE, Bever FN, Uddin Z, Hockman EM, Herman BA. Source: J Am Osteopath Assoc. 2002 August; 102(8): 423-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12201546

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Deepest vertical amniotic fluid pocket at term. Normal values and clinical application. Author(s): Myles TD, Morgan JL, Santolaya-Forgas J. Source: J Reprod Med. 2003 January; 48(1): 7-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12611088

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Delivery room management of neonates born through meconium stained amniotic fluid. Author(s): Singh D, Dutta S. Source: Indian Pediatrics. 2001 April; 38(4): 434-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11313524

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Delivery room management of neonates born through meconium stained amniotic fluid. Author(s): Chaturvedi P, Yadav B, Bharambe MS. Source: Indian Pediatrics. 2000 November; 37(11): 1251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11086309

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Detection and characterization of a type IIA secretory phospholipase A2 inhibitory protein in human amniotic fluid. Author(s): Moon TC, Lee JH, Lee SH, Park YK, Baek SH, Chan HW. Source: Biological & Pharmaceutical Bulletin. 2000 October; 23(10): 1163-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11041244

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Detection of endocrine disrupting chemicals in samples of second trimester human amniotic fluid. Author(s): Foster W, Chan S, Platt L, Hughes C. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 August; 85(8): 2954-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10946910

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Detection of Gardnerella vaginalis in the vagina and amniotic fluid using the polymerase chain reaction. Author(s): Lin HM, Tsui MS, Tu FC. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2000 December; 71(3): 221-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11102607

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Detection of house-dust-mite allergen in amniotic fluid and umbilical-cord blood. Author(s): Holloway JA, Warner JO, Vance GH, Diaper ND, Warner JA, Jones CA. Source: Lancet. 2000 December 2; 356(9245): 1900-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11130390

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Detection of mosaic isochromosome 20q in amniotic fluid in a pregnancy with fetal arthrogryposis multiplex congenita and normal karyotype in fetal blood and postnatal samples of placenta, skin, and liver. Author(s): Chen CP. Source: Prenatal Diagnosis. 2003 January; 23(1): 85-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12533820

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Detection of mosaicism in amniotic fluid cultures: a CYTO2000 collaborative study. Author(s): Ing PS, Van Dyke DL, Caudill SP, Reidy JA, Bice G, Bieber FR, Buchanan PD, Carroll AJ, Cheung SW, DeWald G, Donahue RP, Gardner HA, Higgins J, Hsu LY, Jamehdor M, Keitges EA, Laundon CH, Luthardt FW, Mascarello J, May KM, Meck JM, Morton C, Patil S, Peakman D, Pettenati MJ, Rao N, Sanger WG, Saxe DF, Schwartz S, Sekhon GS, Vance GH, Wyandt HE, Yu CW, Zenger-Hain J, Chen AT. Source: Genetics in Medicine : Official Journal of the American College of Medical Genetics. 1999 March-April; 1(3): 94-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11336459

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Detection of Ureaplasma urealyticum in second-trimester amniotic fluid by polymerase chain reaction correlates with subsequent preterm labor and delivery. Author(s): Gerber S, Vial Y, Hohlfeld P, Witkin SS. Source: The Journal of Infectious Diseases. 2003 February 1; 187(3): 518-21. Epub 2003 January 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12552439

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Determination of amniotic fluid volume in twin pregnancies: ultrasonographic evaluation versus operator estimation. Author(s): Magann EF, Chauhan SP, Whitworth NS, Anfanger P, Rinehart BK, Morrison JC. Source: American Journal of Obstetrics and Gynecology. 2000 June; 182(6): 1606-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10871484

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Differences between amnioinfusion and amniotic fluid exchange. Author(s): Akgur FM, Aktug T, Hakguder G, Olguner M. Source: Journal of Pediatric Surgery. 2000 December; 35(12): 1846-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11101754

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Direct prediction of amniotic fluid volume in the third trimester by 3-dimensional measurements of intrauterine pockets: a tool for routine clinical use. Author(s): Hombo Y, Ohshita M, Takamura S, Uchide K, Inoue M. Source: American Journal of Obstetrics and Gynecology. 2002 February; 186(2): 245-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11854643

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Discrepancy between cytogenetic and FISH results on an amniotic fluid sample of 45,X/46,X,idic(Y)(p11). Author(s): Gole LA, Anandakumar C, Yang R, Chan J, Wong YC, Bongso A. Source: Fetal Diagnosis and Therapy. 2000 July-August; 15(4): 212-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10867481

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Does amniotic fluid alpha-fetoprotein have diagnostic or prognostic value at the time of second midtrimester genetic amniocentesis? Author(s): Mandruzzato GP, Fischer-Tamaro L, De Seta F, D'Ottavio G, Rustico MA, Conoscenti G, Meir YL, Pinzano R, Maso G, Grasso A, Gigli C. Source: Fetal Diagnosis and Therapy. 2002 May-June; 17(3): 147-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11914566

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Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms. Author(s): Umur A, van Gemert MJ, Ross MG. Source: Physics in Medicine and Biology. 2002 June 21; 47(12): 2165-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12118607

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Dye-dilution techniques using aminohippurate sodium: do they accurately reflect amniotic fluid volume? Author(s): Magann EF, Whitworth NS, Files JC, Terrone DA, Chauhan SP, Morrison JC. Source: J Matern Fetal Neonatal Med. 2002 March;11(3):167-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12380671

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Effect of 1 week of oral hydration on the amniotic fluid index. Author(s): Fait G, Pauzner D, Gull I, Lessing JB, Jaffa AJ, Wolman I. Source: J Reprod Med. 2003 March; 48(3): 187-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12698777

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Effect of adeno-associated virus-specific immunoglobulin G in human amniotic fluid on gene transfer. Author(s): Boyle MP, Enke RA, Mogayzel PJ Jr, Guggino WB, Martin DB, Agarwal S, Zeitlin PL. Source: Human Gene Therapy. 2003 March 1; 14(4): 365-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12659677

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Effect of amniotic fluid upon prostaglandin E2 and I2 production by cultured human myometrial cells. Author(s): Kayem G, Dallot E, Ferre F, Cabrol D. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 June 10; 108(2): 152-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12781403

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Effect of indomethacin on amniotic fluid prostaglandin and aldosterone levels in a fetus with Bartter syndrome. Author(s): Amsalem H, Valsky DV, Yagel S, Celnikier DH, Anteby EY. Source: Prenatal Diagnosis. 2003 May; 23(5): 431-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12749044

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Effect of maternal hydration on amniotic fluid volume. Author(s): Magann EF, Doherty DA, Chauhan SP, Barrilleaux SP, Verity LA, Martin JN Jr. Source: Obstetrics and Gynecology. 2003 June; 101(6): 1261-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12798534

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Effect of maternal oral hydration on amniotic fluid index in women with pregnancyinduced hypertension. Author(s): Malhotra B, Deka D. Source: The Journal of Obstetrics and Gynaecology Research. 2002 August; 28(4): 194-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12452260

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Effects of exposure to tobacco smoke in pregnancies complicted by oligohydramnios and premature rupture of the membranes. II. Activity of brush border enzymes in human amniotic fluid. Author(s): Milnerowicz H, Zalewski J, Milnerowicz-Nabzdyk E, Zaslawski R, Woyton J. Source: International Journal of Occupational Medicine and Environmental Health. 2001; 14(3): 275-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11764857

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Effects of human amniotic fluid on peripheral nerve scarring and regeneration in rats. Author(s): Ozgenel GY, Filiz G. Source: Journal of Neurosurgery. 2003 February; 98(2): 371-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12593625

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Effects of human amniotic fluid on peritendinous adhesion formation and tendon healing after flexor tendon surgery in rabbits. Author(s): Ozgenel GY, Samli B, Ozcan M. Source: The Journal of Hand Surgery. 2001 March; 26(2): 332-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11279581

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Elevated amniotic fluid C-reactive protein at the time of genetic amniocentesis is a marker for preterm delivery. Author(s): Ghezzi F, Franchi M, Raio L, Di Naro E, Bossi G, D'Eril GV, Bolis P. Source: American Journal of Obstetrics and Gynecology. 2002 February; 186(2): 268-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11854648

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Elevated amniotic fluid ferritin levels are associated with inflammation-related pregnancy loss following mid-trimester amniocentesis. Author(s): Ramsey PS, Andrews WW, Goldenberg RL, Tamura T, Wenstrom KD, Johnston KE. Source: J Matern Fetal Neonatal Med. 2002 May;11(5):302-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12389670

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Elevated monocyte chemotactic protein-1 in amniotic fluid is a risk factor for pregnancy loss. Author(s): Chaiworapongsa T, Romero R, Tolosa JE, Yoshimatsu J, Espinoza J, Kim YM, Kim JC, Bujold E, Kalache K, Edwin S. Source: J Matern Fetal Neonatal Med. 2002 September;12(3):159-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12530612

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Embolism during pregnancy: thrombus, air, and amniotic fluid. Author(s): Gei AF, Vadhera RB, Hankins GD. Source: Anesthesiology Clinics of North America. 2003 March; 21(1): 165-82. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12698839

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Endothelin 1 concentrations in infants with meconium stained amniotic fluid. Author(s): Yigit S, Tekinalp G, Oran O, Yurdakok M, Aliefendioglu D, Gurgey A. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2002 November; 87(3): F212-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390994

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Epithelial cell-derived neutrophil-activating peptide-78 is present in fetal membranes and amniotic fluid at increased concentrations with intra-amniotic infection and preterm delivery. Author(s): Keelan JA, Yang J, Romero RJ, Chaiworapongsa T, Marvin KW, Sato TA, Mitchell MD. Source: Biology of Reproduction. 2004 January; 70(1): 253-9. Epub 2003 September 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13679321

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Establishment of reference intervals for markers of fetal thyroid status in amniotic fluid. Author(s): Singh PK, Parvin CA, Gronowski AM. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 September; 88(9): 4175-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12970283

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Establishment of reference values of five amniotic fluid enzymes. Analytical performances of the Hitachi 911. Application to complicated pregnancies. Author(s): Burc L, Guibourdenche J, Luton D, Noel M, Beaudeux JL, De Lagausie P, Oury JF, Porquet D. Source: Clinical Biochemistry. 2001 June; 34(4): 317-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11440733

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Estimation of the amniotic fluid volume using the Cavalieri method on ultrasound images. Author(s): Sahin B, Alper T, Kokcu A, Malatyalioglu E, Kosif R. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 July; 82(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12834938

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Evaluation of interleukin concentrations in amniotic fluid in preterm and term parturition and in oligohydramnios. Author(s): Lemancewicz A, Urban R, Urban J, Skotnicki M, Kretowska M, Sierakowski S. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 September-October; 7(5): 924-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11535936

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Expression of aquaporin-8 in human placenta and chorioamniotic membranes: evidence of molecular mechanism for intramembranous amniotic fluid resorption. Author(s): Wang S, Kallichanda N, Song W, Ramirez BA, Ross MG. Source: American Journal of Obstetrics and Gynecology. 2001 November; 185(5): 122631. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11717661

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False-positive diagnosis of trisomy 21 using fluorescence in situ hybridisation (FISH) on uncultured amniotic fluid cells. Author(s): George AM, Oei P, Winship I. Source: Prenatal Diagnosis. 2003 April; 23(4): 302-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12673634

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Fatal amniotic fluid embolism diagnosed histologically. Author(s): Aguilera LG, Fernandez C, Plaza A, Gracia J, Gomar C. Source: Acta Anaesthesiologica Scandinavica. 2002 March; 46(3): 334-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11939928

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Fetal fibronectin concentration in amniotic fluid decreases with advancing gestational age. Author(s): Negishi H, Yamada H, Okuyama K, Sagawa T, Makinoda S, Fujimoto S. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1995 April; 49(1): 17-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9457979

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Fetal Smith-Lemli-Opitz syndrome can be detected accurately and reliably by measuring amniotic fluid dehydrocholesterols. Author(s): Tint GS, Abuelo D, Till M, Cordier MP, Batta AK, Shefer S, Honda A, Honda M, Xu G, Irons M, Elias ER, Salen G. Source: Prenatal Diagnosis. 1998 July; 18(7): 651-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9706645

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Fetal surfactant as a source of arachidonate in human amniotic fluid. Author(s): Bernal AL, Phizackerley PJ. Source: Prostaglandins & Other Lipid Mediators. 2000 January; 60(1-3): 59-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10680776

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Fetal swallowing: relation to amniotic fluid regulation. Author(s): Ross MG, Nijland MJ. Source: Clinical Obstetrics and Gynecology. 1997 June; 40(2): 352-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9199846

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Fetal tissue engineering from amniotic fluid. Author(s): Kaviani A, Guleserian K, Perry TE, Jennings RW, Ziegler MM, Fauza DO. Source: Journal of the American College of Surgeons. 2003 April; 196(4): 592-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12691937

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Fetal unilateral cleft lip and palate: detection of enzymic anomalies in the amniotic fluid. Author(s): Raposio E, Panarese P, Santi P. Source: Plastic and Reconstructive Surgery. 1999 February; 103(2): 391-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9950523

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Fetal urine and amniotic fluid in monochorionic twins with twin-twin transfusion syndrome: simulations of therapy. Author(s): Umur A, van Gemert MJ, Ross MG. Source: American Journal of Obstetrics and Gynecology. 2001 October; 185(4): 996-1003. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11641691

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First-trimester echogenic amniotic fluid in the acrania-anencephaly sequence. Author(s): Cafici D, Sepulveda W. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 2003 October; 22(10): 1075-9; Quiz 1080-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14606564

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Flecainide distribution, transplacental passage, and accumulation in the amniotic fluid during the third trimester of pregnancy. Author(s): Bourget P, Pons JC, Delouis C, Fermont L, Frydman R. Source: The Annals of Pharmacotherapy. 1994 September; 28(9): 1031-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7803877

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Focus on fluids. Examining maternal hydration and amniotic fluid volume. Author(s): Calhoun S. Source: Awhonn Lifelines / Association of Women's Health, Obstetric and Neonatal Nurses. 1999 December-2000 January; 3(6): 20-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11011605

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Foetal compromise by spontaneous foetal heart rate deceleration in reactive nonstress test and decreased amniotic fluid index. Author(s): Begum F, Buckshee K. Source: Bangladesh Med Res Counc Bull. 1998 December; 24(3): 60-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10874369

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Follow-up investigations in uncultured amniotic fluid cells after uncertain cytogenetic results. Author(s): Van Opstal D, van den Berg C, Galjaard RJ, Los FJ. Source: Prenatal Diagnosis. 2001 February; 21(2): 75-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11241529

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Follow-up of infants with congenital toxoplasmosis detected by polymerase chain reaction analysis of amniotic fluid. Author(s): Gratzl R, Hayde M, Kohlhauser C, Hermon M, Burda G, Strobl W, Pollak A. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 1998 December; 17(12): 853-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10052549

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Four-quadrant assessment of gestational age-specific values of amniotic fluid volume in uncomplicated pregnancies. Author(s): Alley MH, Hadjiev A, Mazneikova V, Dimitrov A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1998 March; 77(3): 290-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9539274

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Fractalkine (FRK) levels in amniotic fluid and its production during pregnancy. Author(s): Shimoya K, Zhang Q, Tenma K, Ota Y, Hashimoto K, Shizusawa Y, Kimura T, Koyama M, Murata Y. Source: Molecular Human Reproduction. 2003 February; 9(2): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12569179

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French multi-centric study of 2000 amniotic fluid interphase FISH analyses from high-risk pregnancies and review of the literature. Author(s): Luquet I, Mugneret F, Athis PD, Nadal N, Favre B, Abel C, Chelloug N, Lespinasse J, Portnoi MF, Joye N, Dupont JM, Lebbar A, Bresson JL, Fellmann F, Siffroi JP, Chantot-Bastaraud S, Chiesa J, Amblard F, Devillard F, Jeandidier E, Boceno M, Rival JM, Bellec V, Lallaoui H, Delobel B, Croquette MF, Benzacken B. Source: Annales De Genetique. 2002 April-June; 45(2): 77-88. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12119216

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Frigen II improves the reliability of measurement of interleukin-1 related substances in amniotic fluid. Author(s): Ishihara O, Saitoh M, Kinoshita K, Takanashi H, Arai Y, Kitagawa H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1999 April; 78(4): 321-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10203300

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Fumarate hydratase deficiency: increased fumaric acid in amniotic fluid of two affected pregnancies. Author(s): Manning NJ, Olpin SE, Pollitt RJ, Downing M, Heeley AF, Young ID. Source: Journal of Inherited Metabolic Disease. 2000 November; 23(7): 757-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11117439

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Gastric carcinoma with metastasis to the placenta and amniotic fluid: case report and review of the literature. Author(s): Khatib F, Shaya M, Samueloff A. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 April 25; 107(2): 208-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648871

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Genetic counselling and prenatal diagnosis of cystic fibrosis in Debrecen (Hungary)-prenatal diagnosis by microvillar enzyme assay from amniotic fluid. Author(s): Szabo M, Teichmann F, Huszka M, Munnich A, Veress L, Papp Z. Source: Acta Univ Carol [med] (Praha). 1990; 36(1-4): 132-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2130675

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Genotoxic effects of cadmium chloride on human amniotic fluid cells cultured in vitro. Author(s): Fogu G, Congiu AM, Campus PM, Ladu R, Sanna R, Sini MC, Soro G. Source: Ann Chim. 2000 November-December; 90(11-12): 709-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11218258

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Genotyping of a case of tyrosinaemia type I with normal level of succinylacetone in amniotic fluid. Author(s): Poudrier J, Lettre F, St-Louis M, Tanguay RM. Source: Prenatal Diagnosis. 1999 January; 19(1): 61-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10073910

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Gestational age-related reference values for amniotic fluid amino acids: a useful tool for prenatal diagnosis of aminoacidopathies. Author(s): Rabier D, Chadefaux-Vekemans B, Oury JF, Aupetit J, Bardet J, Gasquet M, Merhand E, Parvy P, Kamoun P. Source: Prenatal Diagnosis. 1996 July; 16(7): 623-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8843471

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Glucose and insulin concentration in amniotic fluid and in maternal blood in early and in late pregnancy. Author(s): Van Assche FA, Dallequin MC, Holemans K. Source: Diabetes Research and Clinical Practice. 1990 October; 10(2): 133-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2261849

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Glucose, insulin, HGH and IGF-I levels in maternal serum, amniotic fluid and umbilical venous serum: a comparison between late normal pregnancy and pregnancies complicated with diabetes and fetal growth retardation. Author(s): Delmis J, Drazancic A, Ivanisevic M, Suchanek E. Source: Journal of Perinatal Medicine. 1992; 20(1): 47-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1608023

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Glycodelin and amniotic fluid transferrin as inhibitors of E-selectin-mediated cell adhesion. Author(s): Jeschke U, Wang X, Briese V, Friese K, Stahn R. Source: Histochemistry and Cell Biology. 2003 May; 119(5): 345-54. Epub 2003 May 13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12743827

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Glycosaminoglycan accumulation in amniotic fluid during early pregnancy. Author(s): Sloan R, Archbold GP, Lloyd F, Elliott RJ. Source: Biochemical Society Transactions. 1996 February; 24(1): 103S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8674582

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Glycosaminoglycan analysis in amniotic fluid and in cultured fibroblasts from normal and holoprosencephalic human embryonic organs. Author(s): Stabellini G, Del Borrello E, De Mattei M, Calastrini C, Orsini LF, Franchina M. Source: Prenatal Diagnosis. 1997 November; 17(11): 1077-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9399358

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Glycosaminoglycans in urine and amniotic fluid in congenital nephrotic syndrome of the Finnish type. Author(s): Ljungberg P. Source: Pediatric Nephrology (Berlin, Germany). 1994 October; 8(5): 531-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7818994

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Granulocyte-macrophage colony-stimulating factor in amniotic fluid and in airway specimens of newborn infants. Author(s): Bry K, Hallman M, Teramo K, Waffarn F, Lappalainen U. Source: Pediatric Research. 1997 January; 41(1): 105-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8979297

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GRO alpha in the fetomaternal and amniotic fluid compartments during pregnancy and parturition. Author(s): Cohen J, Ghezzi F, Romero R, Ghidini A, Mazor M, Tolosa JE, Goncalves LF, Gomez R. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 1996 January; 35(1): 23-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8789556

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Growth hormone, insulin-like growth factor-I and somatostatin in human fetus, newborn, mother plasma and amniotic fluid. Author(s): Bona G, Aquili C, Ravanini P, Gallina MR, Cigolotti AC, Zaffaroni M, Paniccia P, Mussa F. Source: Panminerva Medica. 1994 March; 36(1): 5-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7916454

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hCG in trophoblast tumour cells of the cell line Jeg3 and hCG isolated from amniotic fluid and serum of pregnant women carry oligosaccharides of the sialyl Lewis X and sialyl Lewis a type. Author(s): Jeschke U, Stahn R, Goletz C, Wang X, Briese V, Friese K. Source: Anticancer Res. 2003 March-April; 23(2A): 1087-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12820352

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Heparin-binding EGF-like growth factor is present in human amniotic fluid and breast milk. Author(s): Michalsky MP, Lara-Marquez M, Chun L, Besner GE. Source: Journal of Pediatric Surgery. 2002 January; 37(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11781977

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Hepatocyte growth factor concentration in the early second-trimester amniotic fluid does not predict fetal growth at birth. Author(s): Ohnishi Y, Yamashiro C, Yanagihara T, Hata T. Source: Human Reproduction (Oxford, England). 1999 October; 14(10): 2625-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10527998

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Hepatocyte growth factor in human amniotic fluid promotes the migration of fetal small intestinal epithelial cells. Author(s): Okamura M, Kurauchi O, Itakura A, Morikawa S, Suganuma N, Mizutani S, Tomoda Y. Source: American Journal of Obstetrics and Gynecology. 1998 January; 178(1 Pt 1): 175-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9465825

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Herpes simplex virus DNA in amniotic fluid without neonatal infection. Author(s): Alanen A, Hukkanen V. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 February; 30(2): 363-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10671342

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High immunocontent of S100 beta protein in amniotic fluid of pregnancies with Down syndrome. Author(s): Portela LC, Tort AB, Neto EC, Kessler RG, Penchaszadeh V, Souza DO, Goncalves CA, Giugliani R. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2000 November; 16(6): 590-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11220205

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High levels of fetal membrane activin beta A and activin receptor IIB mRNAs and augmented concentration of amniotic fluid activin A in women in term or preterm labor. Author(s): Petraglia F, Di Blasio AM, Florio P, Gallo R, Genazzani AR, Woodruff TK, Vale W. Source: The Journal of Endocrinology. 1997 July; 154(1): 95-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9246942

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High levels of human chromogranin A in umbilical cord plasma and amniotic fluid at parturition. Author(s): Florio P, Mezzesimi A, Turchetti V, Severi FM, Ticconi C, Forconi S, Petraglia F. Source: Journal of the Society for Gynecologic Investigation. 2002 January-February; 9(1): 32-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11839506

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High resolution chromosome analysis and in situ hybridization on amniotic fluid for diagnosis of a cryptic translocation. Author(s): Guichet A, Briault S, Moraine C. Source: Prenatal Diagnosis. 1998 April; 18(4): 399-403. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9602490

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HIV detection in amniotic fluid samples. Amniocentesis can be performed in HIV pregnant women? Author(s): Maiques V, Garcia-Tejedor A, Perales A, Cordoba J, Esteban RJ. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 June 10; 108(2): 137-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12781400

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HLA-G isoforms produced by placental cytotrophoblasts and found in amniotic fluid are due to unusual glycosylation. Author(s): McMaster M, Zhou Y, Shorter S, Kapasi K, Geraghty D, Lim KH, Fisher S. Source: Journal of Immunology (Baltimore, Md. : 1950). 1998 June 15; 160(12): 5922-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9637505

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How frequently should the amniotic fluid index be performed during the course of antepartum testing? Author(s): Wing DA, Fishman A, Gonzalez C, Paul RH. Source: American Journal of Obstetrics and Gynecology. 1996 January; 174(1 Pt 1): 33-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8572030

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How well do the amniotic fluid index and single deepest pocket indices (below the 3rd and 5th and above the 95th and 97th percentiles) predict oligohydramnios and hydramnios? Author(s): J Pediatr Surg. 2004 Mar;39(3):506-7 Source: American Journal of Obstetrics and Gynecology. 2004 January; 190(1): 164-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15017580

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Human amniotic fluid lacks interleukin-2 and interleukin-15 but can interact with the beta-chain of the interleukin-2 receptor. Author(s): Searle RF, Bromage SJ, Palmer J, Curry JE, Lang AK. Source: Immunology. 2000 March; 99(3): 411-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10712671

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Human amniotic fluid mathematical model: determination and effect of intramembranous sodium flux. Author(s): Curran MA, Nijland MJ, Mann SE, Ross MG. Source: American Journal of Obstetrics and Gynecology. 1998 March; 178(3): 484-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9539513

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Human amniotic fluid stimulates DNA synthesis of rat pancreatic islets. Author(s): Dunger A, Lucke S, Reiher H, Hahn HJ. Source: Acta Histochem Suppl. 1990; 39: 297-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2080275

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Human amniotic fluid--a potential supplement for the cultivation of pancreatic islets. Author(s): Dunger A, Lucke S, Besch W, Hahn HJ. Source: Horm Metab Res Suppl. 1990; 25: 68-71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2088989

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Human and ovine amniotic fluid composition differences: implications for fluid dynamics. Author(s): Albuquerque CA, Nijland MJ, Ross MG. Source: The Journal of Maternal-Fetal Medicine. 1999 May-June; 8(3): 123-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10338067

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Human blood serum and amniotic fluid contain an endogenous activator of betaadrenergic receptor synthesis (an indirect beta-adrenergic modulator). Author(s): Sazanov AV, Nozdrachev AD, Tsirkin VI, Dvoryanskii SA. Source: Doklady Biological Sciences : Proceedings of the Academy of Sciences of the Ussr, Biological Sciences Sections / Translated from Russian. 2000 May-June; 372(1-6): 247-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10944713

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Human glandular kallikrein in breast milk, amniotic fluid, and breast cyst fluid. Author(s): Magklara A, Scorilas A, Lopez-Otin C, Vizoso F, Ruibal A, Diamandis EP. Source: Clinical Chemistry. 1999 October; 45(10): 1774-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10508124

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ICAM-1 in maternal serum and amniotic fluid as an early marker of preeclampsia and IUGR. Author(s): Baviera G, D'Anna R, Corrado F, Ruello A, Buemi M, Jasonni VM. Source: J Reprod Med. 2002 March; 47(3): 191-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11933682

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IGF-I, IGF-II, IGF binding protein 1, and C-peptide in second trimester amniotic fluid are dependent on gestational age but do not predict weight at birth. Author(s): Verhaeghe J, Coopmans W, van Herck E, van Schoubroeck D, Deprest JA, Witters I. Source: Pediatric Research. 1999 July; 46(1): 101-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10400142

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Immunoglobulins of the human amniotic fluid. Author(s): Quan CP, Forestier F, Bouvet JP. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 1999 October; 42(4): 219-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10580603

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Immunologic studies in presumed amniotic fluid embolism. Author(s): Benson MD, Kobayashi H, Silver RK, Oi H, Greenberger PA, Terao T. Source: Obstetrics and Gynecology. 2001 April; 97(4): 510-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11275019

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Immunoreactivity of p53, PSA and bcl-2 in amniotic fluid smears from the second trimester of pregnancy. Author(s): Athanassiadou P, Gonidi M, Liossi A, Nakopoulou L, Petrakakou E, Sakellariou V, Antsaklis A. Source: Acta Cytol. 2002 March-April; 46(2): 440-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11917603

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Improving the prenatal diagnosis of citrullinemia using citrulline/ornithine+arginine ratio in amniotic fluid. Author(s): Chadefaux-Vekemans B, Rabier D, Chabli A, Blanc A, Aupetit J, Bardet J, Kamoun P. Source: Prenatal Diagnosis. 2002 June; 22(6): 456-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12116302

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In vitro survival of Listeria monocytogenes in human amniotic fluid. Author(s): Altieri C, Maruotti G, Natale C, Massa S. Source: Zentralbl Hyg Umweltmed. 1999 September; 202(5): 377-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10546327

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Influence on fetal blood pH when adding amniotic fluid: an in vitro model. Author(s): Losch A, Kainz C, Kohlberger P, Heinze G, Hefler L, Lahodny J, Tempfer C. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 May; 110(5): 453-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12742328

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Interaction between pulmonary surfactant and vernix: a potential mechanism for induction of amniotic fluid turbidity. Author(s): Narendran V, Wickett RR, Pickens WL, Hoath SB. Source: Pediatric Research. 2000 July; 48(1): 120-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10879810

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Interleukin-18 in cervical mucus and amniotic fluid: relationship to microbial invasion of the amniotic fluid, intra-amniotic inflammation and preterm delivery. Author(s): Jacobsson B, Holst RM, Mattsby-Baltzer I, Nikolaitchouk N, Wennerholm UB, Hagberg H. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 June; 110(6): 598-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12798479

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Interleukin-6 and interleukin-1 receptor antagonist in amniotic fluid and cord blood in patients with pre-term, premature rupture of the membranes. Author(s): Fukuda H, Masuzaki H, Ishimaru T. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2002 May; 77(2): 123-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12031562

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Intravenous magnesium sulphate effect on maternal serum and amniotic fluid cytokines levels in preterm labour patients. Author(s): Mezad D, Hallak M, Huleihel M, Gortzak-Uzan L, Smolin A, Mazor M. Source: Magnes Res. 2002 December; 15(3-4): 247-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635880

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Intrinsic fluorescence polarization of amniotic fluid: evaluation of human fetal lung maturity. Author(s): Molcho J, Avraham H, Cohen-Luria R, Parola AH. Source: Photochemistry and Photobiology. 2003 August; 78(2): 105-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12945576

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Intubation and suction for meconium-stained amniotic fluid according to the neonatal resuscitation program: a tricky issue. Author(s): Raupp P, Reynolds G. Source: Pediatrics. 2004 January; 113(1 Pt 1): 182. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14702484

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Involvement of fibrinolytic factors in mid trimester amniotic fluid with development of severe early-onset preeclampsia. Author(s): Adachi T, Nakabayashi M, Sakura M, Ando K. Source: Seminars in Thrombosis and Hemostasis. 1999; 25(5): 447-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10625200

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Is amniotic fluid volume influenced by a 24-hour fast? Author(s): Wolman I, Groutz A, Gull I, Gordon D, Geva E, Lessing JB, Jaffa AJ. Source: J Reprod Med. 2000 August; 45(8): 685-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10986690

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Is amniotic fluid volume status predictive of fetal acidosis at delivery? Author(s): Magann EF, Chauhan SP, Martin JN Jr. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2003 April; 43(2): 129-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14712968

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Is gastric lavage needed in neonates with meconium-stained amniotic fluid? Author(s): Narchi H, Kulaylat N. Source: European Journal of Pediatrics. 1999 April; 158(4): 315-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10206131

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Is there a relationship between fetal weight and amniotic fluid index? Author(s): Owen P, Osman I, Farrell T. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 July; 20(1): 61-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12100420

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Iterative, spectrophotometric method for determination of amniotic fluid bilirubin concentrations: comparison with the Liley method. Author(s): Egberts J, van den Heuvel B, Duiser HJ, van Dam W, Lentjes EG, Kanhai HH. Source: Clinical Chemistry. 2002 November; 48(11): 2045-7. Erratum In: Clin Chem. 2003 February; 49(2): 349. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12406992

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Karyotype of amniotic fluid cells at the AUB-MC results on 2000 cases. Author(s): Zahed L, al-Oreibi G, Darwiche N, el-Khechen S. Source: J Med Liban. 2000 May-June; 48(3): 121-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11268563

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Kinetics of the degradation of NG-nitro-L-arginine and its methyl ester in human umbilical vein blood and amniotic fluid. Author(s): Klein BH, Dudenhausen JW. Source: Eur J Clin Chem Clin Biochem. 1996 October; 34(10): 805-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8933103

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Lack of utility of amniotic fluid index in predicting perinatal morbidity and mortality. Author(s): Magann EF, Martin JN Jr, Chauhan SP. Source: American Journal of Obstetrics and Gynecology. 2001 March; 184(4): 778-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11262491

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Lamellar body count in amniotic fluid: a comparative study of four different hematology analyzers. Author(s): Szallasi A, Gronowski AM, Eby CS. Source: Clinical Chemistry. 2003 June; 49(6 Pt 1): 994-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12766010

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Lamellar body counts in amniotic fluid for prediction of fetal lung maturity. Author(s): Beinlich A, Fischass C, Kaufmann M, Schlosser R, Dericks-Tan JS. Source: Archives of Gynecology and Obstetrics. 1999; 262(3-4): 173-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10326636

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Large amounts of cell-free fetal DNA are present in amniotic fluid. Author(s): Bianchi DW, LeShane ES, Cowan JM. Source: Clinical Chemistry. 2001 October; 47(10): 1867-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11568107

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Leptin concentrations in amniotic fluid, venous and arterial cord blood and maternal serum: high leptin synthesis in the fetus and inverse correlation with placental weight. Author(s): Schubring C, Kiess W, Englaro P, Rascher W, Blum W. Source: European Journal of Pediatrics. 1996 September; 155(9): 830. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8874123

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Leptin concentrations in maternal serum and amniotic fluid during the second trimenon: differential relation to fetal gender and maternal morphometry. Author(s): Schubring C, Prohaska F, Prohaska A, Englaro P, Blum W, Siebler T, Kratzsch J, Kiess W. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 October; 86(2): 151-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10509783

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Leptotrichia amnionii sp. nov., a novel bacterium isolated from the amniotic fluid of a woman after intrauterine fetal demise. Author(s): Shukla SK, Meier PR, Mitchell PD, Frank DN, Reed KD. Source: Journal of Clinical Microbiology. 2002 September; 40(9): 3346-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12202577

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Levels of amniotic fluid insulin and profiles of maternal blood glucose in pregnant women with diabetes type-I. Author(s): Kainer F, Weiss PA, Huttner U, Haas J, Reles M. Source: Early Human Development. 1997 September 19; 49(2): 97-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9226116

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Levels of insulin-like growth factor-binding protein-2 and insulin-like growth factorII in maternal serum, amniotic fluid and extraembryonic coelomic fluid at 9-20 weeks of pregnancy. Author(s): Chard T, Blum WF, Brunjes J, Campbell DJ, Wathen NC. Source: The Journal of Endocrinology. 1994 August; 142(2): 379-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7523563

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Levels of interleukin-6 in second-trimester amniotic fluid are not predictive of adverse neonatal outcome. Author(s): Hasson D, Spong CY, Ghidini A. Source: The Journal of Maternal-Fetal Medicine. 2001 February; 10(1): 35-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11332417

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Levels of soluble HLA-G in amniotic fluid are related to the sex of the offspring. Author(s): Emmer PM, Steegers EA, van Lierop MJ, Loke YW, van der Meer A, Joosten I. Source: European Journal of Immunogenetics : Official Journal of the British Society for Histocompatibility and Immunogenetics. 2003 April; 30(2): 163-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648287

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Lipopolysaccharide binding protein and soluble CD14 receptor protein in amniotic fluid and cord blood in patients at term. Author(s): Roos T, Martin TR, Ruzinski JT, Leturcq DJ, Hillier SL, Patton DL, Eschenbach DA. Source: American Journal of Obstetrics and Gynecology. 1997 November; 177(5): 1230-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9396923

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Lipoxygenase metabolites in amniotic fluid of patients with Zellweger syndrome. Author(s): Mayatepek E, Jakobs C. Source: Journal of Inherited Metabolic Disease. 1998 June; 21(3): 292-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9686378

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Longitudinal measurement of amniotic fluid index in term pregnancies and its association with intrapartum fetal distress. Author(s): Garzetti GG, Ciavattini A, La Marca N, De Cristofaro F. Source: Gynecologic and Obstetric Investigation. 1997; 44(4): 234-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9415520

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Low amniotic fluid glucose levels are a specific but not a sensitive marker for subclinical intrauterine infections in patients in preterm labor with intact membranes. Author(s): Greig PC, Ernest JM, Teot L. Source: American Journal of Obstetrics and Gynecology. 1994 August; 171(2): 365-70; Discussion 370-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8059814

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Low amniotic fluid index as a predictor of adverse perinatal outcome. Author(s): Voxman EG, Tran S, Wing DA. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 June; 22(4): 282-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12032790

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Low amniotic fluid volume is poorly identified in singleton and twin pregnancies using the 2 x 2 cm pocket technique of the biophysical profile. Author(s): Magann EF, Nevils BG, Chauhan SP, Whitworth NS, Klausen JH, Morrison JC. Source: Southern Medical Journal. 1999 August; 92(8): 802-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10456720

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Low cyclic guanosine monophosphate levels in the amniotic fluid of pre-eclamptic pregnancies. Author(s): Rizzo G, Capponi A, Rinaldo D, Arduini D, Romanini C. Source: British Journal of Obstetrics and Gynaecology. 1996 August; 103(8): 834-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8760718

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Low lead levels in amniotic fluid and cord blood in a public hospital population. Author(s): Cicuttini FM, Woodburn CM, Golec R, Forbes A, Sim M. Source: Aust N Z J Public Health. 1998 August; 22(5): 628-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9744225

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Lung mass due to amniotic fluid embolism--an intrathoracic complication of pregnancy. Author(s): Kaptanoglu M, Dogan K, Onen A, Cevit R, Berkan O, Aker H. Source: Scandinavian Cardiovascular Journal : Scj. 1999; 33(2): 117-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10225314

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Maternal serum and amniotic fluid bisphenol A concentrations in the early second trimester. Author(s): Yamada H, Furuta I, Kato EH, Kataoka S, Usuki Y, Kobashi G, Sata F, Kishi R, Fujimoto S. Source: Reproductive Toxicology (Elmsford, N.Y.). 2002 November-December; 16(6): 735-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12401500

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Maternal serum and amniotic fluid cytokines in patients with preterm premature rupture of membranes with and without intrauterine infection. Author(s): Shobokshi A, Shaarawy M. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2002 December; 79(3): 209-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12445984

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Maternal serum and amniotic fluid hydroxyproline levels in neural tube defects. Author(s): Ozyurt H, Totan A, Sahin S, Kilinc C, Sogut S, Akyol O. Source: Fetal Diagnosis and Therapy. 2003 September-October; 18(5): 321-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12913341

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Measurement of pesticides and other toxicants in amniotic fluid as a potential biomarker of prenatal exposure: a validation study. Author(s): Bradman A, Barr DB, Claus Henn BG, Drumheller T, Curry C, Eskenazi B. Source: Environmental Health Perspectives. 2003 November; 111(14): 1779-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14594631

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Meconium passed in labor: how reassuring is clear amniotic fluid? Author(s): Greenwood C, Lalchandani S, MacQuillan K, Sheil O, Murphy J, Impey L. Source: Obstetrics and Gynecology. 2003 July; 102(1): 89-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850612

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Meconium-stained amniotic fluid is associated with puerperal infections. Author(s): Tran SH, Caughey AB, Musci TJ. Source: American Journal of Obstetrics and Gynecology. 2003 September; 189(3): 746-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14526306

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Meconium-stained amniotic fluid is not a risk factor for otitis media. Author(s): Straetemans M, Schonbeck Y, Engel JA, Zielhuis GA. Source: Eur Arch Otorhinolaryngol. 2003 September;260(8):432-5. Epub 2003 April 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12682845

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Microbial invasion and cytokine response in amniotic fluid in a Swedish population of women in preterm labor. Author(s): Jacobsson B, Mattsby-Baltzer I, Andersch B, Bokstrom H, Holst RM, Wennerholm UB, Hagberg H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 February; 82(2): 120-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648172

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Microbial invasion and cytokine response in amniotic fluid in a Swedish population of women with preterm prelabor rupture of membranes. Author(s): Jacobsson B, Mattsby-Baltzer I, Andersch B, Bokstrom H, Holst RM, Nikolaitchouk N, Wennerholm UB, Hagberg H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 May; 82(5): 423-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12752072

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Mid-trimester amniotic fluid angiogenin, lactate dehydrogenase and fibronectin in the prediction of preterm delivery. Author(s): Madazli R, Atis A, Uzun H, Aksu F. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 February 10; 106(2): 160-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12551785

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Molecular weight forms of inhibin A, inhibin B and pro-alphaC in maternal serum, amniotic fluid and placental extracts of normal and Down syndrome pregnancies. Author(s): Thirunavukarasu PP, Lambert-Messerlian G, Robertson DM, Dawson G, Canick J, Wallace EM. Source: Prenatal Diagnosis. 2002 December; 22(12): 1086-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12454963

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Monocyte chemotactic protein-1 in cervical and amniotic fluid: relationship to microbial invasion of the amniotic cavity, intra-amniotic inflammation, and preterm delivery. Author(s): Jacobsson B, Holst RM, Wennerholm UB, Andersson B, Lilja H, Hagberg H. Source: American Journal of Obstetrics and Gynecology. 2003 October; 189(4): 1161-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14586371

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National Institute of Child Health and Development Conference summary: amniotic fluid biology--basic and clinical aspects. Author(s): Ross MG, Brace RA; National Institute of Child Health and Development Workshop Participants. Source: The Journal of Maternal-Fetal Medicine. 2001 February; 10(1): 2-19. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11332413

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Neonatal amniotic fluid aspiration syndrome underdiagnosed? Author(s): Bolisetty S, Patole SK, McBride GA, Whitehall JS. Source: Int J Clin Pract. 2001 December; 55(10): 727-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11777305

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Nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 levels in human amniotic fluid. Author(s): Marx CE, Vance BJ, Jarskog LF, Chescheir NC, Gilmore JH. Source: American Journal of Obstetrics and Gynecology. 1999 November; 181(5 Pt 1): 1225-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10561650

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Neural-tube defects are associated with low concentrations of cobalamin (vitamin B12) in amniotic fluid. Author(s): Steen MT, Boddie AM, Fisher AJ, Macmahon W, Saxe D, Sullivan KM, Dembure PP, Elsas LJ. Source: Prenatal Diagnosis. 1998 June; 18(6): 545-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9664599

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Nitric oxide: a clinically important amniotic fluid marker to distinguish between intra-amniotic mycoplasma and non-mycoplasma infections. Author(s): Hsu CD, Aversa KR, Lu LC, Meaddough E, Jones D, Bahado-Singh RO, Copel JA, Lee IS. Source: American Journal of Perinatology. 1999; 16(4): 161-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10458527

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Non-fatal amniotic fluid embolism after cervical suture removal. Author(s): Haines J, Wilkes RG. Source: British Journal of Anaesthesia. 2003 February; 90(2): 244-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12538385

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Normal amniotic fluid index by gestational week in a Chinese population. CentralSouth China Fetal Growth Study Group. Author(s): Lei H, Wen SW. Source: Obstetrics and Gynecology. 1998 August; 92(2): 237-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9699758

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Normal ultrasonic evaluation of amniotic fluid in low-risk patients at term. Author(s): Myles TD, Santolaya-Forgas J. Source: J Reprod Med. 2002 August; 47(8): 621-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12216427

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Novel technique for assessing amniotic fluid volume: use of a three-dimensional bladder scanner. Author(s): Mann SE, Grover J, Ross MG. Source: The Journal of Maternal-Fetal Medicine. 2000 September-October; 9(5): 308-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132589

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Nutrient levels in amniotic fluid from women with normal and neural tube defect pregnancies. Author(s): Weekes EW, Tamura T, Davis RO, Birch R, Vaughn WH, Franklin JC, Barganier C, Cosper P, Finley SC, Finley WH. Source: Biology of the Neonate. 1992; 61(4): 226-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1610951

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Obstetric and perinatal outcome of pregnancies with term labour and meconiumstained amniotic fluid. Author(s): Ziadeh SM, Sunna E. Source: Archives of Gynecology and Obstetrics. 2000 September; 264(2): 84-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11045329

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Occlusions of branch retinal arterioles following amniotic fluid embolism. Author(s): Kim IT, Choi JB. Source: Ophthalmologica. Journal International D'ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde. 2000; 214(4): 305-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10859517

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Oct-4-expressing cells in human amniotic fluid: a new source for stem cell research? Author(s): Prusa AR, Marton E, Rosner M, Bernaschek G, Hengstschlager M. Source: Human Reproduction (Oxford, England). 2003 July; 18(7): 1489-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12832377

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Olfactory function in the human fetus: evidence from selective neonatal responsiveness to the odor of amniotic fluid. Author(s): Schaal B, Marlier L, Soussignan R. Source: Behavioral Neuroscience. 1998 December; 112(6): 1438-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926826

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Open neural tube defects: immunocytochemical demonstration of neuroepithelial cells in amniotic fluid. Author(s): Greenebaum E, Mansukhani MM, Heller DS, Timor-Tristsch I. Source: Diagnostic Cytopathology. 1997 February; 16(2): 143-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9067106

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Optimization of cytokine stability in stored amniotic fluid. Author(s): Porter AE, Auth J, Prince M, Ghidini A, Brenneman DE, Spong CY. Source: American Journal of Obstetrics and Gynecology. 2001 August; 185(2): 459-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11518909

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Oral administration of fluoride in pregnant women, and the relation between concentration in maternal plasma and in amniotic fluid. Author(s): Brambilla E, Belluomo G, Malerba A, Buscaglia M, Strohmenger L. Source: Archives of Oral Biology. 1994 November; 39(11): 991-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7695513

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Origin of CA125 and SCC antigen in human amniotic fluid. Author(s): Takeshima N, Suminami Y, Takeda O, Abe H, Kato H. Source: Asia Oceania J Obstet Gynaecol. 1993 June; 19(2): 199-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8379869

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Outcome of amniotic fluid analysis and neonatal respiratory status in diabetic and nondiabetic pregnancies. Author(s): Piper JM, Samueloff A, Langer O. Source: J Reprod Med. 1995 November; 40(11): 780-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8592312

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Overwhelming maternal cell contamination in amniotic fluid samples from patients with oligohydramnios can lead to false prenatal interphase FISH results. Author(s): Estabrooks LL, Hanna JS, Lamb AN. Source: Prenatal Diagnosis. 1999 February; 19(2): 179-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10215080

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Placental, maternal serum and amniotic fluid molecular weight forms of inhibin A and pro-alphaC. Author(s): Thirunavukarasu P, Robertson DM, Dole A, Waldron K, Dawson G, Wallace EM. Source: Placenta. 2003 April; 24(4): 370-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12657511

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Polymorphism in intron 2 of the fetal interleukin-1 receptor antagonist genotype influences midtrimester amniotic fluid concentrations of interleukin-1beta and interleukin-1 receptor antagonist and pregnancy outcome. Author(s): Witkin SS, Vardhana S, Yih M, Doh K, Bongiovanni AM, Gerber S. Source: American Journal of Obstetrics and Gynecology. 2003 November; 189(5): 1413-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634579

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Postdated pregnancy, amniotic fluid volume and initiation of labor. Author(s): Maulik D. Source: J Matern Fetal Neonatal Med. 2002 November;12(5):289-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12607759

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Predictability of intrapartum and neonatal outcomes with the amniotic fluid volume distribution: a reassessment using the amniotic fluid index, single deepest pocket, and a dye-determined amniotic fluid volume. Author(s): Magann EF, Chauhan SP, Doherty DA, Barrilleaux PS, Martin JN Jr, Morrison JC. Source: American Journal of Obstetrics and Gynecology. 2003 June; 188(6): 1523-7; Discussion 1527-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12824988

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Prediction markers for respiratory distress syndrome: evaluation of the stable microbubble test, surfactant protein-A and hepatocyte growth factor levels in amniotic fluid. Author(s): Kumazawa K, Hiramatsu Y, Masuyama H, Mizutani Y, Nakata T, Kudo T. Source: Acta Medica Okayama. 2003 February; 57(1): 25-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12765221

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Predictive value of pulse oximetry and fetal scalp blood pH in the case of meconiumstained amniotic fluid. Author(s): Carbonne B, Cudeville C, Maillard F, Goffinet F; French Study Group on Fetal Pulse Oximetry. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 July 1; 109(1): 27-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12818439

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Prenatal diagnosis of congenital human cytomegalovirus infection in amniotic fluid by nucleic acid sequence-based amplification assay. Author(s): Revello MG, Lilleri D, Zavattoni M, Furione M, Middeldorp J, Gerna G. Source: Journal of Clinical Microbiology. 2003 April; 41(4): 1772-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12682184

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Presumed antepartum amniotic fluid embolism. Author(s): Kent KJ, Cooper BC, Thomas KW, Zlatnik FJ. Source: Obstetrics and Gynecology. 2003 September; 102(3): 493-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12962930

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Prevalence of Mycoplasma bacteria in amniotic fluid at the time of genetic amniocentesis using the polymerase chain reaction. Author(s): Markenson GR, Adams LA, Hoffman DE, Reece MT. Source: J Reprod Med. 2003 October; 48(10): 775-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14619644

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Prevalence of viral DNA in amniotic fluid of low-risk pregnancies in the second trimester. Author(s): Baschat AA, Towbin J, Bowles NE, Harman CR, Weiner CP. Source: J Matern Fetal Neonatal Med. 2003 June;13(6):381-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12962262

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Quantification and characterization of pregnancy-associated complexes of angiotensinogen and the proform of eosinophil major basic protein in serum and amniotic fluid. Author(s): Christiansen M, Jaliashvili I, Overgaard MT, Ensinger C, Obrist P, Oxvig C. Source: Clinical Chemistry. 2000 August; 46(8 Pt 1): 1099-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10926889

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Quantification of 3-hydroxyglutaric acid in urine, plasma, cerebrospinal fluid and amniotic fluid by stable-isotope dilution negative chemical ionization gas chromatography-mass spectrometry. Author(s): Schor DS, Verhoeven NM, Struys EA, ten Brink HJ, Jakobs C. Source: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences. 2002 November 15; 780(1): 199-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12383496

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Quantification of 3-methylglutaconic acid in urine, plasma, and amniotic fluid by isotope-dilution gas chromatography/mass spectrometry. Author(s): Kelley RI. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1993 November 15; 220(2): 157-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8111960

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Quantification of 7-dehydrocholesterol in plasma and amniotic fluid by liquid chromatography/particle beam-mass spectrometry as a biochemical diagnostic marker for the Smith-Lemli-Opitz syndrome. Author(s): Sattler W, Leis HJ, Kostner GM, Malle E. Source: Rapid Communications in Mass Spectrometry : Rcm. 1995; 9(13): 1288-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8527820

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Quantification of human amniotic fluid constituents by high resolution proton nuclear magnetic resonance (NMR) spectroscopy. Author(s): Sims CJ, Fujito DT, Burholt DR, Dadok J, Giles HR, Wilkinson DA. Source: Prenatal Diagnosis. 1993 June; 13(6): 473-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8396770

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Quantification of human cytomegalovirus DNA in amniotic fluid of mothers of congenitally infected fetuses. Author(s): Revello MG, Zavattoni M, Furione M, Baldanti F, Gerna G. Source: Journal of Clinical Microbiology. 1999 October; 37(10): 3350-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10488204

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Quantitative 1H-NMR analysis of amniotic fluid. Author(s): McGowan PE, Reglinski J, Wilson R, Walker JJ, Wisdoms S, McKillop JH. Source: Journal of Pharmaceutical and Biomedical Analysis. 1993 August; 11(8): 629-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8257726

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Quantitative analysis of amniotic fluid pyrimidines for the prenatal diagnosis of hereditary orotic aciduria. Author(s): Ohba S, Kidouchi K, Toyama J, Oda T, Tsuboi T, Ichiki T, Sobajima H, Sugiyama N, Morishita H, Kobayashi M, et al. Source: Journal of Inherited Metabolic Disease. 1993; 16(5): 872-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8295404

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Quantitative analysis of the toxicity of human amniotic fluid to cultured rat spinal cord. Author(s): Drewek MJ, Bruner JP, Whetsell WO, Tulipan N. Source: Pediatric Neurosurgery. 1997 October; 27(4): 190-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9577972

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Quantitative assessment of human leukocyte antigen-G protein in amniotic fluid by a double-determinant enzyme-linked immunosorbent assay using anti-human leukocyte antigen-G-specific antibody '87G'. Author(s): Hamai Y, Fujii T, Miki A, Geraghty DE, Harada I, Takai Y, Kozuma S, Tsutsumi O, Taketani Y. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 1999 April; 41(4): 293-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10374707

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Racial disparity in meconium-stained amniotic fluid and meconium aspiration syndrome in the United States, 1989-2000. Author(s): Sriram S, Wall SN, Khoshnood B, Singh JK, Hsieh HL, Lee KS. Source: Obstetrics and Gynecology. 2003 December; 102(6): 1262-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14662213

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Randomised trial of amnioinfusion during labour with meconium stained amniotic fluid. Author(s): Rathor AM, Singh R, Ramji S, Tripathi R. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 January; 109(1): 17-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11843370

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Rapid prenatal diagnosis of trisomy 21 in 5049 consecutive uncultured amniotic fluid samples by fluorescence in situ hybridisation (FISH). Author(s): Witters I, Devriendt K, Legius E, Matthijs G, Van Schoubroeck D, Van Assche FA, Fryns JP. Source: Prenatal Diagnosis. 2002 January; 22(1): 29-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11810646

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Real-time PCR quantification of human cytomegalovirus DNA in amniotic fluid samples from mothers with primary infection. Author(s): Gouarin S, Gault E, Vabret A, Cointe D, Rozenberg F, Grangeot-Keros L, Barjot P, Garbarg-Chenon A, Lebon P, Freymuth F. Source: Journal of Clinical Microbiology. 2002 May; 40(5): 1767-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11980958

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Recommendations for management of the child born through meconium-stained amniotic fluid. Author(s): Keenan WJ. Source: Pediatrics. 2004 January; 113(1 Pt 1): 133-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14702463

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Reduced soluble CD14 levels in amniotic fluid and breast milk are associated with the subsequent development of atopy, eczema, or both. Author(s): Jones CA, Holloway JA, Popplewell EJ, Diaper ND, Holloway JW, Vance GH, Warner JA, Warner JO. Source: The Journal of Allergy and Clinical Immunology. 2002 May; 109(5): 858-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11994712

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Relationship between erythropoietin levels both in cord serum and amniotic fluid at birth and abnormal fetal heart rate records. Author(s): Kakuya F, Shirai M, Takase M, Ishii N, Ishioka T, Hayashi T, Kasamo M, Kawamura M, Sasaki K. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2002 August; 44(4): 414-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12139568

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Relationship between meconium staining and amniotic fluid volume in term pregnancies. Author(s): Blackwell SC, Wolfe HM, Redman ME, Hassan SS, Berry SM, Treadwell MC, Zador I, Carreno CA, Sorokin Y. Source: Fetal Diagnosis and Therapy. 2002 March-April; 17(2): 78-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11844910

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Role of fetal sex in amniotic fluid alphafetoprotein screening. Author(s): Knippel AJ. Source: Prenatal Diagnosis. 2002 October; 22(10): 941-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12378582

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Role of surfactant inhibitors in amniotic fluid in respiratory distress syndrome. Author(s): Gantar IS, Babnik J, Derganc M. Source: Journal of Perinatal Medicine. 2002; 30(5): 416-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12442607

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S100B protein and amniotic fluid. Author(s): Tort AB, Goncalves CA, Souza DO, Giugliani R, Portela LV. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2003 September; 335(1-2): 165-6; Author Reply 167. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12927698

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S100B protein concentrations in amniotic fluid are higher in monoamniotic than in diamniotic twins and singleton pregnancies. Author(s): Gazzolo D, Lituania M, Bruschettini M, Bruschettini P, Michetti F. Source: Clinical Chemistry. 2003 June; 49(6 Pt 1): 997-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12766011

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S100beta protein and amniotic fluid. Author(s): Benn P. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2003 September; 335(1-2): 169. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12927700

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Serum tryptase analysis in a woman with amniotic fluid embolism. A case report. Author(s): Farrar SC, Gherman RB. Source: J Reprod Med. 2001 October; 46(10): 926-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11725740

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Severe maternal respiratory distress due to the amniotic fluid embolism syndrome in a twin pregnancy. Author(s): de Rooij GM, Gelissen HP, Wester JP, Spijkstra JJ, Go AT, Girbes AR. Source: The Netherlands Journal of Medicine. 2003 October; 61(10): 337-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14708914

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Simultaneous use of intrapartum fetal pulse oximetry and amnioinfusion in meconium stained amniotic fluid. Author(s): Halvax L, Szabo I, Vizer M, Csermely T, Ertl T. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2002 September 10; 104(2): 105-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12206919

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Single clone bearing chromosomal aberrations in amniotic fluid culture. Author(s): Segal D, Sheiner E, Manor E. Source: Archives of Gynecology and Obstetrics. 2001 November; 265(4): 207-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11789747

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Sonographic evaluation of amniotic fluid volume. Author(s): Schrimmer DB, Moore TR. Source: Clinical Obstetrics and Gynecology. 2002 December; 45(4): 1026-38. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12438880

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Sphingosine 1-phosphate in amniotic fluid modulates cyclooxygenase-2 expression in human amnion-derived WISH cells. Author(s): Kim JI, Jo EJ, Lee HY, Cha MS, Min JK, Choi CH, Lee YM, Choi YA, Baek SH, Ryu SH, Lee KS, Kwak JY, Bae YS. Source: The Journal of Biological Chemistry. 2003 August 22; 278(34): 31731-6. Epub 2003 June 09. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12796504

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Stem cell marker expression in human trisomy 21 amniotic fluid cells and trophoblasts. Author(s): Prusa AR, Marton E, Rosner M, Freilinger A, Bernaschek G, Hengstschlager M. Source: Journal of Neural Transmission. Supplementum. 2003; (67): 235-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15068255

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Tetrasomy 8p: discordance of amniotic fluid and blood karyotypes. Author(s): Lopez-Pajares I, Delicado A, Lapunzina P, Mori MA, De Torres ML, Aso S, Garcia Sanchez P. Source: American Journal of Medical Genetics. 2003 May 1; 118A(4): 353-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12687667

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The amniotic fluid index as a predictor of fetal macrosomia in a Turkish population. Author(s): Sahinoglu Z, Gurbuz A, Kabaca C. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2003 May; 81(2): 223-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12706284

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The amniotic fluid index in late pregnancy. Author(s): Stigter RH, Mulder EJ, Bruinse HW, Visser GH. Source: J Matern Fetal Neonatal Med. 2002 November;12(5):291-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12607760

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The clinical significance of detecting Ureaplasma urealyticum by the polymerase chain reaction in the amniotic fluid of patients with preterm labor. Author(s): Yoon BH, Romero R, Lim JH, Shim SS, Hong JS, Shim JY, Jun JK. Source: American Journal of Obstetrics and Gynecology. 2003 October; 189(4): 919-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14586326

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The effect of nuchal cord on amniotic fluid and cord blood erythropoietin at delivery. Author(s): Hashimoto K, Clapp JF. Source: Journal of the Society for Gynecologic Investigation. 2003 October; 10(7): 406-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14519481

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The relationship between amniotic fluid index and successful external cephalic version: a 14-year experience. Author(s): Boucher M, Bujold E, Marquette GP, Vezina Y. Source: American Journal of Obstetrics and Gynecology. 2003 September; 189(3): 751-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14526307

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The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. Author(s): Morris JM, Thompson K, Smithey J, Gaffney G, Cooke I, Chamberlain P, Hope P, Altman D, MacKenzie IZ. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 November; 110(11): 989-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14592583

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Total antioxidant capacity and reactive oxygen species in amniotic fluid. Author(s): Burlingame JM, Esfandiari N, Sharma RK, Mascha E, Falcone T. Source: Obstetrics and Gynecology. 2003 April; 101(4): 756-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12681882

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Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), TRAIL receptors, and the soluble receptor osteoprotegerin in human gestational membranes and amniotic fluid during pregnancy and labor at term and preterm. Author(s): Lonergan M, Aponso D, Marvin KW, Helliwell RJ, Sato TA, Mitchell MD, Chaiwaropongsa T, Romero R, Keelan JA. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 August; 88(8): 3835-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12915677

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Two cases of hemorrhage secondary to amniotic fluid embolus managed with uterine artery embolization. Author(s): Goldszmidt E, Davies S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 November; 50(9): 917-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14617589

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Ultrasonic assessment of the amniotic fluid volume in diamniotic twins. Author(s): Magann EF, Chauhan SP, Martin JN Jr, Whitworth NS, Morrison JC. Source: Journal of the Society for Gynecologic Investigation. 1995 July-August; 2(4): 60913. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9420865

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Ultrasonically dense amniotic fluid in early pregnancy in asymptomatic women without vaginal bleeding. A report of two cases. Author(s): Vengalil S, Santolaya-Forgas J, Meyer W, Myles T. Source: J Reprod Med. 1998 May; 43(5): 462-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9610473

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Ultrasound estimate of amniotic fluid volume: color Doppler overdiagnosis of oligohydramnios. Author(s): Magann EF, Chauhan SP, Barrilleaux PS, Whitworth NS, McCurley S, Martin JN. Source: Obstetrics and Gynecology. 2001 July; 98(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11430959

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Ultrasound estimation of amniotic fluid volume using the largest vertical pocket containing umbilical cord: measure to or through the cord? Author(s): Magann EF, Chauhan SP, Washington W, Whitworth NS, Martin JN, Morrison JC. Source: Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 November; 20(5): 464-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12423483

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Unexplained elevated serum hCG is associated with raised amniotic fluid erythropoietin levels in second-trimester pregnancies. Author(s): Heinonen S, Breymann C, Ryynanen M, Gautschi K, Huch R, Huch A, Kirkinen P. Source: Fetal Diagnosis and Therapy. 1999 September-October; 14(5): 286-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10529572

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Ureaplasma/Mycoplasma-infected amniotic fluid: pregnancy outcome in treated and nontreated patients. Author(s): Berg TG, Philpot KL, Welsh MS, Sanger WG, Smith CV. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 1999 June; 19(4): 275-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10685238

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Urinary trypsin inhibitor levels in amniotic fluid of normal human pregnancy: decreased levels observed at parturition. Author(s): Kobayashi H, Suzuki K, Sugino D, Terao T. Source: American Journal of Obstetrics and Gynecology. 1999 January; 180(1 Pt 1): 141-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9914593

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Use of electrical conductivity of amniotic fluid in the evaluation of fetal lung maturation. Author(s): Pachi A, De Luca F, Cametti C, Barresi S, Berta S. Source: Fetal Diagnosis and Therapy. 2001 March-April; 16(2): 90-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11173954

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Use of quantitative amniotic fluid phosphatidylglycerol as a criterion for fetal lung maturation. Author(s): Tsao FH, Zachman RD. Source: American Journal of Perinatology. 1992 January; 9(1): 34-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1550630

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Usefulness of quantitative polymerase chain reaction in amniotic fluid as early prognostic marker of fetal infection with Toxoplasma gondii. Author(s): Romand S, Chosson M, Franck J, Wallon M, Kieffer F, Kaiser K, Dumon H, Peyron F, Thulliez P, Picot S. Source: American Journal of Obstetrics and Gynecology. 2004 March; 190(3): 797-802. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15042017

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Vaginal indicators of amniotic fluid infection in preterm labor. Author(s): Hitti J, Hillier SL, Agnew KJ, Krohn MA, Reisner DP, Eschenbach DA. Source: Obstetrics and Gynecology. 2001 February; 97(2): 211-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11165584

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Vaginal prostaglandin E2 and fatal amniotic fluid embolus. Author(s): Less A, Goldberger SB, Bernheim J, Ben-Nun I, Fejgin MD. Source: Jama : the Journal of the American Medical Association. 1990 June 27; 263(24): 3259-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2348536

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Value of amniotic fluid neutrophil collagenase concentrations in preterm premature rupture of membranes. Author(s): Maymon E, Romero R, Chaiworapongsa T, Kim JC, Berman S, Gomez R, Edwin S. Source: American Journal of Obstetrics and Gynecology. 2001 November; 185(5): 1143-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11717648

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Variable decelerations in reactive nonstress tests with decreased amniotic fluid index predict fetal compromise. Author(s): Hoskins IA, Frieden FJ, Young BK. Source: American Journal of Obstetrics and Gynecology. 1991 October; 165(4 Pt 1): 10948. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1951521

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Vascular anatomy of monochorionic placenta in relation to discordant growth and amniotic fluid volume. Author(s): Bajoria R. Source: Human Reproduction (Oxford, England). 1998 October; 13(1O): 2933-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9804258

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Vascular endothelial growth factor is bound in amniotic fluid and maternal serum. Author(s): Vuorela-Vepsalainen P, Alfthan H, Orpana A, Alitalo K, Stenman UH, Halmesmaki E. Source: Human Reproduction (Oxford, England). 1999 May; 14(5): 1346-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10325292

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Vasoconstrictive activity of meconium stained amniotic fluid in the human placental vasculature. Author(s): Holcberg G, Huleihel M, Katz M, Segal D, Sapir O, Mazor M, Malek A, Schneider H. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1999 December; 87(2): 147-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10597964

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Very echogenic amniotic fluid: ultrasonography-amniocentesis correlation. Author(s): Brown DL, Polger M, Clark PK, Bromley BS, Doubilet PM. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1994 February; 13(2): 95-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7932968

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Very long fatty acids in amniotic fluid from a fetus affected with Zellweger syndrome. Author(s): Jakobs C, ten Brink H, Kok RM, Stellard F, Kleijer WJ, Wanders RJ, Schutgens RB. Source: European Journal of Pediatrics. 1989 April; 148(6): 581. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2744027

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Viral studies on amniotic fluid from fetuses with and without abnormalities detected by prenatal sonography. Author(s): Petrikovsky BM, Lipson SM, Kaplan MH. Source: J Reprod Med. 2003 April; 48(4): 230-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12746984

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When amniotic fluid cells do not grow. Author(s): Gosden CM. Source: Lancet. 1995 January 14; 345(8942): 78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7815884

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Why is congenital nephrotic syndrome associated with a rise in the concentration of alpha-fetoprotein in the amniotic fluid? Author(s): Rapola J. Source: Pediatric Nephrology (Berlin, Germany). 1990 March; 4(2): 206. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1697762

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Xanthine and hypoxanthine in amniotic fluid during pregnancy. Author(s): Kjaergaard N, Moller-Petersen JF, Kristiansen FV, Petersen PL, Ekelund S, Skovbo P. Source: Dan Med Bull. 1990 December; 37(6): 559-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2127397

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Y chromosomal polysomy: a unique case of 49,X2004 in amniotic fluid cells. Author(s): Frey-Mahn G, Behrendt G, Geiger K, Sohn C, Schafer D, Miny P. Source: American Journal of Medical Genetics. 2003 April 15; 118A(2): 184-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12655500

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Zinc levels in maternal and cord blood and in amniotic fluid--a possible marker for foetal malformation. Author(s): Sharma R, Tewari K, Singhal KC, Gupta M, Veena. Source: Indian J Physiol Pharmacol. 1994 October; 38(4): 300-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7883298

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CHAPTER 2. NUTRITION AND AMNIOTIC FLUID Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and amniotic fluid.

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

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

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

Accuracy of ultrasonography in evaluating amniotic fluid volume at less than 24 weeks' gestation. Author(s): Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA. Source: Magann, E F Whitworth, N S Klausen, J H Perry, K G Martin, J N Morrison, J C J-Ultrasound-Med. 1995 December; 14(12): 895-7 0278-4297

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Calcium concentrations in maternal and fetal blood and in amniotic fluid from pregnant rats. Source: Harada, I. Ono, K. Hasegawa, A. Tomoda, I. Jap-J-Vet-Sci-Nihon-JuigakuZasshi. Tokyo : Japanese Society of Veterinary Science. April 1984. volume 46 (2) page 239-242. ill. 0021-5295

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Ceruloplasmin is found in milk and amniotic fluid and may have a nutritional role. Source: Wooten, L. Shulze, R.A. Lancey, R.W. Lietzow, M. Linder, M.C. J-nutr-biochem. New York, N.Y. : Elsevier Science Inc. November 1996. volume 7 (11) page 632-639. 0955-2863

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Concentrations of total and ionic calcium, inorganic phosphorus, magnesium, and protein in maternal and fetal blood and in amniotic fluid in parathyroidectomized pregnant rats. Source: Harada, I. Ono, K. Hasegawa, A. Tomoda, I. Jap-J-Vet-Sci-Nihon-JuigakuZasshi. Tokyo : Japanese Society of Veterinary Science. June 1985. volume 47 (3) page 403-411. ill. 0021-5295

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Differences of size and shape of active and inactive X-chromosome domains in human amniotic fluid cell nuclei. Author(s): Institute of Applied Physics, University of Heidelberg, Federal Republic of Germany. Source: Bischoff, A Albers, J Kharboush, I Stelzer, E Cremer, T Cremer, C Microsc-ResTech. 1993 May 1; 25(1): 68-77 1059-910X

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Effect of indomethacin on individual amniotic fluid indices in multiple gestations. Author(s): Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania, USA. Source: Hill, L M Lazebnik, N Many, A J-Ultrasound-Med. 1996 May; 15(5): 395-9 02784297

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Effects of heavy metals on alpha-fetoprotein in maternal sera and amniotic fluid of pregnant mice. Author(s): Wadsworth Center for Laboratories and Research, New York State Department of Health, Albany 12201-0509. Source: Mizejewski, G J Antelman, D E Keenan, J F Preiss, I L Toxicology. 1990 October; 64(1): 19-32 0300-483X

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Effects of intrauterine growth restriction and intraamniotic insulin-like growth factorI treatment on blood and amniotic fluid concentrations and on fetal gut uptake of amino acids in late-gestation ovine fetuses. Author(s): Liggins Institute, University of Auckland, PB 92019, Auckland, New Zealand. Source: Bloomfield, F H van Zijl, P L Bauer, M K Harding, J E J-Pediatr-GastroenterolNutr. 2002 September; 35(3): 287-97 0277-2116

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Fatty acids of sphingomyelin from amniotic fluid of normal and diabetic pregnancies. Source: Kokatnur, M. Brooks, V. Plauche, W.C. Lipids. Champaign, Ill. : American Oil Chemists' Society. July 1985. volume 20 (7) page 449-453. ill. 0024-4201

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Gamma-carboxyglutamic acid excretion into rat amniotic fluid during late gestation. Author(s): Department of Pediatrics, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033. Source: Gallaher, K J Wolpert, E B Rannels, S R J-Dev-Physiol. 1990 June; 13(6): 327-32 0141-9846

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In pregnancy, corticotropin-releasing-factor in maternal blood and amniotic fluid correlates with the gestational age. Author(s): Abt. fur Pharmakologie, Universitat Heidelberg, Germany. Source: Maser Gluth, C Lorenz, U Vecsei, P Horm-Metab-Res-Suppl. 1987; 1642-4 01705903

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Interleukin-2 in human amniotic fluid during pregnancy and parturition: implications for prostaglandin E2 release by fetal membranes. Author(s): Department of Experimental Medicine and Pathology, University 'La Sapienza', Rome, Italy. Source: Zicari, A Ticconi, C Pasetto, N Losardo, A Salerno, A Pontieri, G Piccone, E JReprod-Immunol. 1995 October; 29(3): 197-208 0165-0378

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Trophic effect of multiple growth factors in amniotic fluid or human milk on cultured human fetal small intestinal cells. Author(s): Department of Pediatrics, Osaka City University Graduate School of Medicine, Japan. Source: Hirai, C Ichiba, H Saito, M Shintaku, H Yamano, T Kusuda, S J-PediatrGastroenterol-Nutr. 2002 May; 34(5): 524-8 0277-2116

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Vitamin A transfer to the fetus and to the amniotic fluid in Rhesus Monkey (Macaca mulatta). Source: Vahlquist, A. Nilsson, S. Ann-Nutr-Metab. Basel, Switzerland : S. Karger. Nov/December 1984. volume 28 (6) page 321-333. 0250-6807

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

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

•

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

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

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

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

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

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

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

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

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

•

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

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

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

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

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

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

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

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

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

A novel method of purifying lung surfactant proteins A and D from the lung lavage of alveolar proteinosis patients and from pooled amniotic fluid. Author(s): Strong P, Kishore U, Morgan C, Lopez Bernal A, Singh M, Reid KB. Source: Journal of Immunological Methods. 1998 November 1; 220(1-2): 139-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9839935

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A proposed system whereby a (colcemid-induced) S2 phase is responsible for the tetraploidy found in cultured human amniotic fluid cells. Author(s): Tegenkamp TR, Hux C, Tegenkamp IE. Source: American Journal of Obstetrics and Gynecology. 1976 June 15; 125(4): 554-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=984092

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A protein-binding assay for direct determination of adenosine 3',5'-monophosphate in amniotic fluid, cerebrospinal fluid, plasma, and urine. Author(s): Aksnes L, Sovik O. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 1976 May; 36(3): 289-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=181838

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A simple method for preparing prometaphase chromosomes from amniotic fluid cell cultures. Author(s): Cheung SW, Crane JP, Johnson A, Simms L, Reid J. Source: Prenatal Diagnosis. 1987 July; 7(6): 383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3658911

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Activation of renin in human amniotic fluid by low pH. Author(s): Lumbers ER. Source: Enzymologia. 1971 June 31; 40(6): 329-36. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4105386

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Alpha-fetoprotein subfractions in amniotic fluid identified by a modification of the method of concanavalin A, lentil lectin or phytohemagglutinin-E affinity crossed-line immunoelectrophoresis. Author(s): Ishiguro T, Sakaguchi H, Fukui M, Sugitachi I. Source: Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine. 1985; 6(3): 195-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2416031

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Amniotic fluid composition responds to changes in maternal dietary carbohydrate and is related to metabolic status in term fetal rats. Author(s): Koski KG, Fergusson MA. Source: The Journal of Nutrition. 1992 February; 122(2): 385-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1732479

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Amniotic fluid levels of substance P. Author(s): Sanfilippo JS, Botti JJ, Wild RA, Osuamkpe CO. Source: J Reprod Med. 1992 August; 37(8): 733-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1279166

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Analysis of phospholipids in human amniotic fluid by 31P NMR. Author(s): Pearce JM, Shifman MA, Pappas AA, Komoroski RA.

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Source: Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine / Society of Magnetic Resonance in Medicine. 1991 September; 21(1): 107-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1943667 •

Antibacterial activity in human amniotic fluid: dependence on divalent cations. Author(s): Scane TM, Hawkins DF. Source: British Journal of Obstetrics and Gynaecology. 1986 June; 93(6): 577-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3089274

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Assay of phospholipids in the amniotic fluid. Author(s): Verder H, Clausen J. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1974 March 26; 51(3): 257-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4207863

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Bacterial growth inhibition by amniotic fluid. VII. The effect of zinc supplementation on bacterial inhibitory activity of amniotic fluids from gestation of 20 weeks. Author(s): Schlievert P, Johnson W, Galask RP. Source: American Journal of Obstetrics and Gynecology. 1977 March 15; 127(6): 603-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=842586

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Detection of phytoestrogens in samples of second trimester human amniotic fluid. Author(s): Foster WG, Chan S, Platt L, Hughes CL Jr. Source: Toxicology Letters. 2002 March 28; 129(3): 199-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11888703

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Detection of soluble HLA-G molecules in plasma and amniotic fluid. Author(s): Rebmann V, Pfeiffer K, Passler M, Ferrone S, Maier S, Weiss E, Grosse-Wilde H. Source: Tissue Antigens. 1999 January; 53(1): 14-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10082427

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Effect of Viscum album L. on rapidly proliferating amniotic fluid cells. Sister chromatid exchange frequency and proliferation index. Author(s): Bussing A, Lehnert A, Schink M, Mertens R, Schweizer K. Source: Arzneimittel-Forschung. 1995 January; 45(1): 81-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7893276

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Elevated folate levels in amniotic fluid after oral supplementation. Author(s): Steegers-Theunissen RP, Steegers EA, de Boer R, Thomas CM, Kloosterman MD, Eskes TK.

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Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1990 September; 36(3): 283-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2379664 •

Factor IX and prothrombin in amniotic fluid and fetal plasma: constraints on prenatal diagnosis of hemophilia B and evidence of proteolysis. Author(s): Thompson AR. Source: Blood. 1984 October; 64(4): 867-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6478059

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Garlic ingestion by pregnant women alters the odor of amniotic fluid. Author(s): Mennella JA, Johnson A, Beauchamp GK. Source: Chemical Senses. 1995 April; 20(2): 207-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7583013

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Incidence of tetraploidy as related to amniotic fluid cell types. Author(s): Tegenkamp TR, Hux CH. Source: American Journal of Obstetrics and Gynecology. 1974 December 15; 120(8): 106670. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4473898

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Increased matrix metalloproteinase activity and reduced tissue inhibitor of metalloproteinases-1 levels in amniotic fluids from pregnancies complicated by premature rupture of membranes. Author(s): Vadillo-Ortega F, Hernandez A, Gonzalez-Avila G, Bermejo L, Iwata K, Strauss JF 3rd. Source: American Journal of Obstetrics and Gynecology. 1996 April; 174(4): 1371-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8623872

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Mechanisms involved in the stimulatory effect of amniotic fluid on prostaglandin production by human fetal membranes. Author(s): Brennand JE, Leask R, Kelly RW, Greer IA, Calder AA. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 1998 May; 58(5): 369-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9690715

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Nonstress testing with acoustic stimulation and amniotic fluid volume assessment: 5973 tests without unexpected fetal death. Author(s): Clark SL, Sabey P, Jolley K. Source: American Journal of Obstetrics and Gynecology. 1989 March; 160(3): 694-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2929695

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Occurrence of aminopeptidases (arylaminopeptidases) in human amniotic fluid and their participation on kinin degradation. Author(s): Rybak M, Blazkova B, Petakova M. Source: Hoppe Seylers Z Physiol Chem. 1971 December; 352(12): 1611-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5004261

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Prostaglandin E and F2 alpha levels in plasma and amniotic fluid during midtrimester abortion induced by trichosanthin. Author(s): Wang YF, Zhou WD, Liu JX, Fi C, Zhu WX, Chen YZ, Yan LM, Shen GS, Wu YE, Zhu W. Source: Prostaglandins. 1981 August; 22(2): 289-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6945634

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Prostaglandins, not cyclic GMP, inhibit oxytocinase isoenzymes from human amniotic fluid in vitro. Author(s): Roy AC, Yeang M, Tan SM, Kottegoda SR, Ratnam SS. Source: Prostaglandins. 1985 August; 30(2): 255-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2996058

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Proteolysis of insulin-like growth factor binding protein-5 by pregnancy serum and amniotic fluid. Author(s): Claussen M, Zapf J, Braulke T. Source: Endocrinology. 1994 April; 134(4): 1964-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7511097

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Rapid detection of group B streptococcal antigen in human amniotic fluid. Author(s): Moriarty RA, Smith LP, Hemming VG, Fischer GW. Source: Journal of Clinical Microbiology. 1987 February; 25(2): 259-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3546363

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Should assessment of amniotic fluid volume form an integral part of antenatal fetal surveillance of high risk pregnancy? Author(s): Anandakumar C, Biswas A, Arulkumaran S, Wong YC, Malarvishy G, Ratnam SS. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1993 August; 33(3): 272-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8304891

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The analysis of human amniotic fluid using capillary electrophoresis. Author(s): Stewart CJ, Iles RK, Perrett D.

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Source: Electrophoresis. 2001 April; 22(6): 1136-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11358139 •

The effect of diet supplementation and addition of zinc in vitro on the growthsupporting property of amniotic fluid in African women. Author(s): Appelbaum PC, Ross SM, Dhupelia I, Naeye RL. Source: American Journal of Obstetrics and Gynecology. 1979 September 1; 135(1): 82-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=474664

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The effect of fetal acoustic stimulation on fetal swallowing and amniotic fluid index. Author(s): Petrikovsky BM, Schifrin B, Diana L. Source: Obstetrics and Gynecology. 1993 April; 81(4): 548-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8459964

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The measurement of phosphatidate phosphohydrolase in human amniotic fluid. Author(s): Bleasdale JE, Davis CS, Agranoff BW. Source: Biochimica Et Biophysica Acta. 1978 March 30; 528(3): 331-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=205249

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The nature of secretory agglutinins and aggregating factors. I. Secretory conglutininlike factor, secretory bacterial aggregating factors and secretory IgA antibody in human saliva and amniotic fluid. Author(s): Eggert FM. Source: Int Arch Allergy Appl Immunol. 1980; 61(2): 192-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6766122

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The nature of secretory agglutinins and aggregating factors. IV. Complexing between non-mucin glycoproteins, immunoglobulins and mucins in human saliva and amniotic fluid. Author(s): Eggert FM. Source: Int Arch Allergy Appl Immunol. 1980; 62(1): 46-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7372362

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The significance of amniotic fluid volume during intrapartum fetal acoustic stimulation. Author(s): Sarno AP Jr. Source: American Journal of Obstetrics and Gynecology. 1991 April; 164(4): 1100-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2014832

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Trophic effect of multiple growth factors in amniotic fluid or human milk on cultured human fetal small intestinal cells. Author(s): Hirai C, Ichiba H, Saito M, Shintaku H, Yamano T, Kusuda S.

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Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 May; 34(5): 524-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12050579

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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CHAPTER 4. DISSERTATIONS ON AMNIOTIC FLUID Overview In this chapter, we will give you a bibliography on recent dissertations relating to amniotic fluid. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “amniotic fluid” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on amniotic fluid, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Amniotic Fluid ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to amniotic fluid. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A study on glycosyltransferases in amniotic fluid and endometrium by Nelson, Jill Diana; PhD from University of Toronto (Canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK32850

•

The development of two assays, employing enzymes as reagents, for the determination of lecithin and total choline-containing phospholipids in amniotic fluid; A study of co-substrates for peroxidase coupled reactions; A study of the applicability of a bi by Artiss, Joseph Donald; PhD from University of Windsor (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK49193

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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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

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

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

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

Amniotic fluid alerting device Inventor(s): Berry; Daniel K. (135 Vinsant St., Brooks AFB, TX 78235-1015) Assignee(s): none reported Patent Number: 6,363,271 Date filed: November 1, 2000 Abstract: A device for implantation on the cervix of a pregnant female that provides a means by which a female patient or her health caregiver is notified of the rupture of membranes by the release of amniotic fluid. The device comprises a housing manufactured from biocompatible material having a hole through which amniotic fluid in the patient's vagina may pass. The housing contains a pH meter and a transmitter in electronic communication therewith as well as a power source for the sensor and transmitter. When amniotic fluid is released through the cervix into the vagina, a quantity thereof may pass into the housing and sensed by the sensor, causing the sensor to direct a signal to the transmitter. The transmitter issues an electronic signal to a second electronic device such as a pager or PDA, notifying the patient or her health caregiver that her water has broken. Excerpt(s): The present invention relates to the determination of when the amniotic fluid of a pregnant female mammal has been discharged through the cervix. More particularly, the present invention relates to a device having a pH sensor which may be implanted in the female's cervix which is capable of sensing a shift in pH of the vagina from a normally acidic condition to a basic condition caused by the influx of amniotic fluid. The device then transmits a warning signal to an auxiliary electronic device. It is often difficult for a pregnant woman to know when labor has begun. For example, during the last trimester of pregnancy, false labor comprising irregular and shallow contractions of the uterus, the so-called "Braxton Hicks contractions", may be confused with actual labor. Unlike true labor, these contractions are highly irregular and may be felt in the abdomen at onset rather than in the back. Furthermore, Braxton Hicks contractions are weak and do not strengthen. Despite these distinguishing characteristics, many women, especially those lacking competent care, may not be able to tell the difference between false labor and actual labor. During the latent phase of labor (pre labor), the cervix begins thinning out and may dilate very gradually. The first stage of labor is generally considered to begin when the cervix starts to open and ends when it is fully open. Women are admitted to the hospital when the dilation of the cervix reaches about 4 cm. The vagina may be examined to determine if the membranes surrounding the fetus have ruptured and to measure how dilated and effaced the cervix is. To save the woman's energy and to avoid tearing her cervix, pushing is discouraged during the first stage of labor which may last anywhere from a few hours to 12 hours. Pushing efforts are needed during the second stage of labor which begins when the cervix has achieved a maximum dilation of about 10 cm. Web site: http://www.delphion.com/details?pn=US06363271__

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Annexin containing compositions and methods for their use Inventor(s): Tsao; Francis H. C. (Madison, WI) Assignee(s): Wisconsin Alumni Research Foundation (Madison, WI) Patent Number: 5,849,502 Date filed: February 4, 1997 Abstract: Method of determining if a pregnant patient is at risk of premature delivery comprising analyzing the patient's amniotic fluid for the presence of Annexin I and Annexin I breakdown products, the presence of these breakdown products being predictive of a premature delivery. Excerpt(s): The present invention generally relates to annexins. More particularly, it relates to pharmaceutical compositions containing an annexin and methods of treating lung disease and endotoxin shock in animals, including humans. Annexins are a group of calcium-dependent, phospholipid-binding proteins. The calcium and phospholipid binding sites of most annexins are located in four repeated and highly conserved regions each of which contains about 70 amino acids. These proteins are widely distributed and at least nine members of the annexin family of proteins have been identified in mammalian tissues. The lung is rich in annexins. Several members of the annexin family of proteins with apparent molecular weights ranging from about 32 to about 40 kDa have been isolated from lungs of animals. Annexin I, a 36 kD phospholipid binding protein, 36 kDa(PLBP), appears to be the most abundant of the annexin family of proteins in the lung. There is about five times more Annexin I present in the lung than the related annexin 33 kDa phospholipid-binding protein, 33 kDa(PLBP). Web site: http://www.delphion.com/details?pn=US05849502__

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Apparatus and method for measuring the concentration of meconium in amniotic fluid Inventor(s): Eisenfeld; Leonard I. (18 Faxon Dr., West Hartford, CT 06117), Oh; John Young (Durham, NC) Assignee(s): Eisenfeld; Leonard I. (West Hartford, CT) Patent Number: 6,044,284 Date filed: October 8, 1998 Abstract: In an apparatus and method for measuring in vitro the concentration of meconium in amniotic fluid, a plurality of sensors are placed in predetermined locations throughout an amniotic sac. Each sensor includes a blue light-emitting diode having a peak transmission wavelength centered at about 430 nm, a transducer comprising a blue-enhanced photodiode for converting the light received from the lightemitting diode to a voltage signal, and an operational amplifier for amplifying the voltage signal. The light source and transducer are spaced a predetermined distance relative to each other, and define an amniotic fluid passageway therebetween for receiving the amniotic fluid. A micro-controller calculates, in accordance with an empirically-determined linear equation, the meconium concentration based on the natural log of each transducer signal. The transducer signals are continuously converted to meconium concentration readings, and generated on a display to provide a

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continuous, real-time, quantitative and/or qualitative assessment of the presence of, and concentration of meconium in a plurality of locations within the amniotic sac. Excerpt(s): The present invention relates to apparatus and methods for monitoring amniotic fluid, and more particularly, to apparatus and methods for optically monitoring the concentration of meconium in amniotic fluid. Meconium is fetal stool, and when passed in utero, it may indicate or be associated with fetal stress. If the concentration of meconium in the amniotic sac is sufficiently high, the fetus may aspirate the meconium into the respiratory system and cause potentially-fatal complications in the airways and lungs. To date, most clinical caretakers assess the concentration of meconium in amniotic fluid by visual inspection. In this type of analysis, the concentration of meconium is typically characterized as being "thin" (i.e., a relatively low concentration) or "thick" (i.e., a relatively high concentration). Amniotic fluid having a "thick" meconium concentration typically may have the consistency of pea soup and contain particulate matter. Web site: http://www.delphion.com/details?pn=US06044284__ •

Assembly for filtering amniotic fluid Inventor(s): Romine; Lori (11735 SW. 112th Ter., Miami, FL 33186), Sholders; Ronald (7640 SW. 168th St., Miami, FL 33157), Warren; Richard (c/o 11735 SW. 112 Ter., Miami, FL 33186) Assignee(s): none reported Patent Number: 5,015,369 Date filed: January 22, 1990 Abstract: An assembly for the removal and examination of amnioytes in early pregnancy by filtering the amniotic fluid and returning the fluid to the fetus subsequent to filtering wherein a conduit structure has a filter incorporated therein and is constructed to include two different paths of fluid flow, one for drawing off said amniotic fluid through the filter means and one for returning the amniotic fluid subsequent to filtering along a path which bypasses said filter structure. Excerpt(s): A conduit structure used in combination with a syringe and a penetrating needle for the withdrawing, filtering and subsequent return of amniotic fluid of a fetus during pregnancy for the purpose of examination of amniocytes. The testing of amniotic fluid, especially during the early stages of pregnancy, has been conducted and recognized for some time as being an accurate method of determining irregularities and/or general health and well-being of the fetus. Typically, in the testing of such amniotic fluid, the fluid is withdrawn directly from the fetal sac by means of an elongated needle attached to a syringe instrument. The removed fluid is then submitted to other procedures and apparatus for laboratory testing. Based on the popularity and success of such techniques, it has become desired in the medical profession to have a more efficient means of withdrawing, filtering and subsequently returning the amniotic fluid to the fetus by means of a close system specifically wherein a preferred structure would incorporate a filter mechanism capable of filtering out the amniocytes from the amniotic fluid subsequent to returning of the fluid to the fetus. Naturally, such an apparatus including the aforementioned filter structure should be defined as a closed system in order to maintain a sterile environment. Other apparatus exists in the medical profession which incorporate certain basic structural features such as a withdrawing syringe, a penetrating needle and some type of filter apparatus. Typically, such

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structures are utilized in the area of blood sampling and collection. The following U.S. Patents are generally representative of known prior art structures of the type set forth above but which are not related to the removal, sampling and return of amniotic fluid to and from the fetus: U.S. Pat. Nos. 3,520,416; 3,892,226; and 4,685,472. Web site: http://www.delphion.com/details?pn=US05015369__ •

Assessing fetal lung maturity Inventor(s): Macri; James (170 Sidney St., Oyster Bay, NY 11771) Assignee(s): none reported Patent Number: 5,024,936 Date filed: September 26, 1988 Abstract: A method for assessing whether the lungs of a fetus are mature comprising obtaining a sample of the amniotic fluid surrounding the fetus and determining the presence or absence of phosphatidyl glycerol in the sample. The presence of phosphatidyl glycerol indicates that the fetus lungs are mature, and the absence indicates that the fetus lungs are not mature. More particularly, in one embodiment of the present invention, the presence of phosphatidyl glycerol is determined by adding phospholipase C to the amniotic fluid to convert the phosphatidyl glycerol to glycerol3-phosphate. Then adding glycerol-3-phosphate oxidase to convert the glyerol-3phosphate to dihydroxyacetone phosphate and hydrogen peroxide and then reacting the hydrogen peroxide with a substrate and peroxidase to form a visually detectable reaction product. Excerpt(s): This invention relates to ligand-receptor assays. Ligand-receptor assay procedures have been known for some time. In such procedures a molecule or substance of interest (ligand) is bound or otherwise reacted with a receptor which is specific to the ligand of interest to form an identifiable or even a quantifiable product. Often, the receptor is bound to a membrane. Thus, the reaction or binding between the receptor and the ligand of interest is localized at the membrane. When the receptor is bound to a membrane, the sample is allowed to incubate on the surface of the membrane for a sufficient time to allow the ligand to come in contact with and bind or react with the receptor. See, for example, U.S. Pat. No. 4,246,339. Alternatively, an absorbent pad is attached to one side of the membrane to which the receptor is bound. The capillary action of the absorbent pad draws the sample through the membrane and brings the ligand in contact with the receptor. See, for example, U.S. Pat. No. 4,727,019. Web site: http://www.delphion.com/details?pn=US05024936__

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Cervical canal balloon catheter Inventor(s): Kocur; Basil (Buffalo, NY), Kocur; Walter (Yonkers, NY) Assignee(s): Kocur Medical Associates (Yonkers, NY) Patent Number: 5,338,297 Date filed: March 19, 1993 Abstract: A cervical canal obturator and infusing catheter comprises a threaded metal tube formed at one end with a balloon adapted to be expanded and snugly fit against the internal cervical os while a ring threaded onto the tube bears against the external

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cervical canal and is locked against unscrewing by a locking nut also on the outer tube. An inner tube within the outer tube can deliver an infusing or antibiotic solution into the uterus or withdraw amniotic fluid and can be held in the outer tube between a pair of plugs said into the outer tube. Excerpt(s): Our present invention relates to a cervical canal obturator and catheter and, more particularly, to a device adapted to be inserted into the cervical canal and to block uncontrolled escape of fluid therefrom and permit irrigation of the uterus or womb through the cervix. In U.S. Pat. No. 4,693,704, a cervical canal catheter is described which is intended to treat premature rupture of the membrane before the beginning of parturition, efflux of amniotic fluid from the womb and the onset of parturition. In that arrangement, a two lobe balloon seal is inserted into the cervical canal and the balloons are inflated or expanded so that one of the balloons seats primarily at the isthmus of the uterus while the other is located generally within the canal. Key to this system, in addition to the gourd-shape of the balloon which engages at the isthmus of the uterus, is the provision of or a requirement for a ligature which extends through the body of the cervix between these tubes to prevent the widening of the cervical canal and ejection of the stopper formed by this assembly. Web site: http://www.delphion.com/details?pn=US05338297__ •

Cesarian section collecting incise drape Inventor(s): Glassman; Jacob A. (1680 Michigan Ave., Miami Beach, FL 33139) Assignee(s): none reported Patent Number: 5,209,243 Date filed: October 18, 1991 Abstract: A Cesarian Section Collecting Incise Drape, for collecting and retaining outgushing amniotic fluid that escapes from an opened amniotic sac during surgery. Specifically, the drape comprises a waterproof main body drape having an incise opening that overlies and exposes a wide operative area on the body covered thereby. In order to collect such fluid a sheet of clear transparent plastic material or its equivalent, having an opening therein of larger size than the bottom incise opening of the main body drape, whereupon its external peripheral margins are secured to the main body drape by adhesive means, such as adhesive tape, heat-seal, or cement to form a waterproof bag that will receive waste fluids rapidly flowing therein.Furthermore, the results obtained by the aforementioned constructed drape collecting bag combination may also be achieved by the use of a clear transparent plastic sheet like that described hereinabove, and subsequently affix it by a waterproof adhesive or heat-seal around its outer edges onto any brand of a regular body drape that has a traditional operative opening and thus avoid the need and extra cost of obtaining a ready factory made CSection Collecting Drape. Excerpt(s): This application is related to Ser. No. 314,081 filed Feb. 23, 1989, now abandoned. The invention relates to a Cesarian Section Collecting Incise Drape with a built-in collecting means to trap the outgushing of amniotic fluid as it suddenly escapes from the opened amniotic sac when once it is incised. Until now the amniotic fluid was allowed to pour out and spill all over the drapes, surgeon's gown, and operating room floor. Today this is a most serious accident because AIDS is spreading at an alarming rate and every precaution must be taken to prevent being contaminated by the viruscontaining amniotic fluid from the mother with AIDS. When the amniotic fluid

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suddenly escapes from the uterus it spreads out in all directions. But more especially, it spreads out laterally on both sides, and inferiorly down to the groin. The only way to capture or entrap this escaping fluid is to provide a collecting system that will entrap the fluid at any point in its 360 degree circular opening. Unless the operating table is tilted so that the head is lowered (a position referred to as a Trendelenburg position), the flow of the amniotic fluid is rarely upwards. The Cesarian Section Collecting Incise Drape described herein offers several advantages to the surgeon, the patient, and operating room personnel. The patient benefits from the incise drape because it helps to prevent bacterial infection throughout the surgical procedure. The sterile incise drape by virtue of its adhesive strips around the edges of the fenestration, both on top and bottom, keeps the main body drape fixed to the skin surface of the abdomen. More importantly, the plastic incise drape is carefully laid down over the skin of the abdomen AND literally blocks all the openings or outlets of the sweat with its sudoriferous and sebaceous glands within the skin. In so doing, the plastic incise drape blocks off a variety of bacteria that are constantly present in the sebaceous and sudoriferous glands and thereby prevents them from spreading toward the site of the operative wound. The oil and sweat are constantly contaminated with staphylococci epidermidis and aureus, and other low grade bacteria. It is these organisms that are responsible for postoperative wound infections. Today there is such great concern regarding AIDS that every possible precaution must be taken to prevent contamination by the AIDS virus; this includes the surgeon, assistant, nurses, and operating room personnel. As a result they carefully stand clear of any of the patient's bodily secretions, such as amniotic fluid, serum, blood, pus or any form of drainage material. All personnel in the operating room with open sores or fresh cuts or injuries, are most careful not to come into direct contact with any of these fluids, especially when the mother is reported to have AIDS or is suspected of it. The purpose of the collecting pouch described herein, is to reduce the present-day fear that attends the surgery of a cesarian section. Potentially infected amniotic fluid is so readily trapped and kept trapped in the pouch, to be drained off by a side communicating container, that the attending fears of the operating room personnel have been greatly allayed. The built-in fluid collection features should instill a feeling of safety and confidence among those surgeons, nurses, and O.R. attendants who have to deal with the surgery of a cesarian section (C-Section) and postoperative clean-up of the operating room wastes. Web site: http://www.delphion.com/details?pn=US05209243__ •

Detection of prostate-specific antigen in amniotic fluid, maternal serum and breast milk Inventor(s): Diamandis; Eleftherios P. (44 Gerrard Street, West, Apt. 1504, Toronto, Ontario, M5G 2K2, CA) Assignee(s): none reported Patent Number: 5,679,534 Date filed: August 1, 1995 Abstract: A method for the evaluation of the condition of a fetus by quantitative measurement of prostate specific antigen (PSA) is provided. In the method, a sample of amniotic fluid or maternal serum is obtained at a gestational week and the sample is assayed for the amount of PSA present. The amount of PSA in the sample is compared with the PSA mean for the given gestational week and evaluated for the risk of a phenotypic and/or genotypic disorder.

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Excerpt(s): This invention relates to the detection of prostate-specific antigen (PSA) in amniotic fluid and pregnant women's serum to provide information on the fetus well being and also the detection of PSA in breast milk to provide information on circulating maternal steroids. Prostate specific antigen (PSA), a 33 kDa serine protease, was until recently, only detected in normal, benign hypertrophic and malignant prostatic tissues, but not in other human tissues. It was discovered that PSA exists at elevated amounts in the sera of patients with prostate cancer and therefore considered to be a highly specific biochemical marker of prostatic epithelial cells (Lilja 1985, Armbruster 1993). U.S. Pat. No. RE. 33,405 describes this prostate antigen and the diagnosis of prostate cancer through detection of PSA. PSA was not found in the sera of normal healthy persons or patients with other forms of cancer. Furthermore, tissue extracts of non prostatic origin, whether normal or neoplastic, gave no immunologic reactivity with anti-prostate antigen antiserum. These tissues included liver, spleen, lung, bone marrow, bladder, breast, intestine, heart, pancreas, kidney, cerebral and cortex. PSA biochemistry and its clinical applications for prostate cancer screening, diagnosis and monitoring have recently been reviewed (Osterling 1991, Armbruster 1993). Surprisingly PSA was later discovered in approximately 30% of breast tumors and it was established that PSA production by breast cells is mediated by steroid hormone receptors (Yu et. al., 1994). This discovery is described in PCT Patent application No. PCT/CA94/00267. The presence of prostate-specific antigen in breast tumors is associated with earlier disease stage, younger women, and better survival. Furthermore, we discovered that PSA production could be stimulated by steroids in non-PSA producing breast tumor cell lines (United Kingdom Patent Application No. 9401491.7, Yu et al., 1994). Web site: http://www.delphion.com/details?pn=US05679534__ •

Device for detecting free IGFBP-1 Inventor(s): Boltovskaya; Marina (Moscow, RU), Fuks; Boris (Mountain View, CA), Konstantinov; Alexander (Plainsboro, NJ), Nazimova; Svetlana (Moscow, RU), Starosvetskaya; Nelli (Moscow, RU), Stepanov; Alexander (Elektrostal, RU), Zaraisky; Evgeny (Moscow, RU) Assignee(s): California Research LLC (Mountain View, CA) Patent Number: 5,877,029 Date filed: October 28, 1996 Abstract: Antibodies having binding affinity for free IGFBP-1, biological compositions including antibodies having binding affinity for free IGFBP-1, kits for detecting free IGFBP-1 using the antibodies, and cell lines for producing the antibodies are provided. Also provided are devices and methods for detecting free IGFBP-1 and a rupture in a fetal membrane based on the presence of amniotic fluid in a vaginal secretion, as indicated by the presence of free IGFBP-1 in the vaginal secretion. The antibodies that are provided may be characterized by their ability to selectively recognize those IGFBP1 molecules which are free of IGF-1 and IGF-2, i.e., antibodies which have a binding affinity for free IGFBP-1 that is greater than a binding affinity of the antibody to bound IGFBP-1. These antibodies may also be characterized by their competition with IGF-1 and IGF-2 for binding to IGFBP-1. Excerpt(s): The present invention relates to antibodies, biological compositions, diagnostic methods and test devices for detecting a rupture in a fetal membrane based on the presence of amniotic fluid in a vaginal secretion. More specifically, the present invention relates to the detection of insulin-like growth-factor-binding protein 1 (IGFBP-

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1) in a free form, uncompleted to insulin-like growth-factor 1 (IGF-1) and insulin-like growth-factor 2 (IGF-2) (referred to herein as free IGFBP-1) and its use in the detection of the presence of amniotic fluid in a vaginal secretion. Premature rupturing of fetal membranes (the membrane defining the amniotic sac) in pregnant women occurs in about 5% to 14% of all pregnancies and is the cause of about 10% of all perinatal deaths. When a fetal membrane rupture occurs toward the end of a pregnancy (38-40 weeks of pregnancy), delivery of the fetus should be effected as soon as possible in order to minimize the associated risks to the fetus and the mother. A simple, rapid and effective method for identifying fetal membrane ruptures is therefore needed so that the occurrence of a fetal membrane rupture toward the end of a pregnancy can be effectively monitored in order to limit the amount of time between the occurrence of the fetal membrane rupture and delivery. Premature rupturing of fetal membranes is not a problem that is limited to the last few weeks of pregnancy. More than 30% of premature fetal membrane ruptures occur before 37 weeks of pregnancy. Fetal membrane ruptures before 37 weeks of pregnancy have been associated with significant increases in the risk of an intrauterine infection, Keirse M. J. N. C., et al., "Prelabor Rupture of the Membrane Preterm," in Efficient Care in Pregnancy and Child-birth, 1989, Vol. 1, Oxford, New York, Toronto. Edited by J. Chalmers, M. Enkin, and M. Keirse. Intrauterine penetration of such infections increase both maternal and perinatal mortality. The risk of intrauterine penetration of the intrauterine infection increases significantly as time passes between the rupture of the membrane and delivery. Early diagnosis of fetal membrane ruptures that occur before 37 weeks of pregnancy is therefore extremely important. Positive diagnosis of fetal membrane ruptures before 34 weeks of pregnancy is also important since it permits the timely monitoring and treatment of pregnant women to prevent intra-amnion infection and to stimulate fetal lung development. Web site: http://www.delphion.com/details?pn=US05877029__ •

Diamine oxidase and assay for rupture of amniotic membrane in pregnant mammals Inventor(s): Cowley; David M. (Brisbane, AU), Maguire; David J. (Brisbane, AU), Voroteliak; Victor (Brisbane, AU) Assignee(s): Griffith University (Queensland, AU) Patent Number: 5,284,749 Date filed: October 31, 1990 Abstract: Assay for detection of a form of diamine oxidase which is present only in amniotic fluid and, more especially, for detection of amniotic membrane rupture by detection of the amniotic fluid diamine oxidase. The assay includes the steps of detecting the amniotic fluid diamine oxidase and distinguishing that from another form of diamine oxidase found in serum. The assay may be carried out on a sample of vaginal fluid from a pregnant female wherein the sample is subjected to the assay to detect the leakage or presence of amniotic fluid diamine oxidase. Purified forms of amniotic fluid diamine oxidase and serum diamine oxidase which is different from amniotic fluid diamine oxidase and found in serum are also described, together with a method of purifying both forms of diamine oxidase. Excerpt(s): This is a continuation of PCT application No. PCT/AU90/00085, filed Mar. 2, 1990. The invention also relates to an assay for detection of amniotic fluid DAO in body fluids and in particular to an assay for diagnosis of rupture of amniotic membrane or leakage of amniotic fluid through the membrane. Diamine Oxidase (E.C.1.4.3.6) (hereinafter called DAO) catalyses the oxidation of diamines such as histamine,

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putrescine and cadaverine, which yields an aminoaldehyde. During early investigations the enzyme was believed to only oxidise histamine: thus the enzyme was initially named Histaminase by Best and McHenry (1929). Further investigations proved that the enzyme was capable of oxidation of other diamines such as those listed above. The nomenclature currently in use, Diamine Oxidase, was later suggested by Zeller (1965). Web site: http://www.delphion.com/details?pn=US05284749__ •

Fetal growth Inventor(s): Gluckman; Peter David (Auckland, NZ), Harding; Jane Elizabeth (Auckland, NZ), Kimble; Roy Mark (Auckland, NZ) Assignee(s): Auckland UniServices Limited (Auckland, NZ) Patent Number: 5,858,966 Date filed: June 10, 1997 Abstract: A method of enhancing fetal growth and/or development and/or neonatal survival by the administration over a period of insulin-like growth factor (IGF-1), to either the amniotic fluid or direct to the fetal gastrointestinal tract. Administration may be by way of an ultrasonically monitored injection or placement of a catheter. Excerpt(s): This invention relates to the treatment of mammalian fetuses (including human fetuses) with compositions that enhance the ability of the fetus and neonatal infant to survive. Intrauterine growth retardation (IUGR) remains a major cause of intrauterine and neonatal death and is associated with a high morbidity in the neonatal period and potentially with morbidity extending to adult life. It is frequently associated with abnormalities of placental growth and/or function. IUGR can be diagnosed with standard obstetrical techniques such as ultrasonography. However treatment of IUGR remains inadequate and restricted to either maternal bedrest or premature elective caesarean section. Immaturity of lung growth and development in fetal life may occur associated with IUGR or independent of it. Isolated failure of fetal lung growth is known as pulmonary hypoplasia and is a significant cause of neonatal death. It may be diagnosed prenatally. In prematurely born infants, immaturity of lung structure and function leads to the respiratory distress syndrome (RDS). RDS is currently treated by ventilation and pulmonary insufflation of surfactant but remains a major problem in neonatal nurseries. It has been the practice for many years to treat women at risk of premature birth or in premature labour, where delivery is delayed pharmaceutically, with steroid hormones which cross the placenta and mature the lungs. However this therapy only partially alleviates RDS. Web site: http://www.delphion.com/details?pn=US05858966__

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Fetal sensor which self-inflates using capillary force Inventor(s): Levinson; Mitchell (Pleasanton, CA) Assignee(s): Nellcor Puritan Bennett Incorporated (Pleasanton, CA) Patent Number: 6,195,575 Date filed: April 2, 1997 Abstract: A fetal sensor with a biasing mechanism for biasing the sensor against the fetus, with the biasing mechanism being automatically self-inflating and insertable in

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compressed form. The biasing mechanism in a preferred embodiment is a compressed foam or sponge which expands upon being exposed to fluid, such as amniotic fluid within the uterus. Thus, the biasing mechanism can be compressed to allow easy insertion, and then can expand once in place to provide the pressure needed to hold the sensor against the fetus. Excerpt(s): The present invention relates to a non-invasive fetal intrauterine sensor, in particular a pulse oximeter sensor. Pulse oximetry is typically used to measure various blood flow characteristics including, but not limited to, the blood-oxygen saturation of hemoglobin in arterial blood, the volume of individual blood pulsations supplying the tissue, and the rate of blood pulsations corresponding to each heartbeat of a patient. Measurement of these characteristics has been accomplished by use of a non-invasive sensor which passes light through a portion of the patient's tissue where blood perfuses the tissue, and photoelectrically senses the absorption of light in such tissue. The amount of light absorbed is then used to calculate the amount of blood constituent being measured. The light passed through the tissue is selected to be of one or more wavelengths that are absorbed by the blood in an amount representative of the amount of the blood constituent present in the blood. The amount of transmitted light passed through the tissue will vary in accordance with the changing amount of blood constituent in the tissue and the related light absorption. For measuring blood oxygen level, such sensors have been provided with light sources and photodetectors that are adapted to operate at two different wavelengths, in accordance with known techniques for measuring blood oxygen saturation. Web site: http://www.delphion.com/details?pn=US06195575__ •

In vitro activation of a nucleus Inventor(s): Wangh; Lawrence J. (Auburndale, MA) Assignee(s): Brandeis University (Waltham, MA) Patent Number: 5,480,772 Date filed: February 3, 1993 Abstract: Products and methods particularly useful for activating and analyzing the nuclei and nucleic acids of human fetal red blood cells or cells found in amniotic fluid thereby facilitating prenatal screening are described. The featured products include activating egg extracts, cytostatic factor (CSF) extracts, kits containing these extracts, and a microchamber microscope slide useful in analyzing nucleus activation. Excerpt(s): This invention concerns products, methods and apparatus for analysis of human prenatal cells. According to Roberts, Science 18:378 (1991), two procedures available for prenatal screening are chorionic villus sampling (CVS) and amniocentesis. Both these procedures have problems involving waiting time and risk of miscarriage, "estimated at 1% to 2% for CVS and 0.5% for amniocentesis." Supra. Roberts also points out a procedure for analyzing nuclear DNA directly when cells are in interphase. Lohka and Masui, Science 220:719 (1983), describe inducing the formation of a nuclear envelope in demembraned sperm of Xenopus laevis using a cell-free preparation from the cytoplasm of activated eggs of Rana pipiens. Web site: http://www.delphion.com/details?pn=US05480772__

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Intrauterine meconium detection system Inventor(s): Billings; R. Gail (Salt Lake City, UT), Smith; Roger E. (Bountiful, UT) Assignee(s): Utah Medical Products, Inc. (Midvale, UT) Patent Number: 5,713,351 Date filed: November 20, 1995 Abstract: A system for intrauterine detection of one or more biological substances, such as meconium or blood, is described. The presence in amniotic fluid of such biological substances indicates an abnormal condition which justifies intervention on the part of a medical practitioner supervising the labor and delivery. A flexible cable which can be inserted into the uterus is provided which includes at least two lumens. The first lumen is used to draw amniotic fluid through the lumen into an observation chamber outside of the uterus and at the an end of the first lumen. The fluid is visually observed by a medical practitioner for the presence of a biological substance or the biological substance can be detected by any one several described instruments. It is preferred that if an instrument is used to detect the biological substance that a transparent visual observation chamber also be included so allow visual detection also. The apparatus allows stained fluid to be withdrawn from, and clean fluid to be infused into, the uterus in order to reduce the concentration of, and the effect of, the undesirable biological substance in the uterus. Excerpt(s): This invention relates to devices and methods used in the field of obstetrics and gynecology and more particularly to devices and methods used to monitor uterine conditions during labor and delivery. During development of a human fetus, various biological materials, such as mucus, bile, and epithelial cells, accumulate in the colon of the fetus. Such materials accumulated in the fetus intestinal tract are referred to as meconium. Generally, the fetus expels the accumulated meconium during the days following parturition. Undesirably, a fetus may pass meconium into the amniotic fluid before or during birth. For example, a stressful birth may cause the fetus to pass meconium into the amniotic fluid during labor and delivery. Web site: http://www.delphion.com/details?pn=US05713351__

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Isoferritin as a marker for pathological pregnancy Inventor(s): Moroz; Chaya (40 Yehuda Hanasi St., Tel Aviv, IL) Assignee(s): none reported Patent Number: 5,871,735 Date filed: June 12, 1990 Abstract: The present invention relates to a method of diagnosis of pathological pregnancy which relies on an evaluation of the amount of placental isoferritin (PLF) in the serum or amniotic fluid of a pregnant woman. Diagnosis may also be achieved by observation of percentages of PLF-bearing lymphocytes in the pregnant female. Detection of PLF levels is achieved by immunoassay with a PLF-specific antibody. Also described is a method of treating or preventing pathological pregnancies and transplant or graft rejection by administration of effective amounts of PLF and/or a PLF-specific antibody in combination with immunization. Excerpt(s): There is currently a widespread need for simple yet accurate means of diagnosis for a number of conditions which affect pregnant women. It is often difficult,

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if not impossible, to determine in advance which pregnant women are at risk for certain conditions which may prevent carrying a child to term, and/or which may endanger the life of both mother and fetus. Early detection of problem pregnancies enables rapid implementation of necessary therapy or prophylactic measures. The present invention now provides a serum marker which may be used for the diagnosis and detection of several types of pathological pregnancies. The marker which is indicative in all these conditions is placental isoferritin (PLF; or oncofetal or embryonic ferritin). Accurate detection of the presence or absence of the marker is enabled by the discovery of a PLFspecific monoclonal antibody, as well as a broadly cross-reacting monoclonal antibody to isoferritin. The existence of these antibodies has made possible the construction of immunoassays which can accurately and rapidly facilitate diagnosis of the aforementioned disease states. Iron is known to be an essential element of the makeup of every living organism, but may also become toxic at physiological pH values by virtue of its tending to oxidize, hydrolyze and precipitate as insoluble ferric oxide polymers. The protein ferritin, found in all living cells, is the body's means for ensuring that iron toxicity does not occur. Ferritin functions by storing iron in the cells in a soluble and readily available form. The iron stored in cells may then be mobilized whenever needed by the body, for example, for erythropoiesis. The name "ferritin" actually encompasses a number of individual isomeric forms which are characteristic of different tissue types. Each isoferritin has 24 subunits of two distinct types, namely light subunits (L) and heavy subunits (H). These subunits differ in molecular weight, the light subunit being about 18 kDa, and the heavy subunit about 19-21 kDa. The isoferritins extracted from different tissues or organs typically exhibit different isoelectric points, with the isoelectric focusing pattern of human tissues forming a continuous spectrum; those tissues associated with high iron storage have ferritins at the basic end of the spectrum (e.g. spleen and liver), while iron poor tissues, (e.g. heart and placenta) and malignant cells have acidic ferritins. (Drysdale, Ciba Found. Symp. 51:41, 1977). The difference in isoelectric point appears to be related to the different distribution of light and heavy subunits in each type. Specifically, heavy subunit-rich ferritins are relatively acidic, and light chain rich ferritins are relatively basic (Cosell, et al., in Ferritins and Isoferritins as Biochemical Markers, p. 49-65, 1984, Elsevier). Current studies indicate that the H and L subunits are encoded by a complex group of genes, therefore suggesting that there is an even greater heterogeneity of ferritin molecules than had previously been expected. Web site: http://www.delphion.com/details?pn=US05871735__ •

Measurement of a CNS protein in cerebrospinal or amniotic fluid Inventor(s): Perrone-Bizzozero; Nora (Albuquerque, NM), Thompson; Peter M. (Albuquerque, NM) Assignee(s): University of New Mexico (Albuquerque, NM) Patent Number: 6,132,977 Date filed: March 13, 1998 Abstract: SNAP-25 (synaptosomal associated protein) is purified from cerebrospinal or amniotic fluid for immunoassay and quantitation. Quantitation of these proteins is useful in the diagnosis and monitoring of brain disorders and diseases such as schizophrenia and Alzheimer's. Excerpt(s): The invention relates to the identification and quantitation of a central nervous system (CNS) protein in cerebral spinal fluid and amniotic fluid. Certain CNS

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proteins are of interest as markers and trackers of brain pathophysiology, especially in the areas of synaptogenesis and synaptic vesicle release. Neurotransmitter release is, however, a complicated process involving many different proteins (Nature 355: 409-415, 1992), some of which are SNAP-25 (synaptosomal associated protein-25 kDa), VAMP/synaptobrevin (1,2), syntaxin (1a, 1b), neurexin (1,2), synapsin (1,2), and synaptophysin. The understanding of normal brain physiology is moving at great speed. One area that is especially important to diagnosing and treating mental illnesses is the pathway for release of neurotransmitters. In this process proteins called vesicular snares (V-snares) attach to plasma membrane and release neurotransmitter (Nature 335: 409415, 1992). One T-snare that is associated with mental illness is SNAP-25. This protein is found predominately in brain tissue of neuronal origin (Molecular Brain Research 1: 116, 1986). The other major brain tissue (glial cells) is non-neuronal and SNAP-25 has not been associated with this tissue. SNAP-25 in monomeric form is 25 kDa, but can be found in vivo as a dimer, or associated with other synaptic proteins (e.g. syntaxins). Web site: http://www.delphion.com/details?pn=US06132977__ •

Meconium monitoring system Inventor(s): Danielian; Peter J. (Aberdeen, GB2), Genevier; Eric S. G. (London, GB2), Randall; Nigel J. (London, GB2), Smith; Robin W. (Crovdon, GB2), Steer; Philip J. (Kingdyon upon Thames, GB2) Assignee(s): Charing Cross & Westminster Medical School (London, GB2) Patent Number: 5,361,759 Date filed: July 1, 1993 Abstract: A system for in vivo monitoring of the presence and concentration of meconium and/or blood in amniotic fluid during labor by spectral analysis includes a probe for insertion in the uterus, the probe having a flexible body housing an optical cell. The probe has at least one aperture so that amniotic fluid can enter the cell. A fiber optic cable connects the cell to a light source and to a spectral analyzer, and the probe includes structure for shielding the fiber optic cable from any light scattered by the wall of the uterus or fetus. Excerpt(s): This application relates to a system and method for monitoring the quality of amniotic fluid during labor. In recent years, it has become accepted that there is a need for more information concerning the condition within the uterus just prior to and during labour in order to predict and avoid birth complications. U.K. Patent Application No. 87 23605 (Publication No. 2195897) describes an intrauterine probe which enables certain conditions, especially the fetal heart rate and the intrauterine pressure to be continuously monitored during labor. Any monitoring system should desirably be noninvasive to the fetus and be capable of a continuous collection of data concerning the condition of interest. During intrauterine life, the human fetus collects within its bowel a collection of debris known as meconium. Passage of meconium in utero occurs in about 10% of babies overall, probably as part of a sympathetic `fright, flight or fight` reaction. Because regular uterine contractions interfere with maternal blood flow within the placenta, the mean oxygen tension in fetal blood during labour drops from about 5 to 3 kPa. This is thought to be the major stimulus causing the fetus to pass meconium in utero; it occurs with increasing frequency as gestation advances, reaching almost one third of all fetuses by 42 weeks gestation. Web site: http://www.delphion.com/details?pn=US05361759__

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Method for assessing fetal lung maturity using amniotic fluid samples Inventor(s): Alvarez; Juan G. (Boston, MA), Ludmir; Jack (Chestnut Hill, MA) Assignee(s): Beth Israel Hospital Association (Boston, MA) Patent Number: 5,443,989 Date filed: October 25, 1993 Abstract: The present invention provides an accurate, rapid and precise methodology for assessing maturity of the lungs in a fetus prior to birth, especially for premature fetuses having a gestation period of 37 weeks or less. The methodology quantitatively measures a specific phosphoglyceride, dipalmitoyl phosphatidyl choline, in samples of amniotic fluid for the assessment of fetal lung maturity. The process enzymatically cleaves such phophoglycerides and preferably detects the resulting diacylglycerols by HPTLC-reflectance spectrodensitometry. Excerpt(s): The present invention is concerned with the assessment of fetal lung maturity; and is particularly directed to a high-specificity assay for the determination of dipalmitoyl phosphatidyl choline in amniotic fluid samples as the means by which to assess if the fetal lung is mature, immature, or borderline in development. One of the major dilemmas that an obstetrician frequently encounters in his daily practice is whether or not to deliver a woman in preterm labor (onset of labor at.ltoreq.37 weeks of gestational age), or to deliver or not a woman with some underlying disease that could be alleviated by terminating the preterm pregnancy. If the baby is delivered and the lungs of the baby are not mature or are borderline, the baby will develop Respiratory Distress Syndrome (or "RDS") which can result either in fetal death or long-lasting periods of repeated respiratory difficulty. The prevalence of RDS when the gestational age is below 31 weeks is 60%, but drops to 1% by a gestation of 36 weeks. It is estimated today that in the metropolitan Boston area alone the number of patients that need to be tested for the assessment of fetal lung maturity (or "FLM") is about 4,000 per year. Immature fetal lungs lack an adequate surfactant layer which normally lines the alveoli and helps to keep the alveoli open after exhalation. The quantity of phospholipids generally in amniotic fluid, and of dipalmitoyl phosphatidyl choline (or "DPPC") in particular, has been correlated with the amount of surfactant lining the alveoli and with the degree of fetal lung maturity. Phosphatidyl choline (or "PC") fractional species represent nearly 80 percent of the surfactant phospholipid varieties in the fetal lung (Clements, Am. Rev. Resp. Dis, 101:984 (1970); and dipalmitoyl phosphatidyl choline (or "DPPC") constitutes about 60 percent of the fetal lung phosphatidyl choline species fraction. Other PC fraction species include 1-palmitoyl, 2-palmitoleoyI-PC (20%); 1palmitoyl, 2-oleoyl-PC (10%); and other minor PC varietal species (10% ). The remaining lung surfactant phospholipid components also include phosphatidyl inositol, phosphatidyl ethanolamine, sphingomyelin and phosphatidyl serine. Interestingly enough, the second major phospholipid of lung surfactants is phosphatidyl glycerol, comprising more than 10 percent of the mature surfactant in the lining of the lung (Pleger and Thomas, Arch. Intern. Med, 127:863 (1971); Hallman and Gluck, Biochem. Biophys. Res. Commun. 60:1 (1974). Web site: http://www.delphion.com/details?pn=US05443989__

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Method for predicting and/or preventing preterm labor Inventor(s): Woodruff; Teresa K. (San Bruno, CA) Assignee(s): Genentech, Inc. (South San Francisco, CA) Patent Number: 5,545,616 Date filed: September 22, 1994 Abstract: A method is provided for avoiding premature labor in a pregnant mammal comprising administering to said mammal, during labor, but before an infant is to be delivered, an effective amount of an activin antagonist. In one embodiment, the antagonist is follistatin. In another aspect a method is provided for assaying whether a pregnant mammal is in imminent delivery of its fetus in preterm labor comprising contacting a maternal serum sample or amniotic fluid sample of the mammal with a reagent that detects activin A and measuring the level of activin A in the serum or amniotic fluid. In addition, a kit for the assay is provided. Excerpt(s): This invention relates to methods to forecast premature labor in a pregnant mammal and to prolong the term of pregnancy thereof to avoid preterm delivery. Inhibin and activin are members of a family of growth and differentiation factors. The prototype of this family is transforming growth factor-beta (TGF-.beta.). Derynck et al., Nature, 316: 701-705 (1985); Ying et al., Biochem. Biophys. Res. Commun., 135: 950-956 (1986). Other members of the TGF-.beta. family include the Mullerian inhibitory substance, the fly decapentaplegic gene complex, and the product of Xenopus Vg-1 mRNA. Inhibin is a glycoprotein produced by diverse tissues, including the gonads, pituitary, brain, bone marrow, placenta, and adrenal gland. It was initially identified by its ability to inhibit the secretion of follicle stimulating hormone (FSH) by the pituitary. De Jong and Sharpe, Nature, 263: 71-72 (1976); Schwartz and Channing, Proc. Natl. Acad. Sci. USA, 74: 5721-5724 (1977). Such preferential regulation of the gonadotropin secretion has generated a great deal of interest and prompted many laboratories in the past fifty years to attempt to isolate and characterize this substance from extracts of testis, spermatozoa, rete testis fluid, seminal plasma, and ovarian follicular fluid using various bioassays. Rivier et al., Biochem. Biophys. Res. Commun., 133: 120 (1985); Ling et al., Proc. Natl. Acad. Sci. USA, 82: 7217 (1985); Fukuda et al., Mol. Cell Endocrinol., 44: 55 (1985). The structure of inhibin, characterized from several species, consists of two disulfide-linked subunits: an.alpha. and either a.beta.sub.A or a.beta.sub.B chain. Web site: http://www.delphion.com/details?pn=US05545616__

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Method for taking a sample of amniotic fluid Inventor(s): Sundberg; Karin (Hellerup, DK) Assignee(s): Amnitec A/S (Soberg, DK) Patent Number: 5,494,044 Date filed: May 6, 1994 Abstract: A sample of amniotic fluid containing cells may be taken out from the amniotic cavity by penetrating the wall of the amniotic cavity by means of a hollow needle (15) through which a volume of the amniotic fluid may be withdrawn. Outside the amniotic cavity the cells or part thereof are separated from the amniotic fluid which is immediately thereafter returned to the amniotic cavity. This means that it is possible to withdraw a relatively large amount of cells without considerably reducing the total

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volume of the amniotic fluid present in the amniotic cavity. Therefore, it is possible to take out a sample at an early stage of pregnancy period. The sample may, for example, be withdrawn by means of a sampling device comprising a one-way valve (16, 17) including a cell filter (17). The sampling device may further comprise a syringe with cylinder (10) and a piston (11) movably arranged therein. By moving the piston (11) through a suitable number of consecutive suction and pressure strokes a suitable amount of cell material is deposited on the cell filter (17). The filter (17) may be withdrawn from the sampling device and the cells may be cultured on the cell filter or the cells may be flushed from the filter by means of a culturing medium. Excerpt(s): The present invention relates to a method of taking out a sample of a cellcontaining amniotic fluid from an amniotic cavity, said method comprising penetrating the wall of the amniotic cavity by means of a hollow needle or cannula and extracting a volume of cell-containing amniotic fluid therethrough. In some countries sampling of amniotic fluid is offered to pregnant women having an increased risk of bearing children with chromosome disorders. If the sample collected indicates that the child to be born is diseased an induced abortion is offered. With the presently applied sampling technique 15-20 ml amniotic fluid is collected in the 16th week of pregnancy, and normally a further 3-4 weeks elapse before a result of the laboratory examination is available. Consequently, the pregnant woman in most cases will be in the 19th-20th week of pregnancy before an abortion can be induced. Of course this represents a heavy strain for the woman at this advanced stage of pregnancy and also from a medical point of view it is inappropriate. Web site: http://www.delphion.com/details?pn=US05494044__ •

Method for the identification of a liquid secreted by a living subject particularly for identification of amniotic fluid Inventor(s): Abraham-Fuchs; Klaus (Erlangen, DE), Binder; Helge (Herzogenaurach, DE), Schmidt; Kai-Uwe (Erlangen, DE), Tork; Joachim (Erlangen, DE), Wildt; Ludwig (Herzogenaurach, DE) Assignee(s): Siemens Aktiengesellschaft (Munich, DE) Patent Number: 6,206,840 Date filed: August 12, 1999 Abstract: In a method for identifying a liquid secreted by a living subject, particularly amniotic fluid, the liquid is identified by means of its characteristic volatile constituents. Excerpt(s): The present invention is directed to a method for the identification of a liquid secreted by a living subject, particularly amniotic fluid, and is also directed to an apparatus for implementation of the method. During a pregnancy, a premature rupture of the amnion can occur, which is the loss of amniotic fluid with opening the water bag without the uterus being in labor. The clinical reason for a premature rupture of the amnion is that a path through the vagina between the exterior environment and the intra-uterine embryonic region is established, and as a result the access of bacteria with subsequent intra-uterine infection becomes possible. An intra-uterine infection can be life-threatening for the child as well as for the mother, and moreover can lead to permanent sterility. Whereas manifest rupture of the amnion with some loss of amniotic fluid raises no diagnostic problems, a so-called high rupture of the amnion often can be detected only with great difficulty. Patients report a loss of fluid, but it is not clear whether it is amniotic fluid, urine or vaginal secretion.

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Method of detecting rupture of the amniotic membranes in pregnant mammals Inventor(s): Cowley; David Michael (16 Mapleleaf Street, Eight, Mile Plains, Brisbane, Queensland 4113, AU), Voroteliak; Victor (342 Lillian Avenue, Salisbury, Queensland, 4107, AU) Assignee(s): none reported Patent Number: 5,783,396 Date filed: September 7, 1995 Excerpt(s): The present invention relates to the method of detecting rupture of the amniotic membranes in pregnant mammals including humans using an immunoassay and reagents useful in such an assay. The method describes how to prepare a suitable protein antigen from amniotic fluid, gives criteria for the selection of this protein from the mixture of proteins present in amniotic fluid using the techniques of protein purification, gives criteria for assessing a sufficient degree of antigen purity for raising antibodies to the antigen and shows how the resultant antibodies can be used in immunoassays to detect the presence of amniotic fluid in the vagina and consequently to detect rupture of the amniotic membranes. The method also relates to the detection of amniotic fluid in other situations. (1) Rupture of the amniotic membranes in mammals. (2) Detection of rupture of the amniotic membranes in mammals. Web site: http://www.delphion.com/details?pn=US05783396__

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Method of isolating a CA 195-like immunoreactive antigen from human amniotic fluid Inventor(s): Duffy; Thomas H. (Santa Ana, CA) Assignee(s): Ciba Corning Diagnostics Corp. (Medfield, MA) Patent Number: 5,324,822 Date filed: December 21, 1992 Abstract: A method of isolation of a material with similar immunological properties to CA-195 from human amniotic fluid has been disclosed. This material can be substituted for CA-195 in many processes, for example in the preparation of analytical control materials. Excerpt(s): A CA 195-like immunoreactive antigen has been identified in human amniotic fluid. This material appears to perform the same as and quite likely have the same composition as CA 195. This invention also relates to the isolation, and use, of the CA 195- like material. This invention relates to the identification of an CA 195-like material in human amniotic fluid. This material is present in amniotic fluid in a much higher level than that in normal human serum and can be isolated without encountering the difficulties of handling the other human materials. The identification of the CA 195like material in amniotic fluid has lead to the ability to isolate a material which is much less expensive to produce than the previous materials and methods and which appears to be as useful as the previous materials. The invention covers not only the identification of the material but also techniques for isolation and use of the CA 195-like material. Web site: http://www.delphion.com/details?pn=US05324822__

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Method of treatment for premature rupture of membranes in pregnancy (PROM) Inventor(s): Enscore; David J. (Sudbury, MA), Herman; Stephen J. (Andover, MA), Kablik; J. Jeffrey (Tyngsboro, MA), Kazo; Glenn M. (New Ipswich, NH) Assignee(s): Andre Bieniarz (Chicago, IL) Patent Number: 6,350,463 Date filed: May 21, 1999 Abstract: Premature Rupture of the Membranes (PROM) is a serious complication of pregnancy. PROM is treated by creation of a seal or barrier at the site of the rupture or in or near the cervix, thereby controlling the loss of amniotic fluid and preventing bacterial access. Instruments and techniques for application of sealing and barrierforming materials at appropriate sites are described, as well as appropriate selection of materials and formation techniques. The instruments and techniques facilitate application of any fluent material to physiology associated with pregnancy and rendering the fluent material non fluent so as to form a barrier of seal. Excerpt(s): If membrane rupture could be repaired, or if leakage of amniotic fluid could be minimized or prevented, it is believed that premature delivery could be significantly delayed, thereby significantly extending the degree of fetal maturity. Every day of extension of pregnancy can decrease the severity of fetal impairment due to prematurity by up to one percent; thus, maximizing the duration of pregnancy is clinically important. Cessation of leakage would also tend to minimize intrauterine infection. However, there are at present no reliable techniques for such treatment. In particular, the amniotic membrane is poorly vascularized and slow to heal, and is not easily accessible. Moreover, the location of the rupture is often difficult to determine. The literature describes attempts to block amniotic fluid release by means of balloons, or with fibrin glue. Neither of these techniques has been sufficiently successful to enter general practice. Restriction of amniotic fluid loss with a balloon or similar device may be ineffective to prevent infection, and fibrin glue is typically rapidly degraded. Materials and techniques for treating body tissues and sealing leaking lesions in tissues are known. Web site: http://www.delphion.com/details?pn=US06350463__

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Nontoxic vernix compositions and method of producing Inventor(s): Hoath; Steven B. (Cincinnati, OH), Pickens; William L. (Cincinnati, OH), Visscher; Martha O. (Cincinnati, OH) Assignee(s): Children's Hospital Medical Center (Cincinnati, OH) Patent Number: 5,989,577 Date filed: March 2, 1998 Abstract: A composition consisting essentially of vernix for a skin curative and skin protectant effect and a method of producing. A natural or synthetic vernix is dispersed in a film-forming amount in a biocompatable liquid such as dimethylsulfoxide, amniotic fluid and/or pulmonary surfactant to form a film. The film may be applied to a growing layer of epithelial cells either directly or supported on a substrate such as a wound dressing, a diaper, or a feminine hygiene product.

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Excerpt(s): The invention relates generally to a therapeutic or prophylactic vernix film for enhanced skin growth and maturation. Skin is one of the largest organs in the body and covers substantially the entire body surface. Skin is composed of two main layers: the surface epithelium or epidermis which includes the uppermost stratum corneum, and the subjacent connective tissue layer or dermis. The skin has a number of functions such as protecting an organism from injury and dessication, receiving environmental stimuli, excreting various substances, regulating body temperature and helping to maintain water balance. Because of its quantitative and qualitative importance, substantially intact and healthy skin is crucial not only for the well being of an organism but for its very survival. The health and integrity of skin may be compromised by wounds, abrasions, ulcers, burns, infections, irritations, premature birth and other conditions for which normal skin production and repair processes may be inadequate. For example, acute conditions such as patients who are burned over a large surface area often require immediate skin replacement. Less life-threatening but chronic skin problems such as decubitus ulcers or irritations from diaper rash may progress to more severe conditions if left untreated or if they occur in a neonate or a geriatric patient. Skin treatments encompass a variety of methods and products. These may range from symptomatic treatments such as the use of topical anti-inflammatory compounds to the use of replacement skin. For various physiological, medical, and other reasons, however, none of these treatments meet the desired goal of utilizing the body's own healing and repair system to promote its own skin growth and maturation. Web site: http://www.delphion.com/details?pn=US05989577__ •

Prenatal diagnosis by cytokine-induced proliferation of fetal T-cells Inventor(s): Roncarolo; Maria-Grazia (Los Altos, CA) Assignee(s): Schering Corporation (Kenilworth, NJ) Patent Number: 5,405,751 Date filed: January 12, 1994 Abstract: The invention provides improved methods of prenatal diagnosis that can be performed earlier in pregnancy, and/or with greater safety, and/or rapidity, and/or with greater accuracy than conventional methods. A volume of amniotic fluid containing fetal cells is extracted from a pregnant woman, and the fetal T-cells are propagated in a culture medium comprising one or more cytokines. The fetal T-cells are then diagnosed for genetic defects. Excerpt(s): The invention applies the technical field of cell biology to the development of novel methods of prenatal diagnosis. In certain disease states, the genetic component predominates over environmental factors. These diseases are termed genetic disorders and typically fall into one of three categories: (1) disorders characterized by the absence, excess, or abnormal arrangement of one or more chromosomes; (2) Mendelian or simply-inherited disorders, primarily caused by a single mutant gene and subclassified into autosomal dominant, autosomal recessive, or X-linked types; and (3) multifactorial disorders caused by interaction of multiple genes and environmental factors. The economic cost of genetic disorders is enormous. For example, the annual U.S. expenditure on treatment for the genetic disease cystic fibrosis alone is estimated at about $500 million. Cystic fibrosis and other genetic diseases account for the presence of at least one-third of the children in pediatric hospitals. Thompson & Thompson, Genetics in Medicine (4th ed. 1986). The psychological and emotional costs to those afflicted with genetic disorders and their families are incalculable. Prenatal diagnosis

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and genetic counselling are important in detecting, preventing, and treating genetic disorders. If no abnormality is detected, parents' worries are diminished as the fetus is carried to term. If a fetal abnormality is detected sufficiently early, parents have the option of aborting the pregnancy. Occasionally, antenatal detection of an abnormality may allow its treatment before birth, or facilitate its treatment immediately after birth by notifying doctors when treatment is required and allowing for early preparation. Web site: http://www.delphion.com/details?pn=US05405751__ •

Prenatal non-invasive detection of meconium stained amniotic fluid Inventor(s): Doody; Michael C. (4203 Towanda Trail, Knoxville, TN 37919) Assignee(s): none reported Patent Number: 5,172,693 Date filed: January 16, 1990 Abstract: This invention describes a process for the diagnosis of meconium stained amniotic fluid. Meconium staining is often the result of ongoing or transient fetal distress or prolonged gestation. This process involves the non-invasive illumination of the amnion with light of a specific wavelength and detecting the fluorescence of certain biological pigments contained within the meconium. The process uses a source of light and a means of selecting the desired wavelength of light, directing the light to the target area, retrieving the fluorescence, converting the fluorescent emission to an electrical signal, amplifying the signal and analyzing the signal with a data processing unit. Excerpt(s): This invention relates generally to the field of obstetrics and gynecology and more particularly to the noninvasive prenatal diagnosis of a meconium state pregnancy. During gestation and prior to birth, the fetus, in a normal state pregnancy is continent. During its prenatal life, mucus, bile and epithelial cells build up in the fetus's colon. This buildup is known as "meconium". Meconium contains a large amount of bilirubin and its metabolites which is derived from the breakdown of fetal blood cells. In the normal pregnancy meconium is not excreted until after parturition; however, ongoing or transient stress can cause the fetus to expel meconium into the surrounding amniotic fluid. The incidence of meconium staining often increases with gestational age. This staining results in a "Meconium state pregnancy". The presence of meconium stained fluid is indicative of a need for more intensive early labor monitoring. Infants born with meconium staining have lower overall infant assessment scores than their peers born without meconium staining. Another danger associated with meconium staining is the risk of the infant inhaling meconium into its lungs at the time of birth. This results in "Meconium Aspiration Syndrome", a very severe form of pneumonia that often kills the infant or renders it a pulmonary cripple for life. Meconium aspiration syndrome is also a significant cause of cerebral palsy. Because of the lower infant assessment scores and the risk of meconium aspiration syndrome, infants born with meconium staining have a higher mortality and morbidity rate than infants born without meconium staining. Currently meconium staining can be diagnosed only by direct visualization of the amniotic fluid. This would usually occur at the time the placental membranes rupture; an event which may not necessarily occur at an early enough stage of labor to allow the detection of meconium staining by that method to be of any practical value. Meconium can also be detected during an amniocentesis. This is an invasive procedure wherein a needle is inserted into the amniotic sac through the abdominal wall and an aliquot of amniotic fluid is withdrawn. This procedure is most often performed in order to perform certain prenatal genetic tests or protein assays. It is not performed for the sole

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purpose of meconium detection, and is not performed routinely. A diagnostic process that would allow a non-invasive means of detecting meconium staining in a term pregnancy is therefore needed. It is at least one object of this invention to provide a low risk non-invasive process for the detection of meconium stained amniotic fluid that could be performed at any stage of pregnancy. However, those skilled in the art will recognize that this invention could also be useful in the diagnosis of other prenatal conditions that result in the presence of increased porphyrin breakdown products in amniotic fluid. Web site: http://www.delphion.com/details?pn=US05172693__ •

Pressure catheter device with enhanced positioning features Inventor(s): Cutler; Christopher A. (Centerville, UT), Smith; Steven R. (Draper, UT), Wallace; Wm. Dean (Salt Lake City, UT) Assignee(s): Clinical Innovation Associates, Inc. (Murray, UT) Patent Number: 5,951,497 Date filed: June 18, 1997 Abstract: A pressure catheter for monitoring changes in pressure within the body is comprised of an outer tube containing a fluid channel and a closed air column having a pressure-compliant member which is deformable upon an increase in pressure. A change in pressure deforms the pressure-compliant member, which modifies the pressure in the air column, and is translated to a pressure sensor, which converts the pressure change data to an electrical signal recognizable by a fetal monitor. The outer tube employs a window extending along at least a portion of the side thereof for viewing of bodily fluids moving through the fluid channel from the body in which the catheter is inserted toward the proximal catheter end. The pressure catheter of the present invention is particularly suitable for intrauterine pressure monitoring during labor. Viewing of amniotic fluid through the window facilitates verification of proper catheter tip placement within the amniotic fluid space. Venting closures for facilitating venting of fluid through the channel are also disclosed. Excerpt(s): This invention relates to devices for detecting changes in intrauterine pressure during labor. More specifically, the invention relates to catheter devices for determining pressure changes in the uterus through transference of uterine pressure to a gas-containing compliant chamber associated with a closed air column, such catheter devices including features to facilitate appropriate positioning within the uterus of a patient. Other intracorporeal applications for the catheter of the invention are also contemplated. It has become common practice in the delivery and birth of a baby to monitor intrauterine conditions throughout the period of labor. Monitoring the intrauterine environment, including fetal heart rate and uterine contractions, enables the attending medical personnel to evaluate the progress of the delivery and to diagnose the existence of, or potential for, emergency situations which require immediate attention or action. Where intrauterine monitoring was once of singular importance in high risk and difficult deliveries, it has now become a routine part of the delivery procedure in many births. While only ten percent of all births are considered to be high-risk, warranting the use of intrauterine monitoring, intrauterine monitoring is used in sixty to seventy percent of all births regardless of the level of risk attributed to the birth. In actuality, about twenty percent of births experience complications. It has long been recognized that an important relationship exists between fetal heart rate (FHR) and intrauterine pressure (IUP) and that such data relates to the well-being of the fetus during labor and

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delivery. Historically, two types of uterine monitoring have been practiced--external and internal. External uterine monitoring essentially comprises the attachment of a monitoring device to the mother's abdomen. The external uterine monitoring device generally detects fetal heart rate, and may have some capability for detecting intrauterine pressure or other indicia of the labor process. However, external monitoring is limited in its effectiveness because of the inaccuracy of readings obtained from the device. As uterine contractions increase, more "noise" is detected in such systems and data output becomes difficult to interpret. In addition, externally attached uterine monitoring devices move when the patient moves and, therefore, require frequent repositioning. Web site: http://www.delphion.com/details?pn=US05951497__ •

Transurethrovesical biopsy, amniocentesis and biological sampling guide Inventor(s): Wright; Jeffrey (San Antonio, TX) Assignee(s): Board of Regents, The University of Texas System (Austin, TX) Patent Number: 5,147,335 Date filed: August 24, 1989 Abstract: A metehod and device for transurethrovesical biopsies, amniocenteses and other biological sampling procedures utilizing a double lumen catheter is achieved by the present invention. The catheter includes a rigid lumen to guide a needle and a second lumen able to pass fluid. In transurethrovesical sampling procedures, the catheter is positioned across the bladder with one end of the catheter against the bladder wall which adjoins the uterus wall. Fluids pass through the second lumen to fill the bladder and increase sonographic visibility allowing the user better visibility for precise placement of the catheter. Preferably, an amniocentesis or biopsy needle is passed through the first rigid lumen, through the bladder wall, through the uterus wall and into the amniotic sac to allow withdrawal of amniotic fluid or other biological sample. The needle may then be withdrawn through the rigid lumen and the catheter removed. In other biosampling procedures, the catheter is positioned across a body cavity to permit filling the cavity with fluid, sampling the target and sonographically viewing the biosampling operation. Excerpt(s): The invention in a broad aspect relates to a multi-lumen catheter and a method for using the catheter for performing transurethrovesical biopsies, amniocenteses and other biological sampling procedures. More particularly, the invention provides for filling a bladder or other body cavity with a solution to increase sonographic visibility, during sonographic monitoring, and guiding a needle through the bladder or other cavity to accomplish a biopsy, amniocentesis or other biological sampling procedure. Conventional amniocentesis is performed by passing an amniocentesis needle through the abdominal wall to gain access to the amniotic sac. Care must be exercised when passing the needle to avoid misguidance of the needle resulting in injury to the mother or fetus. Because X-ray imaging may damage the fetus, the preferred imaging method to aid in guiding the amniocentesis needle is sonographic. Typically, a sonographic transducer is positioned to allow observation of the amniotic sac and the amniocentesis needle as the needle approaches and enters the amniotic sac. When a sonographic image is made through a cavity, the quality of the image, referred to as sonographic visibility, is improved when the cavity is filled with a fluid, preferably a liquid, rather than merely air.

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Triple gradient process for recovering nucleated fetal cells from maternal blood Inventor(s): Bhat; Neelima M. (Cupertino, CA), Bieber; Marcia M. (Los Altos Hills, CA), Teng; Nelson N. H. (Hillsborough, CA) Assignee(s): The Board of Trustees of the Leland Stanford Junior University (Stanford, CA) Patent Number: 5,275,933 Date filed: September 25, 1992 Abstract: Nucleated fetal cells such as nucleated fetal red blood cells are separated from maternal blood with a discontinuous triple gradient gel and centrifugation. Nucleated fetal red blood cells are collected at an interface between a gel layer having a density in the range of from 1.105 to 1.110 g/mL and the second layer having a density in the range of from 1.075 to 1.085 g/mL, and maternal granulocytes are collected at an interface between a gel layer having a density in the range of from 1.115 to 1.125 g/mL and a layer having a density in the range of from 1.105 to 1.110 g/mL. This allows separation of fetal cells for testing from the maternal blood rather than the placenta or amniotic fluid, reducing the risk of sample collection and facilitating routine testing of fetal cells for evidence of genetic defects. Excerpt(s): This invention relates to a method or process for separating nucleated fetal red blood cells and other nucleated fetal cells from maternal blood using a discontinuous or step triple gradient gel. The examination of fetal cells for early detection of fetal diseases and genetic abnormalities is undertaken in approximately one out of every thirty pregnant women. The main indication is maternal age (over 35 years). The tests may involve DNA gene typing or, more commonly, the use of live fetal cells for chromosomal karyotyping. Fetal cells are usually obtained by amniocentesis, the removal of amniotic fluid from the amniotic cavity within the amniotic sac or placenta. The procedure presents a risk of harm to the fetus, particularly after the first trimester of pregnancy. The risk to the fetus together with the high cost of the procedure have prevented the establishment of examination of fetal cells for early detection of abnormalities as a routine procedure in pregnancy. Web site: http://www.delphion.com/details?pn=US05275933__

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Wound therapeutic mixture containing medical grade hyaluronic acid and tissue culture grade plasma-fibronectin in a delivery system that creates a moist environment which simulates in utero healing Inventor(s): Taylor-McCord; Darlene (24666 Morningstar La., Dana Point, CA 92629) Assignee(s): none reported Patent Number: 5,604,200 Date filed: May 2, 1994 Abstract: A wound therapeutic mixture is formulated to work alone or in combination with human growth factors, and is useful for treatment of burns, open sores, incisions, and wounds. The mixture is comprised of a medical grade hyaluronic acid (hyaluronan) and tissue culture grade plasma-fibronectin in combination with calcium, phosphate,

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uric acid, urea, sodium, potassium, chloride, and magnesium, all elements found in amniotic fluid. The mixture creates a moist healing environment which simulates the fetal in utero wound healing matrix. The therapeutic mixture can be sterile or contain an FDA acceptable preservative system. The compositions may be in the form of a liquid, creme, ointment, gel, hydrogel, hydrocolloid or dressing. Excerpt(s): This invention relates the treatment of burns, open sores, incisions and wounds. In particular it relates to topical wound therapeutic formulations containing a hyaluronic acid (hyaluronan) and plasma-fibronectin in combination with elements found in amniotic fluid which simulates the fetal in utero wound healing matrix. The "greying of America" is well documented. People are living longer and have expectations for a quality life as well as well as a long life. People afflicted with long term illness run the risk of getting bed sores, pressure sores and a myriad of skin irritations and chronic wounds. Web site: http://www.delphion.com/details?pn=US05604200__

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

3D ultrasound-based instrument for non-invasive measurement of amniotic fluid volume Inventor(s): Chalana, Vikram; (Mill Creek, WA), Dudycha, Stephen; (Bothell, CA), McMorrow, Gerald; (Kirkland, WA) Correspondence: Black Lowe & Graham Pllc; 816 Second Avenue; Seattle; WA; 98104; US Patent Application Number: 20040024302 Date filed: May 20, 2003 Abstract: A hand-held 3D ultrasound instrument is disclosed which is used to noninvasively and automatically measure amniotic fluid volume in the uterus requiring a minimum of operator intervention. Using a 2D image-processing algorithm, the instrument gives automatic feedback to the user about where to acquire the 3D image set. The user acquires one or more 3D data sets covering all of the amniotic fluid in the uterus and this data is then processed using an optimized 3D algorithm to output the total amniotic fluid volume corrected for any fetal head brain volume contributions. Excerpt(s): This invention claims priority to provisional patent application Serial No. 60/423,881 filed Nov. 5, 2002, and to provisional patent application Serial No. 60/400,624, filed Aug. 2, 2002. This invention pertains to the field of obstetrics, particularly to ultrasound-based non-invasive obstetric measurements. Measurement of the amount of Amniotic Fluid (AF) volume is critical for assessing the kidney and lung function of a fetus and also for assessing the placental function of the mother. Amniotic fluid volume is also a key measure to diagnose conditions such as polyhydramnios (too much AF) and oligohydramnios (too little AF). Polyhydramnios and oligohydramnios

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

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are diagnosed in about 7-8% of all pregnancies and these conditions are of concern because they may lead to birth defects or to delivery complications. The amniotic fluid volume is also one of the important components of the fetal biophysical profile, a major indicator of fetal well-being. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Amniotic apoptosis modulating substances Inventor(s): Bakhutashvili, Vladimir; (Tbilisi, GE) Correspondence: Albert Wai-Kit Chan; Attorney AT Law; Suite 604; 141-07 20th AVE.; Whitestone; NY; 11357; US Patent Application Number: 20020114846 Date filed: August 9, 2001 Abstract: This invention is directed to methods of obtaining compounds from human amniotic tissue and/or by synthesizing these compounds by chemical and genetic engineering methods known in the art that modulate apoptosis in animals, including humans, their preparation, their applications in human conditions for the treatment of all disease conditions and other conditions in which apoptosis occurs and in laboratory tests for diagnostic studies and other potential uses. The invention describes methods of obtaining compositions that modulate apoptosis and compositions obtained thereby. These compositions are herein referred to as Amnion Apoptosis Modulators (AAM). AAM includes materials comprised of biologically active factors found in amniotic tissue and amniotic fluid associated therewith. AAM could be manufactured from the amniotic tissue of mammalian origin--human, pig etc. All AAMs, derived from amnions or chemically or genetically prepared are physiologically acceptable for administration in amount sufficient to modulate apoptosis. The invention encompasses methods of use of the AAMs. Excerpt(s): Throughout this application, references are made to various publications. Disclosures of these publications in their entireties are hereby incorporated by reference into this application to more fully describe the state of the art to which this invention pertains. The invention(s) is directed to method(s) of obtaining compounds from human amniotic tissue and/or by synthesizing these compounds by chemical and genetic engineering methods known in the art that modulate apoptosis in animals, including humans, their preparation, their applications in human conditions for the treatment of all disease conditions and other conditions in which apoptosis occurs and in laboratory tests for diagnostic studies and other potential uses. Apoptosis, is a Greek word that describes the process of "leaves falling from a tree" and can be understood as that naturally occurring process. It is a mode of cell death that occurs in plants and animals under normal physiological conditions as well under conditions of disease and trauma. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 117

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Device and method for measuring fetal blood pH Inventor(s): Belson, Amir; (Cupertino, CA), Kreiser, Doron; (Herzlia, IL) Correspondence: Leary & Associates; 3900 Newpark Mall RD.; Third Floor, Suite 317; Newark; CA; 94560; US Patent Application Number: 20040092843 Date filed: February 22, 2002 Abstract: A hand-mounted device for obtaining a sample of blood from the scalp of a fetus and for measuring the pH of the blood sample includes a lancet for incising the scalp of the fetus, a capillary for obtaining a drop-sized sample of blood and a pH electrode within the capillary for analyzing the pH of the blood. Optionally, a motorized actuator may be provided for automatically advancing and withdrawing the lancet and the capillary. The pH measuring device includes an isolating mechanism, in the form of an everting bell-shaped member, an inflatable balloon member or an expandable funnel member, and a flushing/aspiration lumen for clearing the distal region of the device of amniotic fluid while in use. Excerpt(s): The present application claims the benefit of U.S. Provisional Patent Application 60/270,669, filed on Feb. 22, 2001. The present invention relates generally to devices and methods for obtaining a sample of blood from the scalp of a fetus and for measuring the pH of the blood sample. More particularly, it relates to a device for measuring fetal blood pH that is mounted on a physician's hand and incorporated into a glove, finger cot or ring for convenience of use. Fetal blood pH is an important indicator of fetal stress during labor and delivery. The following U.S. patents describe devices and methods of measuring fetal blood pH: U.S. Pat. No. 6,058,321 Instrument for continuously monitoring fetal heart rate and intermittently monitoring fetal blood pH and method of use; and U.S. Pat. No. 4,441,510 Method and apparatus for fetal pH scalp studies. The following U.S. patent discloses a finger-tip applicator for placement of an ECG electrode on the scalp of a fetus: U.S. Pat. No. 4,244,375 Transcutaneous electrode with finger operative attachment assembly. These patents and all other patents and patent applications referred to herein are hereby incorporated by reference in their entirety. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Diagnostic agents for the prenatal diagnosis of preterm delivery, fetal infection, and fetal damage, and diagnostic kit containing the same Inventor(s): Yoon, Bo Hyun; (Seoul, KR) Correspondence: Joseph Hyosuk Kim; Jhk Law; PO Box 1078; LA Canada; CA; 910121078; US Patent Application Number: 20040029176 Date filed: April 30, 2003 Abstract: This invention is about a method for the prenatal diagnosis of preterm delivery, fetal infection, and fetal damage, and diagnostic reagent system and diagnostic kit for the diagnosis. The method, diagnostic reagent system, and kit are based on the finding that the level of MMP-8 in the amniotic fluid is significantly higher when the pregnant woman is at risk for preterm delivery, intrauterine infection, and fetal damage. The diagnostic reagent system and kit can be applied to the patients without, as well as

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with, clinical signs of preterm labor or premature rupture of fetal membranes. With the superiority in sensitivity and specificity as well as its less invasiveness compared to the conventional method of measuring fetal blood cytokine levels, this diagnostic reagent system and kit is very useful in the prenatal diagnosis of preterm delivery, fetal infection, and fetal damage. Excerpt(s): The present invention relates to a diagnostic reagent system for the prenatal diagnosis of preterm delivery, fetal infection, and fetal damage, and a diagnostic kit using the same reagents and, more particularly, to the use of an amniotic fluid matrix metalloproteinase-8 (MMP-8) concentration as a prenatal diagnostic marker for preterm delivery, fetal infection, and fetal damage. It has long been recognized in the medical world that the prevention of preterm delivery or premature rupture of fetal membranes is preferred to the post-treatment thereof. However, a great variety of factors are now known to cause preterm delivery or premature rupture of fetal membranes, making it difficult to prevent the undesirable events. Traditional approach to the prevention of preterm delivery was to identify high-risk group of women to which special attention should be paid based on the knowledge of obstetrics and gynecology, demography, and various syndromes (Main et al., Am. J. Obstet. Gynecol., 151:892-898, 1985). However, this approach has the problem of being neither sensitive nor specific. To circumvent this problem, extensive research has been directed to find biochemical markers for the prediction of impending preterm delivery and premature rupture of fetal membranes, leading to the nomination of plasma estradiol-17 beta, progesterone, C-reactive protein as promising candidates. However, these candidates were found to be of poor accuracy. Besides the identification of such biochemical predictable markers, significant attention has been paid to the biochemical role of collagen, based on the fact that the chorionic membrane is composed of fibrous connective tissue and the tensile strength of fibrous connective tissue is determined by its collagen content, as revealed through studies on the premature rupture of fetal membranes. On the basis of their finding that prematurely ruptured fetal membranes has low collagen content compared to normal membranes, some scientists concluded that the premature rupture of fetal membranes is attributable to the lower tensile strength than that of normal fetal membranes (Obstet. Gynecol., 57:487-89, 1981). According to another study, it was reported that the serum activity of collagenase was high in prematurely ruptured fetal membranes and preterm labor (Obstet. Gynecol., 75:84-88, 1990). However, the precise mechanism of such biochemical changes has not yet been elucidated (FEBBS Letters, 244(2):315-318, 1989). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Diagnostic pad Inventor(s): Behar, Yael; (Moshav Ein Ayala, IL), Kritzman, Amnon; (Zichron Yaakov, IL), Nachshon, Nitsa Galili; (Kibbutz Geva, IL) Correspondence: Winston & Strawn; Patent Department; 1400 L Street, N.W.; Washington; DC; 20005-3502; US Patent Application Number: 20030017605 Date filed: July 19, 2001 Abstract: An indicator system including two pH sensitive indicators and a reagent is disclosed. The indicator system can be integrated into a number of products such as sanitary napkins or panty shields and thus can indicate the presence of amniotic fluid or secretions associated with vaginosis without giving a false positive result upon exposure to urine.

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Excerpt(s): The present invention relates to the field of medical diagnostics and, more specifically, to an improved substrate and indicator system that are useful, for example, for the diagnosis of medical conditions by identification of vaginal secretions. Many bodily fluids can be readily identified by chemical properties such as pH One exceptionally useful method of determining the pH of a liquid sample is through the use of an indicator, a chemical compound or combination of compounds, that has a pH dependent color. Well known examples include tea and wine. General details and descriptions of some indicators can be found, for example, in "Indicators", E. Bishop, Pergamon Press, 1972, chapter 3, which is incorporated by reference for all purposes as if fully set forth herein. Often an indicator is attached to a solid substrate such as paper A sample of a liquid of which the pH needs to be determined is applied to the substrate. The pH of the liquid is determined by determining the color of the indicator present on the substrate. Depending on how the indicator is attached to the substrate, application of the liquid sample may cause the indicator to leach out of the substrate. Since in many applications indicator leaching is undesirable, the indicator is often substantially immobilized on the substrate. One use wherein pH sensitive indicators are immobilized on a substrate is in medical diagnostics, specifically when the indicator is incorporated in a swab, gauze, panty shields, hygienic napkin or related product. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method to treat pulmonary hypoplasia in the newborn Inventor(s): Moskowitz, David W.; (St. Louis, MO) Correspondence: Patrea L. Pabst; Holland & Knight Llp; Suite 2000, One Atlantic Center; 1201 West Peachtree Street, N.E.; Atlanta; GA; 30309-3400; US Patent Application Number: 20030032598 Date filed: August 8, 2002 Abstract: A method of treating pulmonary hypoplasia in infants has been developed, wherein epidermal growth factor (EGF) is administered to the pulmonary system of an infant in need of treatment thereof. The EGF is administered as an aerosol or dry powder directly to the pulmonary tree, or into the amniotic fluid before birth if a situation such as oligohydramnios is recognized pre-term. The method can also be used to treat persistent pulmonary hypertension of the newborn. A hydrophobic angiotensin I-converting enzyme (ACE) inhibitor such as ramipril can also be used for the oral treatment of persistent pulmonary hypertension of the newborn. Excerpt(s): This application claims priority to U.S. Ser. No. 60/311,663 filed Aug. 13, 2001. This application is generally in the field of methods and epidermal growth factor compositions for treatment of pulmonary hypoplasia in newborn infants. The main problem with babies born prematurely is secondary pulmonary immaturity (hypoplasia). Persistent pulmonary hypertension of the newborn (PPHN) is the result of elevated pulmonary vascular resistance to the point that venous blood is diverted to some degree through fetal channels into the systemic circulation and bypasses the lungs, resulting in systemic arterial hypoxemia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods and apparatus for harvesting vaccine from eggs Inventor(s): Hebrank, John H.; (Durham, NC) Correspondence: Myers Bigel Sibley & Sajovec; PO Box 37428; Raleigh; NC; 27627; US Patent Application Number: 20030227613 Date filed: June 10, 2002 Abstract: Methods and apparatus for producing vaccine within a plurality of eggs are provided. Each of a plurality of eggs is illuminated with light from one or more LEDs. A detector is positioned adjacent each egg and detects light passing therethrough. Each egg is then identified as containing a live embryo or as being a non-live egg. Each egg that is determined not to contain a live embryo may be removed, either automatically or by hand. A seed virus is injected into each egg identified as containing a live embryo. After a predetermined period of incubation each live embryo is euthanized and amniotic fluid containing a vaccine produced as a result of the presence of a seed virus is harvested from each euthanized egg. Excerpt(s): The present invention relates generally to eggs and, more particularly, to methods and apparatus for processing eggs. Discrimination between poultry eggs on the basis of some observable quality is a well-known and long-used practice in the poultry industry. "Candling" is a common name for one such technique, a term which has its roots in the original practice of inspecting an egg using the light from a candle. As is known to those familiar with eggs, although egg shells appear opaque under most lighting conditions, they are in reality somewhat translucent, and when placed in front of a direct light, the contents of the egg can be observed. An egg may be a "clear" or "infertile" egg, meaning that it does not have an embryo. More particularly, a "clear" egg is an infertile egg that has not rotted. An egg may be an "early dead" egg, meaning that it has an embryo which died at about one to five days old. An egg may be a "mid-dead" egg, meaning that it has an embryo which died at about five to fifteen days old. An egg may be a "late-dead" egg, meaning that it has an embryo which died at about fifteen to eighteen days old. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Multiple and multivalent DNA vaccines in ovo Inventor(s): Kuo, Tsun Yung; (I-Lan, TW) Correspondence: Venable, Baetjer, Howard And Civiletti, Llp; P.O. Box 34385; Washington; DC; 20043-9998; US Patent Application Number: 20030175291 Date filed: March 4, 2003 Abstract: The present invention provides a muliple DNA vaccine and/or a multivalent DNA vaccine for use in aquiring embroyonic immunity in fowl eggs. The multiple DNA vaccine contains two or more DNA constructs, each containing a DNA molecule encoding an avian viral protein or a fragment thereof capable of inducing a protective immune response against the avian viral disease in fowl. The multivalent DNA vaccine contains one DNA construct which contains two or more DNA molecules, each representing an avian viral gene or a fragment thereof. The multivalent DNA vaccine is capable of expressing two or more viral antigens and inducing protective immune responses against the avian viral diseases in fowl. Both the multiple DNA vaccine and

Patents 121

the multivalent DNA vaccine are preferred to be injected into the amniotic fluid of the fowl egg after being fertilized for about 18 days. Excerpt(s): This application claims the priority of U.S. Provisional Application Serial No. 60/362,547, filed on Mar. 8, 2002, which is herein incorporated by reference. The present invention relates to either a muliple DNA vaccine or a multivalent DNA vaccine for use in aquiring embroyonic immunity in fowl eggs and methods for preparing and using the same. The multiple DNA vaccine contains two or more DNA constructs, each containing a DNA molecule encoding an avian viral protein or a fragment thereof capable of inducing a protective immune response against an avian viral disease in fowl. The multivalent DNA vaccine contains a DNA construct which contains two or more DNA molecules. Each of the DNA molecules represents an avian viral gene or a fragment thereof. The multivalent DNA vaccine is capable of expressing two or more viral antigens and inducing protective immune responses against two or more of the avian viral diseases in fowl. Both the multiple DNA vaccine and the multivalent DNA vaccine are preferred to be injected into the amniotic fluid of the fowl egg after being fertilized for about 18 days. In ovo vaccination of virus-containing vaccines was extensively described by Sharma et al. (U.S. Pat. No. 4,458,630). In particular, it teaches that live Marek's disease virus can be injected into amniotic fluid within the egg, whereafter the embryo is infected and the vaccine virus replicates to a high titer which induces the formation of protective antibodies in the treated embryo. (See Sharma (1985), Avian Diseases 29, 1155, 1167-68). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Probiotic strains, a process for the selection of them, compositions thereof, and their use Inventor(s): Boza Puerta, Julio; (Granada, ES), Jimenez Lopez, Jesus; (Granada, ES), Martin Jimenez, Rocio; (Granada, ES), Rodriguez Gomez, Juan Miguel; (Madrid, ES), Xaus Pey, Jordi; (Granada, ES) Correspondence: Katten Muchin Zavis Rosenman; 575 Madison Avenue; New York; NY; 10022-2585; US Patent Application Number: 20040057943 Date filed: June 26, 2003 Abstract: The present invention relates to a novel process for the selection of new probiotic strains which comprises the following steps: a) selecting for non-pathogenic strains which are capable of surviving in breast milk and/or amniotic fluid, and b) selecting for non-pathogenic strains which are able to be transferred to breast milk and/or amniotic fluid after oral intake in healthy individuals without colonizing other internal organs except mucousas. The invention also provides new Lactobacillus strains, which are: CECT5711 (Lactobacillus coryniformis), CECT5713 (Lactobacillus salivarius subsp. salivarius), CECT5714: (Lactobacillus gasseri, formerly L. acidophilus), CETC5715: (Lactobacillus gasseri), and CECT5716: (Lactobacillus fermentum); and refers to their use for the prophylaxis or treatment against digestive, infective, neurodegenerative and immune related diseases such as allergies or inflammatory diseases. Excerpt(s): The present invention relates to a novel process for the selection of new probiotic strains, to new probiotic microorganisms of the genus Lactobacillus selected according to this method and to compositions comprising these microorganisms; to their use for the prophylaxis or treatment against digestive, infective, neuro-degenerative and

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immune related diseases such as allergies or inflammatory diseases, and to a novel source to obtain said microorganisms. For many years, lactic acid bacteria have been utilized as fermenting agents for the preservation of food taking benefit of a low pH and the action of fermentation products generated during the fermentative activity thereof to inhibit the growth of spoilage bacteria. With this aim, non-well characterized lactic acid bacteria or "fermentum" have been used to prepare a variety of different foodstuffs such as dry fermented meat products, cheese, and other fermented dairy products from milk. Recently, lactic acid bacteria have attracted a great deal of attention because some strains have been found to exhibit valuable properties to man and animals upon ingestion. In particular, specific strains of the genus Lactobacillus or Bifidobacterium have been found to be able to colonize the intestinal mucosa and to assist in the maintenance of the well-being of man and animal, and has been named such as probiotics. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Repair of ruptured membrane by injection of naturally occurring protein in amniotic fluid sac Inventor(s): Berry, David; (Austin, TX) Correspondence: David L. Parker; Fulbright & Jaworski L.L.P.; Suite 2400; 600 Congress Avenue; Austin; TX; 78701; US Patent Application Number: 20020133169 Date filed: May 13, 2002 Abstract: The present invention provides compositions and methods for use in treatment of premature rupture of membrane. The compositions of the invention include a therapeutic amount of an avian thick egg white composition. Preferably, the compositions include the purified thick egg white protein, ovomucin. The methods of the invention involve injecting an effective amount of the compositions into the prematurely ruptured amniotic sac of a patient in order to seal the rupture. Excerpt(s): The present invention relates generally to the fields of obstetrics and/or perinatal medicine. More particularly the invention relates to repair of pre-parturition rupture of the amniotic fluid sac. Premature rupture of membranes (PROM) during the second and early third trimester of human pregnancy creates a management dilemma for obstetricians. There are currently many management protocols for PROM. Recent literature argues the risks and benefits of tocolytic agents, antibiotics, and corticosteroid injections primarily for delaying delivery, preventing intraamniotic infection, and enhancing fetal maturity, respectively, in the event of almost certain preterm delivery. However, to date, no true accepted treatment for PROM exists. Medline searches of this topic reveal only scant data in Italian studies on intracervical instillation of fibrin glue, and Japanese attempts at mechanical blockage of the cervix using double balloon-tipped catheters. The ideal therapy for PROM in the absence of chorioamnionitis, and deciduitis (infections implicated in premature rupture and preterm labor) would seem to be to recreate an intact amniotic fluid sac using a benign sealant injected into the amniotic sac using needles no bigger than those now commonly used for amniocentesis. By recreating the integrity of the amnion, such a technique would provide a barrier to ascending infection from the normal bacterial flora of the cervix and vagina commonly isolated in most all obstetric and gynecologic infections. Such a technique would also allow reaccumulation of normal amniotic fluid volumes, thus protecting the fetus from compression of its own umbilical cord.

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

Secretion-monitoring article Inventor(s): Kritzman, Amnon; (Zichron Yaakov, IL), Nachshon, Nitsa G.; (Kibbutz Geva, IL), Yael, Bechar; (Moshav Ein Ayala, IL) Correspondence: Winston & Strawn; Patent Department; 1400 L Street, N.W.; Washington; DC; 20005-3502; US Patent Application Number: 20030166293 Date filed: November 1, 2002 Abstract: A secretion-monitoring article for identifying a secreted biological fluid having a body with an absorbent material and least one pH determining member and a reagent associated with the absorbent material is disclosed. The article can be embodied as a swab, gauze, panty shield, hygienic napkin, diaper or interlabial absorbent structure and can be used to indicate the presence of amniotic fluid, or secretions associated with bacterial, parasite, fungal, or yeast infections without giving a false positive result upon exposure to urine. The present invention also teaches a pH indicator mixture and method of attaching the indicator to a substrate for use alone or integrated in an absorbent body and further teaches a method for monitoring the health condition of a person using the secretion-monitoring article. Excerpt(s): This application is a continuation-in-part of the U.S. national stage designation of International Application PCT/IL02/00588, filed Jul. 18, 2002, which in turn is a continuation-in-part of U.S. application Ser. No. 09/907,926, filed Jul. 19, 2001. The International application claims the benefit of U.S. Provisional Application No. 60/365,684, filed Mar. 18, 2002. The present invention relates to the field of medical diagnostics and more specifically, to an improved identification of secreted biological fluids using a secretion-monitoring article to identify amniotic fluid or secretions associated with bacterial, parasite, fungal, or yeast infections even in the presence of interfering biological fluids. The present invention also relates to improved methods of attaching an indicator to a substrate and methods of preparing and using a secretionmonitoring article to identify a secretion. Many bodily fluids can be readily identified by chemical properties such as pH. One exceptionally useful method of determining the pH of a liquid sample is through the use of an indicator, a chemical compound or combination of compounds, that has a pH dependent color. Well known examples include tea and wine. General details and descriptions of some indicators can be found, for example, in "Indicators," E. Bishop, Pergamon Press, 1972, chapter 3. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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System for identifying premature rupture of membrane during pregnancy Inventor(s): Montgomery-Rice, Valerie; (Parkville, MO), Smith, Ramada S.; (Columbia, MD), Torok, Brian A.; (Berkley, MI) Correspondence: Powell, Goldstein, Frazer & Murphy Llp; P.O. Box 97233; Washington; DC; 20090-7223; US Patent Application Number: 20010025140 Date filed: January 12, 2001

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Abstract: An article for the identification of the premature rupture of a membrane during pregnancy is disclosed. In its preferred embodiment, the article comprises a pad having an upper outer layer, a lower outer layer, and an intermediate pH-responsive component. A double-sided adhesive strip is attached to the lower outer layer. The upper outer layer is composed of a liquid permeable material. Intermediate of the upper out layer and the inner outer layer is a pH-sensitive component. This intermediate layer is a pH-sensitive material and may be one of a variety of such materials, although a preferred material is nitrazine paper. In the presence of an alkaline fluid, such as amniotic fluid, the pH-sensitive material responds by turning to a purple-blue color. The change in color acts as a visual indicator to the wearer of the possible presence of amniotic fluid outside of the amniotic sac. As an alternate embodiment, the article may be fitted with a slide for gathering amniotic fluid, thus allowing the examining physician to make a visual evaluation. Excerpt(s): The present invention is generally directed to an article for the identification of the premature rupture of a membrane during pregnancy. More particularly, the present invention is directed to an indicating article in the form of a multilayered pad that is fitted to the undergarment of a user. The multilayered pad includes a treated component which responds to the presence of amniotic fluid as a discharge. As an alternate embodiment, a thin flexible plastic slide may be incorporated with the pad for microscopic examination. The amnion develops around the embryo during the second week following fertilization. This is the second membrane to appear after the placenta forms around the chorion. The margin of the amnion is attached to the periphery of the embryonic disk. Eventually, as the embryo grows, the amnion fuses with the chorion surrounding it and the two membranes become a single amniochorionic membrane. Amniotic fluid fills the amniochorionic membrane to provide a watery environment to protect the growing embryo. Ordinarily the amniochorionic membrane acts as a primary barrier to bacteria and other potentially damaging organisms by providing a protected, substantially sealed environment throughout the development of the embryo until it ruptures subsequent to the onset of labor. However, this environment is occasionally compromised when it is prematurely ruptured prior to the onset of labor. Technically, premature rupture of the membrane can occur at any time during the forty weeks of gestation. Although definitions vary, "premature rupture of the membrane" refers to rupture of the amniochorionic membrane prior to the onset of labor at any time. In either case, a ruptured membrane poses a considerable risk of infection to both mother and fetus. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Topical wound therapeutic compositions Inventor(s): Lezdey, Darren; (Indian Rocks Beach, FL), Lezdey, John; (Indian Rocks Beach, FL) Correspondence: John Lezdey ESQ.; 1409 A North FT Harrison; Clearwater; FL; 33755; US Patent Application Number: 20010041684 Date filed: May 1, 2001 Abstract: There is provided a composition for healing burns and wounds in mammals, which contains a cromolyn compound or the combination of a cromolyn compound and hyaluronic acid a corticosteroid.Advantageously, elements found in amniotic fluid are also included.

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Excerpt(s): This application is a continuation in-part of application Ser. No. 09/503,833 filed Feb. 15, 2000 of Lezdey et al. This invention relates the treatment of decubitus ulcers, burns, open sores, incisions and wounds in mammals. In particular, it relates to topical wound therapeutic formulations containing a cromolyn compound alone or the combination of hyaluronic acid (hyaluronan) and a cromolyn compound. The formulations can also be used in combination with elements found in amniotic fluid. Adult wound repair is characterized by fibrosis, scarring, and sometimes by contracture. The results of this deforming process affect every form of surgery and can have devastating consequences. In contrast fetal wound healing proceeds without such fibrosis or scar formation, Michael T. Longaker, M.D., Ernie S. Chiu, B.S., N. Scott Adzick, M.D., Michael Stern, D.D.S., Michael R. Harrison, M.D., and Robert Stern, M.D., Studies in Fetal Wound Healing, V. A Prolonged Presence of Hyaluronic Acid Characterizes Fetal Wound Fluid, Ann Surg, April 1991, pp. 292-296. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Vaccine accelerator factor (VAF) for improvement of vaccinations in poultry Inventor(s): Kuo, Tsun Yung; (I-Lan, TW) Correspondence: Venable, Baetjer, Howard And Civiletti, Llp; P.O. Box 34385; Washington; DC; 20043-9998; US Patent Application Number: 20030207836 Date filed: May 6, 2003 Abstract: The present invention provides a vaccine accelerator factor (VAF) which is an in ovo nucleotide immuno-stimulant. The VAF contains one or more DNA constructs, each having a DNA molecule and a vector. Each of the DNA molecule contains one or more genes or gene fragments, each encoding an antigenic peptide of an avian virus. The VAF is preferably administered to the amniotic fluid of an egg after being fertilized for about 17-19 days. The VAF can be co-administered with a viral vaccine containing one or more attenuated or inactive avian viruses. Alternatively, the VAF can be administered prior to the administration of the viral vaccine, which is administered at hatch or post-hatch. The VAF stimulates and accelerate a protective immune response of a viral vaccine. Excerpt(s): The present application is a continuation-in-part (CIP) of U.S. patent application Ser. No. 10/377,718 filed on Mar. 4, 2003, which in turn claims the benefit of the filing date of U.S. provisional application No. 60/362,547, filed on Mar. 8, 2002, which are herein incorporated by reference. The present invention relates to a vaccine accelerator factor (VAF) which is an in ovo nucleotides-immuno-stimulant containing one or more DNA constructs, each having a DNA molecule and a vector. Each of the DNA molecule contains one or more genes or gene fragments, each encoding an antigenic peptide of an avian virus. The VAF is preferably administered to the amniotic fluid of an egg, which has been fertilized for about 17-19 days. The VAF can be coadministered with a viral vaccine containing one or more attenuated or inactive avian viruses or a recombinant DNA vaccine. Alternatively, the VAF can be injected into egg prior to the administration of the viral vaccine. In that case, the viral vaccine is preferably administered at hatch or post-hatch. The VAF stimulates and accelerate a protective immune response of a viral vaccine against the avian virus of which the DNA molecule of the VAF contains a gene or a fragment thereof. Routine vaccinations used in veterinary practice have had a highly beneicial impact on the health and welfare of livestock and companion animals. Poultry vaccines can be administered via different

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routes and by various methods. For example, a post-hatch spray vaccination method has been widely used. This method can mass-immunize day old chicks through aerosol spray. Also, live or attenuated vaccines can be administered to poultry through traditional method, i.e., by subcutaneous injection to chicks, rearing stock and breeders. Furthermore, poultry vaccines can be delivered via eye drops and/or intranasal routes during brooding of chicks. Finally, and most prevalently, vaccines can be administered to poultry via drinking water. This vaccination method has the advantage of low cost, but its effectiveness, particularly against some infections, is limited due to less control of vaccination. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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

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CHAPTER 6. BOOKS ON AMNIOTIC FLUID Overview This chapter provides bibliographic book references relating to amniotic fluid. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on amniotic fluid 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 “amniotic fluid” (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 amniotic fluid: •

Embracing Laura: The Grief and Healing Following the Death of an Infant Twin Source: Omaha, NE: Centering Corporation. 1998. 20 p. Contact: Available from Centering Corporation, 7230 Maple Street, Omaha, NE 68134. (402) 553-1200, (402) 553-0507 (Fax), [email protected] (E-mail), http://www.centering.com (Web Site). $5.75 including shipping and handling. ISBN 1-56123-109-6. Summary: In this book the author relates the story of her pregnancy with twins and the trauma of losing one of them in utero. The ultrasound showed a boy and a girl, but the girl was very sick. Laura had Down's Syndrome, a cystic hygroma, a heart defect, and a club foot; the doctors told the author and her husband that with her conditions she would die in utero or at birth. There also was the possibility that as she developed in the womb she would produce too much amniotic fluid, in which case miscarriage of both babies could occur. The parents opted for selective reduction, and Laura was delivered with her brother, David, later that year. The author relates the anguish of carrying the

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dead fetus and the constant fear that the other twin would not survive. The book describes how difficult it was for the parents to tell their 3-year-old daughter, Christine, about her sister's death; the differences in the way the author and her husband grieved the death of their daughter; and how the author prepared for a birth in which one baby was alive and the other dead. The author felt divided loyalties when leaving the hospital. She wanted to be joyful over David's birth, but it felt disloyal to Laura. When she grieved for Laura, she felt disloyal to David. The parents affirmed Laura's life by writing birth announcements for both babies; having a mother's ring made that contained three stones, one for each child; and planting a sugar maple tree in her honor in a park overlooking the Mississippi. They buried her ashes with the roots of the tree, which has become a place to go when they need to remember her. The book concludes with a list of suggestions for other parents who have experienced the loss of a twin or multiple.

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

Testing for Gestational Diabetes Source: in Reece, E.A. and Coustan, D.R., eds. Diabetes Mellitus in Pregnancy. 2nd ed. New York, NY: Churchill Livingstone. 1995. p. 261-275. Contact: Available from Churchill Livingstone. 300 Lighting Way, Secaucus, NJ 07094. (800) 553-5426. PRICE: $92.00. ISBN: 0443089795. Summary: This chapter covers diagnostic criteria for the oral glucose tolerance test and for the intravenous glucose tolerance test (IVGTT) in testing for gestational diabetes. In addition, the author examines proposed screening tests, including historical factors, glycosylated hemoglobin and other blood protein levels, and other oral challenge tests. The diagnostic use of amniotic fluid glucose, insulin, and C-peptide, as well as postpartum evaluation of women with suspected diabetic fetopathy, are also discussed. 6 tables. 90 references. (AA-M).

•

Fetal Lung Development Source: in Reece, E.A.; Coustan, D.R., eds. Diabetes Mellitus in Pregnancy. 2nd ed. New York, NY: Churchill Livingstone. 1995. p. 93-106. Contact: Available from Churchill Livingstone. 300 Lighting Way, Secaucus, NJ 07094. (800) 553-5426. PRICE: $92.00. ISBN: 0443089795. Summary: This chapter, from a medical textbook on diabetes mellitus in pregnancy, discusses fetal lung development. The authors stress that in pregnancy complicated by diabetes, abnormalities in the metabolic and hormonal environment result in delayed fetal lung maturation. Topics include the physiology of fetal lung development;

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respiratory distress syndrome (RDS), its diagnosis, and risk factors; amniotic fluid indices of lung maturity; diabetic pregnancy and fetal lung maturity, including the mechanisms leading to RDS, how hormonal changes delay lung maturity, how insulin and hyperglycemia may affect fetal lung maturation, White's classification system and its role in assessing RDS risk, how maternal glycemic control affects RDS risk, and recommendations for clinical management of these pregnancies. The authors note that, with the advent of methods to analyze surfactant components and deficiencies, it is now possible to predict the risk of respiratory distress syndrome (RDS) in infants of mothers with diabetes (IDMs). The authors conclude that improvements in obstetric management aimed at controlling maternal glycemia and eliminating metabolic and hormonal abnormalities, as well as efforts to promote vaginal delivery with mature amniotic fluid fetal lung profiles, have resulted in a dramatic decrease in the incidence of RDS among IDMs. Continued advances, including hormone therapy to accelerate fetal lung maturation when delivery is indicated despite known fetal lung immaturity, are likely to further reduce this risk. 3 figures. 4 tables. 81 references.

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CHAPTER 7. PERIODICALS AND NEWS ON AMNIOTIC FLUID Overview In this chapter, we suggest a number of news sources and present various periodicals that cover amniotic fluid.

News Services and Press Releases One of the simplest ways of tracking press releases on amniotic fluid 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 “amniotic fluid” (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 amniotic fluid. 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 “amniotic fluid” (or synonyms). The following was recently listed in this archive for amniotic fluid: •

C-reactive protein in amniotic fluid predicts preterm delivery Source: Reuters Medical News Date: March 01, 2002

•

Ureaplasma urealyticum in amniotic fluid linked to adverse outcomes Source: Reuters Medical News Date: December 06, 2000

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•

Ultrasound-identified pocket a poor indicator of low amniotic fluid volume Source: Reuters Medical News Date: September 10, 1999

•

Preterm labor: matrix metalloproteinase-9 levels in amniotic fluid predict intraamniotic infection Source: Reuters Medical News Date: July 06, 1999

•

Meconium-Stained Amniotic Fluid Risk Factor For Cerebral Palsy In Preterm Infants Source: Reuters Medical News Date: October 29, 1997

•

Volume of Amniotic Fluid Can Be Increased By Maternal Hydration Source: Reuters Medical News Date: May 21, 1996 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 “amniotic fluid” (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 “amniotic fluid” (or synonyms). If you know the name of a company that is relevant to

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amniotic fluid, 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 “amniotic fluid” (or synonyms).

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

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APPENDICES

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

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

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

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

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

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

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

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

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

10

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

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•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 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:12 •

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

•

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

•

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

•

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

•

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

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

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

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

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

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

•

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

11

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

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•

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

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

The NLM Gateway13 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.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “amniotic fluid” (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 20410 233 978 36 181 21838

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 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.17 Simply search by “amniotic fluid” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

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

14

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). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

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

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

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Coffee Break: Tutorials for Biologists18 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.19 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.20 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/.

18 Adapted 19

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. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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

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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 Prenatal Testing http://www.nlm.nih.gov/medlineplus/prenataltesting.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 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 amniotic fluid. 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/

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

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

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to amniotic fluid. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with amniotic fluid. 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 amniotic fluid. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “amniotic fluid” (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 “amniotic fluid”. 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 “amniotic fluid” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “amniotic fluid” (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.21

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

21

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)22: •

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/

22

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

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•

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

•

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

•

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

•

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

•

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/

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

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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

•

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

•

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

•

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

•

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

•

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

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on amniotic fluid: •

Basic Guidelines for Amniotic Fluid Amniotic fluid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002220.htm

•

Signs & Symptoms for Amniotic Fluid Polyhydramnios Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003267.htm

•

Diagnostics and Tests for Amniotic Fluid Amniocentesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003921.htm

•

Background Topics for Amniotic Fluid Gestation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002367.htm

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

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

•

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

•

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

•

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

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AMNIOTIC FLUID DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 1-phosphate: A drug that halts cell suicide in human white blood cells. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidemia: Increased acidity of blood. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenoleukodystrophy: A chromosome X-linked disease. [NIH]

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Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Agglutinins: Substances, usually of biological origin, that cause cells or other organic particles to aggregate and stick to each other. They also include those antibodies which cause aggregation or agglutination of a particulate or insoluble antigen. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Air Sacs: Thin-walled sacs or spaces which function as a part of the respiratory system in birds, fishes, insects, and mammals. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [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] Albuminuria: More than normal amounts of a protein called albumin in the urine.

Dictionary 157

Albuminuria may be a sign of kidney disease. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Allantois: An embryonic diverticulum of the hindgut of reptiles, birds, and mammals; in man its blood vessels give rise to those of the umbilical cord. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allogeneic: Taken from different individuals of the same species. [NIH] Alpha-Defensins: Defensins found in azurophilic granules of neutrophils and in the secretory granules of intestinal paneth cells. [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] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form

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proteins. [NIH] Aminopeptidases: A subclass of exopeptidases that act on the free N terminus end of a polypeptide liberating a single amino acid residue. EC 3.4.11. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amniocentesis: Percutaneous transabdominal puncture of the uterus during pregnancy to obtain amniotic fluid. It is commonly used for fetal karyotype determination in order to diagnose abnormal fetal conditions. [NIH] Amnion: The extraembryonic membrane which contains the embryo and amniotic fluid. [NIH]

Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anemic: Hypoxia due to reduction of the oxygen-carrying capacity of the blood as a result of a decrease in the total hemoglobin or an alteration of the hemoglobin constituents. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneuploidy: The chromosomal constitution of cells which deviate from the normal by the addition or subtraction of chromosomes or chromosome pairs. In a normally diploid cell the loss of a chromosome pair is termed nullisomy (symbol: 2N-2), the loss of a single chromosome is monosomy (symbol: 2N-1), the addition of a chromosome pair is tetrasomy (symbol: 2N+2), the addition of a single chromosome is trisomy (symbol: 2N+1). [NIH]

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Anginal: Pertaining to or characteristic of angina. [EU] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anisotropy: A physical property showing different values in relation to the direction in or along which the measurement is made. The physical property may be with regard to thermal or electric conductivity or light refraction. In crystallography, it describes crystals whose index of refraction varies with the direction of the incident light. It is also called acolotropy and colotropy. The opposite of anisotropy is isotropy wherein the same values characterize the object when measured along axes in all directions. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Annexins: Family of calcium- and phospholipid-binding proteins which are structurally related and exhibit immunological cross-reactivity. Each member contains four homologous 70 kD repeats. The annexins are differentially distributed in vertebrate tissues (and lower eukaryotes) and appear to be involved in membrane fusion and signal transduction. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the 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] Anticholinergics: Medicines that calm muscle spasms in the intestine. Examples are dicyclomine (dy-SY-kloh-meen) (Bentyl) and hyoscyamine (HY-oh-SY-uh-meen) (Levsin). [NIH]

Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU]

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Antidiuretic: Suppressing the rate of urine formation. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the

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pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspartate: A synthetic amino acid. [NIH] Aspirate: Fluid withdrawn from a lump, often a cyst, or a nipple. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied

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pharmacologic activities. [NIH] Avian: A plasmodial infection in birds. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta-Defensins: Defensins found mainly in epithelial cells. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH]

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Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioassays: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [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] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood Preservation: The process by which blood or its components are kept viable outside of the organism from which they are derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber.

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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] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Bodily Secretions: Endogenous substances produced through the activity of intact cells of glands, tissues, or organs. They do not include hormones or enzymes. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] 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] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bronchopulmonary: Pertaining to the lungs and their air passages; both bronchial and pulmonary. [EU] Bronchopulmonary Dysplasia: A chronic lung disease appearing in certain newborn infants treated for respiratory distress syndrome with mechanical ventilation and elevated concentration of inspired oxygen. [NIH] Cadaverine: A foul-smelling diamine formed by bacterial decarboxylation of lysine. [NIH] Cadmium: An element with atomic symbol Cd, atomic number 48, and atomic weight 114. It is a metal and ingestion will lead to cadmium poisoning. [NIH] Cadmium Poisoning: Poisoning occurring after exposure to cadmium compounds or fumes. It may cause gastrointestinal syndromes, anemia, or pneumonitis. [NIH] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in

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the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and

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secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell motility: The ability of a cell to move. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU]

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Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical Ripening: A change in the cervix with respect to its readiness to relax. The cervix becomes softer, more flexible, more distensible, and shorter in the final weeks of pregnancy. Though naturally occurring during normal pregnancy, it can also be induced for certain cases of prolonged or high-risk pregnancy by administration of hormones. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Child Development: The continuous sequential physiological and psychological maturing of the child from birth up to but not including adolescence. It includes healthy responses to situations, but does not include growth in stature or size (= growth). [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] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU]

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Chondrodysplasia Punctata: A heterogeneous group of bone dysplasias, the common character of which is stippling of the epiphyses in infancy. The group includes a severe autosomal recessive form (Chondrodysplasia punctata, rhizomelic), an autosomal dominant form (Conradi-Hunermann syndrome), and a milder X-linked form. Metabolic defects associated with impaired peroxisomes are present only in the rhizomelic form. [NIH] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chorioamnionitis: An inflammatory process involving the chorion, its fetal blood vessels, the umbilical cord, and the amnion by extension of the inflammation, as the amnion itself has no blood supply. This inflammatory process is potentially fatal to mother and fetus. [NIH]

Chorion: The outermost extraembryonic membrane. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [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 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] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Cleft Lip: Congenital defect in the upper lip where the maxillary prominence fails to merge with the merged medial nasal prominences. It is thought to be caused by faulty migration of the mesoderm in the head region. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [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]

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Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] 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] Compacta: Part of substantia nigra. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complement Activation: The sequential activation of serum components C1 through C9, initiated by an erythrocyte-antibody complex or by microbial polysaccharides and properdin, and producing an inflammatory response. [NIH]

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Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the

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new treatment works. [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] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Corticotropin-Releasing Hormone: A neuropeptide released by the hypothalamus that stimulates the release of corticotropin by the anterior pituitary gland. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to

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stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Criterion: A standard by which something may be judged. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [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] Cyst Fluid: Liquid material found in epithelial-lined closed cavities or sacs. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [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] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytostatic: An agent that suppresses cell growth and multiplication. [EU] Cytotoxic: Cell-killing. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [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] Decubitus: An act of lying down; also the position assumed in lying down. [EU] Decubitus Ulcer: An ulceration caused by prolonged pressure in patients permitted to lie too still for a long period of time. The bony prominences of the body are the most frequently affected sites. The ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles as a result of the sustained and constant pressure. [NIH] Defensins: Family of antimicrobial peptides that have been identified in humans, animals,

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and plants. They are thought to play a role in host defenses against infections, inflammation, wound repair, and acquired immunity. Based on the disulfide pairing of their characteristic six cysteine residues, they are divided into alpha-defensins and beta-defensins. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Demography: Statistical interpretation and description of a population with reference to distribution, composition, or structure. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermatitis: Any inflammation of the skin. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or

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esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diamines: Organic chemicals which have two amino groups in an aliphatic chain. [NIH] Diaper Rash: A type of irritant dermatitis localized to the area in contact with a diaper and occurring most often as a reaction to prolonged contact with urine, feces, or retained soap or detergent. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dicyclomine: A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydroxyacetone: A ketotriose compound. Its addition to blood preservation solutions results in better maintenance of 2,3-diphosphoglycerate levels during storage. It is readily phosphorylated to dihydroxyacetone phosphate by triokinase in erythrocytes. In combination with naphthoquinones it acts as a sunscreening agent. [NIH] Dihydroxyacetone Phosphate: An important intermediate in lipid biosynthesis and in glycolysis. [NIH] Dilate: Relax; expand. [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] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal

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points. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dystocia: Difficult childbirth or labor. [NIH] Dystonia: Disordered tonicity of muscle. [EU] 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]

Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH]

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Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Eicosanoids: A class of oxygenated, endogenous, unsaturated fatty acids derived from arachidonic acid. They include prostaglandins, leukotrienes, thromboxanes, and hydroxyeicosatetraenoic acid compounds (HETE). They are hormone-like substances that act near the site of synthesis without altering functions throughout the body. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [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] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

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] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [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] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] 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] Embryology: The study of the development of an organism during the embryonic and fetal

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stages of life. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Encephalocele: Cerebral tissue herniation through a congenital or acquired defect in the skull. The majority of congenital encephaloceles occur in the occipital or frontal regions. Clinical features include a protuberant mass that may be pulsatile. The quantity and location of protruding neural tissue determines the type and degree of neurologic deficit. Visual defects, psychomotor developmental delay, and persistent motor deficits frequently occur. [NIH]

Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]

Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Enteropeptidase: A specialized proteolytic enzyme secreted by intestinal cells. It converts trypsinogen into its active form trypsin by removing the N-terminal peptide. EC 3.4.21.9. [NIH]

Environmental Health: The science of controlling or modifying those conditions, influences,

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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] Enzyme-Linked Immunosorbent Assay: An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. [NIH] Eosinophil: A polymorphonuclear leucocyte with large eosinophilic granules in its cytoplasm, which plays a role in hypersensitivity reactions. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by radioisotope dilution technique. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoiesis: The production of erythrocytes. [EU] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estriol: (16 alpha,17 beta)-Estra-1,3,5(10)-triene-3,16,17-triol. A metabolite of estradiol and

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usually the predominant estrogenic metabolite in urine. During pregnancy, large amounts of estriol are produced by the placenta. It has also been obtained from plant sources. The 16 beta-isomer has also been isolated from the urine of pregnant women. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethanolamine: A viscous, hygroscopic amino alcohol with an ammoniacal odor. It is widely distributed in biological tissue and is a component of lecithin. It is used as a surfactant, fluorimetric reagent, and to remove CO2 and H2S from natural gas and other gases. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exopeptidases: A sub-subclass of peptide hydrolases that act only near the ends of polypeptide chains. Exopeptidases are further divided into aminopeptidases, EC 3.4.11; dipeptidases, EC 3.4.13; dipeptidyl peptidases & tripeptidyl peptidases, EC 3.4.14; peptidyldipeptidases, EC 3.4.15; carboxypeptidases, EC 3.4.16 - EC 3.4.18, and omega peptidases, EC 3.4.19. EC 3.4.-. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Family Planning: Programs or services designed to assist the family in controlling

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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] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [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] Fetal Death: Death of the young developing in utero. [NIH] Fetal Distress: Adverse or threatening condition of the fetus identified by fetal bradycardia or tachycardia and passage of meconium in vertex presentation. [NIH] Fetal Growth Retardation: The failure of a fetus to attain its expected growth potential at any gestational stage. [NIH] Fetal Heart: The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (heart/embryology) only on the basis of time. [NIH] Fetal Macrosomia: A complication of several conditions including diabetes mellitus and prolonged pregnancy. A macrosomic fetus is defined as weighing more than 4000 grams. [NIH]

Fetal Membranes: Thin layers of tissue which surround the embryo or fetus and provide for its nutrition, respiration, excretion and protection; they are the yolk sac, allantois, amnion, and chorion. [NIH] Fetal Monitoring: Physiologic or biochemical monitoring of the fetus. It is usually done during labor and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery. [NIH] Fetal Movement: Motion of the fetus perceived by the mother and felt by palpation of the abdomen. [NIH] Fetal Weight: The weight of the fetus in utero, which is usually estimated by various formulas based on measurements made during prenatal ultrasonography. [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]

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Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexor: Muscles which flex a joint. [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] Fluorescence Polarization: Measurement of the polarization of fluorescent light from solutions or microscopic specimens. It is used to provide information concerning molecular size, shape, and conformation, molecular anisotropy, electronic energy transfer, molecular interaction, including dye and coenzyme binding, and the antigen-antibody reaction. [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] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Foetal: Of or pertaining to a fetus; pertaining to in utero development after the embryonic period. [EU] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and

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megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Follicular Fluid: A fluid consisting of sex steroid hormones, plasma proteins, mucopolysaccharides, and electrolytes that is present in the vesicular ovarian follicle (Graafian follicle) surrounding the ovum. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [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] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gavage: Feeding by a tube passed into the stomach; called also tube feeding. [NIH] Gelatinases: A class of enzymes that catalyzes the degradation of gelatin by acting on the peptide bonds. EC 3.4.24.-. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH]

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Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]

Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [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] Gestation period: The period of development of the young from the time of conception until birth. [NIH] 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] 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] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Gluconeogenesis: The process by which glucose is formed from a non-carbohydrate source. [NIH]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state

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before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Glycosyltransferases: Enzymes that catalyze the transfer of glycosyl groups to an acceptor. Most often another carbohydrate molecule acts as an acceptor, but inorganic phosphate can also act as an acceptor, such as in the case of phosphorylases. Some of the enzymes in this group also catalyze hydrolysis, which can be regarded as transfer of a glycosyl group from the donor to water. Subclasses include the hexosyltransferases, pentosyltransferases, sialyltransferases, and those transferring other glycosyl groups. EC 2.4. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] 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]

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Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granulosa Cells: Cells of the membrana granulosa lining the vesicular ovarian follicle which become luteal cells after ovulation. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For

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example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematogenous: Originating in the blood or spread through the bloodstream. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobin C: A commonly occurring abnormal hemoglobin in which lysine replaces a glutamic acid residue at the sixth position of the beta chains. It results in reduced plasticity of erythrocytes. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatocyte: A liver cell. [NIH] Hepatocyte Growth Factor: Multifunctional growth factor which regulates both cell growth and cell motility. It exerts a strong mitogenic effect on hepatocytes and primary epithelial cells. Its receptor is proto-oncogene protein C-met. [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] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

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Hexosyltransferases: Enzymes that catalyze the transfer of hexose groups. EC 2.4.1.-. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Homeobox: Distinctive sequence of DNA bases. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [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] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Horseradish Peroxidase: An enzyme isolated from horseradish which is able to act as an antigen. It is frequently used as a histochemical tracer for light and electron microscopy. Its antigenicity has permitted its use as a combined antigen and marker in experimental immunology. [NIH] Human Development: Continuous sequential changes which occur in the physiological and psychological functions during the individual's life. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydration: Combining with water. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH]

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Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydronephrosis: Abnormal enlargement of a kidney, which may be caused by blockage of the ureter (such as by a kidney stone) or chronic kidney disease that prevents urine from draining into the bladder. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperemesis: Excessive vomiting. [EU] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrichosis: Localized or generalized excess hair. The concept does not include hirsutism, which is excess hair in females and children with an adult male pattern of distribution. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in the formation of nucleic acids by the salvage pathway. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU]

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Hypoxic: Having too little oxygen. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Immaturity: The state or quality of being unripe or not fully developed. [EU] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immune Tolerance: The specific failure of a normally responsive individual to make an immune response to a known antigen. It results from previous contact with the antigen by an immunologically immature individual (fetus or neonate) or by an adult exposed to extreme high-dose or low-dose antigen, or by exposure to radiation, antimetabolites, antilymphocytic serum, etc. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] 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] Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH]

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Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] 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] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infuse: To pour (a liquid) into something. [EU] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH]

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Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inhibin: Glyceroprotein hormone produced in the seminiferous tubules by the Sertoli cells in the male and by the granulosa cells in the female follicles. The hormone inhibits FSH and LH synthesis and secretion by the pituitary cells thereby affecting sexual maturation and fertility. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] Instillation: . [EU] Insufflation: The act of blowing a powder, vapor, or gas into any body cavity for experimental, diagnostic, or therapeutic purposes. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-15: Cytokine that stimulates the proliferation of T-lymphocytes and shares biological activities with IL-2. IL-15 also can induce B-lymphocyte proliferation and differentiation. [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] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, T-

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lymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Intermediate Filaments: Cytoplasmic filaments intermediate in diameter (about 10 nanometers) between the microfilaments and the microtubules. They may be composed of any of a number of different proteins and form a ring around the cell nucleus. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interphase: The interval between two successive cell divisions during which the chromosomes are not individually distinguishable and DNA replication occurs. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [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]

Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irrigation: The washing of a body cavity or surface by flowing solution which is inserted and then removed. Any drug in the irrigation solution may be absorbed. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoelectric: Separation of amphoteric substances, dissolved in water, based on their isoelectric behavior. The amphoteric substances are a mixture of proteins to be separated and of auxiliary "carrier ampholytes". [NIH] Isoelectric Focusing: Electrophoresis in which a pH gradient is established in a gel medium

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and proteins migrate until they reach the site (or focus) at which the pH is equal to their isoelectric point. [NIH] Isoelectric Point: The pH in solutions of proteins and related compounds at which the dipolar ions are at a maximum. [NIH] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] 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 fragments are up to 50 kilobases long. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactate Dehydrogenase: A tetrameric enzyme that, along with the coenzyme NAD+, catalyzes the interconversion of lactate and pyruvate. In vertebrates, genes for three different subunits (LDH-A, LDH-B and LDH-C) exist. [NIH] Lactation: The period of the secretion of milk. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH]

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Lethal: Deadly, fatal. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [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] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is laser lithotripsy. [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]

Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [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]

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Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte Depletion: Immunosuppression by reduction of circulating lymphocytes or by T-cell depletion of bone marrow. The former may be accomplished in vivo by thoracic duct drainage or administration of antilymphocyte serum. The latter is performed ex vivo on bone marrow before its transplantation. [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] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] 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] Macrophage Colony-Stimulating Factor: A mononuclear phagocyte colony-stimulating factor synthesized by mesenchymal cells. The compound stimulates the survival, proliferation, and differentiation of hematopoietic cells of the monocyte-macrophage series. M-CSF is a disulfide-bonded glycoprotein dimer with a MW of 70 kDa. It binds to a specific high affinity receptor (receptor, macrophage colony-stimulating factor). [NIH] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

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Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple). [NIH] Meconium: The thick green-to-black mucilaginous material found in the intestines of a fullterm fetus. It consists of secretions of the intestinal glands, bile pigments, fatty acids, amniotic fluid, and intrauterine debris. It constitutes the first stools passed by a newborn. [NIH]

Meconium Aspiration: Syndrome caused by sucking of thick meconium into the lungs, usually by term or post-term infants (often small for gestational age) either in utero or with first breath. The resultant small airway obstruction may produce respiratory distress, tachypnea, cyanosis, pneumothorax, and/or pneumomediastinum. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediastinum: The area between the lungs. The organs in this area include the heart and its large blood vessels, the trachea, the esophagus, the bronchi, and lymph nodes. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] 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] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Fusion: The adherence of cell membranes, intracellular membranes, or artifical membrane models of either to each other or to viruses, parasites, or interstitial particles through a variety of chemical and physical processes. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [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

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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] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methoxychlor: An insecticide. Methoxychlor has estrogenic effects in mammals, among other effects. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microfilaments: The smallest of the cytoskeletal filaments. They are composed chiefly of actin. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH]

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Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]

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] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Monosomy: The condition in which one chromosome of a pair is missing. In a normally diploid cell it is represented symbolically as 2N-1. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [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] Mosaicism: The occurrence in an individual of two or more cell populations of different chromosomal constitutions, derived from a single zygote, as opposed to chimerism in which the different cell populations are derived from more than one zygote. [NIH] Motility: The ability to move spontaneously. [EU] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucilaginous: Pertaining to or secreting mucus. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multivalent: Pertaining to a group of 5 or more homologous or partly homologous chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Mycoplasma: A genus of gram-negative, facultatively anaerobic bacteria bounded by a plasma membrane only. Its organisms are parasites and pathogens, found on the mucous membranes of humans, animals, and birds. [NIH] Mycoplasma Infections: Infections with species of the genus Mycoplasma. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naphthoquinones: Naphthalene rings which contain two ketone moieties in any position. They can be substituted in any position except at the ketone groups. [NIH]

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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] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neonatal period: The first 4 weeks after birth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nephrolithiasis: Kidney stones. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural tube defects: These defects include problems stemming from fetal development of the spinal cord, spine, brain, and skull, and include birth defects such as spina bifida, anencephaly, and encephalocele. Neural tube defects occur early in pregnancy at about 4 to 6 weeks, usually before a woman knows she is pregnant. Many babies with neural tube defects have difficulty walking and with bladder and bowel control. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce

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and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrophil: A type of white blood cell. [NIH] Neutrophil Collagenase: A member of the matrix metalloproteinases that cleaves triplehelical collagens types I, II, and III. EC 3.4.24.34. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Envelope: The membrane system of the cell nucleus that surrounds the nucleoplasm. It consists of two concentric membranes separated by the perinuclear space. The structures of the envelope where it opens to the cytoplasm are called the nuclear pores (nuclear pore). [NIH] Nuclear Pore: An opening through the nuclear envelope formed by the nuclear pore complex which transports nuclear proteins or RNA into or out of the cell nucleus and which, under some conditions, acts as an ion channel. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH]

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Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nurseries: Facilities which provide care for infants. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Oligohydramnios: Presence of less than 300 ml of amniotic fluid at term. Principal causes include malformations of fetal urinary tracts, intra-uterine growth retardation, high maternal blood pressure, nicotine poisoning, and prolonged pregnancy. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [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] Oncotic: Pertaining to, caused by, or marked by swelling. [EU] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots,

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beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Organogenesis: Clonal propagation which involves culturing explants from roots, leaves, or stems to form undifferentiated callus tissue; after the cells form shoots, they are separated and rooted. Alternatively, if the callus is put in liquid culture, somatic embryos form. [NIH] Ornithine: An amino acid produced in the urea cycle by the splitting off of urea from arginine. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmolality: The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per kilogram of solvent. The osmolality is directly proportional to the colligative properties of solutions; osmotic pressure, boiling point elevation, freezing point depression, and vapour pressure lowering. [EU] Osmoles: The standard unit of osmotic pressure. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [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] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Ovarian Follicle: Spheroidal cell aggregation in the ovary containing an ovum. It consists of an external fibro-vascular coat, an internal coat of nucleated cells, and a transparent, albuminous fluid in which the ovum is suspended. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overall survival: The percentage of subjects in a study who have survived for a defined period of time. Usually reported as time since diagnosis or treatment. Often called the survival rate. [NIH] Ovomucin: A heterogeneous mixture of glycoproteins responsible for the gel structure of egg white. It has trypsin-inhibiting activity. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oximetry: The determination of oxygen-hemoglobin saturation of blood either by

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withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Oxytocin: A nonapeptide posterior pituitary hormone that causes uterine contractions and stimulates lactation. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [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] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pentosyltransferases: Enzymes of the transferase class that catalyze the transfer of a pentose

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group from one compound to another. (Dorland, 28th ed) EC 2.4.2. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Peroxisomal Disorders: A heterogeneous group of inherited metabolic disorders marked by absent or dysfunctional peroxisomes. Peroxisomal enzymatic abnormalities may be single or multiple. Biosynthetic peroxisomal pathways are compromised, including the ability to synthesize ether lipids and to oxidize long-chain fatty acid precursors. Diseases in this category include Zellweger syndrome; infantile Refsum disease; rhizomelic chondrodysplasia (chondrodysplasia punctata, rhizomelic); hyperpipecolic acidemia; neonatal adrenoleukodystrophy; and adrenoleukodystrophy (X-linked). Neurologic dysfunction is a prominent feature of most peroxisomal disorders. [NIH] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [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] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH]

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Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] 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]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] 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 Extracts: Extracts prepared from placental tissue; they may contain specific but uncharacterized factors or proteins with specific activities. [NIH] Placental Insufficiency: Failure of the placenta to deliver an adequate supply of nutrients and oxygen to the fetus. [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] Placentation: Development of a site of fetomaternal union for physiologic exchange, a placenta or placenta-like organ. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] 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

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proteins. [EU] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet Factor 4: A high-molecular-weight proteoglycan-platelet factor complex which is released from blood platelets by thrombin. It acts as a mediator in the heparin-neutralizing capacity of the blood and plays a role in platelet aggregation. At high ionic strength (I=0.75), the complex dissociates into the active component (molecular weight 29,000) and the proteoglycan carrier (chondroitin 4-sulfate, molecular weight 350,000). The molecule exists in the form of a dimer consisting of 8 moles of platelet factor 4 and 2 moles of proteoglycan. [NIH]

Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Pneumothorax: Accumulation of air or gas in the space between the lung and chest wall, resulting in partial or complete collapse of the lung. [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] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polyhydramnios: Excess of amniotic fluid greater than 2,000 ml. It is a common obstetrical complication whose major causes include maternal diabetes, chromosomal disorders, isoimmunological disease, congenital abnormalities, and multiple gestations. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called

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tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH] Pregnancy Complications: The co-occurrence of pregnancy and a disease. The disease may precede or follow conception and it may or may not have a deleterious effect on the pregnant woman or fetus. [NIH] 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] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Diagnosis: Determination of the nature of a pathological condition or disease in the postimplantation embryo, fetus, or pregnant female before birth. [NIH]

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Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [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]

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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] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostate-Specific Antigen: Kallikrein-like serine proteinase produced by epithelial cells of both benign and malignant prostate tissue. It is an important marker for the diagnosis of prostate cancer. EC 3.4.21.77. [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein 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 working properly. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]

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

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH]

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Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Puerperal Infection: An infection occurring in the puerperium or postpartum period. [NIH] Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Putrescine: A toxic diamine formed by putrefaction from the decarboxylation of arginine and ornithine. [NIH] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial

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infection. [EU] Pyrimidines: A family of 6-membered heterocyclic compounds occurring in nature in a wide variety of forms. They include several nucleic acid constituents (cytosine, thymine, and uracil) and form the basic structure of the barbiturates. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] 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] Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reference Values: The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive

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error (myopia, hyperopia, or astigmatism). [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Rete Testis: The network of canals at the termination of the straight seminiferous tubules in the mediastinum testis. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines

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with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rod: A reception for vision, located in the retina. [NIH] Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents. [NIH]

Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sanitary: Relating or belonging to health and hygiene; conductive to the restoration or maintenance of health. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions,

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depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] 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] Seminiferous tubule: Tube used to transport sperm made in the testes. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sequester: A portion of dead bone which has become detached from the healthy bone tissue, as occurs in necrosis. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] 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]

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Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Sialyltransferases: A group of enzymes with the general formula CMP-Nacetylneuraminate:acceptor N-acetylneuraminyl transferase. They catalyze the transfer of Nacetylneuraminic acid from CMP-N-acetylneuraminic acid to an acceptor, which is usually the terminal sugar residue of an oligosaccharide, a glycoprotein, or a glycolipid. EC 2.4.99.-. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [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] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall

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in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] 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] Stabilization: The creation of a stable state. [EU] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation.

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[EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [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] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sudoriferous glands: The para-urethral ducts of the female urethra. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium

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chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptophysin: A 38-kDa integral membrane glycoprotein of the presynaptic vesicles in neuron and neuroendocrine cells. It is expressed by a variety of normal and neoplastic neuroendocrine cells and is therefore used as an immunocytochemical marker for neuroendocrine differentiation in various tumors. In Alzheimer disease and other dementing disorders there is an important synapse loss due in part to a decrease of synaptophysin in the presynaptic vesicles. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH]

Dictionary 219

Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tissue Extracts: Preparations made from animal tissues or organs; they usually contain many components, any one of which may be pharmacologically or physiologically active; extracts may contain specific, but uncharacterized factors or proteins with specific actions. [NIH]

Tocolytic Agents: Drugs that prevent preterm labor and immature birth by suppressing uterine contractions. Agents used to delay premature uterine activity include magnesium sulfate, beta-mimetics, oxytocin antagonists, calcium channel inhibitors, and adrenergic beta-receptor agonists. The use of intravenous alcohol as a tocolytic is now obsolete. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for

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increasing doses to maintain a constant response. [EU] Tonicity: The normal state of muscular tension. [NIH] Topical: On the surface of the body. [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] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH]

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Triad: Trivalent. [NIH] Trichosanthin: Plant-derived ribosome-inactivating protein purified from the Chinese medicinal herb tian-hua-fen which is obtained from the root tubers of Trichosanthes kirilowii. It has been used as an abortifacient and in the treatment of trophoblastic tumors. GLQ223 (Compound Q), a highly purified form of trichosanthin, has been proposed as antiviral treatment for AIDS. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]

Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tumor 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] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] 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] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] 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] Umbilical Arteries: Either of a pair of arteries originating from the internal iliac artery and passing through the umbilical cord to carry blood from the fetus to the placenta. [NIH] Umbilical Cord: The flexible structure, giving passage to the umbilical arteries and vein, which connects the embryo or fetus to the placenta. [NIH] Umbilical cord blood: Blood from the placenta (afterbirth) that contains high concentrations of stem cells needed to produce new blood cells. [NIH] Uracil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the

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deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterine Monitoring: Measurement or recording of contraction activity of the uterine muscle. It is used to determine progress of labor and assess status of pregnancy. It is also used in conjunction with fetal monitoring to determine fetal response to stress of maternal uterine contractions. [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] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginosis: A condition caused by the overgrowth of anaerobic bacteria (e. g., Gardnerella vaginalis), resulting in vaginal irritation and discharge. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH]

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Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villus: Cell found in the lining of the small intestine. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virulent: A virus or bacteriophage capable only of lytic growth, as opposed to temperate phages establishing the lysogenic response. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

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Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Yolk Sac: An embryonic membrane formed from endoderm and mesoderm. In reptiles and birds it incorporates the yolk into the digestive tract for nourishing the embryo. In placental mammals its nutritional function is vestigial; however, it is the source of most of the intestinal mucosa and the site of formation of the germ cells. It is sometimes called the vitelline sac, which should not be confused with the vitelline membrane of the egg. [NIH] Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

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INDEX 1 1-phosphate, 70, 155 A Abdomen, 92, 97, 113, 155, 164, 178, 180, 185, 189, 192, 194, 203, 213, 216, 217 Abdominal, 32, 111, 113, 155, 164, 167, 203, 213 Aberrant, 25, 155 Acceptor, 155, 184, 202, 215, 220 Acetylcholine, 155, 167, 200 Acidemia, 155, 204 Acidosis, 55, 155 Acne, 155, 213 Acoustic, 84, 86, 155 Adaptability, 155, 166 Adenine, 155, 210 Adenosine, 82, 155, 165, 188, 205, 218 Adipocytes, 155, 170, 193 Adolescence, 155, 167, 203 Adrenal Cortex, 155, 157, 171, 178, 208 Adrenal Glands, 31, 155 Adrenergic, 53, 155, 160, 175, 178, 218, 219 Adrenoleukodystrophy, 155, 204 Adverse Effect, 24, 156, 215 Aerosol, 119, 126, 156 Afferent, 156, 193 Affinity, 10, 82, 98, 156, 195, 215 Agar, 156, 189, 205 Agarose, 156, 189 Agglutinins, 86, 156 Agonist, 19, 156, 175, 198, 200 Air Sacs, 156, 157 Airway, 49, 156, 196 Airway Obstruction, 156, 196 Akathisia, 156, 160 Albumin, 17, 156, 205 Albuminuria, 156, 207 Aldosterone, 42, 157 Alertness, 157, 164 Algorithms, 25, 157, 163 Alimentary, 157, 203 Alkaline, 124, 155, 157, 158, 165 Allantois, 157, 180 Alleles, 20, 157 Allergen, 40, 157, 173 Allogeneic, 157, 185 Alpha-Defensins, 157, 173

Alpha-fetoprotein, 32, 33, 41, 75, 78, 82, 157, 180 Alternative medicine, 132, 157 Alveolar Process, 157, 212 Alveoli, 27, 105, 157, 223 Amenorrhea, 157, 206 Amine, 157, 187 Amino Acid Sequence, 157, 159, 162, 182 Amino Acids, 48, 78, 93, 157, 159, 162, 182, 199, 204, 206, 209, 213, 214, 220, 222 Aminopeptidases, 85, 158, 179 Ammonia, 157, 158, 218, 221 Amniocentesis, 9, 10, 15, 18, 24, 25, 32, 35, 41, 43, 51, 65, 74, 101, 111, 113, 114, 122, 153, 158 Amnion, 7, 14, 20, 21, 35, 70, 99, 107, 111, 116, 122, 124, 158, 168, 180 Amplification, 29, 65, 158 Anaerobic, 158, 198, 222 Anaesthesia, 62, 72, 158, 190 Analgesic, 158, 177 Analytes, 13, 158 Anaphylatoxins, 158, 169 Anatomical, 14, 22, 26, 158, 161, 167, 170, 190 Androgens, 7, 155, 158, 171 Anemia, 4, 8, 17, 158, 164, 182, 186 Anemic, 17, 158 Anesthesia, 17, 156, 158 Aneuploidy, 10, 14, 158 Anginal, 159, 200 Angiotensinogen, 66, 159, 212 Animal model, 22, 24, 159 Anions, 156, 159, 192 Anisotropy, 159, 181 Annealing, 159, 206 Annexins, 93, 159 Anomalies, 13, 46, 159 Anovulation, 159, 206 Antagonism, 159, 165, 218 Antiallergic, 159, 171 Antibacterial, 83, 159, 216 Antibiotic, 96, 159, 216 Antibodies, 28, 98, 103, 108, 121, 156, 159, 160, 185, 187, 189, 205 Antibody, 67, 86, 98, 102, 103, 156, 159, 160, 169, 178, 181, 185, 187, 189, 190, 196, 198, 216

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Anticholinergics, 6, 159 Anticoagulant, 159, 209 Anticonvulsant, 9, 159 Antidiuretic, 19, 160 Antiemetic, 160 Antigen, 4, 63, 67, 85, 97, 98, 108, 156, 159, 160, 169, 178, 181, 187, 188, 189, 190, 196 Antigen-Antibody Complex, 160, 169 Antihypertensive, 4, 160 Anti-infective, 160, 188 Anti-inflammatory, 110, 160, 171, 173, 183, 190 Anti-Inflammatory Agents, 160, 171 Antimicrobial, 33, 160, 172 Antineoplastic, 160, 171 Antioxidant, 25, 71, 160, 161 Antipsychotic, 9, 160, 199 Antiserum, 98, 160 Antiviral, 160, 221 Anus, 160, 164, 169 Aorta, 160, 165, 223 Apoptosis, 13, 71, 116, 160 Applicability, 89, 161 Aqueous, 161, 162, 172, 188, 193 Arachidonic Acid, 161, 176, 194, 208 Arginine, 17, 18, 19, 54, 56, 158, 161, 200, 202, 210, 221 Arterial, 57, 101, 119, 161, 171, 188, 209, 218 Arteries, 160, 161, 164, 171, 210, 219, 221 Arterioles, 63, 161, 164, 165, 222 Arteriovenous, 4, 161 Arteriovenous Fistula, 4, 161 Artery, 26, 72, 161, 176, 180, 210, 221 Ascorbic Acid, 161, 188 Aseptic, 161, 201, 216 Aspartate, 21, 161 Aspirate, 94, 161 Aspiration, 61, 111, 117, 161, 180 Assay, 29, 34, 35, 48, 65, 82, 83, 95, 99, 105, 106, 108, 161, 189 Asymptomatic, 26, 72, 161 Atrial, 161, 171, 221 Atrioventricular, 161, 171 Atrium, 161, 165, 171, 221, 223 Attenuated, 125, 161, 174 Atypical, 9, 161 Autacoids, 161, 190 Avian, 120, 121, 122, 125, 162 B Bacterium, 29, 57, 162 Barbiturates, 162, 211

Basal Ganglia, 160, 162, 168 Base, 4, 16, 155, 162, 172, 173, 182, 193, 218 Basement Membrane, 4, 162, 179, 193 Basophils, 162, 185 Benign, 98, 122, 162, 185, 199, 209 Beta-Defensins, 162, 173 Beta-Endorphin, 30, 162 Beta-Thromboglobulin, 162, 192 Bilateral, 162, 206 Bile, 33, 102, 111, 162, 163, 182, 194, 196, 216 Bile Acids, 162, 216 Bile Acids and Salts, 162 Bile Pigments, 163, 196 Bilirubin, 34, 56, 111, 156, 163 Binding Sites, 93, 163 Bioassays, 106, 163 Biochemical, 20, 26, 28, 34, 49, 66, 98, 103, 118, 157, 163, 180, 181, 184, 193, 214 Biological therapy, 163, 185 Biomarkers, 10, 11, 163 Biopsy, 4, 113, 163, 204 Biosynthesis, 7, 161, 163, 174, 214 Biotechnology, 28, 29, 132, 139, 163 Bipolar Disorder, 9, 163 Bladder, 6, 62, 98, 113, 163, 170, 188, 194, 199, 209, 212, 222 Blastocyst, 163, 170, 176, 205 Blood Cell Count, 163, 185 Blood Coagulation, 163, 165, 219 Blood Glucose, 57, 163, 186, 191 Blood Platelets, 163, 206, 214 Blood Preservation, 163, 174 Blood pressure, 5, 18, 21, 33, 160, 163, 167, 188, 198, 200, 201, 210, 215 Blood vessel, 157, 163, 164, 165, 166, 167, 168, 171, 176, 177, 183, 192, 195, 196, 197, 204, 205, 210, 215, 218, 222 Blood Volume, 18, 164 Bodily Secretions, 97, 164 Body Fluids, 23, 99, 163, 164, 175, 201, 215, 221 Bone Marrow, 8, 98, 106, 164, 178, 189, 195, 215 Bowel, 22, 104, 164, 192, 199, 217 Bowel Movement, 164, 217 Bradycardia, 164, 180 Bradykinin, 164, 200, 205 Bronchi, 164, 178, 196, 218, 220 Bronchial, 164, 187, 218 Bronchioles, 157, 164 Bronchopulmonary, 27, 164

227

Bronchopulmonary Dysplasia, 27, 164 C Cadaverine, 100, 164 Cadmium, 8, 14, 48, 164 Cadmium Poisoning, 164 Caesarean section, 100, 164 Caffeine, 23, 164, 210 Calcium, 78, 93, 114, 159, 165, 169, 195, 200, 209, 215, 219 Callus, 165, 202 Cannula, 107, 165 Capillary, 85, 95, 100, 117, 164, 165, 223 Carbohydrate, 82, 165, 171, 183, 184, 207 Carbon Dioxide, 165, 172, 182, 205, 212, 223 Carcinogenic, 165, 191, 208, 216 Carcinoma, 48, 165 Cardiac, 27, 164, 165, 171, 176, 178, 186, 212, 216 Cardiopulmonary, 31, 165 Cardiopulmonary Bypass, 31, 165 Cardiovascular, 19, 33, 59, 165, 174, 194, 214 Carotene, 165, 212 Case report, 31, 48, 69, 165, 168 Case series, 165, 168 Catecholamine, 165, 175 Catheter, 95, 96, 100, 112, 113, 166, 192, 194 Catheterization, 6, 166, 192 Cathode, 166, 176 Cations, 83, 166, 192 Caudal, 166, 188, 207 Causal, 166, 192 Cause of Death, 31, 166 Cell Adhesion, 49, 166 Cell Death, 116, 160, 166, 199 Cell Differentiation, 166, 215 Cell Division, 162, 166, 172, 185, 192, 196, 197, 205, 208 Cell membrane, 166, 173, 196, 204 Cell motility, 166, 186 Cell proliferation, 166, 215 Cell Size, 166, 181 Cell Survival, 166, 185 Central Nervous System, 103, 155, 164, 166, 182, 184, 185, 194, 214, 218 Centrifugation, 114, 166, 185 Cerebral, 12, 98, 103, 111, 132, 162, 166, 167, 171, 173, 177, 178, 179 Cerebral Palsy, 12, 111, 132, 166 Cerebrospinal, 66, 82, 103, 166, 167

Cerebrospinal fluid, 66, 82, 167 Cerebrum, 166, 167 Cervical, 14, 18, 54, 61, 62, 95, 96, 167 Cervical Ripening, 18, 167 Cervix, 18, 37, 92, 96, 109, 122, 167 Cesarean Section, 7, 12, 17, 37, 167 Character, 167, 168, 173 Chemokines, 14, 167 Chemoreceptor, 160, 167 Chemotactic Factors, 167, 169 Chemotaxis, 14, 18, 167 Child Development, 9, 167 Chin, 167, 196 Cholesterol, 13, 162, 167, 171, 196, 216 Choline, 89, 105, 167 Cholinergic, 6, 160, 167, 200 Chondrodysplasia Punctata, 168, 204 Chorea, 160, 168 Chorioamnionitis, 122, 168 Chorion, 18, 21, 124, 168, 180 Chromaffin System, 168, 177 Chromatin, 161, 168, 195, 216 Chromosomal, 10, 70, 75, 114, 158, 168, 198, 206 Chromosome, 14, 15, 51, 78, 107, 155, 158, 168, 185, 193, 194, 198, 221 Chronic, 4, 5, 10, 18, 19, 27, 110, 115, 164, 168, 174, 177, 188, 190, 193, 206, 209, 217 Chronic renal, 4, 168, 206 Circulatory system, 168, 177 CIS, 168, 212 Clear cell carcinoma, 168, 173 Cleft Lip, 46, 168 Clinical Medicine, 168, 207 Clinical study, 9, 24, 168 Clinical trial, 6, 139, 168, 170, 211 Cloning, 163, 169 Coagulation, 37, 163, 169, 186, 193, 205 Coenzyme, 161, 169, 181, 193 Collagen, 7, 14, 118, 162, 169, 179, 181, 195, 206, 208 Colloidal, 156, 169, 176 Colon, 102, 111, 169, 193 Compacta, 7, 169 Complement, 11, 158, 169, 170, 182, 193, 205 Complement Activation, 11, 158, 169 Complementary and alternative medicine, 81, 87, 170 Complementary medicine, 81, 170 Compliance, 4, 170 Computational Biology, 139, 170

228

Amniotic Fluid

Concentric, 170, 200 Conception, 170, 180, 183, 207, 216 Cones, 170, 213 Congenita, 40, 170 Congestion, 160, 170 Connective Tissue, 110, 118, 161, 164, 169, 170, 173, 181, 182, 194, 197, 209, 218 Connective Tissue Cells, 170 Consciousness, 158, 170, 173, 175, 210, 212 Constipation, 160, 170 Constriction, 170, 192, 222 Constriction, Pathologic, 170, 222 Contamination, 25, 35, 64, 97, 170 Contractility, 12, 170 Contracture, 125, 170 Contraindications, ii, 170 Control group, 5, 7, 170 Convulsions, 159, 171, 175, 207 Cor, 34, 79, 171 Corneum, 110, 171, 178 Coronary, 18, 171 Coronary heart disease, 18, 171 Corpus, 171, 208 Corpus Luteum, 171, 208 Cortex, 24, 98, 171, 179 Cortical, 24, 171 Corticosteroid, 122, 124, 171 Corticotropin-Releasing Hormone, 34, 171 Cortisol, 7, 156, 171 Cortisone, 172, 174 Creatinine, 4, 5, 172 Criterion, 73, 172 Curative, 109, 172, 219 Cyanosis, 172, 196 Cyclic, 59, 85, 165, 172, 185, 200, 208, 218 Cyst, 53, 161, 172 Cyst Fluid, 53, 172 Cysteine, 167, 172, 173 Cytogenetics, 8, 172 Cytokine, 12, 18, 24, 36, 38, 60, 63, 110, 118, 172, 191 Cytomegalovirus, 29, 37, 65, 66, 68, 172 Cytoplasm, 101, 161, 162, 166, 172, 178, 185, 195, 200, 213 Cytosine, 172, 211 Cytostatic, 101, 172 Cytotoxic, 172, 190, 215 D Dairy Products, 122, 172 Deamination, 172, 222 Decarboxylation, 164, 172, 187, 210 Decidua, 12, 18, 172, 205

Decubitus, 110, 125, 172 Decubitus Ulcer, 110, 125, 172 Defensins, 33, 157, 162, 172 Degenerative, 121, 173, 198 Dehydration, 18, 173 Deletion, 161, 173 Delirium, 160, 173 Dementia, 160, 173 Demography, 118, 173 Denaturation, 173, 206 Dendrites, 173, 199 Depolarization, 173, 215 Dermatitis, 173, 174, 175 Dermis, 110, 173, 218 DES, 10, 158, 173 Desensitization, 173, 189 Deuterium, 173, 187 Dexamethasone, 12, 173 Diabetes Mellitus, 128, 174, 180, 183, 186 Diabetic Retinopathy, 174, 205 Diagnostic procedure, 91, 132, 174 Dialyzer, 174, 186 Diamines, 99, 174 Diaper Rash, 110, 174 Diastolic, 174, 188 Dicyclomine, 159, 174 Diffusion, 174, 189, 190 Digestion, 157, 162, 164, 174, 192, 194, 217 Dihydroxyacetone, 95, 174 Dihydroxyacetone Phosphate, 95, 174 Dilate, 92, 174 Dilation, 92, 164, 174 Dilution, 41, 66, 174, 178, 206 Diploid, 158, 174, 198, 205, 221 Direct, iii, 19, 29, 41, 82, 92, 97, 100, 111, 120, 168, 174, 175, 211, 218 Discrete, 174, 218 Disease Progression, 174, 223 Disparity, 67, 174 Dissociation, 156, 175, 192 Distal, 28, 117, 175, 176, 209 Diuresis, 164, 175, 218 Dopamine, 9, 160, 175, 200 Dorsal, 175, 207 Drug Interactions, 175 Drug Tolerance, 175, 219 Duct, 165, 166, 175, 179, 195, 213, 218 Duodenum, 162, 175, 217 Dyskinesia, 160, 175 Dystocia, 7, 175 Dystonia, 160, 175 Dystrophy, 29, 175

229

E Eclampsia, 175, 207 Eczema, 68, 175 Edema, 19, 174, 175, 199, 201, 207 Effector, 155, 169, 175 Efficacy, 13, 19, 176 Eicosanoids, 12, 176 Elastic, 28, 176, 217 Elastin, 28, 169, 176, 179 Elective, 100, 176 Electrocoagulation, 169, 176 Electrode, 117, 166, 176 Electrolysis, 159, 166, 176 Electrolyte, 17, 18, 157, 171, 173, 176, 186, 197, 201, 207, 215 Electrons, 160, 162, 166, 176, 192, 202, 211 Electrophoresis, 10, 85, 86, 176, 189, 192 Emboli, 72, 176 Embolism, 31, 37, 43, 45, 53, 59, 62, 63, 65, 69, 176 Embolization, 72, 176 Embolus, 31, 72, 73, 176 Embryo, 11, 120, 121, 124, 158, 163, 166, 176, 180, 190, 197, 207, 216, 221, 224 Embryo Transfer, 176, 207 Embryology, 176, 180 Emollient, 177, 184 Encephalocele, 177, 199 Endocrine Glands, 177 Endocrine System, 24, 177, 199 Endocrinology, 35, 39, 44, 51, 57, 71, 85, 177, 185 Endogenous, 25, 53, 162, 164, 175, 176, 177 Endometrium, 89, 172, 177, 196 Endorphin, 33, 162, 177 Endothelial cell, 15, 177, 192, 219 Endothelium, 28, 177, 200 Endothelium, Lymphatic, 177 Endothelium, Vascular, 177 Endothelium-derived, 177, 200 Endotoxin, 93, 177, 221 End-stage renal, 168, 177, 206 Energy balance, 177, 193 Enkephalin, 162, 177 Enteropeptidase, 177, 221 Environmental Health, 16, 42, 60, 138, 140, 177 Enzymatic, 165, 169, 178, 181, 187, 196, 204, 206, 212 Enzyme-Linked Immunosorbent Assay, 67, 178 Eosinophil, 66, 178

Eosinophilic, 178 Epidermal, 119, 178, 193 Epidermal Growth Factor, 119, 178 Epidermis, 110, 171, 173, 178, 187, 193 Epigastric, 178, 203 Epinephrine, 155, 175, 178, 200, 221 Epithelial, 8, 15, 25, 28, 44, 50, 98, 102, 109, 111, 162, 172, 178, 186, 193, 209 Epithelial Cells, 8, 25, 50, 98, 102, 109, 111, 162, 178, 186, 193, 209 Epithelium, 28, 110, 162, 177, 178 Erythrocyte Volume, 164, 178 Erythrocytes, 158, 163, 164, 174, 178, 186, 211 Erythropoiesis, 103, 178 Erythropoietin, 22, 68, 71, 72, 178 Estradiol, 7, 118, 178 Estriol, 13, 178 Estrogen, 7, 24, 179 Ethanol, 179, 180 Ethanolamine, 105, 179 Ether, 179, 204 Eukaryotic Cells, 179, 190, 202 Evoke, 179, 217 Excitation, 167, 179, 181, 200 Exocrine, 179, 203 Exogenous, 22, 175, 177, 179 Exopeptidases, 158, 179 Extracellular, 20, 28, 170, 179, 181, 195, 215 Extracellular Matrix, 20, 28, 170, 179, 181, 195 Extracellular Matrix Proteins, 179, 195 Extracellular Space, 179 Extrapyramidal, 156, 160, 175, 179 F Facial, 4, 179 Facial Expression, 4, 179 Family Planning, 139, 179 Fat, 155, 161, 162, 164, 165, 171, 172, 176, 180, 193, 194, 214, 215, 217 Fatty acids, 75, 79, 156, 176, 180, 184, 196, 208, 219 Feces, 170, 174, 180, 217 Femoral, 165, 180 Femoral Artery, 165, 180 Fermentation, 122, 180 Ferritin, 43, 103, 180 Fertilization in Vitro, 180, 207 Fetal Blood, 12, 21, 40, 54, 78, 104, 111, 117, 118, 168, 180, 205 Fetal Death, 17, 84, 105, 180 Fetal Distress, 26, 58, 111, 180

230

Amniotic Fluid

Fetal Growth Retardation, 49, 180 Fetal Heart, 26, 68, 104, 112, 117, 180 Fetal Macrosomia, 70, 180 Fetal Membranes, 7, 12, 13, 15, 19, 20, 21, 36, 44, 79, 84, 99, 118, 180 Fetal Monitoring, 180, 222 Fetal Movement, 19, 180 Fetal Weight, 56, 180 Fetoprotein, 180 Fibrin, 109, 122, 163, 180, 181, 219 Fibrinogen, 180, 181, 205, 219 Fibrinolytic, 55, 181 Fibroblasts, 49, 170, 181, 191, 192 Fibronectin, 20, 45, 60, 114, 115, 181 Fibrosis, 48, 110, 125, 170, 181 Flatus, 181, 182 Flexor, 43, 181 Flow Cytometry, 13, 181 Fluorescence, 45, 55, 68, 111, 181 Fluorescence Polarization, 55, 181 Fluorescent Dyes, 181 Flushing, 117, 181 Foetal, 46, 75, 181 Folate, 83, 181 Fold, 10, 181, 203 Folic Acid, 181 Follicles, 182, 191 Follicular Fluid, 106, 182 Forearm, 164, 182 Free Radicals, 160, 175, 182 G Gallbladder, 155, 182, 194 Ganglia, 155, 182, 199, 204 Gas, 66, 112, 158, 165, 174, 179, 181, 182, 187, 191, 200, 206, 210, 212, 217, 223 Gas exchange, 182, 212, 223 Gastric, 48, 56, 178, 182, 187 Gastrin, 182, 187 Gastrointestinal, 22, 100, 164, 174, 178, 179, 182, 194, 214, 217, 221 Gastrointestinal tract, 22, 100, 179, 182, 194, 214, 221 Gastrostomy, 22, 182 Gavage, 22, 182 Gelatinases, 20, 182 Gene, 11, 14, 16, 20, 21, 25, 28, 42, 106, 110, 114, 120, 121, 125, 157, 163, 182, 201 Gene Expression, 15, 20, 21, 25, 28, 182 Genetic Code, 182, 201 Genetic Engineering, 116, 163, 169, 182 Genetic testing, 182, 206 Genetics, 40, 70, 75, 110, 172, 182

Genital, 13, 168, 183, 185, 222 Genitourinary, 183, 222 Genomics, 16, 183 Genotype, 11, 64, 183, 204 Geriatric, 110, 183 Germ Cells, 183, 196, 202, 216, 218, 224 Gestation period, 105, 183 Gestational, 5, 10, 15, 16, 26, 45, 47, 48, 53, 62, 71, 79, 97, 105, 111, 128, 180, 183, 196 Gestational Age, 10, 15, 16, 26, 45, 47, 53, 79, 105, 111, 183, 196 Gland, 106, 155, 168, 172, 183, 194, 203, 205, 209, 214, 217, 218, 219 Glomerular, 4, 183, 212 Glomeruli, 183, 210 Glomerulonephritis, 4, 183 Glomerulus, 183 Glucocorticoid, 173, 183 Gluconeogenesis, 183 Glucose, 38, 48, 49, 58, 128, 161, 163, 174, 183, 184, 186, 191, 213 Glucose Intolerance, 174, 183 Glucose tolerance, 128, 183 Glucose Tolerance Test, 128, 183 Glutamate, 21, 184 Glutamic Acid, 181, 184, 186, 200, 208 Glutathione Peroxidase, 25, 184 Glycerol, 95, 105, 184, 204 Glycerophospholipids, 184, 204 Glycine, 162, 184, 200, 214 Glycogen, 184 Glycolysis, 174, 184 Glycoprotein, 106, 178, 181, 184, 193, 195, 215, 218, 219, 221 Glycosaminoglycans, 49, 179, 184, 209 Glycosidic, 184, 201 Glycosylation, 52, 184 Glycosyltransferases, 89, 184 Goats, 172, 184 Gonad, 184 Gonadal, 11, 184, 216 Gonadotropin, 106, 184 Governing Board, 185, 207 Grade, 97, 114, 185 Graft, 4, 5, 102, 185 Graft Rejection, 4, 102, 185 Grafting, 185, 190 Gram-negative, 185, 198 Granulocytes, 114, 185, 194, 215, 223 Granulosa Cells, 185, 191 Groin, 97, 185 Growth factors, 28, 79, 86, 114, 185

231

Guanylate Cyclase, 185, 200 H Hair follicles, 173, 185 Half-Life, 14, 185 Haploid, 185, 205 Haptens, 156, 185 Headache, 165, 185 Heartbeat, 5, 101, 185 Hematocrit, 4, 163, 185 Hematogenous, 15, 186 Hematology, 56, 186 Hemodiafiltration, 37, 186 Hemodialysis, 4, 174, 186 Hemofiltration, 186 Hemoglobin, 101, 128, 158, 163, 172, 178, 186, 194, 202 Hemoglobin A, 128, 186 Hemoglobin C, 158, 186 Hemophilia, 84, 186 Hemorrhage, 4, 72, 174, 176, 185, 186 Hemostasis, 55, 186, 214 Hepatic, 156, 173, 183, 186 Hepatocyte, 50, 65, 186 Hepatocyte Growth Factor, 65, 186 Hereditary, 67, 186, 198, 204 Heredity, 182, 186 Heterogeneity, 103, 156, 186 Hexosyltransferases, 184, 187 Hirsutism, 11, 187, 188 Histamine, 99, 158, 160, 187 Histidine, 187 Homeobox, 16, 187 Homeostasis, 24, 187 Homologous, 157, 159, 187, 198, 218 Hormonal, 11, 128, 171, 187 Hormone therapy, 129, 187 Horny layer, 178, 187 Horseradish Peroxidase, 178, 187 Human Development, 9, 16, 57, 138, 187 Humoral, 185, 187 Hybrid, 187 Hybridization, 22, 25, 187 Hybridomas, 187, 191 Hydration, 19, 41, 42, 46, 132, 187 Hydrogel, 115, 187 Hydrogen, 95, 155, 157, 162, 165, 173, 179, 184, 187, 188, 198, 201, 202, 209 Hydrogen Peroxide, 95, 184, 188 Hydrolysis, 184, 188, 204, 206, 209, 221 Hydronephrosis, 6, 188 Hydrophilic, 187, 188 Hydrophobic, 119, 184, 188

Hydroxylysine, 169, 188 Hydroxyproline, 59, 169, 188 Hygienic, 119, 123, 188 Hyperemesis, 18, 188 Hyperglycemia, 129, 188 Hyperplasia, 11, 15, 188 Hypersensitivity, 157, 173, 178, 188, 194 Hypertension, 4, 5, 18, 42, 119, 185, 188, 207, 219 Hypertrichosis, 187, 188 Hypertrophy, 171, 188, 221 Hypogonadism, 11, 188 Hypoplasia, 6, 28, 100, 119, 188 Hypotension, 160, 171, 188 Hypothalamic, 7, 20, 188 Hypothalamus, 171, 177, 188, 205 Hypoxanthine, 75, 188 Hypoxemia, 119, 188 Hypoxia, 14, 17, 22, 36, 158, 173, 188 Hypoxic, 17, 189 Hysterotomy, 167, 189 I Immaturity, 100, 119, 129, 189 Immune response, 120, 121, 125, 160, 171, 172, 185, 189, 217, 222, 223 Immune Sera, 189 Immune system, 24, 163, 189, 190, 194, 195, 204, 222, 223 Immune Tolerance, 11, 189 Immunity, 120, 121, 173, 189, 220 Immunization, 102, 189 Immunoassay, 102, 103, 108, 178, 189 Immunodiffusion, 156, 189 Immunoelectrophoresis, 82, 156, 189 Immunofluorescence, 28, 189 Immunoglobulins, 53, 86, 189, 205 Immunohistochemistry, 12, 14, 22, 189 Immunologic, 53, 98, 167, 183, 189 Immunology, 36, 38, 50, 52, 53, 67, 68, 156, 181, 187, 189 Immunosuppression, 5, 189, 190, 195 Immunosuppressive, 183, 189, 190 Immunosuppressive Agents, 189, 190 Impairment, 27, 109, 173, 175, 190, 196, 210 Implantation, 11, 92, 170, 190 In situ, 14, 20, 45, 51, 68, 190 In Situ Hybridization, 14, 20, 51, 190 In vitro, 11, 20, 22, 24, 25, 48, 54, 85, 86, 93, 101, 176, 190, 206, 219 In vivo, 22, 104, 190, 195, 219 Incision, 164, 189, 190, 192

232

Amniotic Fluid

Incubation, 120, 190 Indomethacin, 12, 42, 78, 190 Induction, 19, 21, 25, 54, 158, 160, 190 Infant Mortality, 15, 190 Infantile, 190, 204 Infiltration, 183, 190 Inflammation, 11, 33, 43, 54, 61, 155, 156, 160, 168, 173, 181, 190, 194, 202, 206, 210 Infuse, 12, 190 Infusion, 7, 12, 190, 220 Ingestion, 84, 122, 164, 183, 191, 206 Inhalation, 156, 191, 206 Inhibin, 61, 64, 106, 191 Initiation, 64, 191 Initiator, 7, 191 Inorganic, 78, 184, 191, 198 Inositol, 105, 191 Inotropic, 175, 191 Insecticides, 191, 204 Instillation, 122, 191 Insufflation, 100, 191 Insulin, 11, 32, 48, 49, 50, 57, 78, 85, 98, 100, 128, 129, 183, 191 Insulin-dependent diabetes mellitus, 191 Insulin-like, 50, 57, 78, 85, 98, 100, 191 Interleukin-1, 47, 52, 54, 55, 64, 191 Interleukin-15, 52, 191 Interleukin-2, 52, 79, 191 Interleukin-6, 55, 58, 191 Interleukin-8, 18, 191 Intermediate Filaments, 28, 192 Intermittent, 6, 192 Internal Medicine, 177, 186, 192 Interphase, 47, 64, 101, 192 Interstitial, 7, 14, 179, 192, 196, 212 Intervention Studies, 15, 192 Intestinal, 22, 50, 79, 86, 102, 122, 157, 165, 177, 183, 192, 196, 224 Intestinal Mucosa, 122, 192, 224 Intestine, 22, 98, 159, 162, 164, 192, 193 Intoxication, 173, 192, 224 Intracellular, 165, 190, 192, 196, 200, 207, 208, 211, 215 Intramuscular, 192, 203 Intravascular, 37, 192 Intravenous, 55, 128, 190, 192, 203, 219 Intrinsic, 55, 156, 162, 192 Intubation, 55, 166, 192 Invasive, 10, 13, 101, 104, 111, 115, 189, 192, 203 Ionization, 10, 66, 192 Ions, 162, 175, 176, 187, 192, 193, 209

Irrigation, 96, 192 Ischemia, 172, 192 Isoelectric, 103, 192, 193 Isoelectric Focusing, 103, 192 Isoelectric Point, 103, 193 Isoenzyme, 11, 193 K Karyotype, 40, 56, 158, 193 Kb, 138, 193 Keratinocytes, 192, 193 Kidney Disease, 138, 157, 188, 193 Kidney stone, 6, 188, 193, 199, 222 L Labile, 169, 193 Lactate Dehydrogenase, 60, 193 Lactation, 4, 193, 203 Laminin, 162, 179, 193 Large Intestine, 192, 193, 211, 215 Laser Surgery, 27, 193 Latent, 92, 193 Lectin, 82, 193 Lens, 170, 193 Leptin, 30, 38, 57, 193 Lesion, 193, 194, 218, 221 Lethal, 22, 194 Leucine, 162, 194 Leucocyte, 178, 194 Leukotrienes, 84, 161, 176, 194 Libido, 158, 194 Ligament, 194, 209 Linkages, 184, 186, 194 Lip, 168, 194 Lipid, 33, 45, 167, 174, 184, 191, 194 Lithium, 160, 194 Lithotripsy, 6, 194 Liver, 40, 98, 103, 155, 156, 157, 161, 162, 172, 178, 180, 181, 182, 183, 184, 186, 194, 211, 221 Liver cancer, 157, 194 Lobe, 96, 194 Localization, 12, 22, 189, 194 Localized, 95, 174, 187, 188, 190, 193, 194, 201, 205, 221 Locomotion, 194, 205 Lymph, 167, 168, 177, 194, 195, 196, 217 Lymph node, 167, 194, 195, 196 Lymphatic, 177, 190, 194, 195, 197, 201, 215, 216, 219 Lymphatic system, 194, 195, 215, 216, 219 Lymphocyte Depletion, 189, 195 Lymphocytes, 102, 160, 187, 189, 191, 194, 195, 216, 219, 223

233

Lymphoid, 159, 194, 195 Lysine, 164, 186, 188, 195, 221 Lytic, 195, 214, 223 M Macrophage, 49, 191, 195 Macrophage Colony-Stimulating Factor, 49, 195 Malformation, 6, 75, 195 Malignant, 98, 103, 160, 194, 195, 199, 209 Malnutrition, 156, 195 Mandible, 157, 167, 195, 212 Manic, 160, 163, 194, 195, 210 Manifest, 107, 195 Matrix metalloproteinase, 12, 20, 84, 118, 132, 195, 200 Maxillary, 168, 195 Meat, 122, 195, 196 Meat Products, 122, 196 Meconium, 26, 36, 39, 43, 55, 56, 60, 62, 65, 67, 68, 70, 74, 93, 94, 102, 104, 111, 132, 180, 196 Meconium Aspiration, 67, 111, 196 Medial, 168, 196 Mediastinum, 196, 212 Mediate, 175, 196 Mediator, 191, 196, 206, 214 MEDLINE, 139, 196 Meiosis, 196, 198, 218 Membrane Fusion, 159, 196 Membrane Lipids, 196, 204 Meninges, 166, 196 Menstrual Cycle, 196, 208 Menstruation, 157, 172, 196, 201 Mental, iv, 6, 13, 24, 104, 138, 140, 167, 173, 175, 196, 209, 210, 213, 222 Mental Retardation, 13, 24, 196 Mercury, 181, 196 Mesenchymal, 7, 28, 30, 178, 195, 197 Mesoderm, 168, 197, 224 Mesolimbic, 160, 197 Metabolic disorder, 13, 197, 204 Metabolite, 178, 197, 208, 211 Metastasis, 48, 195, 197 Methoxychlor, 25, 197 Microbe, 197, 220 Microbiology, 47, 57, 65, 66, 68, 85, 161, 197 Microfilaments, 192, 197 Microorganism, 197, 203, 223 Micro-organism, 197 Microscopy, 14, 28, 162, 187, 197 Microtubules, 192, 197

Migration, 14, 50, 168, 197 Mineralocorticoids, 155, 171, 197 Miscarriage, 10, 101, 127, 197 Mitochondrial Swelling, 197, 199 Mitosis, 161, 197 Modification, 24, 82, 182, 197 Modulator, 53, 198 Molecule, 95, 120, 121, 125, 160, 162, 163, 169, 172, 175, 177, 179, 184, 188, 193, 198, 201, 202, 206, 209, 211, 215, 222 Monitor, 9, 30, 44, 102, 112, 172, 198, 200 Monoclonal, 103, 187, 198 Monocyte, 32, 43, 61, 195, 198 Mononuclear, 195, 198, 221 Monophosphate, 59, 82, 198 Monosomy, 158, 198 Morphogenesis, 16, 198 Morphological, 13, 176, 198 Morphology, 186, 198 Mosaicism, 40, 198 Motility, 190, 198, 214 Movement Disorders, 160, 198 Mucilaginous, 196, 198 Mucins, 86, 198, 213 Mucus, 54, 102, 111, 198 Multivalent, 120, 121, 198 Mycoplasma, 62, 65, 73, 198 Mycoplasma Infections, 62, 198 Mydriatic, 174, 198 N Naloxone, 162, 198 Naphthoquinones, 174, 198 Nausea, 160, 199, 222 Necrosis, 71, 161, 199, 214 Neonatal period, 100, 199 Neoplasm, 199, 221 Nephrolithiasis, 6, 199 Nephropathy, 5, 6, 193, 199 Nephrosis, 199 Nephrotic, 5, 49, 75, 199 Nephrotic Syndrome, 49, 75, 199 Nerve Growth Factor, 24, 199 Nervous System, 24, 156, 166, 196, 199, 204, 218 Neural, 24, 38, 59, 61, 62, 63, 70, 156, 177, 180, 187, 199 Neural tube defects, 24, 38, 59, 63, 180, 199 Neuroendocrine, 199, 218 Neuroleptic, 156, 160, 199 Neurologic, 27, 177, 199, 204 Neuronal, 21, 104, 199 Neurons, 22, 24, 173, 182, 199, 200, 218

234

Amniotic Fluid

Neuropeptide, 171, 199 Neurosecretory Systems, 177, 199 Neurotoxic, 24, 200 Neurotransmitter, 104, 155, 164, 175, 184, 187, 200, 215, 217 Neutrophil, 18, 44, 74, 200 Neutrophil Collagenase, 74, 200 Nicotine, 200, 201 Nifedipine, 4, 200 Nitric Oxide, 21, 200 Nitrogen, 156, 157, 158, 179, 200, 221 Norepinephrine, 155, 175, 200 Nuclear, 66, 101, 162, 176, 179, 199, 200 Nuclear Envelope, 101, 200 Nuclear Pore, 200 Nuclei, 18, 78, 101, 176, 182, 197, 200, 209 Nucleic acid, 14, 65, 101, 172, 182, 187, 188, 190, 200, 201, 210, 211 Nucleic Acid Hybridization, 187, 201 Nucleus, 101, 161, 162, 168, 172, 173, 179, 192, 195, 196, 198, 200, 201, 208, 209, 217 Nurseries, 100, 201 Nutritional Support, 182, 201 O Observational study, 71, 201 Oedema, 201, 207 Oligohydramnios, 6, 17, 19, 21, 27, 42, 44, 52, 64, 72, 115, 119, 201 Oligomenorrhea, 201, 206 Oligosaccharides, 50, 201 Oliguria, 6, 201 Oncogene, 186, 201 Oncotic, 17, 201 Opiate, 162, 177, 198, 201 Opsin, 201, 212, 213 Organ Culture, 201, 219 Organelles, 166, 172, 202 Organogenesis, 24, 202 Ornithine, 54, 202, 210 Orthostatic, 160, 202 Osmolality, 18, 19, 202 Osmoles, 202 Osmosis, 202 Osmotic, 17, 18, 19, 22, 156, 197, 202 Otitis, 60, 202 Otitis Media, 60, 202 Ovarian Follicle, 171, 182, 185, 202 Ovaries, 202, 206, 214 Ovary, 36, 171, 178, 184, 202 Overall survival, 27, 202 Ovomucin, 122, 202 Ovulation, 9, 159, 185, 202

Ovum, 171, 172, 182, 183, 202, 208, 224 Oxidation, 99, 155, 160, 184, 202 Oximetry, 65, 70, 101, 202 Oxygenation, 188, 203 Oxygenator, 165, 203 Oxytocin, 203, 219 P Palate, 46, 203 Palliative, 203, 219 Palpation, 180, 203 Palsy, 12, 203 Pancreas, 98, 155, 163, 191, 203, 221 Pancreatic, 52, 203 Parasite, 123, 203 Parenteral, 28, 203 Parkinsonism, 160, 203 Particle, 66, 203, 220 Parturition, 7, 18, 20, 32, 38, 44, 50, 51, 73, 79, 96, 102, 111, 122, 201, 203 Pathogen, 190, 203 Pathologic, 155, 161, 163, 171, 188, 203, 209, 212 Pathologic Processes, 161, 203 Pathologies, 15, 203 Pathophysiology, 13, 27, 104, 203 Pediatrics, 3, 9, 11, 22, 27, 37, 39, 55, 56, 57, 68, 75, 79, 203 Pelvic, 203, 209 Pelvis, 155, 202, 203, 210, 222 Pentosyltransferases, 184, 203 Peptide, 35, 44, 53, 125, 128, 162, 177, 179, 182, 193, 204, 206, 209 Percutaneous, 158, 194, 204 Perfusion, 188, 204 Perinatal, 5, 9, 19, 21, 23, 25, 27, 31, 35, 49, 56, 58, 62, 69, 73, 99, 122, 190, 204 Peripheral Nervous System, 200, 203, 204, 217 Peroxidase, 89, 95, 204 Peroxide, 95, 204 Peroxisomal Disorders, 33, 204 Pesticides, 24, 60, 191, 204 Phagocyte, 195, 204 Phagocytosis, 14, 204 Pharmacologic, 158, 162, 185, 204, 220 Phenotype, 11, 204 Phospholipases, 204, 215 Phospholipids, 82, 83, 89, 105, 180, 191, 196, 204 Phosphorus, 78, 165, 205 Phosphorylated, 169, 174, 205 Photocoagulation, 27, 169, 205

235

Physical Examination, 183, 205 Physiologic, 18, 20, 25, 156, 163, 180, 185, 196, 205, 208, 211, 212 Physiology, 16, 24, 104, 109, 128, 177, 185, 186, 205 Pigment, 163, 205 Pilot study, 15, 205 Pituitary Gland, 171, 205 Placental Extracts, 61, 205 Placental Insufficiency, 17, 205 Placental tissue, 205 Placentation, 10, 205 Plants, 116, 165, 167, 173, 183, 193, 198, 200, 205, 213, 220 Plaque, 15, 205 Plasma cells, 159, 205 Plasma protein, 156, 177, 182, 205, 209 Plasma Volume, 18, 19, 164, 197, 206 Platelet Activation, 206, 215 Platelet Aggregation, 158, 200, 206, 219 Platelet Factor 4, 192, 206 Platelets, 162, 200, 206 Pneumonia, 111, 170, 206 Pneumothorax, 196, 206 Poisoning, 164, 173, 192, 197, 199, 201, 206 Polycystic, 11, 206 Polycystic Ovary Syndrome, 11, 206 Polyhydramnios, 17, 21, 115, 153, 206 Polymerase, 15, 35, 40, 47, 65, 71, 73, 206 Polymerase Chain Reaction, 15, 35, 40, 47, 65, 71, 73, 206 Polymers, 103, 206, 209 Polypeptide, 157, 158, 169, 178, 179, 181, 187, 206, 224 Polysaccharide, 156, 160, 207, 209 Posterior, 6, 16, 175, 203, 207 Postnatal, 3, 21, 25, 28, 40, 207, 216 Postoperative, 12, 97, 207 Postsynaptic, 207, 215 Potassium, 115, 157, 197, 207 Potentiates, 191, 207 Potentiation, 207, 215 Practice Guidelines, 140, 207 Precursor, 13, 159, 161, 167, 175, 178, 200, 207, 208, 209, 221 Predictive factor, 23, 207 Preeclampsia, 4, 5, 10, 19, 30, 53, 55, 207 Pre-Eclampsia, 38, 162, 207 Pre-eclamptic, 59, 175, 207 Pregnancy Complications, 15, 207 Pregnancy Outcome, 10, 16, 23, 35, 37, 64, 73, 207

Pregnancy Tests, 183, 207 Presynaptic, 200, 208, 218 Prevalence, 13, 65, 105, 208 Probe, 20, 104, 208 Prodrug, 208, 211 Progesterone, 18, 118, 208, 216 Progression, 5, 159, 208 Progressive, 17, 166, 168, 173, 175, 199, 206, 208, 212, 221 Proline, 169, 188, 208 Promoter, 20, 208 Prone, 14, 208 Prophase, 198, 208, 218 Prophylaxis, 121, 208, 213, 222 Prostaglandin, 12, 36, 42, 73, 79, 84, 85, 208, 219 Prostaglandins A, 190, 208 Prostate, 97, 98, 163, 209, 221 Prostate gland, 209 Prostate-Specific Antigen, 97, 98, 209 Prostatic Hyperplasia, 6, 209 Protease, 98, 209 Protein C, 69, 156, 157, 180, 209, 222 Protein S, 163, 182, 209, 213 Proteinuria, 4, 5, 199, 207, 209 Proteoglycan, 28, 206, 209 Proteolytic, 20, 169, 177, 181, 209 Prothrombin, 84, 209, 219 Protons, 187, 209, 211 Proximal, 112, 175, 208, 209 Pruritic, 175, 209 Psoriasis, 209, 213 Psychiatric, 9, 209 Psychiatry, 8, 23, 209, 223 Psychic, 194, 196, 210 Psychoactive, 210, 224 Psychosis, 160, 183, 210 Psychotropic, 9, 210 Public Policy, 139, 210 Publishing, 28, 210 Puerperal Infection, 60, 210 Puerperium, 201, 210 Pulmonary, 4, 5, 6, 31, 54, 100, 109, 111, 119, 164, 171, 178, 186, 194, 210, 212, 217, 223 Pulmonary Artery, 164, 210, 223 Pulmonary hypertension, 119, 171, 210 Pulmonary Ventilation, 210, 212 Pulse, 65, 70, 101, 198, 203, 210 Pupil, 174, 198, 210 Purifying, 81, 99, 210 Purines, 210, 214

236

Amniotic Fluid

Putrefaction, 210 Putrescine, 100, 210 Pyelonephritis, 5, 210 Pyrimidines, 67, 211, 214 R Race, 13, 193, 197, 211 Radiation, 181, 182, 189, 211, 224 Radioactive, 185, 187, 190, 192, 200, 211 Radiography, 183, 211 Ramipril, 119, 211 Randomized, 27, 176, 211 Randomized clinical trial, 27, 211 Reactive Oxygen Species, 71, 211 Reagent, 106, 117, 118, 123, 179, 211 Receptors, Serotonin, 211, 214 Recombinant, 125, 211, 222 Rectum, 160, 164, 169, 181, 182, 193, 209, 211 Recurrence, 4, 163, 211 Red blood cells, 101, 114, 178, 211, 213 Refer, 1, 169, 194, 199, 210, 211, 220 Reference Values, 32, 44, 48, 211 Refraction, 159, 211, 216 Regeneration, 43, 212 Regimen, 176, 212 Reliability, 47, 212 Remission, 163, 211, 212 Renal failure, 4, 5, 173, 212 Renal pelvis, 193, 212 Renin, 82, 159, 212 Resorption, 19, 44, 212 Respiration, 165, 167, 180, 198, 212 Respiratory distress syndrome, 65, 69, 100, 129, 164, 212 Respiratory Physiology, 212, 223 Respiratory System, 94, 156, 212 Resuscitation, 55, 212 Rete Testis, 106, 212 Retina, 170, 174, 193, 212, 213 Retinal, 63, 174, 212, 213 Retinoids, 28, 213, 223 Retinol, 28, 212, 213 Retroperitoneal, 155, 213 Rhodopsin, 201, 212, 213 Ribose, 155, 213 Ribosome, 213, 220, 221 Rigidity, 203, 205, 213 Risk factor, 20, 23, 24, 43, 60, 129, 213 Risk patient, 62, 213 Rod, 162, 213 Rodenticides, 204, 213

S Saline, 7, 213 Saliva, 86, 213 Salivary, 172, 213, 217 Salivary glands, 172, 213 Sanitary, 118, 213 Saponins, 213, 216 Schizoid, 213, 224 Schizophrenia, 9, 23, 103, 213, 214, 224 Schizotypal Personality Disorder, 213, 224 Screening, 5, 10, 13, 30, 69, 98, 101, 128, 168, 214 Sebaceous, 97, 173, 214 Sebaceous gland, 97, 173, 214 Sebum, 214 Secondary tumor, 197, 214 Secretion, 7, 12, 17, 18, 19, 98, 106, 107, 123, 171, 174, 178, 187, 191, 193, 197, 198, 214 Secretory, 39, 86, 157, 214 Sedimentation, 166, 214 Semen, 209, 214 Seminiferous tubule, 191, 212, 214, 216 Sensor, 92, 93, 100, 101, 112, 214 Sequencing, 16, 206, 214 Sequester, 8, 214 Serine, 98, 105, 209, 214, 221 Serologic, 189, 214 Serotonin, 9, 160, 200, 211, 214, 221 Serous, 177, 214 Serum, 4, 5, 9, 10, 13, 14, 23, 25, 30, 36, 37, 38, 49, 50, 53, 55, 57, 59, 61, 64, 66, 68, 69, 72, 74, 85, 97, 98, 99, 102, 103, 106, 108, 118, 156, 158, 160, 169, 184, 189, 195, 197, 214, 221 Sex Characteristics, 155, 158, 214 Shock, 37, 93, 194, 215, 220 Sialyltransferases, 184, 215 Side effect, 25, 156, 160, 163, 215, 220 Signal Transduction, 20, 159, 191, 215 Skeletal, 158, 215 Skeleton, 208, 215 Skull, 177, 199, 215, 218 Small intestine, 175, 187, 192, 215, 221, 223 Smooth muscle, 158, 161, 164, 170, 187, 215, 217 Sodium, 41, 52, 115, 157, 197, 215, 217 Soft tissue, 164, 215 Solid tumor, 8, 215 Solvent, 179, 184, 202, 215 Somatic, 155, 187, 196, 197, 202, 204, 215 Specialist, 145, 174, 216

237

Specificity, 10, 105, 118, 156, 216 Spectrum, 11, 16, 27, 35, 103, 216 Sperm, 101, 158, 168, 214, 216 Spermatozoa, 106, 214, 216 Spina bifida, 199, 216 Spinal cord, 67, 166, 167, 196, 199, 204, 216 Spinous, 178, 193, 216 Spleen, 98, 103, 172, 195, 216 Spontaneous Abortion, 207, 216 Stabilization, 12, 216 Statistically significant, 5, 216 Stem Cells, 30, 178, 216, 221 Sterile, 16, 94, 97, 115, 161, 216 Sterility, 107, 216 Steroid, 7, 12, 98, 100, 162, 171, 172, 182, 213, 216 Stillbirth, 207, 216 Stimulant, 125, 164, 187, 216 Stimulus, 25, 104, 170, 176, 179, 192, 217, 219 Stomach, 155, 182, 183, 187, 199, 215, 216, 217 Stool, 94, 169, 193, 217 Strand, 206, 217 Streptococcal, 29, 85, 217 Streptococcus, 217 Stress, 19, 22, 25, 26, 46, 94, 111, 117, 128, 166, 172, 181, 199, 217, 222 Subacute, 190, 217 Subclinical, 58, 190, 217 Subcutaneous, 126, 155, 175, 201, 203, 217 Submaxillary, 178, 217 Subspecies, 15, 216, 217 Substance P, 197, 214, 217 Substrate, 95, 109, 119, 123, 178, 217 Suction, 55, 107, 217 Sudoriferous glands, 97, 217 Supplementation, 83, 86, 217 Suppression, 21, 25, 171, 217 Surfactant, 45, 54, 65, 69, 81, 100, 105, 109, 129, 179, 217 Survival Rate, 202, 217 Sweat, 97, 173, 217, 218 Sweat Glands, 173, 217, 218 Sympathomimetic, 175, 178, 200, 218 Symphysis, 167, 209, 218 Symptomatic, 110, 218 Symptomatic treatment, 110, 218 Synapse, 24, 155, 208, 218, 220 Synapsis, 218 Synaptic, 104, 200, 215, 218 Synaptophysin, 104, 218

Systemic, 10, 119, 160, 164, 173, 178, 190, 201, 218, 220, 221, 222 Systolic, 188, 218 T Tachycardia, 180, 218 Tachypnea, 196, 218 Tardive, 160, 218 Temporal, 12, 218 Tendon, 43, 218 Testis, 106, 178, 212, 218 Theophylline, 23, 210, 218 Therapeutics, 219 Thermal, 159, 175, 206, 219 Thigh, 180, 185, 219 Threonine, 214, 219 Threshold, 17, 188, 219 Thrombin, 180, 181, 206, 209, 219 Thrombomodulin, 209, 219 Thromboxanes, 161, 176, 219 Thymus, 189, 195, 219 Thyroid, 29, 44, 219, 221 Thyroxine, 156, 219 Tinnitus, 202, 219 Tissue Culture, 114, 219 Tissue Extracts, 98, 219 Tocolytic Agents, 122, 219 Tolerance, 11, 128, 155, 183, 219 Tonicity, 18, 20, 175, 220 Topical, 110, 115, 124, 125, 179, 188, 220 Toxaemia, 207, 220 Toxic, iv, 103, 189, 200, 210, 220 Toxicity, 67, 103, 175, 197, 220 Toxicology, 16, 59, 78, 83, 140, 220 Toxin, 177, 219, 220 Toxoplasmosis, 47, 220 Trachea, 164, 196, 219, 220 Transduction, 215, 220 Transfection, 163, 220 Transfer Factor, 189, 220 Transferases, 184, 220 Transfusion, 26, 41, 46, 220 Translation, 20, 220 Translocation, 11, 51, 220 Transmitter, 92, 155, 175, 196, 200, 220 Transplantation, 4, 30, 168, 176, 189, 195, 220 Trauma, 116, 127, 173, 185, 199, 219, 220, 224 Triad, 4, 221 Trichosanthin, 85, 221 Tricuspid Atresia, 171, 221 Trigger zone, 160, 221

238

Amniotic Fluid

Trisomy, 34, 45, 68, 70, 158, 221 Trypsin, 37, 73, 177, 202, 221, 224 Tryptophan, 169, 214, 221 Tumor marker, 163, 221 Tumor Necrosis Factor, 24, 221 Tumour, 50, 82, 221 Tyrosine, 175, 221 U Ulcer, 172, 221 Ulceration, 172, 221 Ultrasonography, 74, 78, 100, 180, 183, 221 Umbilical Arteries, 221 Umbilical Cord, 9, 15, 25, 38, 51, 72, 122, 157, 168, 221 Umbilical cord blood, 9, 25, 38, 221 Uracil, 211, 221 Urea, 115, 202, 218, 221, 222 Uremia, 212, 222 Ureters, 193, 222 Urethra, 6, 209, 217, 222 Uric, 115, 210, 222 Urinary, 23, 37, 73, 174, 183, 201, 222 Urinary tract, 174, 201, 222 Urine, 5, 6, 13, 17, 18, 19, 23, 36, 46, 49, 66, 82, 107, 118, 123, 156, 160, 163, 172, 174, 175, 178, 179, 188, 193, 201, 209, 212, 222 Urogenital, 15, 183, 222 Uterine Contraction, 104, 112, 203, 219, 222 Uterine Monitoring, 113, 222 V Vaccination, 121, 126, 222 Vaccine, 120, 121, 125, 222 Vagina, 15, 40, 92, 107, 108, 122, 167, 173, 189, 196, 222 Vaginal, 15, 18, 20, 72, 73, 98, 99, 107, 119, 129, 222 Vaginosis, 118, 222 Valves, 6, 222 Vascular, 7, 21, 28, 74, 119, 173, 177, 190, 200, 201, 202, 205, 222 Vascular endothelial growth factor, 21, 28, 74, 222

Vascular Resistance, 119, 222 Vasoconstriction, 31, 178, 222 Vasodilator, 164, 175, 187, 200, 222 Vector, 125, 220, 222 Vein, 15, 56, 161, 192, 200, 221, 223 Venous, 49, 57, 119, 161, 162, 163, 201, 209, 221, 223 Venous blood, 119, 163, 223 Ventilation, 100, 164, 223 Ventricle, 161, 171, 188, 210, 218, 221, 223 Ventricular, 171, 221, 223 Venules, 164, 165, 177, 223 Vertebrae, 216, 223 Vertigo, 202, 223 Vesicular, 104, 182, 185, 223 Veterinary Medicine, 139, 223 Villus, 8, 16, 33, 101, 223 Viral, 37, 65, 75, 120, 121, 125, 220, 223 Viral Load, 37, 223 Virulence, 161, 220, 223 Virulent, 15, 223 Virus, 37, 42, 51, 96, 120, 121, 125, 182, 205, 220, 223 Vitamin A, 79, 191, 213, 223 Vitro, 22, 223 Vivo, 9, 22, 195, 223 W White blood cell, 155, 159, 195, 198, 200, 205, 223 Windpipe, 219, 224 Withdrawal, 113, 173, 224 Womb, 96, 127, 222, 224 Wound Healing, 115, 125, 195, 224 Wound Infection, 97, 224 X Xenograft, 159, 224 X-ray, 113, 166, 181, 200, 224 Y Yeasts, 204, 224 Yolk Sac, 180, 224 Z Zygote, 170, 198, 224 Zymogen, 209, 224

239

240

Amniotic Fluid