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

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

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AVASCULAR NECROSIS 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., 1960Avascular Necrosis: 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: 0-497-00114-4 1. Avascular Necrosis-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 avascular necrosis. 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 AVASCULAR NECROSIS ............................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Avascular Necrosis ....................................................................... 5 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND AVASCULAR NECROSIS................................................................... 55 Overview...................................................................................................................................... 55 Finding Nutrition Studies on Avascular Necrosis ...................................................................... 55 Federal Resources on Nutrition ................................................................................................... 56 Additional Web Resources ........................................................................................................... 57 CHAPTER 3. ALTERNATIVE MEDICINE AND AVASCULAR NECROSIS ............................................ 59 Overview...................................................................................................................................... 59 National Center for Complementary and Alternative Medicine.................................................. 59 Additional Web Resources ........................................................................................................... 64 General References ....................................................................................................................... 64 CHAPTER 4. PATENTS ON AVASCULAR NECROSIS ......................................................................... 65 Overview...................................................................................................................................... 65 Patent Applications on Avascular Necrosis................................................................................. 65 Keeping Current .......................................................................................................................... 67 CHAPTER 5. BOOKS ON AVASCULAR NECROSIS ............................................................................. 69 Overview...................................................................................................................................... 69 Book Summaries: Online Booksellers........................................................................................... 69 Chapters on Avascular Necrosis .................................................................................................. 69 CHAPTER 6. PERIODICALS AND NEWS ON AVASCULAR NECROSIS ............................................... 71 Overview...................................................................................................................................... 71 News Services and Press Releases................................................................................................ 71 Newsletter Articles ...................................................................................................................... 73 Academic Periodicals covering Avascular Necrosis..................................................................... 75 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 79 Overview...................................................................................................................................... 79 NIH Guidelines............................................................................................................................ 79 NIH Databases............................................................................................................................. 81 Other Commercial Databases....................................................................................................... 83 APPENDIX B. PATIENT RESOURCES ................................................................................................. 85 Overview...................................................................................................................................... 85 Patient Guideline Sources............................................................................................................ 85 Finding Associations.................................................................................................................... 89 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 91 Overview...................................................................................................................................... 91 Preparation................................................................................................................................... 91 Finding a Local Medical Library.................................................................................................. 91 Medical Libraries in the U.S. and Canada ................................................................................... 91 ONLINE GLOSSARIES.................................................................................................................. 97 Online Dictionary Directories ..................................................................................................... 97 AVASCULAR NECROSIS DICTIONARY ................................................................................. 99 INDEX .............................................................................................................................................. 133

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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 avascular necrosis 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 avascular necrosis, 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 avascular necrosis, 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 avascular necrosis. 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 avascular necrosis, 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 avascular necrosis. 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 AVASCULAR NECROSIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on avascular necrosis.

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

Prevalence Rates and an Evaluation of Reported Risk Factors for Osteonecrosis (Avascular Necrosis) in Crohn's Disease Source: Canadian Journal of Gastroenterology. 14(2): 138-143. February 2000. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Fax (905) 829-4799. E-mail: [email protected]. Summary: Avascular necrosis (osteonecrosis, or bone death) occurs in Crohn's disease, but the rate of this particular complication is not known. This article reports on a study undertaken to elucidate the prevalence rates and reported risk factors for osteonecrosis in patients with Crohn's disease. Over 20 years, 875 patients with Crohn's disease, 492 women (56.1 percent) and 383 men (43.9 percent) were evaluated, with patient followup

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data available for a mean of 7.8 years. In this group, four men were seen with osteonecrosis. No woman was affected. All 4 patients had typical radiological, magnetic resonance imaging (MRI), or pathological changes of osteonecrosis involving the femoral heads, while two patients also had superimposed avascular necrosis involving the humeral heads. Patients ages ranged from 19 to 36 years at the time of diagnosis of their Crohn's disease, and all were white. In one patient, disease was confined to the colon, while three patients had disease involving the terminal ileum and colon. Disease behavior in two of the patients was classified as penetrating because of concomitant ischiorectal abscesses, while one patient developed a metastatic colon carcinoma (cancer). Ankylosing spondylitis (a chronic inflammatory condition affecting the spine) was present in two patients, but no other extraintestinal manifestations developed. Two patients received corticosteroids as well as parenteral nutrition during the course of their disease; two received neither treatment. The overall rate of avascular necrosis in Crohn's disease was less than 0.5 percent, but for men with Crohn's disease, the risk was about 1 percent. In this series, risk of osteonecrosis could not be attributed to corticosteroid use, parenteral nutrition, or both forms of therapy administered together. 1 figure. 2 tables. 20 references. •

Avascular Necrosis Following Renal Transplantation Source: Transplantation Proceedings. 30(7): 3034-3035. November 1998. Contact: Available from Appleton and Lange. P.O. Box 86, Congers, NY 10920-0086. (203) 406-4623. Summary: Current improved graft survival following organ transplantation depends upon the combined use of various immunosuppressive drugs. Regardless of many favorable effects of each drug, they have some side effects. Avascular necrosis (AVN) following organ transplant is one of the complications that sometimes results from treatments to preserve the organ allograft. This article reports on a study that retrospectively analyzed patients with renal allografts in order to determine the cause or precipitating conditions for AVN, to evaluate the clinicopathologic features associated with AVN, and to establish a treatment strategy. Thirteen cases (2.8 percent) of AVN of femoral head were developed among 462 patients studied. Among these, 11 cases of 365 (3.0 percent) were from living donors and 2 cases out of 97 (2.2 percent) were from cadaveric donors. The main clinical manifestations were hip joint pain and limitation of weight bearing and motion. The mean onset of first bone symptoms of AVN was 5.5 months. The type of donor, pretransplant type, and duration of dialysis showed no relation with the occurrence of AVN. The pretransplant level of blood urea nitrogen (BUN) was higher in the AVN group, but its significance is questionable due to a fluctuating level of the time of blood sampling. In this study, the cholesterol level did not show any significant relation with the AVN. Posttransplant weight gain can be suspected to be a favorable condition for AVN; however, in this population, posttransplant weight gain was not significant. The authors contend that AVN in bone may be induced by individual reactions to the steroid treatment. In the early stage of AVN, core decompression alone can be a successful treatment. In this study, 7 of 13 patients underwent core decompression. The authors conclude that they could not illustrate the definite precipitating factors for AVN in renal transplant recipients using steroids. 8 references.

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Avascular Necrosis: Diagnosis, Staging, and Management Source: Journal of Musculoskeletal Medicine. 14(11):13-15,17, 21-24; November 1997.

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Summary: This journal article for health professionals discusses the early diagnosis, evaluation, and staging of nontraumatic avascular necrosis (AVN) of the hip joint. AVN is a poorly understood condition in which a decrease in the blood supply to bone results in its death. The hip is more frequently involved than other joints, and the consequences there are more serious. Without treatment, most cases will progress to bone collapse and eventually require reconstructive surgery. Understanding the causes and pathogenesis aids early diagnosis, which leads to more effective management. In the earlier stages, the goal is to institute treatment designed to retard disease progression and prevent femoral head collapse, including core decompression, bone grafting, osteotomy, and electrical stimulation. In the later stages, after significant collapse has occurred, management is conservative until reconstructive surgery, usually total hip replacement arthroplasty, is indicated. 15 references, 4 figures, and 5 tables. (AA-M).

Federally Funded Research on Avascular Necrosis The U.S. Government supports a variety of research studies relating to avascular necrosis. 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 avascular necrosis. 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 avascular necrosis. The following is typical of the type of information found when searching the CRISP database for avascular necrosis: •

Project Title: DECOMPRESSION CORING VS CONSERVATIVE THERAPY FOR AVASCULAR NECROSIS O Principal Investigator & Institution: Orringer, Eugene P.; Professor; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EARLY DIAGNOSIS OF GROWTH DISORDERS UING MR IMAGING Principal Investigator & Institution: Jaramillo, Diego; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 15-JUL-1994; Project End 30-JUN-2005

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

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Summary: (provided by applicant): The goal of this research is the detection of epiphyseal ischemia and prediction of its growth sequelae using novel non-invasive magnetic resonance (MR) approaches. In animal models, we propose to determine the earliest changes in ischemia, to differentiate early from late ischemia leading to avascular necrosis; and to predict the deverlopment of growth arrest. In addition to conventional MR measures (proton density and T2 relaxation), we will investigate perfusion-related changes by early gadolinum (Gd) enhanced imaging; and diffusion related changes by line diffusion scanning and diffusion tensor imaging. We will also evaluate disturbances of the cartilaginous matrix including glycosaminoglycan depletion revealed by delayed GD enhanced imaging, and collagen content by magnetization transfer imaging. The major hypotheses are that MR parameters can 1) detect early ischemia, 2) differentiate early from late ischemia leading to sequelae, and 3) predict growth deformity through MR parameters that reflect tissue structure and vascularization of the immature epiphysis. Epiphyseal ischemia is a pathogenic pathway shared by many common pediatric disorders. Ischemia leading to avascular necrosis of the femoral head frequently causes hip deformity and disability in childhood. A hip that grows abnormally also predisposes to degenerative joint disease in adult; more than half of all adults with osteoarthritis of the hip suffered hip diseases as children. Imaging of cartilaginous disorders serves to guide early therapy, prevent or minimize deformity, and detect children predisposed to premature cartilage degeneration in adulthood. The specific aims are to: 1) determine the MR tissue characteristics of normal epiphyseal cartilage. Specifically, we wish to test whether the greater cellularity and vascularization of immature epiphyseal cartilage result in different MR tissue characteristics; 2) in early ischemia, determine temporal and spatial differences between diffusion imaging, T2 maps and Gd-enhanced imaging; 3) in prolonged ischemia, determine which MR parameters best predict irreversible damage; and 4) in a model of avascular necrosis, determine which MR parameters predict abnormal growth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HOST FACTORS AND ETIOLOGY OF LEUKEMIA Principal Investigator & Institution: Davies, Stella; Professor and Jacob G. Schmidlapp Endowe; Pediatrics; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 18-DEC-2001; Project End 30-SEP-2002 Summary: Individuals show considerable variation in their ability to metabolize therapeutic drugs, and in the metabolism of potentially toxic chemicals occurring in the environment. The variability is due in large part to genetic differences (polymorphisms) in genes involved in detoxification or in the response to genetic damage. Preliminary data indicate that polymorphic host factors are important in response to leukemia treatment, in etiology of leukemia, and in the occurrence of complications of treatment. The overall aim of this proposal is to develop a DNA resource from children with cytogenetically well characterized and uniformly treated leukemia, and to use it to analyze host factors influencing the outcome of treatment for leukemia and the etiology of leukemia. This study is a correlative study complementing and expanding NCI funded Children's Oncology Group (COG) chemotherapy treatment trials. In this investigation we will examine allele frequencies at polymorphic sites in genes involved in drug metabolism, DNA repair, DNA synthesis and in defense against oxidant damage in children enrolled on COG therapeutic studies. The data will be analyzed to determine whether allelic variation at these sites influence the outcome of therapy. In

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addition, allele frequencies will be compared with those seen in normal population to determine whether they influence susceptibility to leukemia. Lastly, the DNA collected will serve as a resource for studies of polymorphisms which influence complications of therapy such as second cancers, avascular necrosis of bone and thrombotic events. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LUPUS COHORT Principal Investigator & Institution: Petri, Michelle A.; Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 30-SEP-1996; Project End 31-MAR-2007 Summary: (provided by applicant): The Hopkins Lupus Cohort is an ongoing, prospective study in which SLE patients are followed by protocol, with visits at a minimum of every 3 months, now in its 16th year. The Cohort is racially balanced, with one-half of the members being African-American, and reflects a broad socioeconomic range. The Cohort represents a 15 year investment in the study of SLE outcomes, sponsored by NIH. It has led to a unique, prospective database of demographic, social, clinical and laboratory (routine, serologic, and antiphospholipid antibody) measures. The four major accomplishments of the Cohort during the last funding period were: 1) the determination that serologic markers of disease activity, such as anti-dsDNA, C3, and C4, have limited utility in the prediction of SLE flare; 2) the determination that the cumulative prednisone dose is predictive of coronary artery disease and osteoporosis, whereas high-dose prednisone is predictive of avascular necrosis; 3) the determination that antiphospholipid antibodies are associated with future risk of thrombosis and with atherosclerosis; and 4) the finding that the poor health status of SLE patients is associated with fibromyalgia, whereas fibromyalgia itself correlates highly with neurally-mediated hypotension, a form of autonomic neuropathy. In this revised grant, four new specific aims will be undertaken. First, in the cohort as a whole and in an inception cohort followed since diagnosis, we will determine the relative importance of disease activity versus corticosteroid treatment as a predictor of specific types of organ damage. Second, in a study of 75 patients seen monthly, we will investigate cytokines and platelet-related factors as predictors of disease activity. Third, 250 patients from the inception cohort will have carotid duplex and helical CT (for coronary calcification scores) at baseline and 2 years later to determine associates and predictors of atherosclerosis, including traditional and novel cardiovascular risk factors. Fourth, we will assess, in 100 SLE patients with and 100 without fibromyalgia, the frequency of autonomic neuropathy and the correlation with health status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NONSPECIFIC BONE PAIN AND AVASCULAR NECROSIS Principal Investigator & Institution: Chen, Edward; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002 Summary: For the patient with a successful organ transplant, the musculoskeletal complications of non-specific bone pain and osteonecrosis all too frequently arise within the first several years after transplantation and are debilitating just as the patient is enjoying a new lease on life. The long term objectives of this proposal are to study 3 issues central to the musculoskeletal problems encountered by transplant patients. (1) Nonspecific bone pain (NSBP) is a newly recognized entity which is poorly understood and is secondary to immunosuppression. It may be related to early stage osteonecrosis.

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This proposal will prospectively study the natural history, improve the diagnostic criteria and test calcium channel blockers in the treatment of NSBP using a double blind, randomized study as well as explore a potential relationship to osteonecrosis. (2) Osteonecrosis of the femoral head (ONFH) is a dreaded complication of immunosuppression as it is crippling and there is no treatment which can reliably salvage the hip joint. A reversible stage of osteonecrosis has recently been described. This proposal will use MRI to prospectively study whether or not a reversible stage exists and the prognostic factors which may predict which patients will develop progressive collapse f the femoral head. (3) At present, surgical procedures to preserve the hip joint are unreliable in their success. This proposal will use functional and clinical outcomes measurement to study a new procedure, core decompression with methylmethacrylate cement packing, designed to prevent or forestall the development of end-stage arthritis in patients with either pre- femoral head collapse ONFH (single blind, randomized, prospective study), or post-femoral head collapse ONFH (single blind, randomized, prospective study), or post-femoral head collapse ONFH (prospective study). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ORGAN TRANSPLANTATION IN ANIMALS AND MAN Principal Investigator & Institution: Matas, Arthur J.; Professor; Surgery; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2003; Project Start 30-SEP-1992; Project End 31-MAR-2008 Summary: This is an application for competitive renewal of a program project grant which has been active for 34 years. It involves many investigators and many different projects all relating to the improvement of the results of organ transplantation. The basic overall OBJECTIVES of this grant are to: 1. analyze and isolate the clinical problems involved in organ transplantation and precisely document clinical laboratory correlations; 2. organize clinical trials and experimental approaches based on available data, to solve clinical problems. Within these objectives, all projects are organized into two essential AIMS: AIM 1: TO PREVENT ORGAN DESTRUCTION. This includes not only immunological manipulations designed to prevent rejection but also those designed to prevent nonimmunologic graft loss, to prolong patient survival, and to modify or control drug toxicity and recurrent disease; AIM 2: TO MAXIMIZE REHABILITATION: The focus here is on minimizing complications and maximizing compliance with the immunosuppressive regimen. Within this framework, the current applications include projects addressing morbidity, mortality, and late graft loss (2 projects), chronic graft loss (3 projects), morbidity from avascular necrosis (1 project), and long-term living donor follow-up (1 project). The 2 Cores--Clinical and Administrative--support all projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RANDOMIZED TRIAL FOR CORE DECOMPRESSION IN SICKLE CELL ANEMIA Principal Investigator & Institution: Vichinsky, Elliott; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002 Summary: The primary aim of this study is determine if decompression coring procedures result in a substantial improvement in pain and mobility compared to standard care non-weight baring in sickle cell disease (SCD). As a secondary objective,

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this multi-institutional collaborative study is designed to follow a standardized protocol that will characterize and compare the radiographic, histologic and surgical course of patients. SCD is the most common cause of avascular necrosis (AVN) of the hip in young patients. By age 25 almost half of all SCD patients have AVN. Eventual total collapse of the femoral head eventually necessitates hip replacement. Unfortunately, his arthroplasty fails in over 50-75% of cases. A major focus of the health community is to develop effective therapy that will half the progression of early AVN. The National Preoperative Transfusion Study Group recently reported a high perioperative morbidity rate with hip replacement and experience with decompression coring. A pilot prospective study to evaluate decompression coring in 13 hips was completed and demonstrated long-term improvement in both pain and range of motion in all early stage hips. Based on the preliminary data in SCD and non-SCD, a multi-institutional prospective study by SCD experts, orthopedic surgeons and physiatrists is planned to determine the efficacy od decompression coring in SCD. The study will randomize 100 patients with early AVN to a standardized program of non- weight bearing with crutches for 6 weeks versus decompression coring procedure. All patients will follow standard care protocols including Harris hip score and Oberg scale of lower extremity function, radiographic and laboratory testing every 3 to 6 months for an average of 3 years. Radiographic (MRI) and histologic sections of the core biopsy will be centrally analyzed. The extent of the lesion on MRI and pathology will be quantitated and compared to the clinical course in order to investigate the predictors of outcome. In summary, this study if successful, will change the approach to hip disease in SCD patients and result in improved quality of life and decreased morbidity from Surgery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SLEEP, FATIGUE, AND DEXAMETHOSONE IN CHILDHOOD CANCER Principal Investigator & Institution: Hinds, Pamela S.; Director of Nursing Research; St. Jude Children's Research Hospital Memphis, Tn 381052794 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 30-JUN-2004 Summary: Mounting evidence indicates that adding dexamethasone to the therapy for children and adolescents diagnosed with lymphoblastic leukernia contributes to more positive long-term outcomes such as lower rates of meningeal leukemia. The significant positive contributions of dexamethasone have not occurred without adverse effects including avascular necrosis. mania and psychosis, and aberrant sleep and fatigue. These adverse effects could be related to inter-individual variability in the systemic exposure to dexamethasone and if so, the adverse effects could serve as behavioral indicators of patient sensitivity to the dosing schedule. To determine whether dexamethasone dosing schedules need to be individualized to minimize adverse effects while maintaining antileukernic effects, the relationship between inter-individual variability and adverse effects must be established. The overall purpose of this two-site study is to determine the relationship between systemic exposure to dexamethasone and patients' sleep and fatigue by comparing multiple indicators of patient sleep and fatigue in two consecutive 5-day periods during Continuation therapy off and on dexatnethasone. Approximately 134 children and adolescents with low or standard fisk ALL will wear a wnist actigraph for the two consecutive 5-day study periods and will complete a self-report fatigue questionnaire during a telephone interview on Days 2 and 5 of both study periods. Their parents will complete a sleep diary and a fatigue questionnaire on Days 2 and 5 of both study periods regarding their child's sleep and fatigue patterns. In addition, on Day I of the on dexamethasone 5-day study period,

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patients will-have sequential blood samples collected pre- and post- the morning dose of dexamethasone. These samples will be analyzed for dexamethasone pharmacokinetics and genetic polymorphism. Using these data, we will test the hypothesis that dexamethasone contributes to aberrant sleep and increased fatigue in children and adolescents with ALL, and that the altered sleep and fatigue are related to the pharmacokinetics of the drug. Our study findings will explicate the relationship between sleep efficiency and fatigue, and between sleep, fatigue, and systemic exposure to dexamethasone. 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 “avascular necrosis” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for avascular necrosis in the PubMed Central database: •

Corticosteroids and avascular necrosis of the femoral head. by Knight A.; 2001 Aug 21; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=81358

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Corticosteroids and avascular necrosis of the femoral head. by McKee MD, Waddell JP, Kudo PA, Schemitsch EH, Richards RR.; 2001 Aug 21; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=81359

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals.

3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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

An unusual presentation of idiopathic bilateral avascular necrosis of the femoral heads. Author(s): Parmar KA. Source: Emergency Medicine (Fremantle, W.A.). 2003 June; 15(3): 296-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12786653

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Avascular necrosis after first metatarsal head osteotomies. Author(s): Meisenhelder DA, Harkless LB, Patterson JW. Source: J Foot Surg. 1984 November-December; 23(6): 429-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6520342

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Avascular necrosis and bone marrow edema syndrome. Author(s): Watson RM, Roach NA, Dalinka MK. Source: Radiologic Clinics of North America. 2004 January; 42(1): 207-19. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15049532

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Avascular necrosis and corticosteroids. Author(s): Snyder S. Source: Annals of Internal Medicine. 1984 May; 100(5): 770-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6712049

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Avascular necrosis associated with nailing of femoral neck fracture. Two cases examined pre- and postoperatively by tetracycline and radionuclide tracer techniques. Author(s): Stromqvist B, Hansson LI. Source: Acta Orthopaedica Scandinavica. 1983 October; 54(5): 687-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6230856

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Avascular necrosis following a "routine" intertrochanteric fracture of the femur. Author(s): Kelbel JM, Connolly JF. Source: Nebr Med J. 1984 May; 69(5): 156-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6728070

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Avascular necrosis in HIV-infected patients receiving antiretroviral treatment: study of seven cases. Author(s): Valencia ME, Barreiro P, Soriano V, Blanco F, Moreno V, Lahoz JG. Source: Hiv Clinical Trials. 2003 March-April; 4(2): 132-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12671781

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Avascular necrosis in long-term survivors after allogeneic or autologous stem cell transplantation: a single center experience and a review. Author(s): Tauchmanova L, De Rosa G, Serio B, Fazioli F, Mainolfi C, Lombardi G, Colao A, Salvatore M, Rotoli B, Selleri C. Source: Cancer. 2003 May 15; 97(10): 2453-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12733144

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Avascular necrosis of bone after high doses of dexamethasone during neurosurgery. Author(s): Watkins S, Williams JR. Source: British Medical Journal (Clinical Research Ed.). 1982 March 6; 284(6317): 742. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6802315

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Avascular necrosis of bone after high doses of dexamethasone during neurosurgery. Author(s): McCluskey J, Gutteridge DH. Source: British Medical Journal (Clinical Research Ed.). 1982 January 30; 284(6312): 333-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6800452

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Avascular necrosis of bone complicating corticosteroid replacement therapy. Author(s): Williams PL, Corbett M. Source: Annals of the Rheumatic Diseases. 1983 June; 42(3): 276-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6859959

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Avascular necrosis of bone following short-term dexamethasone therapy for brain edema. Case report. Author(s): Fast A, Alon M, Weiss S, Zer-Aviv FR. Source: Journal of Neurosurgery. 1984 November; 61(5): 983-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6491744

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Avascular necrosis of bone with rheumatoid vasculitis. Author(s): Shupak R, Bernier V, Rabinovich S, Gordon DA, Wright T. Source: The Journal of Rheumatology. 1983 April; 10(2): 261-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6864680

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Avascular necrosis of bone: a review. Author(s): Nixon JE. Source: Journal of the Royal Society of Medicine. 1983 August; 76(8): 681-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6350586

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Avascular necrosis of common bones seen in the ED. Author(s): Lee CC, Syed H, Crupi RS. Source: The American Journal of Emergency Medicine. 2003 July; 21(4): 336-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12898494

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Avascular necrosis of femoral heads in a man with HIV infection. Author(s): Gasiorowski J, Knysz B, Sokolska V, Gladysz A. Source: The Lancet Infectious Diseases. 2003 November; 3(11): 708. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14592600

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Avascular necrosis of metacarpal heads following renal transplantation. Author(s): Al-Kutoubi MA. Source: The British Journal of Radiology. 1982 January; 55(649): 79-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7032638

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Avascular necrosis of the carpal scaphoid associated with progressive systemic sclerosis. Author(s): Kawai H, Tsuyuguchi Y, Yonenobu K, Inoue A, Tada K. Source: Hand. 1983 October; 15(3): 270-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6642301

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Avascular necrosis of the dens: a follow-up study. Author(s): Dove J, Hsu LC, Yau AC. Source: Spine. 1982 September-October; 7(5): 408-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7178977

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Avascular necrosis of the femoral head in a HIV-1 infected patient receiving lopinavir/ritonavir. Author(s): Bongiovanni M, Chiesa E, Riva A, d'Arminio Monforte A, Bini T. Source: International Journal of Antimicrobial Agents. 2003 December; 22(6): 630-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14659664

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Avascular necrosis of the femoral head in adult Kuwaiti sickle cell disease patients. Author(s): Marouf R, Gupta R, Haider MZ, Al-Wazzan H, Adekile AD. Source: Acta Haematologica. 2003; 110(1): 11-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12975550

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Avascular necrosis of the femoral head--diagnostic techniques, reliability and relevance. Author(s): Meyers MH. Source: Hip. 1983; : 263-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6671915

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Avascular necrosis of the femoral heads following bilateral iliopsoas and adductor releases via the medical approach to the hip. Author(s): Manjarris JF, Mubarak S. Source: Journal of Pediatric Orthopedics. 1984 January; 4(1): 109-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6693553

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Avascular necrosis of the glenoid. Author(s): Dzioba RB, Quinlan WJ. Source: The Journal of Trauma. 1984 May; 24(5): 448-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6716527

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Avascular necrosis of the hallucal sesamoids update with reference to two casereports. Author(s): Toussirot E, Jeunet L, Michel F, Kantelip B, Wendling D. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2003 August; 70(4): 307-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12951318

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Avascular necrosis of the hip in the sickle cell hemoglobinopathies. Author(s): Sebes JI, Kraus AP. Source: J Can Assoc Radiol. 1983 June; 34(2): 136-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6885886

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Avascular necrosis of the intermediate cuneiform bone. Author(s): Watmough PJ, Tselentakis G, Day JB. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2003 November; 12(6): 402-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14530699

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Avascular necrosis of the jaws: risk factors in metastatic cancer patients. Author(s): Tarassoff P, Csermak K. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2003 October; 61(10): 1238-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14586868

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Bilateral avascular necrosis of the capitate. A case report and a review of the literature. Author(s): Bolton-Maggs BG, Helal BH, Revell PA. Source: The Journal of Bone and Joint Surgery. British Volume. 1984 August; 66(4): 5579. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6746692

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Bilateral avascular necrosis of the first metatarsal head in adolescence. A case report. Author(s): Fu FH, Gomez W. Source: Clinical Orthopaedics and Related Research. 1989 September; (246): 282-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2766616

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Bilateral avascular necrosis of the head of the femur. Author(s): Kozminsky MP. Source: The Medical Journal of Australia. 1993 April 5; 158(7): 508. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8469215

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Bilateral avascular necrosis of the hip following Leriche syndrome. Author(s): Hughes EC Jr, Schumacher HR, Sbarbaro JL Jr. Source: The Journal of Bone and Joint Surgery. American Volume. 1971 March; 53(2): 380-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5546715

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Bilateral avascular necrosis of the humeral trochleae after chemotherapy. Author(s): Chan BK, Bell SN. Source: The Journal of Bone and Joint Surgery. British Volume. 2000 July; 82(5): 670-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10963163

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Bilateral avascular necrosis of the talus following strenuous physical activity. Author(s): Travlos J, Learmonth ID. Source: The Journal of Bone and Joint Surgery. British Volume. 1991 September; 73(5): 863-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1894682

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Bilateral capitellar steroid-induced avascular necrosis. Author(s): Beyer CA, Beckenbaugh RD. Source: Orthopedics. 1993 April; 16(4): 480-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8493155

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Bilateral femoral avascular necrosis in a man with psoriasis: responsibility of topical corticosteroids and role of cyclosporine. Author(s): Reichert-Penetrat S, Trechot P, Barbaud A, Gillet P, Schmutz JL. Source: Dermatology (Basel, Switzerland). 2001; 203(4): 356-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11752834

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Bilateral spontaneous avascular necrosis of the navicular. Case presentation with comparative imaging. Author(s): Boc SF, Feldman G. Source: Journal of the American Podiatric Medical Association. 1998 January; 88(1): 41-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9458634

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Bilateral stress fractures of the tarsal navicular with associated avascular necrosis in a pole vaulter. Author(s): Helstad PE, Ringstrom JB, Erdmann BB, Jacobs PM, Julsrud ME. Source: Journal of the American Podiatric Medical Association. 1996 November; 86(11): 551-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8961658

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Bipolar prosthetic replacement for the treatment of avascular necrosis of the femoral head. Author(s): Takaoka K, Nishina T, Ohzono K, Saito M, Matsui M, Sugano N, Saito S, Kadowaki T, Ono K. Source: Clinical Orthopaedics and Related Research. 1992 April; (277): 121-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1555332

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Bipolar versus total hip arthroplasty for avascular necrosis of the femoral head. A comparison. Author(s): Cabanela ME. Source: Clinical Orthopaedics and Related Research. 1990 December; (261): 59-62. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2245563

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Bisphosphonates and avascular necrosis of the jaws. Author(s): Carter GD, Goss AN. Source: Aust Dent J. 2003 December; 48(4): 268. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14738134

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Blood lipids in patients with rheumatoid arthritis and avascular necrosis of the femoral head. Author(s): Schorn D, Niehaus CE, Mowat AG. Source: The Journal of Rheumatology. 1982 September-October; 9(5): 730-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7175844

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Bone marrow scintigraphy in the diagnosis of post-traumatic avascular necrosis of bone. Author(s): Tawn DJ, Watt I. Source: The British Journal of Radiology. 1989 September; 62(741): 790-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2790419

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Bone scintigraphy equipped with a pinhole collimator for diagnosis of avascular necrosis of the femoral head. Author(s): Maillefert JF, Toubeau M, Piroth C, Piroth L, Brunotte F, Tavernier C. Source: Clinical Rheumatology. 1997 June; 16(4): 372-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9259251

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Brucellosis induced avascular necrosis of the femoral head in a 7 year old child. Author(s): Gedalia A, Howard C, Einhorn M. Source: Annals of the Rheumatic Diseases. 1992 March; 51(3): 404-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1575594

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Case of the month no. 72. Avascular necrosis of the hip. Author(s): Dearing JJ, Levy JM, Herwick PH. Source: Ariz Med. 1984 August; 41(8): 545, 548. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6477160

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Case quiz. Avascular necrosis of the T12 and L1 vertebral bodies. Author(s): Au-yeung KM, Griffith JF. Source: Australasian Radiology. 2000 August; 44(3): 355-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10974738

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Case report: avascular necrosis of the femoral head as a complication of complex embolization for severe pelvic haemorrhage. Author(s): Obaro RO, Sniderman KW. Source: The British Journal of Radiology. 1995 August; 68(812): 920-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7551793

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Case report: avascular necrosis of the proximal tibia following upper tibial osteotomy. Author(s): Howell GE. Source: J R Nav Med Serv. 1997; 83(3): 127-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9684445

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Cataracts, glaucoma, and femoral avascular necrosis caused by topical corticosteroid ointment. Author(s): McLean CJ, Lobo RF, Brazier DJ. Source: Lancet. 1995 February 4; 345(8945): 330. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7837896

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Catastrophic antiphospholipid antibody syndrome presenting with multiple thromboses and sites of avascular necrosis. Author(s): Egan RM, Munn RK. Source: The Journal of Rheumatology. 1994 December; 21(12): 2376-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699646

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Cementless total hip arthroplasty in patients with advanced avascular necrosis. Author(s): Gonzalez MH, Ortinau ET, Buonanno W, Prieto J. Source: J South Orthop Assoc. 1997 Fall; 6(3): 162-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9322194

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Cementless total hip arthroplasty in patients with steroid-induced avascular necrosis of the hip. A 62-month follow-up study. Author(s): Phillips FM, Pottenger LA, Finn HA, Vandermolen J. Source: Clinical Orthopaedics and Related Research. 1994 June; (303): 147-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8194225

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Changes on magnetic resonance images after traumatic avascular necrosis of the femoral head. Author(s): Kamano M, Honda Y, Shiokawa H. Source: Journal of Orthopaedic Trauma. 1999 May; 13(4): 268-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10342352

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Chondrolysis and avascular necrosis: complications of slipped capital femoral epiphysis. Author(s): Lubicky JP. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 1996 Summer; 5(3): 162-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8866280

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Chronic myeloid leukemia presenting with avascular necrosis of femur head. Author(s): Gupta D, Gaiha M, Siddaraju N, Daga MK, Anuradha S. Source: J Assoc Physicians India. 2003 February; 51: 214-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12725271

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Classification of avascular necrosis: a comparative study. Author(s): Steinberg ME. Source: Acta Orthop Belg. 1999; 65 Suppl 1: 45-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10084216

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Clinical correlates of avascular necrosis in systemic lupus erythematosus. Author(s): Wallace DJ. Source: The Journal of Rheumatology. 2001 October; 28(10): 2365-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11669186

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Clinical results of rotational osteotomy for treatment of avascular necrosis of the femoral head. Author(s): Belal MA, Reichelt A. Source: Archives of Orthopaedic and Trauma Surgery. 1996; 115(2): 80-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9063857

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Clinically occult avascular necrosis of the hip in systemic lupus erythematosus. Author(s): Aranow C, Zelicof S, Leslie D, Solomon S, Barland P, Norman A, Klein R, Weinstein A. Source: The Journal of Rheumatology. 1997 December; 24(12): 2318-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9415635

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Coincidence of asymptomatic avascular necrosis and fracture of the femoral neck: a rare combination of glucocorticoid induced side effects. Author(s): Loddenkemper K, Perka C, Burmester GR, Buttgereit F. Source: Annals of the Rheumatic Diseases. 2002 July; 61(7): 665-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12079923

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Color Doppler imaging assessment of blood flow in vascularized pedicle grafts for avascular necrosis of the femoral head: angiographic correlation. Author(s): Duchow J, Kubale R, Hopf T. Source: Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. 1998 August; 17(8): 509-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9697954

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Consequences of avascular necrosis of the femoral head in aluminium-related renal osteodystrophy and the role of endochondral ossification in the repair process. Author(s): McClure J, Smith PS. Source: Journal of Clinical Pathology. 1983 March; 36(3): 260-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6402524

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Core decompression and arthroscopic bone grafting for avascular necrosis of the knee. Author(s): Perez Carro L, Gomez Cimiano FJ, Gomez del Alamo G, Garcia Suarez G. Source: Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1996 June; 12(3): 323-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8783826

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Core decompression and conservative treatment for avascular necrosis of the femoral head: a meta-analysis. Author(s): Castro FP Jr, Barrack RL. Source: Am J Orthop. 2000 March; 29(3): 187-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10746469

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Core decompression for avascular necrosis of the distal femur: long term followup. Author(s): Mont MA, Tomek IM, Hungerford DS. Source: Clinical Orthopaedics and Related Research. 1997 January; (334): 124-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9005904

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Core decompression for avascular necrosis of the femoral head. Author(s): Van Laere C, Mulier M, Simon JP, Stuyck J, Fabry G. Source: Acta Orthop Belg. 1998 September; 64(3): 269-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9828471

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Core decompression in avascular necrosis of the hip in sickle-cell disease. Author(s): Styles LA, Vichinsky EP. Source: American Journal of Hematology. 1996 June; 52(2): 103-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8638629

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Core decompression of the femoral head for avascular necrosis: indications and results. Author(s): Steinberg ME. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1995 February; 38 Suppl 1: S18-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7874624

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Correlation between center-edge angle and acetabulum-head index in developmental dysplasia of the hip with avascular necrosis of the femoral head. Author(s): Taketa M, Fujii T, Kubota H, Nakashima Y, Noguchi Y, Iwamoto Y. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2003 May; 12(3): 215-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12703038

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Corticosteroids and avascular necrosis of the femoral head. Author(s): Knight A. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2001 August 21; 165(4): 397, 399. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11531046

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Cushing's disease presenting with avascular necrosis of the hip: an orthopedic emergency. Author(s): Koch CA, Tsigos C, Patronas NJ, Papanicolaou DA. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 September; 84(9): 3010-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10487656

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Decreased fibrinolytic potential in patients with idiopathic avascular necrosis and transient osteoporosis of the hip. Author(s): Van Veldhuizen PJ, Neff J, Murphey MD, Bodensteiner D, Skikne BS. Source: American Journal of Hematology. 1993 December; 44(4): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8237994

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Deformities of the hip in adults who have sickle-cell disease and had avascular necrosis in childhood. A natural history of fifty-two patients. Author(s): Hernigou P, Galacteros F, Bachir D, Goutallier D. Source: The Journal of Bone and Joint Surgery. American Volume. 1991 January; 73(1): 81-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985998

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Degenerative changes in the metatarsophalangeal joints after surgical correction of severe hammer-toe deformities. A complication associated with avascular necrosis in three cases. Author(s): Scheck M. Source: The Journal of Bone and Joint Surgery. American Volume. 1968 June; 50(4): 72737. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5690604

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Detection of femoral head avascular necrosis in adults by SPECT. Author(s): Collier BD, Carrera GF, Johnson RP, Isitman AT, Hellman RS, Knobel J, Finger WA, Gonyo JE, Malloy PJ. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1985 September; 26(9): 979-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3875700

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Diagnosis of avascular necrosis of the femoral head in patients treated for lymphoma. Author(s): Ratcliffe MA, Gilbert FJ, Dawson AA, Bennett B. Source: Hematological Oncology. 1995 May-June; 13(3): 131-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7622143

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Diagnostic imaging of avascular necrosis of the hip. American College of Radiology. ACR Appropriateness Criteria. Author(s): DeSmet AA, Dalinka MK, Alazraki N, Berquist TH, Daffner RH, el-Khoury GY, Goergen TG, Keats TE, Manaster BJ, Newberg A, Pavlov H, Haralson RH 3rd, McCabe JB, Sartoris D. Source: Radiology. 2000 June; 215 Suppl: 247-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11037434

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Diagnostic patterns for bone marrow oedema syndrome and avascular necrosis of the femoral head in dynamic bone scintigraphy. Author(s): Staudenherz A, Hofmann S, Breitenseher M, Schneider W, Engel AE, Imhof H, Leitha T. Source: Nuclear Medicine Communications. 1997 December; 18(12): 1178-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9481765

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Dieterich's disease: avascular necrosis of the metacarpal head: a case report. Author(s): Thienpont E, Vandesande W, De Smet L. Source: Acta Orthop Belg. 2001 April; 67(2): 182-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11383299

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Distinguishing avascular necrosis from segmental impaction of the femoral head following an acetabular fracture: preliminary report. Author(s): Gruen GS, Mears DC, Tauxe WN. Source: Journal of Orthopaedic Trauma. 1988; 2(1): 5-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3265722

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Distinguishing transient osteoporosis from avascular necrosis of the hip. Author(s): Guerra JJ, Steinberg ME. Source: The Journal of Bone and Joint Surgery. American Volume. 1995 April; 77(4): 61624. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7713981

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Distinguishing transient osteoporosis of the hip from avascular necrosis. Author(s): Balakrishnan A, Schemitsch EH, Pearce D, McKee MD. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 2003 June; 46(3): 187-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812240

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Does avascular necrosis cause collapse of the dome of the talus in severe haemophilia? Author(s): MacNicol MF, Ludlam CA. Source: Haemophilia : the Official Journal of the World Federation of Hemophilia. 1999 March; 5(2): 139-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10215965

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Does lesion size affect the outcome in avascular necrosis? Author(s): Steinberg ME, Bands RE, Parry S, Hoffman E, Chan T, Hartman KM. Source: Clinical Orthopaedics and Related Research. 1999 October; (367): 262-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10546624

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Early avascular necrosis of the femoral head. Report of a case and review of the literature. Author(s): Spencer JD, Humphreys S, Tighe JR, Cumming RR. Source: The Journal of Bone and Joint Surgery. British Volume. 1986 May; 68(3): 414-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3525571

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Early detection of avascular necrosis of the femoral head by MRI. Author(s): Fordyce MJ, Solomon L. Source: The Journal of Bone and Joint Surgery. British Volume. 1993 May; 75(3): 365-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8496201

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Early detection of avascular necrosis of the femoral head following renal transplantation. Author(s): Fink B, Degenhardt S, Paselk C, Schneider T, Modder U, Ruther W. Source: Archives of Orthopaedic and Trauma Surgery. 1997; 116(3): 151-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9061170

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Early diagnosis and treatment of steroid induced avascular necrosis of bone. Author(s): Nixon JE. Source: British Medical Journal (Clinical Research Ed.). 1984 March 10; 288(6419): 741-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6423059

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Early diagnosis of avascular necrosis of the femoral head. Author(s): Steinberg ME. Source: Instr Course Lect. 1988; 37: 51-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3047256

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Early innominate osteotomy as a treatment for avascular necrosis complicating developmental hip dysplasia. Author(s): Bar-On E, Huo MH, DeLuca PA. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 1997 April; 6(2): 138-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9165443

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Early results in the treatment of avascular necrosis of the femoral head with electrical stimulation. Author(s): Steinberg ME, Brighton CT, Hayken GD, Tooze SE, Steinberg DR. Source: The Orthopedic Clinics of North America. 1984 January; 15(1): 163-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6607439

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Early treatment of avascular necrosis in systemic lupus erythematosus. Author(s): Kalla AA, Learmonth ID, Klemp P. Source: Annals of the Rheumatic Diseases. 1986 August; 45(8): 649-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3740994

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Early-stage avascular necrosis of the femoral head: MR imaging for prognosis in 31 cases with at least 2 years of follow-up. Author(s): Lafforgue P, Dahan E, Chagnaud C, Schiano A, Kasbarian M, Acquaviva PC. Source: Radiology. 1993 April; 187(1): 199-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8451413

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Effect of early hip decompression on the frequency of avascular necrosis in children with fractures of the neck of the femur. Author(s): Ng GP, Cole WG. Source: Injury. 1996 July; 27(6): 419-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8881139

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Effect of long-term steroid use on prognosis for patients with surgically treated avascular necrosis of the hip. Author(s): Demirors H, Kaya A, Akpinar S, Tuncay C, Tandogan RN. Source: Transplantation Proceedings. 2002 September; 34(6): 2114-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12270334

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Efficacy of percutaneous vertebroplasty in the treatment of intravertebral pseudarthrosis associated with noninfected avascular necrosis of the vertebral body. Author(s): Jang JS, Kim DY, Lee SH. Source: Spine. 2003 July 15; 28(14): 1588-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12865850

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Emission tomography in femoral neck fracture for evaluation of avascular necrosis. Author(s): Stromqvist B, Brismar J, Hansson LI. Source: Acta Orthopaedica Scandinavica. 1983 December; 54(6): 872-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6230858

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End-stage avascular necrosis of bone in renal transplant patients. The natural history. Author(s): Churchill MA, Spencer JD. Source: The Journal of Bone and Joint Surgery. British Volume. 1991 July; 73(4): 618-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2071646

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Enterococcal arthritis with avascular necrosis in a lupus patient. Author(s): Markov G, Dobro J, Shankman S, Belmont HM. Source: British Journal of Rheumatology. 1996 June; 35(6): 595-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8670585

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Etiological factors of avascular necrosis of the femoral head. Twenty years later. Author(s): Rombouts JJ. Source: Acta Orthop Belg. 1999; 65 Suppl 1: 3-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10084209

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Evaluation of the risk factors of avascular necrosis of the femoral head in developmental dysplasia of the hip in infants younger than 18 months of age. Author(s): Agus H, Omeroglu H, Ucar H, Bicimoglu A, Turmer Y. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 2002 January; 11(1): 41-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11866080

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Evaluation of uncemented total hip arthroplasty in patients with avascular necrosis of the femoral head. Author(s): Lins RE, Barnes BC, Callaghan JJ, Mair SD, McCollum DE. Source: Clinical Orthopaedics and Related Research. 1993 December; (297): 168-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8242926

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Evidence for eicosanoids within the reparative front in avascular necrosis of human femoral head. Author(s): Tsai CL, Liu TK. Source: Clinical Orthopaedics and Related Research. 1992 August; (281): 305-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1499223

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Ewing's tumor of the talus misdiagnosed as avascular necrosis. A case report. Author(s): Weissman SL, Salama R, Papo Y, Loewenthal M. Source: The Journal of Bone and Joint Surgery. American Volume. 1966 March; 48(2): 333-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5932919

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Factors relating to hip joint arthritis following three childhood diseases--juvenile rheumatoid arthritis, Perthes disease, and postreduction avascular necrosis in congenital hip dislocation. Author(s): Cooperman DR, Emery H, Keller C. Source: Journal of Pediatric Orthopedics. 1986 November-December; 6(6): 706-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3793893

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Factors responsible for the development of avascular necrosis secondary to the treatment of congenital dislocation of the hip. Author(s): Burgos-Flores J, Ocete-Guzman G, Gonzalez-Herranz P, Hevia-Sierra E, Amaya-Alarcon S. Source: International Orthopaedics. 1993 November; 17(5): 305-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8125668

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Fat intensity within the hypointense zone on MR imaging of avascular necrosis of the femoral head. Author(s): Kokubo T, Takatori Y, Ninomiya S, Nakamura T, Itai Y. Source: Journal of Computer Assisted Tomography. 1991 May-June; 15(3): 470-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2026813

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Femoral head avascular necrosis associated with intramedullary nailing in an adolescent. Author(s): O'Malley DE, Mazur JM, Cummings RJ. Source: Journal of Pediatric Orthopedics. 1995 January-February; 15(1): 21-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7883920

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Femoral head avascular necrosis associated with metaphyseal aneurysmal bone cyst. Author(s): Albinana J, Gonzalez-Moran G, Morcuende JA. Source: Journal of Pediatric Orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America. 1995; 4(1): 110-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7719826

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Femoral head avascular necrosis in sickle cell anemia: MR characteristics. Author(s): Rao VM, Mitchell DG, Steiner RM, Rifkin MD, Burk DL Jr, Levy D, Ballas SK. Source: Magnetic Resonance Imaging. 1988 November-December; 6(6): 661-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3210909

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Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Author(s): Mitchell DG, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Steinberg ME, Fallon M, Kressel HY. Source: Radiology. 1987 March; 162(3): 709-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3809484

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Femoral head avascular necrosis: CT assessment with multiplanar reconstruction. Author(s): Magid D, Fishman EK, Scott WW Jr, Brooker AF, Arnold WP, Lennox DW, Siegelman SS. Source: Radiology. 1985 December; 157(3): 751-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4059563

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Femoral head avascular necrosis: MR imaging with clinical-pathologic and radionuclide correlation. Author(s): Beltran J, Herman LJ, Burk JM, Zuelzer WA, Clark RN, Lucas JG, Weiss LD, Yang A. Source: Radiology. 1988 January; 166(1 Pt 1): 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3336682

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Femoral head perfusion and composition: MR imaging and spectroscopic evaluation of patients with systemic lupus erythematosus and at risk for avascular necrosis. Author(s): Bluemke DA, Petri M, Zerhouni EA. Source: Radiology. 1995 November; 197(2): 433-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7480688

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Femoral neck fracture following avascular necrosis of the femoral head. Author(s): Usui M, Inoue H, Yukihiro S, Abe N. Source: Acta Medica Okayama. 1996 April; 50(2): 111-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8744937

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Femoral osteotomies for avascular necrosis of the femoral head. Author(s): Shannon BD, Trousdale RT. Source: Clinical Orthopaedics and Related Research. 2004 January; (418): 34-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15043090

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Flexion osteotomy in the treatment of avascular necrosis of the hip. Author(s): Gallinaro P, Masse A. Source: Clinical Orthopaedics and Related Research. 2001 May; (386): 79-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11347852

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Flexion osteotomy of the metacarpal neck: a treatment method for avascular necrosis of the head of the third metacarpal: a case report. Author(s): Wada M, Toh S, Iwaya D, Harata S. Source: The Journal of Bone and Joint Surgery. American Volume. 2002 February; 84A(2): 274-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11861735

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Flushing pattern and idiopathic avascular necrosis of the femoral head. Author(s): Shibata A, Fukuda K, Inoue A, Higuchi F, Miyake H, Nishi M, Mori M, Ishii S, Nagao M, Yanagawa H. Source: J Epidemiol. 1996 March; 6(1): 37-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8795956

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Frequency of chondrocalcinosis of the knees and avascular necrosis of the femoral heads in gout, a controlled study. Author(s): Stockman A, Darlington LG, Scott JT. Source: Advances in Experimental Medicine and Biology. 1980; 122A: 55-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7424661

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Frequency of chondrocalcinosis of the knees and avascular necrosis of the femoral heads in gout: a controlled study. Author(s): Stockman A, Darlington LG, Scott JT. Source: Annals of the Rheumatic Diseases. 1980 February; 39(1): 7-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7377863

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Haematological factors associated with avascular necrosis of the femoral head in homozygous sickle cell disease. Author(s): Hawker H, Neilson H, Hayes RJ, Serjeant GR. Source: British Journal of Haematology. 1982 January; 50(1): 29-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6173057

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Harris Galante cementless acetabular replacement in avascular necrosis. Author(s): Taylor AH, Shannon M, Whitehouse SL, Lee MB, Learmonth ID. Source: The Journal of Bone and Joint Surgery. British Volume. 2001 March; 83(2): 17782. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11284560

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Hb ES presenting as avascular necrosis. Author(s): George E, Iqbal QM. Source: Southeast Asian J Trop Med Public Health. 1978 December; 9(4): 568-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=751222

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Hip arthroscopy in staging avascular necrosis of the femoral head. Author(s): Sekiya JK, Ruch DS, Hunter DM, Pope TL Jr, Koman LA, Poehling GG, Russell GB. Source: J South Orthop Assoc. 2000 Winter; 9(4): 254-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12141188

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HIV infection and avascular necrosis. Author(s): Savini CJ, James CW. Source: The Journal of the Association of Nurses in Aids Care : Janac. 2001 SeptemberOctober; 12(5): 83-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11565241

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Hospitalized avascular necrosis after renal transplantation in the United States. Author(s): Abbott KC, Oglesby RJ, Agodoa LY. Source: Kidney International. 2002 December; 62(6): 2250-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12427153

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Hydroxyapatite coated implants. Total hip arthroplasty in the young patient and patients with avascular necrosis. Author(s): D'Antonio JA, Capello WN, Manley MT, Feinberg J. Source: Clinical Orthopaedics and Related Research. 1997 November; (344): 124-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9372765

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Hyperparathyroidism and avascular necrosis of bone after kidney transplantation. A retrospective study of 170 transplant recipients. Author(s): De Graaf P, Van Hooff JP, Boekhout M, Achterberg J, Pauwels EK, Kalff MW. Source: The Netherlands Journal of Medicine. 1982; 25(7): 230-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6755282

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Iatrogenic avascular necrosis of the hip in young children: a long-term follow-up. Author(s): Gore DR. Source: Journal of Pediatric Orthopedics. 1999 September-October; 19(5): 635-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10488866

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Idiopathic avascular necrosis of a vertebral body. Case report and literature review. Author(s): Chou LH, Knight RQ. Source: Spine. 1997 August 15; 22(16): 1928-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9280031

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Idiopathic avascular necrosis of the capitate bone--case report. Author(s): Rahme H. Source: Hand. 1983 October; 15(3): 274-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6642302

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Idiopathic avascular necrosis of the capitate. Author(s): Kutty S, Curtin J. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1995 June; 20(3): 402-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7561422

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Idiopathic avascular necrosis of the capitate--a case report and a review of the literature. Author(s): Niesten JA, Verhaar JA. Source: Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand. 2002 July; 7(1): 159-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12365060

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Idiopathic avascular necrosis of the metacarpal head. Author(s): Karlakki SL, Bindra RR. Source: Clinical Orthopaedics and Related Research. 2003 January; (406): 103-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12579007

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Idiopathic avascular necrosis of the scaphoid in a child demonstrated by bone scintigraphy. Author(s): Zeng W, Driedger A, Pavlosky W, Bruce L. Source: Clinical Nuclear Medicine. 2001 September; 26(9): 782-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11507299

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Idiopathic avascular necrosis of the scaphoid in a child. Author(s): Jensen CH, Leicht P. Source: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery / Nordisk Plastikkirurgisk Forening [and] Nordisk Klubb for Handkirurgi. 1995 December; 29(4): 359-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8771265

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Idiopathic avascular necrosis of the scaphoid. A case report. Author(s): Martini G, Valenti R, Giovani S, Nuti R. Source: Recenti Prog Med. 1995 June; 86(6): 238-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7624584

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Idiopathic avascular necrosis of the scaphoid. A report of two cases. Author(s): Allen PR. Source: The Journal of Bone and Joint Surgery. British Volume. 1983 May; 65(3): 333-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6841406

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Idiopathic avascular necrosis of the scaphoid--a case of early diagnosis by MRI. Author(s): Zadeh HG, Sakka SA, MacLellan GE. Source: Acta Orthopaedica Scandinavica. 1996 June; 67(3): 298-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8686475

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Imaging of avascular necrosis of bone. Author(s): Imhof H, Breitenseher M, Trattnig S, Kramer J, Hofmann S, Plenk H, Schneider W, Engel A. Source: European Radiology. 1997; 7(2): 180-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9038111

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Increasing incidence of avascular necrosis of the hip in HIV-infected patients. Author(s): Keruly JC, Chaisson RE, Moore RD. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2001 September 1; 28(1): 101-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11579286

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Indomethacin induced avascular necrosis of head of femur. Author(s): Prathapkumar KR, Smith I, Attara GA. Source: Postgraduate Medical Journal. 2000 September; 76(899): 574-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10964124

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Influence of contact hip stress on the outcome of surgical treatment of hips affected by avascular necrosis. Author(s): Dolinar D, Antolic V, Herman S, Iglic A, Kralj-Iglic V, Pavlovcic V. Source: Archives of Orthopaedic and Trauma Surgery. 2003 December; 123(10): 509-13. Epub 2003 June 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12827393

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Inter- and intraobserver variation in staging patients with proven avascular necrosis of the hip. Author(s): Kay RM, Lieberman JR, Dorey FJ, Seeger LL. Source: Clinical Orthopaedics and Related Research. 1994 October; (307): 124-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7924024

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Intertrochanteric osteotomy for avascular necrosis of the head of the femur. Survival probability of two different methods. Author(s): Schneider W, Aigner N, Pinggera O, Knahr K. Source: The Journal of Bone and Joint Surgery. British Volume. 2002 August; 84(6): 81724. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12211671

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Intraobserver and interobserver reliability of Kalamchi and Macewen's classification system for evaluation of avascular necrosis of the femoral head in developmental hip dysplasia. Author(s): Omeroglu H, Tumer Y, Bicimoglu A, Agus H. Source: Bull Hosp Jt Dis. 1999; 58(4): 194-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10711368

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Investigation of alcohol metabolizing enzyme genes in Chinese alcoholics with avascular necrosis of hip joint, pancreatitis and cirrhosis of the liver. Author(s): Chao YC, Wang SJ, Chu HC, Chang WK, Hsieh TY. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 2003 September-October; 38(5): 431-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12915519

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Is avascular necrosis of the femoral head the result of inhibition of angiogenesis? Author(s): Smith DW. Source: Medical Hypotheses. 1997 December; 49(6): 497-500. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9466372

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Joint-preserving operations for idiopathic avascular necrosis of the femoral head. Results of core decompression, grafting and osteotomy. Author(s): Saito S, Ohzono K, Ono K. Source: The Journal of Bone and Joint Surgery. British Volume. 1988 January; 70(1): 7884. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3276703

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Juvenile avascular necrosis of the odontoid process. A review on the etiology of os odontoideum and absentia odontoidei. Author(s): Heick A. Source: Dan Med Bull. 1996 September; 43(4): 363-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8884138

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Kienbock's disease--avascular necrosis of the carpal lunate bone--in a 7-year-old girl with dermatomyositis. Author(s): Kahn SJ, Sherry DD. Source: Clinical Pediatrics. 1994 December; 33(12): 752-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7874831

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Kinesiologic measurements of functional performance before and after McKee-Farrar total hip replacement. A study of thirty patients with rheumatoid arthritis, osteoarthritis, or avascular necrosis of the femoral head. Author(s): Murray MP, Brewer BJ, Zuege RC. Source: The Journal of Bone and Joint Surgery. American Volume. 1972 March; 54(2): 237-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4651259

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Late follow-up of femoral head avascular necrosis managed by intertrochanteric osteotomy & bone grafting. Author(s): Scher MA, Jakim I. Source: Acta Orthop Belg. 1999; 65 Suppl 1: 73-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10084222

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Lesson of the week: Depot corticosteroid treatment for hay fever causing avascular necrosis of both hips. Author(s): Nasser SM, Ewan PW. Source: Bmj (Clinical Research Ed.). 2001 June 30; 322(7302): 1589-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11431303

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Letter: Avascular necrosis of bone after renal transplantation. Author(s): Hawking KM. Source: The New England Journal of Medicine. 1976 February 12; 294(7): 397. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1107845

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Letter: Avascular necrosis of the hip joints in hypothyroidism. Author(s): Seedat YK, Randeree M. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1975 November 22; 49(50): 2071-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1198241

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Letter: Survival after postoperative avascular necrosis of lesser curve of stomach. Author(s): Brodie SW. Source: British Medical Journal. 1975 July 26; 3(5977): 229. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1148748

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Limited femoral endoprosthesis for avascular necrosis of the femoral head. Author(s): Krackow KA, Mont MA, Maar DC. Source: Orthop Rev. 1993 April; 22(4): 457-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8479790

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Localized avascular necrosis of lesser curve of stomach complicating highly selective vagotomy. Author(s): Halvorsen JF, Heimann P, Solhaug JH, Jacobsen KB. Source: British Medical Journal. 1975 June 14; 2(5971): 590-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1131625

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Long term followup of thorough debridement and cancellous bone grafting of the femoral head for avascular necrosis. Author(s): Rosenwasser MP, Garino JP, Kiernan HA, Michelsen CB. Source: Clinical Orthopaedics and Related Research. 1994 September; (306): 17-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8070190

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Long-term follow-up after intertrochanteric osteotomies for avascular necrosis of the femoral head. Author(s): Dinulescu I, Stanculescu D, Nicolescu M, Dinu G. Source: Bull Hosp Jt Dis. 1998; 57(2): 84-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9725063

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Long-term follow-up of patients with avascular necrosis after treatment of slipped capital femoral epiphysis. Author(s): Krahn TH, Canale ST, Beaty JH, Warner WC, Lourenco P. Source: Journal of Pediatric Orthopedics. 1993 March-April; 13(2): 154-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8459002

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Long-term follow-up of total hip replacement in patients with avascular necrosis. Author(s): Salvati EA, Cornell CN. Source: Instr Course Lect. 1988; 37: 67-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3418124

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Long-term observation of avascular necrosis of the femoral head in systemic lupus erythematosus: an MRI study. Author(s): Yoshida T, Kanayama Y, Okamura M, Negoro N, Inoue T, Yoshikawa J. Source: Clin Exp Rheumatol. 2002 July-August; 20(4): 525-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12175107

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Long-term outcome of patients with avascular necrosis, after internal fixation of femoral neck fractures. Author(s): Nikolopoulos KE, Papadakis SA, Kateros KT, Themistocleous GS, Vlamis JA, Papagelopoulos PJ, Nikiforidis PA. Source: Injury. 2003 July; 34(7): 525-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12832180

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Magnetic resonance imaging of the femoral head to detect avascular necrosis in active rheumatoid arthritis treated with methylprednisolone pulse therapy. Author(s): van Vugt RM, Sijbrandij ES, Bijlsma JW. Source: Scandinavian Journal of Rheumatology. 1996; 25(2): 74-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8614770

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Magnetic resonance imaging to detect avascular necrosis after open reduction and internal fixation of talar neck fractures. Author(s): Thordarson DB, Triffon MJ, Terk MR. Source: Foot & Ankle International / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society. 1996 December; 17(12): 742-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8973896

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Male infertility and avascular necrosis of the femoral head. Author(s): Skinner JA, Mann BS, Carrington RW, Hashems-Nejad A, Bentley G. Source: Annals of the Royal College of Surgeons of England. 2004 January; 86(1): 15-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005939

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Malpractice and avascular necrosis: legal outcomes. Author(s): Carter RM. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 1999 January-February; 13(1): 79-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10099819

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Malpractice, steroids and avascular necrosis of bone. Author(s): Caldwell JR. Source: J Fla Med Assoc. 1992 June; 79(6): 363-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1379299

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Malreduction and avascular necrosis in subcapital fractures of the femur. Author(s): Garden RS. Source: The Journal of Bone and Joint Surgery. British Volume. 1971 May; 53(2): 183-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5578215

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Management of avascular necrosis of the femoral head. Author(s): Gurganious LR, Pelker RR. Source: Bulletin on the Rheumatic Diseases. 1994 June; 43(4): 1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8049758

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Management of scaphoid nonunion with avascular necrosis using 1, 2 intercompartmental supraretinacular arterial bone grafts. Author(s): Tsai TT, Chao EK, Tu YK, Chen AC, Lee MS, Ueng SW. Source: Chang Gung Med J. 2002 May; 25(5): 321-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12141705

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Microfoci of avascular necrosis in sickle cell anemia: pathophysiology of the dot dash pattern. Author(s): Rothschild BM, Sebes JI, Hershkovitz I. Source: Clin Exp Rheumatol. 1997 November-December; 15(6): 663-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9444424

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Microvascular obstruction in avascular necrosis. Immunohistochemistry of 14 femoral heads. Author(s): Starklint H, Lausten GS, Arnoldi CC. Source: Acta Orthopaedica Scandinavica. 1995 February; 66(1): 9-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7863777

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More on Kienbock's disease and avascular necrosis. Author(s): Miller LC. Source: Clinical Pediatrics. 1995 July; 34(7): 395. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7554692

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MR imaging of avascular necrosis and transient marrow edema of the femoral head. Author(s): Vande Berg BE, Malghem JJ, Labaisse MA, Noel HM, Maldague BE. Source: Radiographics : a Review Publication of the Radiological Society of North America, Inc. 1993 May; 13(3): 501-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8316660

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MRI and avascular necrosis. Author(s): Matta JM. Source: Journal of Orthopaedic Trauma. 1999 September-October; 13(7): 524. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10513980

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MRI of avascular necrosis of bone. Author(s): Bluemke DA, Zerhouni EA. Source: Topics in Magnetic Resonance Imaging : Tmri. 1996 August; 8(4): 231-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8870181

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MRI of avascular necrosis. Author(s): Hashemi-Nejad A. Source: The Journal of Bone and Joint Surgery. British Volume. 1994 May; 76(3): 507. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8175876

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Mucormycosis osteomyelitis causing avascular necrosis of the cuboid bone: MR imaging findings. Author(s): Chaudhuri R, McKeown B, Harrington D, Hay RJ, Bingham JB, Spencer JD. Source: Ajr. American Journal of Roentgenology. 1992 November; 159(5): 1035-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1414771

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Multifocal avascular necrosis after short-term high-dose steroid therapy. A report of three cases. Author(s): Taylor LJ. Source: The Journal of Bone and Joint Surgery. British Volume. 1984 May; 66(3): 431-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6725356

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Multiple joint avascular necrosis: beware of tuberculosis and human immunodeficiency virus--a rare but important cause. Author(s): Cheung NT, Saklatvala J, Dawes PT. Source: British Journal of Rheumatology. 1995 April; 34(4): 387-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7788159

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Multiple-site avascular necrosis. A complication of Goodpasture's syndrome treated with plasma exchange and corticosteroids. Author(s): Boyle PD, Balmer JP, Craswell PW, Johnson FL. Source: The Medical Journal of Australia. 1982 October 30; 2(9): 437-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7177019

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Natural history of avascular necrosis following traumatic hip dislocation in childhood: a review of 145 cases. Author(s): Barquet A. Source: Acta Orthopaedica Scandinavica. 1982 October; 53(5): 815-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7136594

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Natural history of avascular necrosis of the patella due to closed global patellar dislocation. Author(s): Brueckmann FR. Source: J South Orthop Assoc. 1998 Fall; 7(3): 222-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9781900

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Natural history of nontraumatic avascular necrosis of the femoral head. Author(s): Ohzono K, Saito M, Takaoka K, Ono K, Saito S, Nishina T, Kadowaki T. Source: The Journal of Bone and Joint Surgery. British Volume. 1991 January; 73(1): 6872. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1991778

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New surgical approach in pediatric femoral head avascular necrosis. Author(s): Di JD, Zhu YK, Li YC, Wang GL, Guo HC. Source: Chinese Medical Journal. 1982 January; 95(1): 31-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6802578

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No link between avascular necrosis of the femoral head and antiphospholipid antibodies. Author(s): Dromer C, Marc V, Laroche M, Sixou L, Oksman F, Bon E, Cantagrel A, Fournie B, Mazieres B. Source: Rev Rhum Engl Ed. 1997 June; 64(6): 382-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9513610

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Nocardia septic arthritis of the hip with associated avascular necrosis. A case report. Author(s): Ostrum RF. Source: Clinical Orthopaedics and Related Research. 1993 March; (288): 282-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8458146

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Non-Hodgkin's lymphoma of bone causing avascular necrosis of the femoral head. Author(s): Renowden S, Fitzgerald EJ, Kemp AM. Source: Postgraduate Medical Journal. 1988 January; 64(747): 68-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3420062

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Nonspecific avascular necrosis of the pisiform bone: a case report. Author(s): Match RM. Source: The Journal of Hand Surgery. 1980 July; 5(4): 341-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7419876

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Nontraumatic avascular necrosis of the femoral head. Author(s): Trusell JJ. Source: J Am Osteopath Assoc. 1971 September; 71(1): 51-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4937460

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Non-traumatic avascular necrosis of the femoral head. Author(s): Maillefert JF, Tavernier C, Toubeau M, Brunotte F. Source: The Journal of Bone and Joint Surgery. American Volume. 1996 March; 78(3): 473-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8613457

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Non-traumatic avascular necrosis of the femoral head. Author(s): Mont MA, Hungerford DS. Source: The Journal of Bone and Joint Surgery. American Volume. 1995 March; 77(3): 459-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7890797

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Nontraumatic avascular necrosis of the femoral head. Past, present, and future. Author(s): Arlet J. Source: Clinical Orthopaedics and Related Research. 1992 April; (277): 12-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1555331

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Nonunion of a Hawkin's group II talar neck fracture without avascular necrosis. Author(s): Rockett MS, De Yoe B, Gentile SC, Zygmunt K. Source: The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. 1998 March-April; 37(2): 156-61; Discussion 174. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9571464

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Nonunion of the femoral neck and avascular necrosis of the femoral head: treatment with bone grafts. Author(s): Gaertner RL, Deyerle WM. Source: Southern Medical Journal. 1977 September; 70(9): 1039-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=331483

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NSAID induced avascular necrosis and arthropathy of femoral head. Author(s): Liebergall M, Floman Y, Milgrom C. Source: Orthop Rev. 1987 September; 16(9): 652-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3453991

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Occult posttraumatic avascular necrosis of hip revealed by MRI. Author(s): Allard JC, Porter G, Ryerson RW. Source: Magnetic Resonance Imaging. 1992; 10(1): 155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1545675

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Open reduction and cementation for femoral head fracture secondary to avascular necrosis: preliminary report. Author(s): Wood ML, McDowell CM, Kerstetter TL, Kelley SS. Source: Iowa Orthop J. 2000; 20: 17-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10934620

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Open reduction for congenital hip dislocation: the risk of avascular necrosis with three different approaches. Author(s): Powell EN, Gerratana FJ, Gage JR. Source: Journal of Pediatric Orthopedics. 1986 March-April; 6(2): 127-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3958162

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Osseous avascular necrosis associated with renal transplantation. Author(s): Evarts CM, Phalen GS. Source: Clinical Orthopaedics and Related Research. 1971; 78: 330-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4939010

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Osseous avascular necrosis associated with systemic abnormalities. Author(s): Jones JP Jr, Engleman EP. Source: Arthritis and Rheumatism. 1966 October; 9(5): 728-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5333020

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Osteochondrosis dissecans and avascular necrosis of bone. Author(s): Hall FM. Source: Skeletal Radiology. 1991; 20(4): 272. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1853219

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Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. Author(s): Zangger P, Gladman DD, Urowitz MB, Bogoch ER. Source: The Journal of Rheumatology. 2000 April; 27(4): 919-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10782816

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Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. Author(s): Marx RE. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2003 September; 61(9): 1115-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12966493

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Partial resurfacing arthroplasty of the femoral head in avascular necrosis. Methods, indications, and results. Author(s): Siguier T, Siguier M, Judet T, Charnley G, Brumpt B. Source: Clinical Orthopaedics and Related Research. 2001 May; (386): 85-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11347853

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Pedicle bone grafting versus transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. Author(s): Hasegawa Y, Sakano S, Iwase T, Iwasada S, Torii S, Iwata H. Source: The Journal of Bone and Joint Surgery. British Volume. 2003 March; 85(2): 191-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12678351

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Perthes' disease or late avascular necrosis after developmental dislocation of the hip? 10 children followed for 6-35 years. Author(s): Koczewski P, Napiontek M. Source: Acta Orthopaedica Scandinavica. 2001 August; 72(4): 331-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11580119

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Post-renal transplant distal limb bone pain. An under-recognized complication of transplantation distinct from avascular necrosis of bone? Author(s): Stevens JM, Hilson AJ, Sweny P. Source: Transplantation. 1995 August 15; 60(3): 305-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7645046

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Post-traumatic avascular necrosis of the femoral head in children. Report of two cases. Author(s): Stougard J. Source: The Journal of Bone and Joint Surgery. British Volume. 1969 May; 51(2): 354-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5770418

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Post-traumatic avascular necrosis of the femoral head predicted by preoperative technetium-99m antimony-colloid scan. An experimental and clinical study. Author(s): Turner JH. Source: The Journal of Bone and Joint Surgery. American Volume. 1983 July; 65(6): 78696. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6863361

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Prediction of collapse with magnetic resonance imaging of avascular necrosis of the femoral head. Author(s): Shimizu K, Moriya H, Akita T, Sakamoto M, Suguro T. Source: The Journal of Bone and Joint Surgery. American Volume. 1994 February; 76(2): 215-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8113255

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Pregnancy after avascular necrosis of the femur complicating Gaucher's disease. Author(s): Cleary JE, Burke WM, Baxi LV. Source: American Journal of Obstetrics and Gynecology. 2001 January; 184(2): 233-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174510

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Pregnancy and post-pregnancy avascular necrosis of the femoral head. Author(s): Cheng N, Burssens A, Mulier JC. Source: Archives of Orthopaedic and Trauma Surgery. 1982; 100(3): 199-210. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7149942

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Pregnancy-related avascular necrosis. Author(s): Scher MA. Source: The Journal of Bone and Joint Surgery. American Volume. 2000 October; 82A(10): 1516-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11057492

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Preiser's disease: arthroscopic treatment of avascular necrosis of the scaphoid. Author(s): Menth-Chiari WA, Poehling GG. Source: Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2000 March; 16(2): 208-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10705335

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Preliminary traction and the use of under-thigh pillows to prevent avascular necrosis of the femoral head in Pavlik harness treatment of developmental dysplasia of the hip. Author(s): Suzuki S, Seto Y, Futami T, Kashiwagi N. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2000; 5(6): 540-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11180915

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Preliminary traction as a single determinant of avascular necrosis in developmental dislocation of the hip. Author(s): Kutlu A, Ayata C, Ogun TC, Kapicioglu MI, Mutlu M. Source: Journal of Pediatric Orthopedics. 2000 September-October; 20(5): 579-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11008735

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Pretreatment bone scan in SCFE: a predictor of ischemia and avascular necrosis. Author(s): Rhoad RC, Davidson RS, Heyman S, Dormans JP, Drummond DS. Source: Journal of Pediatric Orthopedics. 1999 March-April; 19(2): 164-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10088682

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Prevalence rates and an evaluation of reported risk factors for osteonecrosis (avascular necrosis) in Crohn's disease. Author(s): Freeman HJ, Freeman KJ. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 2000 February; 14(2): 138-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10694287

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Prognosis of early stage avascular necrosis of the femoral head. Author(s): Ito H, Matsuno T, Kaneda K. Source: Clinical Orthopaedics and Related Research. 1999 January; (358): 149-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9973986

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Prognostication of nontraumatic avascular necrosis of the femoral head. Significance of location and size of the necrotic lesion. Author(s): Sugano N, Takaoka K, Ohzono K, Matsui M, Masuhara K, Ono K. Source: Clinical Orthopaedics and Related Research. 1994 June; (303): 155-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8194226

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Progression of avascular necrosis of femoral head and choice of treatment. Author(s): Iwata H, Hasegawa Y, Mizuno M, Genda E, Kataoka Y, Kada A. Source: Nagoya J Med Sci. 1992 March; 54(1-4): 27-39. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1518552

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Protective influence of the ossific femoral nucleus with regard to avascular necrosis in the treatment of developmental hip dislocation was doubted. Author(s): Tonnis D. Source: Journal of Pediatric Orthopedics. 2001 January-February; 21(1): 135-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176368

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Quiz case. Avascular necrosis of the metacarpal head III. Author(s): Barnes NA, Howes AJ, Jeffers H, Carty H. Source: European Journal of Radiology. 2000 November; 36(2): 115-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11221752

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Radiographically negative avascular necrosis: detection with MR imaging. Author(s): Coleman BG, Kressel HY, Dalinka MK, Scheibler ML, Burk DL, Cohen EK. Source: Radiology. 1988 August; 168(2): 525-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3393676

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Radiologic case study. Abrasion chondroplasty mimicking avascular necrosis. Author(s): Amrami KK, Askari KS, Pagnano MW, Sundaram M. Source: Orthopedics. 2002 October; 25(10): 1018, 1107-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12401005

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Radiology rounds. Inflammatory bowel disease (ulcerative colitis) with steroidinduced avascular necrosis of the femoral heads. Author(s): McLennan MK, Margolis M. Source: Can Fam Physician. 1994 July; 40: 1267, 1272-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8086840

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Recurrent avascular necrosis of the proximal femoral epiphysis in the same hip in Gaucher's disease. Author(s): Katz JF. Source: The Journal of Bone and Joint Surgery. American Volume. 1967 April; 49(3): 5148. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6022360

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Revascularization of avascular necrosis of the capitate bone. Author(s): Murakami H, Nishida J, Ehara S, Furumachi K, Shimamura T. Source: Ajr. American Journal of Roentgenology. 2002 September; 179(3): 664-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12185039

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Review of avascular necrosis and HIV. Author(s): Plate AM, Boyle BA. Source: Aids Read. 2000 October; 10(10): 570-3. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11068790

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Revision total hip arthroplasty in patients with avascular necrosis. Author(s): Wei SY, Klimkiewicz JJ, Lai M, Garino JP, Steinberg ME. Source: Orthopedics. 1999 August; 22(8): 747-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10465487

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Risk factors for avascular necrosis in systemic lupus erythematosus. Author(s): Cozen L, Wallace DJ. Source: The Journal of Rheumatology. 1998 January; 25(1): 188. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9458231

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Risk factors for avascular necrosis of bone in patients with systemic lupus erythematosus: is there a role for antiphospholipid antibodies? Author(s): Mok MY, Farewell VT, Isenberg DA. Source: Annals of the Rheumatic Diseases. 2000 June; 59(6): 462-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10834864

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Risk factors of avascular necrosis in the treatment of congenital dislocation of the hip. Author(s): Gregosiewicz A, Wosko I. Source: Journal of Pediatric Orthopedics. 1988 January-February; 8(1): 17-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3335615

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Risk factors of avascular necrosis of the femoral head in patients with systemic lupus erythematosus under high-dose corticosteroid therapy. Author(s): Ono K, Tohjima T, Komazawa T. Source: Clinical Orthopaedics and Related Research. 1992 April; (277): 89-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1555361

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Risk of avascular necrosis following short term megadose methylprednisolone treatment. Author(s): Wing PC, Nance P, Connell DG, Gagnon F. Source: Spinal Cord : the Official Journal of the International Medical Society of Paraplegia. 1998 September; 36(9): 633-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9773448

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Roentgenographic search for avascular necrosis of the head of the femur in alcoholics and normal adults. Author(s): Smith K, Bonfiglio M, Dolan K. Source: The Journal of Bone and Joint Surgery. American Volume. 1977 April; 59(3): 3916. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=849951

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Role of conventional and vascularized bone grafts in scaphoid nonunion with avascular necrosis: A canine experimental study. Author(s): Sunagawa T, Bishop AT, Muramatsu K. Source: The Journal of Hand Surgery. 2000 September; 25(5): 849-59. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11040300

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Rotational osteotomy for non-traumatic avascular necrosis of the femoral head. Author(s): Sugano N, Takaoka K, Ohzono K, Matsui M, Saito M, Saito S. Source: The Journal of Bone and Joint Surgery. British Volume. 1992 September; 74(5): 734-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1527125

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Scaphocapitolunate arthrodesis for idiopathic avascular necrosis of the capitate: a case report. Author(s): Whiting J, Rotman MB. Source: The Journal of Hand Surgery. 2002 July; 27(4): 692-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12132097

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Scaphoid fractures. Problems associated with nonunion and avascular necrosis. Author(s): Cooney WP, Linscheid RL, Dobyns JH. Source: The Orthopedic Clinics of North America. 1984 April; 15(2): 381-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6728452

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Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius. Author(s): Boyer MI, von Schroeder HP, Axelrod TS. Source: Journal of Hand Surgery (Edinburgh, Lothian). 1998 October; 23(5): 686-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9821621

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Screening for avascular necrosis of the hip with rapid MRI: preliminary experience. Author(s): May DA, Disler DG. Source: Journal of Computer Assisted Tomography. 2000 March-April; 24(2): 284-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10752894

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Segmentation of avascular necrosis of the femoral head using 3-D MR images. Author(s): Zoroofi RA, Nishii T, Sato Y, Sugano N, Yoshikawa H, Tamura S. Source: Computerized Medical Imaging and Graphics : the Official Journal of the Computerized Medical Imaging Society. 2001 November-December; 25(6): 511-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11679214

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Severe avascular necrosis of the nasal chambers secondary to cocaine abuse. Author(s): Braverman I, Raviv E, Frenkiel S. Source: The Journal of Otolaryngology. 1999 December; 28(6): 351-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10604166

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Silastic arthroplasty for avascular necrosis of the carpal lunate. Author(s): Pardini AG. Source: International Orthopaedics. 1984; 8(3): 223-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6530319

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Soft-tissue interposition after closed reduction in developmental dysplasia of the hip. The long-term effect on acetabular development and avascular necrosis. Author(s): Hattori T, Ono Y, Kitakoji T, Takashi S, Iwata H. Source: The Journal of Bone and Joint Surgery. British Volume. 1999 May; 81(3): 385-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10872352

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Steroid induced avascular necrosis of the patella in an ulcerative colitis patient. Author(s): Elkayam O, Fishel B, Zhukovsky G, Yaron M. Source: Clin Exp Rheumatol. 1996 July-August; 14(4): 447-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8871849

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Steroid-induced avascular necrosis. Author(s): Clinkscales A, Cleary JD. Source: The Annals of Pharmacotherapy. 2002 June; 36(6): 1105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12058706

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Study of alendronate in avascular necrosis of bone. Author(s): Agarwala S, Sule A, Pai BU, Joshi VR. Source: J Assoc Physicians India. 2001 September; 49: 949-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11837783

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Subperiosteal osteoid osteoma of the triquetrum mimicking an avascular necrosis. Author(s): De Smet L. Source: Chir Main. 2002 March; 21(2): 140-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11980342

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Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. Author(s): Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Source: The Journal of Bone and Joint Surgery. British Volume. 2001 November; 83(8): 1119-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11764423

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Surgical treatment of avascular necrosis of the proximal pole of the capitate--Case report. Author(s): Kimmel RB, O'Brien ET. Source: The Journal of Hand Surgery. 1982 May; 7(3): 284-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7086097

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Surgical treatment of nonunion and avascular necrosis of the proximal part of the scaphoid in adolescents. Author(s): Waters PM, Stewart SL. Source: The Journal of Bone and Joint Surgery. American Volume. 2002 June; 84-A(6): 915-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12063324

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Survival analysis of hips treated with core decompression or vascularized fibular grafting because of avascular necrosis. Author(s): Mont MA, Jones LC, Hungerford DS. Source: The Journal of Bone and Joint Surgery. American Volume. 2000 February; 82(2): 290-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10682738

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Survival analysis of hips treated with core decompression or vascularized fibular grafting because of avascular necrosis. Author(s): Chillag KJ. Source: The Journal of Bone and Joint Surgery. American Volume. 2000 February; 82(2): 289-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10682737

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Survival analysis of hips treated with core decompression or vascularized fibular grafting because of avascular necrosis. Author(s): Goodman SB. Source: The Journal of Bone and Joint Surgery. American Volume. 2000 February; 82(2): 289. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10682736

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Survival analysis of hips treated with core decompression or vascularized fibular grafting because of avascular necrosis. Author(s): Scully SP, Aaron RK, Urbaniak JR. Source: The Journal of Bone and Joint Surgery. American Volume. 1998 September; 80(9): 1270-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9759810

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Symmetric avascular necrosis of the shoulders and hips in sickle cell disease. Author(s): Sinha P, Kim A, Freeman LM. Source: Clinical Nuclear Medicine. 1999 June; 24(6): 445. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10361944

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Talar neck fractures and rates of avascular necrosis. Author(s): Metzger MJ, Levin JS, Clancy JT. Source: The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. 1999 March-April; 38(2): 154-62. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10334706

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Talonavicular coalition following avascular necrosis of the tarsal navicular. Author(s): Ertel AN, O'Connell FD. Source: Journal of Pediatric Orthopedics. 1984 August; 4(4): 482-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6432843

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The arthroscopic treatment of avascular necrosis of the proximal pole following scaphoid nonunion. Author(s): Ruch DS, Chang DS, Poehling GG. Source: Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1998 October; 14(7): 747-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9788372

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The clinical relevance of posttraumatic avascular necrosis of the humeral head. Author(s): J Orthop Trauma. 1999 Feb;13(2):134-7 Source: Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons. [et Al.]. 1998 November-December; 7(6): 586-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10052789

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The incidence and management of osteoporosis, gout, and avascular necrosis in recipients of renal allografts functioning more than 20 years (level 5A) treated with prednisone and azathioprine. Author(s): Braun WE, Richmond BJ, Protiva DA, Gifford RW Jr, Straffon RA. Source: Transplantation Proceedings. 1999 February-March; 31(1-2): 1366-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10083606

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The influence of the biomechanical parameters of the hip on the outcome of treatment of hips subject to avascular necrosis of the femoral head. Author(s): Dolinar D, Kralj-Iglic V, Iglic A, Antolic V, Herman S, Pavlovcic V. Source: Cellular & Molecular Biology Letters. 2002; 7(1): 109-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11944058

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The methylene tetrahydrofolate reductase (C677T) mutation as a potential risk factor for avascular necrosis in sickle cell disease. Author(s): Kutlar A, Kutlar F, Turker I, Tural C. Source: Hemoglobin. 2001 May; 25(2): 213-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11480782

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The problem of avascular necrosis of bone in patients treated for Hodgkin's disease. Author(s): Mould JJ, Adam NM. Source: Clinical Radiology. 1983 March; 34(2): 231-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6825406

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The role of hip arthroscopy in the evaluation of avascular necrosis. Author(s): Ruch DS, Sekiya J, Dickson Schaefer W, Koman LA, Pope TL, Poehling GG. Source: Orthopedics. 2001 April; 24(4): 339-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11332961

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The value of distal greater trochanteric transfer in the treatment of deformity of the proximal femur owing to avascular necrosis. Author(s): Pucher A, Ruszkowski K, Bernardczyk K, Nowicki J. Source: Journal of Pediatric Orthopedics. 2000 May-June; 20(3): 311-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10823596

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Tibiocalcaneal fusion for avascular necrosis of the talus. Author(s): Dennison MG, Pool RD, Simonis RB, Singh BS. Source: The Journal of Bone and Joint Surgery. British Volume. 2001 March; 83(2): 199203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11284565

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Total hip arthroplasty for avascular necrosis and degenerative osteoarthritis of the hip. Author(s): Xenakis TA, Beris AE, Malizos KK, Koukoubis T, Gelalis J, Soucacos PN. Source: Clinical Orthopaedics and Related Research. 1997 August; (341): 62-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9269156

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Total hip arthroplasty for avascular necrosis of the femur in systemic lupus erythematosus. Author(s): Prupas HM, Patzakis M, Quismorio FP Jr. Source: Clinical Orthopaedics and Related Research. 1981 November-December; (161): 186-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7307380

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Transient bone marrow edema syndrome progressing to avascular necrosis of the hip - a case report and review of the literature. Author(s): Radke S, Kenn W, Eulert J. Source: Clinical Rheumatology. 2004 February; 23(1): 83-8. Epub 2003 December 19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749994

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Treatment of avascular necrosis of the femoral head by a combination of bone grafting, decompression, and electrical stimulation. Author(s): Steinberg ME, Brighton CT, Steinberg DR, Tooze SE, Hayken GD. Source: Clinical Orthopaedics and Related Research. 1984 June; (186): 137-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6373086

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Treatment of avascular necrosis of the femoral head with vascularized fibular transplant. Author(s): Soucacos PN, Beris AE, Malizos K, Koropilias A, Zalavras H, Dailiana Z. Source: Clinical Orthopaedics and Related Research. 2001 May; (386): 120-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11347825

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Treatment of avascular necrosis of the femoral head. Author(s): Ficat RP. Source: Hip. 1983; : 279-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6671916

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Treatment of post-traumatic avascular necrosis of the femoral head by multiple drilling and muscle-pedicle bone grafting. Preliminary report. Author(s): Baksi DP. Source: The Journal of Bone and Joint Surgery. British Volume. 1983 May; 65(3): 268-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6341373

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Unilateral congenital hip dislocation with contralateral avascular necrosis. Author(s): Herold HZ. Source: Clinical Orthopaedics and Related Research. 1980 May; (148): 196-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7379395

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Unsuccessful attempts to produce avascular necrosis of bone by compressiondecompression stress and alcohol ingestion in guinea pigs. Author(s): Eguro H, Hills BA, Goldner JL. Source: Clinical Orthopaedics and Related Research. 1974 January-February; 98: 294-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4856291

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Use of radioisotope technique and photon absorptiometry to detect early avascular necrosis. Author(s): Chatterjee SN, Vogel JM, Telfer N. Source: Proc Eur Dial Transplant Assoc. 1979; 16: 672-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=549008

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Use of vascularized pedicle iliac bone graft in the treatment of avascular necrosis of the femoral head. Author(s): Noguchi M, Kawakami T, Yamamoto H. Source: Archives of Orthopaedic and Trauma Surgery. 2001 September; 121(8): 437-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11550829

•

Usefulness of SPECT in the early detection of avascular necrosis of the knees. Author(s): Gupta SM, Foster CR, Kayani N. Source: Clinical Nuclear Medicine. 1987 February; 12(2): 99-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3493874

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Vascularized iliac bone graft for avascular necrosis of the femoral head. Author(s): Ishizaka M, Sofue M, Dohmae Y, Endo N, Takahashi HE. Source: Clinical Orthopaedics and Related Research. 1997 April; (337): 140-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9137185

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Vascularized iliac bone graft for treating avascular necrosis of the femoral head. Author(s): Feng CK, Yu JK, Chang MC, Chen TH, Lo WH. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1998 August; 61(8): 463-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9745162

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Vascularized iliac periosteal transfer for the treatment of avascular necrosis of the femoral head and a new evaluation grading system. Author(s): Wang Y, Zhu S, Zhao D. Source: Chinese Medical Journal. 1996 June; 109(6): 441-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9206076

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Vascularized island pedicle iliac bone grafting for avascular necrosis of the femoral head. Author(s): Yen CY, Lee SS, Yuan LJ, Fu TS, Chan YS, Chen CY, Tu YK, Ueng SW. Source: Changgeng Yi Xue Za Zhi. 2000 September; 23(9): 536-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11092142

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Vascularized pedicle bone-grafting for nontraumatic avascular necrosis of the femoral head. A 5- to 11-year follow-up. Author(s): Hasegawa Y, Iwata H, Torii S, Iwase T, Kawamoto K, Iwasada S. Source: Archives of Orthopaedic and Trauma Surgery. 1997; 116(5): 251-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9177798

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Walking patterns of patients with unilateral hip pain due to osteo-arthritis and avascular necrosis. Author(s): Murray MP, Gore DR, Clarkson BH. Source: The Journal of Bone and Joint Surgery. American Volume. 1971 March; 53(2): 259-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5546699

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Wegener granulomatosis with avascular necrosis of a lower extremity. Author(s): Lowe J, Hecton A. Source: The Western Journal of Medicine. 1979 March; 130(3): 256-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=425509

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CHAPTER 2. NUTRITION AND AVASCULAR NECROSIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and avascular necrosis.

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

7

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

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

Across-study evaluation of association between steroid dose and bolus steroids and avascular necrosis of bone. Source: Felson, D T Anderson, J J Lancet. 1987 April 18; 1(8538): 902-6 0140-6736

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Corticosteroid-induced avascular necrosis of the talus. Author(s): Department of Podiatric Surgery, Metropolitan Hospital/Parkview Division, Philadelphia, PA 19135. Source: Adleberg, J S Smith, G H J-Foot-Surg. 1991 Jan-February; 30(1): 66-9 0449-2544

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Imaging study on the mode of development and changes in avascular necrosis of the femoral head in systemic lupus erythematosus: long-term observations. Author(s): First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan. Source: Nagasawa, K Tsukamoto, H Tada, Y Mayumi, T Satoh, H Onitsuka, H Kuwabara, Y Niho, Y Br-J-Rheumatol. 1994 April; 33(4): 343-7 0263-7103

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Magnetic resonance imaging detection of avascular necrosis of the bone in children receiving intensive prednisone therapy for acute lymphoblastic leukemia or nonHodgkin lymphoma. Author(s): Department of Hematology-Oncology, St Jude Children's Research Hospital, 332 N, Lauderdale, Memphis, TN 38105-2794, USA. Source: Ribeiro, R C Fletcher, B D Kennedy, W Harrison, P L Neel, M D Kaste, S C Sandlund, J T Rubnitz, J E Razzouk, B I Relling, M V Pui, C H Leukemia. 2001 June; 15(6): 891-7 0887-6924

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The prevalence of avascular necrosis in patients treated with chemotherapy for testicular tumours. Author(s): Academic Department of Radiotherapy and Oncology, The Royal Marsden NHS Trust, and Institute of Cancer Research, Downs Road, Sutton, Surrey, SM2 5PT, UK. Source: Cook, A M Dzik Jurasz, A S Padhani, A R Norman, A Huddart, R A Br-J-Cancer. 2001 November 30; 85(11): 1624-6 0007-0920

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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CHAPTER 3. ALTERNATIVE MEDICINE AND AVASCULAR NECROSIS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to avascular necrosis. 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 avascular necrosis 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 “avascular necrosis” (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 avascular necrosis: •

Augmented Berlin-Frankfurt-Munster therapy abrogates the adverse prognostic significance of slow early response to induction chemotherapy for children and adolescents with acute lymphoblastic leukemia and unfavorable presenting features: a report from the Children's Cancer Group. Author(s): Nachman J, Sather HN, Gaynon PS, Lukens JN, Wolff L, Trigg ME. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1997 June; 15(6): 2222-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9196134

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Avascular necrosis following extensive chemotherapy and dexamethasone treatment in a patient with advanced ovarian cancer: case report and review of the literature. Author(s): Gogas H, Fennelly D.

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Source: Gynecologic Oncology. 1996 December; 63(3): 379-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8946875 •

Avascular necrosis in patients treated with BEP chemotherapy for testicular tumours. Author(s): Coles C, Williams M. Source: Clin Oncol (R Coll Radiol). 2000; 12(1): 69. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10749025

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Avascular necrosis in patients treated with BEP chemotherapy for testicular tumours. Author(s): Cook AM, Patterson H, Nicholls J, Huddart RA. Source: Clin Oncol (R Coll Radiol). 1999; 11(2): 126-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10378640

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Avascular necrosis of bone after adult acute lymphocytic leukemia treatment with methotrexate, vincristine, L-asparaginase, and dexamethasone (MOAD). Author(s): Hui L, Wiernik PH. Source: American Journal of Hematology. 1996 July; 52(3): 184-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8756084

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Avascular necrosis of bone caused by combination chemotherapy without corticosteroids. Author(s): Harper PG, Trask C, Souhami RL. Source: British Medical Journal (Clinical Research Ed.). 1984 January 28; 288(6413): 267-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6198019

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Avascular necrosis of bone in Hodgkin's disease patients treated with combined modality therapy. Author(s): Prosnitz LR, Lawson JP, Friedlaender GE, Farber LR, Pezzimenti JF. Source: Cancer. 1981 June 15; 47(12): 2793-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7260869

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Avascular necrosis of bone in neuroblastoma treated with combination chemotherapy. Author(s): Ishii E, Yoshida N, Miyazaki S. Source: European Journal of Pediatrics. 1984 December; 143(2): 152-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6519114

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Avascular necrosis of bone mimicking symmetric polyarthritis in a patient with malignant lymphoma treated with high-dose steroids. Author(s): Buskila D, Thomson GT, Klein M, Keystone EC.

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Source: Isr J Med Sci. 1992 November; 28(11): 804-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1281809 •

Avascular necrosis of the carpal lunate: a case report. Author(s): Irowa GO. Source: Journal of Manipulative and Physiological Therapeutics. 1987 December; 10(6): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3437236

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Avascular necrosis of the femoral head after treatment of Hodgkin's disease. Author(s): Tombolini V, Capua A, Pompili E. Source: Acta Oncologica (Stockholm, Sweden). 1992; 31(1): 64-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1375043

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Avascular necrosis of the femoral head with combination therapy. Author(s): Sweet DL Jr, Roth DG, Desser RK, Miller JB, Ultmann JE. Source: Annals of Internal Medicine. 1976 July; 85(1): 67-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=937924

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Avascular necrosis of the femur head. Author(s): Fried NR, Gerow G. Source: Journal of Manipulative and Physiological Therapeutics. 1989 June; 12(3): 228-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2746146

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Basic fibroblast growth factor stimulates osteoclast recruitment, development, and bone pit resorption in association with angiogenesis in vivo on the chick chorioallantoic membrane and activates isolated avian osteoclast resorption in vitro. Author(s): Collin-Osdoby P, Rothe L, Bekker S, Anderson F, Huang Y, Osdoby P. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 October; 17(10): 1859-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12369790

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Bilateral aseptic necrosis of the humeral head following combined therapy for Hodgkin's lymphoma. Author(s): Virgolini L, De Maglio A. Source: Ital J Orthop Traumatol. 1992; 18(4): 543-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1345650

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Chiropractic radiologists: a survey of demographics, abilities, educational attitudes and practice trends. Author(s): Marchiori DM, Hawk C, Howe J.

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Source: Journal of Manipulative and Physiological Therapeutics. 1998 July-August; 21(6): 392-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9726066 •

Combined modality therapy for advanced Hodgkin's disease: long-term followup data. Author(s): Prosnitz LR, Farber LR, Kapp DS, Bertino JR, Nordlund M, Lawrence R. Source: Cancer Treat Rep. 1982 April; 66(4): 871-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6176322

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Etoposide, vinblastine, adriamycin and prednisolone (EVAP) combination chemotherapy as first-line treatment for Hodgkin's disease. Author(s): Raina V, Sharma A, Mohanti BK, Kumar R, Dawar R, Rath GK. Source: Natl Med J India. 2003 July-August; 16(4): 199-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14606767

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Hass' disease. Author(s): Terrett AG, Molyneux TP. Source: Journal of Manipulative and Physiological Therapeutics. 1988 February; 11(1): 43-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3351400

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Hip and pelvic injuries in the young athlete. Author(s): Waters PM, Millis MB. Source: Clinics in Sports Medicine. 1988 July; 7(3): 513-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3042159

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Hyperbaric oxygen therapy as a treatment for stage-I avascular necrosis of the femoral head. Author(s): Kim HJ. Source: The Journal of Bone and Joint Surgery. British Volume. 2004 January; 86(1): 1501; Author Reply 151. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765887

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Hyperbaric oxygen therapy as a treatment for stage-I avascular necrosis of the femoral head. Author(s): Reis ND, Schwartz O, Militianu D, Ramon Y, Levin D, Norman D, Melamed Y, Shupak A, Goldsher D, Zinman C. Source: The Journal of Bone and Joint Surgery. British Volume. 2003 April; 85(3): 371-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12729112

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In vivo and in vitro evaluation of combretastatin A-4 and its sodium phosphate prodrug. Author(s): Grosios K, Holwell SE, McGown AT, Pettit GR, Bibby MC. Source: British Journal of Cancer. 1999 December; 81(8): 1318-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10604728

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Magnetic resonance imaging detection of avascular necrosis of the bone in children receiving intensive prednisone therapy for acute lymphoblastic leukemia or nonHodgkin lymphoma. Author(s): Ribeiro RC, Fletcher BD, Kennedy W, Harrison PL, Neel MD, Kaste SC, Sandlund JT, Rubnitz JE, Razzouk BI, Relling MV, Pui CH. Source: Leukemia : Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 2001 June; 15(6): 891-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11417473

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Resolution of a photopenic lesion on bone imaging following chemotherapy for metastatic disease. Author(s): Rosen JM, MacLaughlin WW, Jaffe RM. Source: Clinical Nuclear Medicine. 1987 July; 12(7): 552-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3038448

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The prevalence of avascular necrosis in patients treated with chemotherapy for testicular tumours. Author(s): Cook AM, Dzik-Jurasz AS, Padhani AR, Norman A, Huddart RA. Source: British Journal of Cancer. 2001 November 30; 85(11): 1624-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11742478

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The stubborn hip: idiopathic avascular necrosis of the hip. Author(s): Pajaczkowski JA. Source: Journal of Manipulative and Physiological Therapeutics. 2003 February; 26(2): 107. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12584503

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Treatment of experimental avascular necrosis of the femoral head with hyperbaric oxygen in rats: histological evaluation of the femoral heads during the early phase of the reparative process. Author(s): Levin D, Norman D, Zinman C, Rubinstein L, Sabo E, Misselevich I, Reis D, Boss JH. Source: Experimental and Molecular Pathology. 1999 October; 67(2): 99-108. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10527761

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Treatment of neglected femoral neck fractures in young adults. Author(s): Huang CH.

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Source: Clinical Orthopaedics and Related Research. 1986 May; (206): 117-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3708964 •

Treatment of nonunited scaphoid fractures by pulsed electromagnetic field and cast. Author(s): Frykman GK, Taleisnik J, Peters G, Kaufman R, Helal B, Wood VE, Unsell RS. Source: The Journal of Hand Surgery. 1986 May; 11(3): 344-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3711607

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. PATENTS ON AVASCULAR NECROSIS 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 “avascular necrosis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on avascular necrosis, we have not necessarily excluded non-medical patents in this bibliography.

Patent Applications on Avascular Necrosis 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 avascular necrosis:

8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 9 This has been a common practice outside the United States prior to December 2000.

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Expandable porous mesh bag device and methods of use for reduction, filling, fixation, and supporting of bone Inventor(s): Ahern, James W.; (Hopkings, MN), Grobler, Leon J.; (Phoenix, AZ), Kuslich, Stephen D.; (Stillwater, MN), Wolfe, Steven J.; (Cottage Grove, MN) Correspondence: Patterson, Thuente, Skaar & Christensen, P.A.; 4800 Ids Center; 80 South 8th Street; Minneapolis; MN; 55402-2100; US Patent Application Number: 20040073308 Date filed: May 16, 2003 Abstract: The invention provides a method of correcting numerous bone abnormalities including bone tumors and cysts, avascular necrosis of the femoral head, tibial plateau fractures and compression fractures of the spine. The abnormality may be corrected by first accessing and boring into the damaged tissue or bone and reaming out the damaged and/or diseased area using any of the presently accepted procedures or the damaged area may be prepared by expanding a bag within the damaged bone to compact cancellous bone. After removal and/or compaction of the damaged tissue the bone must be stabilized. Excerpt(s): This application claims priority from U.S. patent application Ser. No. 09/909,667, filed Jul. 20, 2001, which claims priority to U.S. Provisional Application No. 60/219,853 filed Jul. 21, 2000, the entirety of which is incorporated herein by reference. This invention relates to methods and devices for correcting bone abnormalities and involves the use of a surgical mesh bag which is inserted into a prepared cavity in bone. The bag is inflated using bone replacement material to expand and fill the cavity. U.S. Pat. Nos. 5,549,679 and 5,571,189 to Kuslich, describe a device and method for stabilizing the spinal segment with an expandable, porous fabric implant for insertion into the interior of a reamed out disc which is packed with material to facilitate bony fusion. In the present invention, a similar bag is used to correct bone abnormalities including, but not limited to, bone tumors and cysts, tibial plateau fractures, avascular necrosis of the femoral head and compression fractures of the spine. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

System, device, composition and method for treating and preventing avascular or osteonecrosis Inventor(s): Fetto, Joseph F.; (New York, NY), Leali, Alejandro; (Hackensack, NJ) Correspondence: Joseph F. Fetto, M.D.,; Alejandro Leali, M.D.; Suite 7-J; 300 E. 56th ST.; New York; NY; 10022; US Patent Application Number: 20030135214 Date filed: January 15, 2002 Abstract: A vascular necrosis of the hip is a common disease that usually affects a young, active patient population. As the disease progresses the undermined structural integrity of the subchondral bone leads to articular collapse and subsequent osteoarthrosis. The ideal treatment is one that hinders or arrests the progression of the disease averting articular collapse and a joint replacement surgery. Several non-surgical and surgical procedures have been described to treat avascular necrosis: core decompression, osteotomies of the hip, non-vascularized and vascularized bone grafts. The purpose of this paper is to describe a surgical strategy that attempts to address the

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multiple factors involved in the progression of the disease: deficits in structural support, increased intraosseous pressure and the bone healing process. This is accomplished through a routine core decompression procedure combined with the insertion of two bone interference screws into the subchondral bone of the femoral head to provide structural support and the use of osteoinductive bone allograft (demineralized bone matrix) in an effort to accelerate the bone response. Prospective studies are currently underway to assess long-term outcomes. Excerpt(s): This invention is concerned with the field of treatment and prevention of pain, discomfort, deformity or disability associated with loss of bone structure, strength or support that accompanies osteonecrosis or avascular necrosis of various load-bearing musculoskeletal structures. Osteonecrosis (avascular necrosis, aseptic necrosis or subchondral avascular necrosis) does not represent a particular disease but the final common pathway of a number of conditions leading to bone death. Trauma, corticosteroids, alcoholism and connective tissue disorders have been historically linked to the occurrence of avascular necrosis. It most commonly involves the femoral head, followed by the knee, the humeral head, and the small bones of the wrist and foot. The prevalence of avascular necrosis is unknown; however, 10,000 to 20,000 new cases of avascular necrosis of the hip have been estimated to develop every year [1]. Approximately 10 to 12 percent of the total hip arthroplasties performed in the U.S. are a consequence of avascular necrosis and the ensuing articular collapse and osteoarthrosis [2]. The average age of patients undergoing total hip replacement for avascular necrosis remains below 40 years [3] with a life expectancy exceeding forty years [4]. 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 avascular necrosis, 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 “avascular necrosis” (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 avascular necrosis. You can also use this procedure to view pending patent applications concerning avascular necrosis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON AVASCULAR NECROSIS Overview This chapter provides bibliographic book references relating to avascular necrosis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on avascular necrosis 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: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “avascular necrosis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “avascular necrosis” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “avascular necrosis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Masters in Arthroscopy: Disk Three-Slap Lesions, Adhesive Capsulitis, and Avascular Necrosis (Masters in Arthroscopy, an Interactive Cd Series, 3) by Gary G. Poehling; ISBN: 0815136145; http://www.amazon.com/exec/obidos/ASIN/0815136145/icongroupinterna

Chapters on Avascular Necrosis In order to find chapters that specifically relate to avascular necrosis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and avascular necrosis 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

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the dates and language you prefer, and the format option “Book Chapter.” Type “avascular necrosis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on avascular necrosis: •

Ischemic Necrosis of Bone Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 293-297. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: [email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: This chapter on ischemic necrosis of bone is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and Ulcerative Colitis (UC), together known as inflammatory bowel disease (IBD). Osteonecrosis (ON) and avascular necrosis of bone (AVN) are the commonly used terms for an entity that also is referred to as ischemic necrosis of bone, aseptic necrosis, and osteochondritis dissecans. Because the bone is truly avascular (no blood flow) only in the end stage of the disease, the term ischemic necrosis of bone is preferred, emphasizing the period of ischemia (reduced or intermittent blood flow) that precedes actual bone death. Pathologically, it is characterized by death of cells in bone, resulting from an interruption of blood supply to bone. Osteonecrosis generally is divided into two major forms: post-traumatic and nontraumatic. Neither minor nor major trauma causes ON unless there has been a fracture or dislocation resulting in physical damage to the arterial circulation. Diseases, such as inflammatory bowel disease (IBD), in which corticosteroids often are used in high doses and for prolonged periods pose an increased risk. Patients with IBD who present with ON may be younger than other patients with ischemic bone changes, and some have ON without having taken steroids. There is a correlation between involvement of the talus (ankle) with the diagnosis of IBD and the long-term administration of glucocorticoids. Multiple sites of bone involvement also correlate with the diagnosis of IBD or systemic lupus erythematosus, perhaps because both diseases often are treated with high doses of steroids for long periods. If the bone disease is untreated, the majority of patients have eventual destruction of the joints. Conservative or medical management consists primarily of non loadbearing in an attempt to prevent collapse while repair is completed. Only about one quarter of patients improve spontaneously and have a tolerable disability. Joint replacement is a possibility, but is not as successful in young and otherwise physically active individuals (which tends to be the case in IBD and osteonecrosis). 1 figure. 2 tables. 11 references.

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CHAPTER 6. PERIODICALS AND NEWS ON AVASCULAR NECROSIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover avascular necrosis.

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

Protease inhibitor use linked to avascular necrosis in HIV-infected patients Source: Reuters Industry Breifing Date: June 19, 2000

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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 “avascular necrosis” (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 “avascular necrosis” (or synonyms). If you know the name of a company that is relevant to avascular necrosis, 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 “avascular necrosis” (or synonyms).

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Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “avascular necrosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on avascular necrosis: •

IBD in Infants, Children, and Adolescents: Unique Aspects of Diagnosis and Treatment Source: Intestinal Fortitude. 9(3): 1-3. 1999. Contact: Available from Intestinal Disease Foundation. 1323 Forbes Avenue, Suite 200, Pittsburgh, PA 15219. (412) 261-5888. Fax (412) 471-2722. Summary: This newsletter article outlines some of the unique features and considerations in the diagnosis of inflammatory bowel disease (IBD) in infants, children, and adolescents. Although IBD (ulcerative colitis and Crohn's disease) has been diagnosed in early infancy, the majority of cases occur between the ages of 10 and 21. One third of the total cases of IBD occur in the pediatric age group. The author stresses that when a child under 10 presents with signs and symptoms of IBD, the physician has to be careful with the diagnosis because a number of other conditions can mimic it. In infants who have persistent diarrhea and rectal bleeding with colitis, the picture may strongly resemble ulcerative colitis, when in fact the symptoms may have been caused by food allergy. Elimination of suspected food allergens, such as milk or soy protein, will improve the clinical picture, and many times these infants will grow out of the tendency for allergies by the age of 2. School age children may have Henoch Schonlein purpura, a condition characterized by inflammation of the small blood vessels that can affect any part of the body. The gastrointestinal symptoms can include abdominal pain, diarrhea, and rectal bleeding, while x rays and colonoscopies may show changes that mimic Crohn's disease. A unique feature of adolescence is the struggle between parental dependency and self reliance, which may contribute to a mistaken or delayed diagnosis. The impact of chronic inflammation on growth can be another unique aspect of IBD in children and adolescents. In addition, the impact of chronic illness (including the effects of chronic use of prednisone) on the emotional makeup of children is an important factor which must be addressed by the gastroenterologist. Physicians must also be diligent in monitoring these children for other side effects of prednisone, such as osteopenia (decreased bone density) and avascular necrosis (death of areas of bone due to insufficient blood supply).

•

Musculoskeletal Manifestations of Thyroid Disease Source: Bulletin on the Rheumatic Diseases. 49(11): 1-4. 2001. Contact: Available from Arthritis Foundation. 1330 West Peachtree Street, Atlanta, GA 30309. (800) 268-6942 or (404) 872-7100. Fax (404) 872-9559. Website: www.arthritis.org. Summary: This newsletter article provides health professionals with information on evaluating and treating the musculoskeletal manifestations of thyroid disease. Thyroid disease can cause musculoskeletal symptoms that mimic known rheumatic syndromes.

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Hypothyroidism and thyrotoxicosis can affect the musculoskeletal system. The manifestations of congenital hypothyroidism and hypothyroidism occurring in childhood are usually dominated by cognitive deficiencies and developmental delays. In adults, hypothyroidism may result from autoimmune and postablative mechanisms, pituitary failure, or iodine deficiency. Hypothyroid adults usually have manifestations consistent with low basal metabolic rate. An arthropathy may occur, or hypothyroidism may be confused with fibromyalgia. Hypothyroidism is also associated with other musculoskeletal and rheumatic diseases, including polymyositis, carpal tunnel syndrome, avascular necrosis of the hip, polymyalgia rheumatica, giant cell arteritis, rheumatoid arthritis, and systemic lupus erythematosus. Thyrotoxicosis may also have musculoskeletal manifestations, including myopathy, osteoporosis, and shoulder pain. Graves' disease, an autoimmune disease caused by antibodies directed against the TSH receptor in the thyroid, is associated with pretibial myxedema and thyroid acropachy. 2 tables and 35 references. •

Total Hip Replacement: Relieve Pain, Improve Mobility Source: Mayo Clinic Newsletter. April 18, 2003. 7 p. Contact: Available from Mayo Foundation for Medical Education and Research. Website: www.mayoclinic.com. Summary: This newsletter article provides information to patients considering hip replacement surgery. Hip replacements are performed for many reasons including injury, rheumatoid arthritis, avascular necrosis, and osteoarthritis. Weight, bone density, age, and overall health need to be considered before having surgery. Doctors usually recommend that patients be older than 60 years of age, as the replaced joint lasts an average of 15 to 20 years. Patients should discuss the surgical procedure, risks, postsurgery medications, and possible complications of the surgery with their doctor. Patients should also plan for their return home. The surgery itself takes 2 to 3 hours and is performed under general or regional anesthesia. The femoral head of the thighbone is replaced with a metal ball and is attached to a metal stem fitting into the thighbone. Possible complications include dislocation, infection, and blood clots. Some patients may have long-term complications including loosening, breaking the prosthesis, and an inflammatory reaction. It takes approximately 6 to 8 weeks to recover from this surgery and during that time the patient's activities will be limited. After a follow-up with the surgeon to ensure that the hip is healing properly, most patients are able to resume their usual activities.

•

Hip-Area Pain Source: Mayo Clinic Health Letter. 18(5): 4-5. May 2000. Contact: Available from Mayo Foundation for Medical Education and Research, 200 First Street SW, Rochester, MN 55905. (800) 291-1128 ext. 250. Summary: This newsletter article provides the general public with information on hip pain. The hip includes the hip joint and the area surrounding the joint from the waist to the upper leg. The location of the pain in the hip area can help determine whether the problem is related to the joint. The groin area is the most common location for pain related to hip joint disorders. However, pain from hip joint disorders can also occur on the side of the hip, the upper thigh, the buttock, and, occasionally, the knee. Osteoarthritis is one of the most common causes of hip joint pain. Other causes include inflammatory arthritis, avascular necrosis, fractures, infection, tumor, and congenital defects in the hip joint structure. Hip area pain not related to the joint can be caused by

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various conditions, including trochanteric bursitis, ischial bursitis, pinched sciatic nerve, sacroiliac joint pain, and hernia. A person needs to see a physician for a physical examination if hip pain causes a limp or significantly interferes with daily activities. Treatments vary depending on the cause of the pain. 1 figure.

Academic Periodicals covering Avascular Necrosis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to avascular necrosis. In addition to these sources, you can search for articles covering avascular necrosis 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

•

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

•

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

•

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

•

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

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

•

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

•

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

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

•

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

•

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

•

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 “avascular necrosis” (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 2865 16 862 21 14 3778

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 “avascular necrosis” (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 avascular necrosis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

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

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Arthritis http://www.nlm.nih.gov/medlineplus/arthritis.html Dislocations http://www.nlm.nih.gov/medlineplus/dislocations.html Hip Injuries and Disorders http://www.nlm.nih.gov/medlineplus/hipinjuriesanddisorders.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Osteonecrosis http://www.nlm.nih.gov/medlineplus/osteonecrosis.html

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

General/Overviews Osteonecrosis (Avascular Necrosis) Source: Arthritis Foundation http://www.arthritis.org/conditions/DiseaseCenter/osteonecrosis.asp

•

Diagnosis/Symptoms Bone Scan Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/bonescan.pdf Computed Tomography (CT)-Body Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/ct_of_the_body.htm MR Imaging (MRI)-Musculoskeletal Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/mr_musculoskeletal.htm

•

Treatment Questions and Answers about Hip Replacement Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/hi/topics/hip/hiprepqa.htm Total Joint Replacement Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/brochure/thr_report.cfm?Thread_ID=18&topcategory=A bout%2520Orthopaedics&searentry=total%2520joint

•

Specific Conditions/Aspects Kienböck's Disease Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=311&topcategory=Hand

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Legg-Calve-Perthes Disease Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=159&topcategory=Abou t%2520Orthopaedics Osteonecrosis of the Hip Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?thread_id=237&topcategory=hip Osteonecrosis of the Knee Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=319&topcategory=Knee •

Children Legg-Calve-Perthes Disease Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=159&topcategory=Hip

•

From the National Institutes of Health Questions and Answers about Avascular Necrosis Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/hi/topics/avascular_necrosis/index.htm

•

Organizations American Academy of Orthopaedic Surgeons http://www.aaos.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on avascular necrosis. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive:

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•

Avascular Necrosis

Questions and Answers About Avascular Necrosis Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 2001. 20 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail: [email protected]. Website: www.niams.nih.gov. PRICE: 1 to 25 copies free. Order Number: AR-150QA (booklet), or AR-150L QA (large print). Summary: This fact sheet for people with avascular necrosis, or osteonecrosis, uses a question and answer format to provide information on the disease. Avascular necrosis, which most commonly affects the ends of long bones, is described as a disease resulting from the temporary or permanent loss of the blood supply to the bones. Causes can be injuries, certain risk factors, steroid medications, and alcohol use. The fact sheet explains how, in its early stages, people may not experience any symptoms, how the disease progresses, how it is diagnosed, and what are the available treatments. It also describes current research on the causes and treatment for the disease. Two voluntary health organizations are listed for additional information about avascular necrosis. A large print version of this fact sheet is also available. The National Guideline Clearinghouse™

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

ACR Appropriateness Criteriatm for diagnostic imaging of avascular necrosis of the hip Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2416&nbr=1642&a mp;string=avascular+AND+necrosis 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 avascular necrosis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

Finding Medical Libraries

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•

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

•

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

•

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

•

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

•

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

97

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).

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

99

AVASCULAR NECROSIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Adductor: A muscle that draws a part toward the median line. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Alendronate: A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis. [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] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH]

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Allergens: Antigen-type substances (hypersensitivity, immediate). [NIH]

that

produce

immediate

hypersensitivity

Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Allogeneic: Taken from different individuals of the same species. [NIH] Allograft: An organ or tissue transplant between two humans. [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] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] 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] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the

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tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [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] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthropathy: Any joint disease. [EU] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Arthroscopy: Endoscopic examination, therapy and surgery of the joint. [NIH]

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Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Asparaginase: A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1. [NIH] Aspartate: A synthetic amino acid. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [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] Basal metabolic rate: Represents the minimum energy expenditure required for the maintenance of vital functions; normally the amount of energy expended, measured in calories, per unit of time at rest; measured after 14-18 hours of rest. [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 duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning

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technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood urea: A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea. As kidney function decreases, the BUN level increases. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [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] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [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] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast

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calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] 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] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell,

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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 Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] 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] Chemotherapy: Treatment with anticancer drugs. [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] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Chorioallantoic membrane: The membrane in hen's eggs that helps chicken embryos get enough oxygen and calcium for development. The calcium comes from the egg shell. [NIH] 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] Cirrhosis: A type of chronic, progressive liver disease. [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] 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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codons: Any triplet of nucleotides (coding unit) in DNA or RNA (if RNA is the carrier of primary genetic information as in some viruses) that codes for particular amino acid or signals the beginning or end of the message. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline,

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hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] 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] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Combined Modality Therapy: The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, radioimmunotherapy, chemoradiotherapy, cryochemotherapy, and salvage therapy are seen most frequently, but their combinations with each other and surgery are also used. [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] 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

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theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [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] Constriction: The act of constricting. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Core biopsy: The removal of a tissue sample with a needle for examination under a microscope. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH]

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Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Detoxification: Treatment designed to free an addict from his drug habit. [EU] 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 esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diathesis: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the person more than usually susceptible to certain diseases. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [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] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel

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movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [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] Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] 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] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Toxicity: Manifestations of the adverse effects of drugs administered therapeutically or in the course of diagnostic techniques. It does not include accidental or intentional poisoning for which specific headings are available. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] 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] Elastin: The protein that gives flexibility to tissues. [NIH] Elbow Joint: A hinge joint connecting the forearm to the arm. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be

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done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epiphyseal: Pertaining to or of the nature of an epiphysis. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [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] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical,

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characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Neck Fractures: Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are hip fractures. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genital: Pertaining to the genitalia. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or

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participate in blood production. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]

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 Survival: The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Guinea Pigs: A common name used for the family Caviidae. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research. [NIH]

Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haematuria: Blood in the urine. [EU] Haemophilia: A haemorrhagic diathesis occurring in two main forms: 1. Haemophilia A (classic haemophilia, factor VIII deficiency), an X-linked disorder due to deficiency of coagulation factor VIII; 2. Haemophilia B (factor IX deficiency, Christmas disease), also Xlinked, due to deficiency of coagulation factor IX. Both forms are determined by a mutant gene near the telomere of the long arm of the X chromosome (Xq), but a different loci, and are characterized by subcutaneous and intramuscular haemorrhages; bleeding from the mouth, gums, lips, and tongue; haematuria; and haemarthroses. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hammer: The largest of the three ossicles of the ear. [NIH]

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Hay Fever: A seasonal variety of allergic rhinitis, marked by acute conjunctivitis with lacrimation and itching, regarded as an allergic condition triggered by specific allergens. [NIH]

Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [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 M: A group of abnormal hemoglobins in which amino acid substitutions take place in either the alpha or beta chains but near the heme iron. This results in facilitated oxidation of the hemoglobin to yield excess methemoglobin which leads to cyanosis. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Hip Fractures: Fractures of the femur head, the femur neck, the trochanters, or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region. For the fractures of the femur neck the specific term femoral neck fractures is available. [NIH] 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] Humeral: 1. Of, relating to, or situated in the region of the humerus: brachial. 2. Of or belonging to the shoulder. 3. Of, relating to, or being any of several body parts that are analogous in structure, function, or location to the humerus or shoulder. [EU] 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] 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] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases

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under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypersensitivity, Immediate: Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigenantibody reaction and causes smooth muscle contraction and increased vascular permeability. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Idiopathic: Describes a disease of unknown cause. [NIH] Ileum: The lower end of the small intestine. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] 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] 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] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of

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

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Ingestion: Taking into the body by mouth [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Introns: Non-coding, intervening sequences of DNA that are transcribed, but are removed from within the primary gene transcript and rapidly degraded during maturation of messenger RNA. Most genes in the nuclei of eukaryotes contain introns, as do mitochondrial and chloroplast genes. [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]

Iodine: A nonmetallic element of the halogen group that is represented by the atomic

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symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischial: A pointed projection on the posterior margin of the ischium. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Living Donors: Non-cadaveric providers of organs for transplant to related or non-related recipients. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lunate: A curved sulcus of the lateral surface which forms the anterior limit of the visual cortex. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH]

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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] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mammogram: An x-ray of the breast. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meningeal: Refers to the meninges, the tissue covering the brain and spinal cord. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] 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]

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Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metastatic cancer: Cancer that has spread from the place in which it started to other parts of the body. [NIH] Metatarsophalangeal Joint: The articulation between a metatarsal bone and a phalanx. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methylmethacrylate: The methyl ester of methacrylic acid. It polymerizes easily to form polymethyl methacrylate. It is used as a bone cement. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH]

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Myopathy: Any disease of a muscle. [EU] Myxedema: A condition characterized by a dry, waxy type of swelling with abnormal deposits of mucin in the skin and other tissues. It is produced by a functional insufficiency of the thyroid gland, resulting in deficiency of thyroid hormone. The skin becomes puffy around the eyes and on the cheeks and the face is dull and expressionless with thickened nose and lips. The congenital form of the disease is cretinism. [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] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] 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] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Odontoid Process: The toothlike process on the upper surface of the axis, which articulates with the atlas above. [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

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cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteochondritis Dissecans: A type of osteochondritis in which articular cartilage and associated bone becomes partially or totally detached to form joint loose bodies. Affects mainly the knee, ankle, and elbow joints. [NIH] Osteodystrophy: Defective bone formation. [EU] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Osteonecrosis: Death of a bone or part of a bone, either atraumatic or posttraumatic. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Osteotomy: The surgical cutting of a bone. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] 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] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Parenteral: Not through the alimentary canal but rather by injection through some other

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route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Patella: The flat, triangular bone situated at the anterior part of the knee. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pedicle: Embryonic link between the optic vesicle or optic cup and the forebrain or diencephalon, which becomes the optic nerve. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [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] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and

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teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] 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]

Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyarthritis: An inflammation of several joints together. [EU] 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] Polymethyl Methacrylate: Polymerized methyl methacrylate monomers which are used as sheets, moulding, extrusion powders, surface coating resins, emulsion polymers, fibers, inks, and films (From International Labor Organization, 1983). This material is also used in tooth implants, bone cements, and hard corneal contact lenses. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [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] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] 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] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [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] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Preoperative: Preceding an operation. [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] 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] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [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] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH]

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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] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [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] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Pseudarthrosis: A new false joint arising at the site of an ununited fracture; may be caused by vibrating hand tools. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [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] 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]

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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]

Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radionuclide Imaging: Process whereby a radionuclide is injected or measured (through tissue) from an external source, and a display is obtained from any one of several rectilinear scanner or gamma camera systems. The image obtained from a moving detector is called a scan, while the image obtained from a stationary camera device is called a scintiphotograph. [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] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH]

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Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [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]

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] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Sacroiliac Joint: The immovable joint formed by the lateral surfaces of the sacrum and ilium. [NIH] Salvage Therapy: A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases. [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] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH]

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Second cancer: Refers to a new primary cancer that is caused by previous cancer treatment, or a new primary cancer in a person with a history of 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] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Sella Turcica: A bony prominence situated on the upper surface of the body of the sphenoid bone. It houses the pituitary gland. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] 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] 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]

Shoulder Pain: Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin. [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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] 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]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol

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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] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectroscopic: The recognition of elements through their emission spectra. [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] Spondylitis: Inflammation of the vertebrae. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [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] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU]

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Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surgical Mesh: Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Tarsal Bones: The seven bones which form the tarsus - namely, calcaneus, talus, cuboid, navicular, and first, second and third cuneiforms. The tarsus is a skeletal part of the foot. [NIH]

Tarsus: The region of the articulation between the foot and the leg. [NIH] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Telomere: A terminal section of a chromosome which has a specialized structure and which is involved in chromosomal replication and stability. Its length is believed to be a few hundred base pairs. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] 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] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein

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synthesis. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thromboses: The formation or presence of a blood clot within a blood vessel during life. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [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] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyrotoxicosis: The clinical syndrome that reflects the response of the peripheral tissues to an excess of thyroid hormone. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH]

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Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [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] 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] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [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] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together

132

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to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [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] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zoledronate: A drug that belongs to the family of drugs called bisphosphonates. It is used to prevent bone fractures and reduce bone pain in people who have cancer that has spread to the bone. [NIH]

133

INDEX A Abdominal, 73, 99, 120, 121, 131 Abdominal Pain, 73, 99, 131 Aberrant, 9, 99 Acidity, 99, 121 Acute lymphoblastic leukemia, 56, 59, 63, 99 Acute lymphocytic leukemia, 60, 99 Adductor, 14, 99 Adolescence, 15, 73, 99 Adrenal Cortex, 99, 107, 123 Adverse Effect, 9, 99, 109, 127 Affinity, 99, 128 Alendronate, 47, 99 Algorithms, 99, 103 Alimentary, 99, 120, 121 Alkaline, 99, 104 Alkaloid, 99, 105 Allergens, 73, 100, 113 Allergic Rhinitis, 100, 113 Allogeneic, 12, 100 Allograft, 4, 67, 100 Alternative medicine, 72, 100 Alveolar Process, 100, 126 Amino acid, 100, 101, 102, 105, 113, 121, 122, 124, 131 Amino Acid Sequence, 100, 101 Amphetamines, 100, 105 Anaesthesia, 100, 115 Anal, 100, 111 Analogous, 100, 113, 131 Anatomical, 100, 115, 126 Androgens, 99, 100, 107 Anemia, 26, 36, 100 Anesthesia, 74, 100 Angiogenesis, 32, 61, 100 Animal model, 6, 101 Ankle, 35, 39, 49, 70, 101, 120 Antiallergic, 101, 107 Antibiotic, 101, 129 Antibodies, 7, 38, 45, 74, 101, 116, 122, 125 Antibody, 7, 18, 99, 101, 106, 108, 114, 115, 125 Antigen, 99, 100, 101, 106, 114, 115 Anti-infective, 101, 116 Anti-inflammatory, 101, 107, 108, 112, 123 Anti-Inflammatory Agents, 101, 107 Antimetabolite, 101, 118

Antineoplastic, 101, 107, 118, 132 Anus, 100, 101, 106, 125 Arachidonic Acid, 101, 109, 124 Arterial, 36, 70, 101, 114, 124 Arteries, 101, 103, 107, 118, 130 Arterioles, 101, 103 Arteritis, 74, 101, 122 Artery, 7, 101, 103, 107, 109, 125, 131 Arthropathy, 39, 74, 101 Arthroplasty, 5, 9, 16, 18, 25, 29, 41, 44, 46, 50, 101 Arthroscopy, 19, 29, 42, 49, 50, 69, 101 Articular, 66, 67, 102, 116, 120 Articulation, 102, 118, 129 Ascites, 102, 119 Aseptic, 61, 67, 70, 102, 128 Asparaginase, 60, 102 Aspartate, 102 Asymptomatic, 19, 102, 120 Atmospheric Pressure, 102, 114 Autodigestion, 102, 120 Autoimmune disease, 74, 102 Autologous, 12, 102 Autonomic, 7, 102, 129 Autonomic Neuropathy, 7, 102 Avian, 61, 102 B Bacteria, 101, 102, 109, 131 Basal metabolic rate, 74, 102, 114 Bilateral, 11, 14, 15, 16, 61, 102, 127 Bile, 102, 111, 114, 116, 128 Bile duct, 102, 114 Biliary, 102, 104, 120 Biliary Tract, 102, 104, 120 Biochemical, 101, 102, 120 Biological Transport, 102, 108 Biopsy, 102, 121 Biotechnology, 10, 72, 81, 102 Biotransformation, 103 Bladder, 102, 103, 106 Blood Coagulation, 103, 104 Blood pressure, 103, 114, 128 Blood urea, 4, 103 Blood vessel, 73, 100, 103, 104, 105, 110, 112, 116, 121, 127, 128, 130, 131 Body Fluids, 103, 128 Bolus, 56, 103 Bolus infusion, 103

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Avascular necrosis

Bone Density, 73, 74, 103 Bone Marrow, 11, 22, 50, 99, 103, 108, 116, 117, 128 Bone scan, 43, 103 Bowel, 70, 100, 103, 108, 115, 128, 131 Brachial, 103, 113, 117 Buccal, 103, 116 Bursitis, 75, 103 C Calcification, 7, 103 Calcium, 8, 103, 104, 105, 106, 118 Calcium channel blocker, 8, 104 Calcium Channel Blockers, 8, 104 Calculi, 104, 112 Carbohydrate, 104, 107, 123 Carbon Dioxide, 104, 111 Carcinogenic, 104, 128 Carcinoma, 4, 104 Cardiac, 104, 118, 128 Cardiovascular, 7, 102, 104 Cardiovascular System, 102, 104 Carpal Tunnel Syndrome, 74, 104 Case report, 12, 14, 15, 17, 22, 26, 28, 29, 30, 38, 46, 47, 50, 59, 61, 104, 105 Case series, 104, 105 Cell membrane, 102, 104 Cell Transplantation, 105 Central Nervous System, 100, 105, 120 Cerebrovascular, 104, 105 Character, 105, 108 Chemotherapy, 6, 15, 56, 59, 60, 63, 105, 126 Cholesterol, 4, 102, 105, 128 Chondrocytes, 105, 111 Chorioallantoic membrane, 61, 105 Chromosome, 105, 112, 129 Chronic, 4, 8, 18, 73, 105, 115, 120, 124, 128, 129, 131 Cirrhosis, 32, 105 Clinical study, 41, 105 Clinical trial, 5, 8, 81, 105, 107, 108, 124, 125 Cloning, 102, 105 Coca, 105 Cocaine, 46, 105 Codons, 105 Colitis, 70, 73, 105 Collagen, 6, 100, 105, 124 Collapse, 5, 8, 9, 23, 42, 66, 67, 70, 106 Colon, 4, 105, 106, 114, 115, 116, 131 Combination chemotherapy, 60, 62, 106 Combined Modality Therapy, 60, 106

Complement, 106 Complementary and alternative medicine, 59, 64, 106 Complementary medicine, 59, 106 Compliance, 8, 106 Computational Biology, 81, 106 Concomitant, 4, 107 Conjunctivitis, 107, 113 Connective Tissue, 67, 103, 105, 107, 111, 126, 129 Connective Tissue Cells, 107 Constriction, 107, 116 Contraindications, ii, 107 Contralateral, 51, 107 Controlled study, 28, 107 Core biopsy, 9, 107 Cornea, 107, 112 Coronary, 7, 107, 118 Coronary Thrombosis, 107, 118 Cortex, 107, 120 Corticosteroid, 4, 7, 12, 17, 33, 45, 56, 107, 123, 128 Cortisone, 107, 108, 123 Cranial, 107, 120, 131 Curative, 107, 130 Cutaneous, 107, 116 Cyclosporine, 15, 108 Cyst, 26, 108 Cytokines, 7, 108, 114 D Decompression, 4, 5, 8, 19, 20, 24, 32, 48, 51, 66, 108 Decompression Sickness, 108 Degenerative, 6, 21, 50, 108, 120 Delusions, 108, 124 Density, 6, 103, 108, 120 Desensitization, 108, 114 Detoxification, 6, 108 Dexamethasone, 9, 12, 59, 60, 108 Diagnostic Imaging, 88, 108 Diagnostic procedure, 65, 72, 108 Diarrhea, 73, 108 Diathesis, 108, 112 Diencephalon, 108, 121 Diffusion, 6, 102, 108 Digestion, 99, 102, 103, 108, 115, 116, 128 Digestive system, 108, 111 Digestive tract, 102, 109, 127 Dihydrotestosterone, 109, 126 Direct, iii, 109, 126 Dislocation, 26, 37, 38, 40, 41, 42, 43, 45, 47, 51, 70, 74, 109

135

Distal, 20, 41, 46, 50, 109 Domesticated, 109, 112 Dopamine, 105, 109 Dorsum, 46, 109 Drug Interactions, 109 Drug Toxicity, 8, 109 Duodenum, 102, 109, 128 Dysplasia, 20, 24, 25, 32, 42, 47, 109 E Edema, 11, 12, 36, 50, 109, 119, 131 Efficacy, 9, 24, 109 Eicosanoids, 25, 109 Elastin, 105, 109 Elbow Joint, 109, 120 Electrolyte, 107, 109, 118, 128, 131 Emboli, 17, 109 Embolization, 17, 109 Embryo, 110, 115 Emulsion, 110, 111, 122 Endogenous, 109, 110 Endothelial cell, 110, 111 Environmental Health, 80, 82, 110 Enzymatic, 100, 104, 106, 110, 111 Enzyme, 32, 102, 110, 117, 124, 126, 132 Epidemic, 41, 110 Epidermis, 110, 125 Epiphyseal, 6, 110 Erythrocytes, 100, 103, 110 Esophagus, 109, 110, 128 Exogenous, 103, 110 Extensor, 110, 124 Extracellular, 107, 110, 128 Extracellular Matrix, 107, 110 Extremity, 9, 53, 110, 117, 126 F Family Planning, 81, 110 Fat, 26, 101, 103, 107, 109, 110, 126, 128 Fatigue, 9, 110, 113 Femoral Neck Fractures, 35, 63, 111, 113 Femur, 11, 15, 18, 20, 24, 31, 32, 35, 42, 45, 50, 61, 111, 113, 130 Fibrinolytic, 21, 111 Fibroblast Growth Factor, 61, 111 Fibrosis, 111, 126 Fibula, 111, 130 Fixation, 35, 66, 111 Fovea, 111 G Gallbladder, 99, 102, 109, 111 Gas, 104, 108, 111, 113, 119 Gastroenterologist, 73, 111 Gastrointestinal, 73, 111

Gene, 103, 111, 112, 115 Genital, 102, 111 Gland, 99, 107, 111, 120, 122, 127, 130 Glucocorticoid, 19, 108, 112, 123 Glycosaminoglycan, 6, 112 Gonadal, 112, 128 Gout, 28, 49, 112 Governing Board, 112, 123 Grade, 112 Grading, 52, 112 Graft, 4, 8, 46, 52, 112 Graft Survival, 4, 112 Grafting, 5, 19, 32, 33, 34, 41, 48, 51, 52, 112 Groin, 74, 112 Guinea Pigs, 51, 112 H Haematoma, 112 Haematuria, 112 Haemophilia, 23, 112 Haemorrhage, 17, 112 Hammer, 21, 112, 120 Hay Fever, 33, 100, 113 Health Status, 7, 113 Heart failure, 113, 119 Hemoglobin, 49, 100, 110, 113 Hemoglobin M, 113 Hemoglobinopathies, 14, 113 Hemorrhage, 113, 125 Heredity, 111, 113 Hernia, 75, 113 Hip Fractures, 111, 113 Hormonal, 107, 113 Hormone, 107, 109, 113, 116, 119, 123, 126, 129, 130 Humeral, 4, 15, 49, 61, 67, 113 Hydrogen, 99, 104, 113, 118, 121 Hydroxylysine, 106, 113 Hydroxyproline, 100, 106, 113 Hyperbaric, 62, 63, 113, 114 Hyperbaric oxygen, 62, 63, 114 Hypersensitivity, 100, 108, 114, 126 Hypersensitivity, Immediate, 100, 114 Hypertension, 104, 114, 131 Hyperuricemia, 112, 114 Hypotension, 7, 114 Hypothyroidism, 33, 74, 114 I Idiopathic, 11, 21, 28, 29, 30, 31, 32, 46, 63, 114 Ileum, 4, 114 Imaging procedures, 114, 130

136

Avascular necrosis

Immune response, 101, 102, 107, 114, 132 Immune system, 114, 116, 132 Immunodeficiency, 37, 114 Immunosuppressant, 114, 118 Immunosuppression, 7, 114, 117 Immunosuppressive, 4, 8, 112, 114 Immunosuppressive Agents, 114 Impaction, 22, 114 Impairment, 114, 117, 124 In vitro, 61, 63, 115 In vivo, 61, 63, 115, 117, 130 Incision, 115 Induction, 59, 100, 115 Infancy, 73, 115 Infarction, 107, 115, 118 Infection, 13, 29, 74, 102, 114, 115, 116, 119, 126, 129, 132 Infertility, 35, 115 Inflammation, 73, 100, 101, 103, 105, 107, 111, 115, 120, 122, 125, 126, 128, 129, 131 Inflammatory bowel disease, 44, 70, 73, 115 Ingestion, 51, 115, 122 Innervation, 115, 117, 121, 126, 130 Intermittent, 70, 115 Intestine, 103, 115, 116 Intracellular, 104, 115 Intramuscular, 112, 115, 121 Intravenous, 115, 121 Introns, 115 Invasive, 6, 115, 117 Iodine, 74, 115 Ischemia, 6, 43, 70, 116 Ischial, 75, 116 K Kb, 80, 116 Kidney Transplantation, 29, 116 Kinetic, 116 L Large Intestine, 109, 115, 116, 125, 127 Lesion, 9, 23, 43, 63, 116 Lethargy, 114, 116 Leukemia, 6, 9, 18, 56, 63, 116 Leukocytes, 103, 108, 116 Life Expectancy, 67, 116 Ligaments, 107, 116 Liver, 32, 99, 101, 102, 105, 109, 110, 111, 116, 123, 131 Living Donors, 4, 116 Localized, 34, 111, 112, 115, 116, 119, 120, 122 Loop, 113, 116

Lumbar, 116, 126, 130 Lunate, 33, 46, 61, 116 Lupus, 7, 25, 86, 116, 129 Luxation, 109, 116 Lymphatic, 115, 116, 119, 122, 128 Lymphoblasts, 99, 116 Lymphocyte, 101, 114, 116, 117 Lymphocyte Depletion, 114, 117 Lymphocytic, 117 Lymphoid, 101, 117 Lymphoma, 21, 38, 56, 60, 61, 63, 117 Lytic, 117, 127 M Magnetic Resonance Imaging, 4, 26, 37, 40, 42, 117 Malignant, 60, 101, 117 Mammogram, 103, 117, 118 Mandible, 100, 117, 126 Mania, 9, 117 Manic, 117, 124 Medial, 117, 130 Median Nerve, 104, 117 Medical Records, 117, 126 MEDLINE, 81, 117 Membrane, 100, 104, 105, 106, 110, 117, 118, 120 Meningeal, 9, 117 Meninges, 105, 117 Mental, iv, 5, 80, 82, 110, 114, 117, 124, 131 Mental Disorders, 117, 124 Meta-Analysis, 20, 117 Metabolic disorder, 112, 117 Metabolite, 103, 117, 123 Metastasis, 118 Metastatic, 4, 14, 63, 118 Metastatic cancer, 14, 118 Metatarsophalangeal Joint, 21, 118 Methotrexate, 60, 118 Methylmethacrylate, 8, 118 Methylprednisolone, 35, 45, 118 MI, 42, 46, 97, 118 Microcalcifications, 104, 118 Milliliter, 103, 118 Mineralocorticoids, 99, 107, 118 Mitochondrial Swelling, 118, 119 Mitotic, 118, 132 Mobility, 8, 74, 118 Modification, 100, 118, 125 Molecular, 49, 63, 81, 83, 102, 107, 118 Molecule, 101, 106, 112, 118, 125 Mucosa, 116, 118 Mucus, 118, 131

137

Myocardium, 118 Myopathy, 74, 119 Myxedema, 74, 119 N Neoplastic, 117, 119, 126 Nerve, 100, 115, 117, 119, 120, 121, 126, 130, 131 Nervous System, 105, 119, 129 Neuroblastoma, 60, 119 Neurons, 105, 119, 129 Neuropathy, 7, 102, 119 Neurosurgery, 12, 119 Nitrogen, 4, 99, 100, 108, 111, 119, 131 Nuclear, 21, 22, 30, 48, 52, 63, 119, 131 Nuclei, 115, 117, 119, 120 Nucleic acid, 119 Nucleus, 43, 119 O Occult, 19, 40, 119 Odontoid Process, 32, 119 Oedema, 22, 119 Opacity, 108, 120 Ophthalmology, 111, 120 Optic cup, 120, 121 Optic Nerve, 120, 121 Organ Transplantation, 4, 8, 120 Ossicles, 112, 120 Ossification, 19, 120 Osteoarthritis, 6, 33, 50, 74, 120 Osteochondritis Dissecans, 70, 120 Osteodystrophy, 19, 120 Osteomyelitis, 37, 120 Osteonecrosis, 3, 7, 43, 66, 67, 70, 86, 87, 88, 120 Osteoporosis, 7, 21, 22, 49, 74, 99, 120 Osteotomy, 5, 17, 19, 24, 27, 28, 32, 33, 41, 45, 120 P Palliative, 120, 130 Pancreas, 99, 109, 120 Pancreatic, 120 Pancreatitis, 32, 120 Parenteral, 4, 120, 121 Parenteral Nutrition, 4, 121 Patella, 38, 47, 121 Pathogenesis, 5, 121 Pathologic, 27, 102, 107, 114, 121, 124, 126, 127 Pathophysiology, 36, 121 Patient Education, 87, 92, 94, 97, 121 Pedicle, 19, 41, 51, 52, 121 Pelvic, 17, 62, 121

Pelvis, 116, 121 Peptide, 100, 111, 121, 122, 124, 130 Percutaneous, 24, 121 Perfusion, 6, 27, 121 Perioperative, 9, 121 Peritoneal, 102, 119, 121 Peritoneal Cavity, 102, 120, 121 Peroneal Nerve, 121, 126 Petechiae, 112, 121 PH, 17, 51, 60, 103, 121 Phallic, 111, 121 Pharmacokinetic, 121 Pharmacologic, 100, 121, 130 Phosphorus, 104, 121 Physical Examination, 75, 122 Physiologic, 108, 122, 125, 126 Pituitary Gland, 107, 111, 122, 127 Plants, 99, 104, 105, 122, 126, 130 Plasma, 37, 101, 104, 113, 118, 122 Plasma cells, 101, 122 Pleural, 120, 122 Pleural cavity, 120, 122 Plexus, 117, 122, 126 Pneumonia, 107, 122 Poisoning, 109, 122 Polyarthritis, 60, 122 Polymers, 122, 124, 129 Polymethyl Methacrylate, 118, 122 Polymorphic, 6, 105, 122 Polymorphism, 10, 122 Polymyalgia Rheumatica, 74, 122 Polypeptide, 100, 105, 122 Polysaccharide, 101, 112, 123 Posterior, 100, 109, 116, 120, 123 Postmenopausal, 99, 120, 123 Postoperative, 33, 123 Post-traumatic, 16, 41, 51, 70, 123 Practice Guidelines, 82, 88, 123 Precipitating Factors, 4, 123 Precursor, 101, 109, 110, 123, 131 Prednisolone, 62, 118, 123 Prednisone, 7, 49, 56, 63, 73, 123 Preoperative, 9, 41, 123 Prevalence, 3, 43, 56, 63, 67, 123 Prodrug, 63, 123 Progesterone, 123, 128 Prognostic factor, 8, 123 Progression, 5, 9, 43, 66, 101, 123 Progressive, 8, 13, 105, 119, 120, 123 Projection, 116, 120, 123 Proline, 105, 113, 124 Prospective study, 7, 8, 9, 124

138

Avascular necrosis

Prostaglandins, 101, 109, 124 Prosthesis, 74, 124 Protease, 71, 124, 126 Protective Agents, 104, 124 Protein S, 103, 124, 130 Proteins, 100, 101, 105, 106, 108, 118, 119, 121, 122, 124, 127, 130, 131 Protocol, 7, 9, 124 Pseudarthrosis, 24, 124 Psoriasis, 15, 124 Psychiatry, 111, 124 Psychosis, 9, 124 Public Policy, 81, 124 Publishing, 10, 124 Pulse, 35, 125 Purpura, 73, 112, 125 Pyogenic, 120, 125 Q Quality of Life, 9, 125 R Radiation, 114, 125, 126, 132 Radiation therapy, 114, 125, 126 Radioactive, 103, 113, 119, 125, 129, 131 Radioimmunotherapy, 106, 125 Radioisotope, 51, 125, 130 Radiological, 4, 36, 86, 121, 125 Radiology, 13, 16, 17, 22, 24, 27, 31, 40, 43, 44, 50, 86, 88, 125 Radionuclide Imaging, 27, 125 Randomized, 8, 109, 125 Reality Testing, 124, 125 Receptor, 74, 101, 109, 125 Rectal, 73, 125 Rectum, 101, 106, 109, 111, 115, 116, 125 Reductase, 49, 118, 126 Refer, 1, 103, 106, 111, 124, 125, 126 Regeneration, 111, 126 Regimen, 8, 109, 126 Reliability, 13, 32, 126 Resorption, 61, 126 Retreatment, 43, 126 Retrospective, 29, 126 Retrospective study, 29, 126 Rheumatism, 40, 126 Rheumatoid, 12, 16, 26, 33, 35, 74, 126 Rheumatoid arthritis, 16, 26, 33, 35, 74, 126 Risk factor, 3, 7, 14, 25, 43, 44, 45, 49, 88, 124, 126 Ritonavir, 13, 126 S Sacroiliac Joint, 75, 126

Salvage Therapy, 106, 126 Saponins, 126, 128 Sciatic Nerve, 75, 121, 126, 130 Sclerosis, 13, 126 Screening, 46, 105, 126 Second cancer, 7, 127 Secretion, 107, 114, 118, 127 Sedimentation, 122, 127 Segmental, 22, 127 Segmentation, 46, 127 Sella Turcica, 109, 122, 127 Senile, 120, 127 Septic, 38, 102, 127 Serologic, 7, 127 Serum, 106, 117, 118, 127 Sex Characteristics, 99, 100, 127, 129 Shock, 127, 131 Shoulder Pain, 74, 127 Side effect, 4, 19, 73, 99, 114, 127, 130 Signs and Symptoms, 73, 127, 131 Skeleton, 111, 127, 130 Skull, 127, 129 Small intestine, 109, 113, 114, 115, 127 Smooth muscle, 100, 104, 107, 114, 127 Social Environment, 125, 127 Sodium, 63, 112, 118, 127 Soft tissue, 103, 127, 128 Solid tumor, 100, 128 Somatic, 99, 128 Specialist, 89, 128 Species, 100, 105, 109, 112, 120, 128, 131, 132 Spectroscopic, 27, 128 Spinal cord, 103, 105, 117, 119, 126, 128, 129 Spondylitis, 4, 128 Staging, 4, 5, 27, 29, 31, 128 Stem cell transplantation, 12, 128 Stem Cells, 128 Sterile, 102, 128 Sterility, 115, 128 Steroid, 4, 15, 18, 23, 24, 37, 44, 47, 56, 88, 107, 126, 128 Steroid therapy, 37, 128 Stomach, 33, 34, 99, 102, 109, 110, 111, 113, 121, 127, 128 Stool, 106, 114, 116, 128 Stress, 16, 31, 51, 126, 128 Subacute, 115, 128 Subclinical, 115, 129 Subcutaneous, 109, 112, 119, 121, 129 Suppression, 107, 129

139

Surgical Mesh, 66, 129 Sympathetic Nervous System, 119, 129 Symptomatic, 120, 129 Systemic, 9, 13, 19, 24, 27, 34, 40, 44, 45, 50, 56, 70, 74, 103, 115, 119, 123, 125, 129 Systemic lupus erythematosus, 19, 24, 27, 34, 40, 44, 45, 50, 56, 70, 74, 129 T Talus, 15, 23, 26, 50, 56, 70, 129, 130 Tarsal Bones, 129 Tarsus, 129 Technetium, 41, 129 Telomere, 112, 129 Temporal, 6, 122, 129 Tendon, 103, 129 Testicular, 56, 60, 63, 129 Testis, 129 Testosterone, 126, 129 Tetracycline, 11, 129 Therapeutics, 61, 62, 63, 130 Thigh, 42, 74, 111, 112, 130 Thromboses, 18, 130 Thrombosis, 7, 124, 130 Thromboxanes, 101, 109, 130 Thyroid, 73, 114, 116, 119, 130 Thyroid Gland, 119, 130 Thyrotoxicosis, 74, 130 Thyrotropin, 114, 130 Tibia, 17, 111, 130 Tibial Nerve, 126, 130 Tomography, 25, 26, 46, 86, 103, 130 Topical, 15, 17, 130 Toxic, iv, 6, 119, 130 Toxicity, 109, 130 Toxicokinetics, 130 Toxicology, 82, 130 Toxins, 101, 115, 125, 130 Tracer, 11, 130 Trachea, 130, 131 Traction, 42, 131 Transfection, 102, 131 Transplantation, 4, 7, 8, 13, 23, 24, 29, 33, 40, 41, 49, 117, 131

Trauma, 14, 18, 19, 22, 23, 31, 36, 42, 49, 52, 67, 70, 119, 120, 131 Tryptophan, 106, 131 Tuberculosis, 37, 116, 131 U Ulcerative colitis, 44, 47, 73, 115, 131 Uraemia, 120, 131 Uranium, 129, 131 Urea, 103, 131 Uric, 112, 114, 131 V Vaccines, 131, 132 Vagotomy, 34, 131 Vascular, 11, 12, 13, 14, 17, 29, 30, 31, 41, 51, 59, 60, 61, 66, 86, 104, 114, 115, 119, 130, 131 Vasculitis, 12, 120, 131 Veins, 103, 122, 131, 132 Venous, 119, 124, 131 Ventricle, 125, 131 Venules, 103, 131 Vertebrae, 128, 132 Vertebral, 17, 24, 29, 132 Veterinary Medicine, 81, 132 Vinblastine, 62, 132 Vinca Alkaloids, 132 Vincristine, 60, 132 Virus, 37, 132 Visceral, 102, 132 Visual Cortex, 116, 132 Vitro, 132 Vivo, 117, 132 W White blood cell, 99, 101, 116, 117, 118, 122, 132 Windpipe, 130, 132 Wound Healing, 111, 132 X Xenograft, 101, 132 X-ray, 103, 117, 119, 125, 132 Z Zoledronate, 41, 132

140

Avascular necrosis

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