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

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

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

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Hyperthyroidism: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83937-9 1. Hyperthyroidism-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 hyperthyroidism. 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 HYPERTHYROIDISM................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Hyperthyroidism........................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 20 The National Library of Medicine: PubMed ................................................................................ 21 CHAPTER 2. NUTRITION AND HYPERTHYROIDISM ......................................................................... 57 Overview...................................................................................................................................... 57 Finding Nutrition Studies on Hyperthyroidism.......................................................................... 57 Federal Resources on Nutrition ................................................................................................... 62 Additional Web Resources ........................................................................................................... 62 CHAPTER 3. ALTERNATIVE MEDICINE AND HYPERTHYROIDISM .................................................. 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 71 General References ....................................................................................................................... 73 CHAPTER 4. CLINICAL TRIALS AND HYPERTHYROIDISM ............................................................... 75 Overview...................................................................................................................................... 75 Recent Trials on Hyperthyroidism............................................................................................... 75 Keeping Current on Clinical Trials ............................................................................................. 76 CHAPTER 5. PATENTS ON HYPERTHYROIDISM ............................................................................... 79 Overview...................................................................................................................................... 79 Patents on Hyperthyroidism........................................................................................................ 79 Patent Applications on Hyperthyroidism .................................................................................... 85 Keeping Current .......................................................................................................................... 88 CHAPTER 6. BOOKS ON HYPERTHYROIDISM ................................................................................... 89 Overview...................................................................................................................................... 89 Book Summaries: Online Booksellers........................................................................................... 89 The National Library of Medicine Book Index ............................................................................. 90 Chapters on Hyperthyroidism...................................................................................................... 91 CHAPTER 7. MULTIMEDIA ON HYPERTHYROIDISM ........................................................................ 95 Overview...................................................................................................................................... 95 Bibliography: Multimedia on Hyperthyroidism .......................................................................... 95 CHAPTER 8. PERIODICALS AND NEWS ON HYPERTHYROIDISM ..................................................... 97 Overview...................................................................................................................................... 97 News Services and Press Releases................................................................................................ 97 Newsletter Articles ...................................................................................................................... 99 Academic Periodicals covering Hyperthyroidism ........................................................................ 99 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................. 101 Overview.................................................................................................................................... 101 U.S. Pharmacopeia..................................................................................................................... 101 Commercial Databases ............................................................................................................... 104 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 109 Overview.................................................................................................................................... 109 NIH Guidelines.......................................................................................................................... 109 NIH Databases........................................................................................................................... 111 Other Commercial Databases..................................................................................................... 113 The Genome Project and Hyperthyroidism................................................................................ 113 APPENDIX B. PATIENT RESOURCES ............................................................................................... 117 Overview.................................................................................................................................... 117

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Patient Guideline Sources.......................................................................................................... 117 Finding Associations.................................................................................................................. 126 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 129 Overview.................................................................................................................................... 129 Preparation................................................................................................................................. 129 Finding a Local Medical Library................................................................................................ 129 Medical Libraries in the U.S. and Canada ................................................................................. 129 ONLINE GLOSSARIES................................................................................................................ 135 Online Dictionary Directories ................................................................................................... 140 HYPERTHYROIDISM DICTIONARY ...................................................................................... 141 INDEX .............................................................................................................................................. 199

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

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

Hypothyroidism, Hyperthyroidism, Hyperparathyroidism Source: Patient Care. 33(14): 186-188, 191, 195-200, 202-203, 206. September 15, 1999. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: This article discusses the diagnosis and treatment of thyroid illnesses. These types of illnesses are among the most prevalent of the hormonal diseases that afflict people in the United States. Although hypothyroidism and hyperthyroidism are the most widespread, hyperparathyroidism (HPT) occurs in a large number of Americans as well. Diagnosis can be complicated because numerous patients present with nonspecific signs and symptoms that closely resemble other physical and mental conditions. Primary hypothyroidism occurs from failure of the thyroid gland itself, whereas

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secondary hypothyroidism results from a deficiency of pituitary thyroid-stimulating hormone. The most common cause of hypothyroidism among adult patients is Hashimoto's thyroiditis. Other causes include drug side effects, congenital hypothyroidism, iodine excess, previous thyroidectomy, neck irradiation, and pituitary or hypothalamic disorders. Women who have type 1 diabetes are at greater risk for a temporary disorder known as postpartum thyroiditis. Signs and symptoms can be overt, subtle, or nonexistent. Diagnosis involves performing a physical examination and conducting laboratory tests. The treatment of choice for managing hypothyroidism is daily oral administration of levothyroxine. Some patients may benefit from referral to an endocrinologist. Hyperthyroidism, which is not as prevalent as hypothyroidism, is caused by Graves' disease or diffuse toxic goiter. Other causes include pituitary tumors, pituitary resistance to thyroid hormones, neonatal hyperthyroidism, and malignancies. Signs and symptoms can be overt, subtle, or nonexistent. Diagnosis involves performing a physical examination and conducting laboratory tests. Patient referral to an endocrinologist is indicated following a positive diagnosis or when hyperthyroidism is suspected. Treatment options include radioactive iodine therapy, antithyroid drugs, and surgery. HPT, another fairly common endocrine disorder, is the most common cause of hypercalcemia. Although about 75 percent of patients have no signs or symptoms attributable to this disease, it may affect the skeletal system, kidneys, and gastrointestinal tract. The only successful treatment is surgical removal of one or more parathyroid glands. Patients who have primary HPT should be referred to an endocrinologist. 1 figure. 4 tables. 5 references.

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

Project Title: AN ANIMAL MODEL FOR GRAVES'DISEASE/OPHTHALMOPATHY Principal Investigator & Institution: Jaume, Juan C.; Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2006

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

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Summary: (provided by applicant): The ophthalmopathy of Graves' disease is a disfiguring, sight threatening condition of unclear pathogenesis and no specific or definitive therapy. Graves' disease primarily manifests with hyperthyroidism that results from the stimulation of the TSHR by specific autoantibodies that mimic the effect of TSH. Often the ophthalmopathy accompanies the hyperthyroidism. Rather than being considered two separate entities, hyperthyroidism and ophthalmopathy are different manifestations of the same underlying autoimmune process. No spontaneous animal model of Graves' disease exists. Recently, an animal model has been developed in which a proportion of individuals manifest immunological and endocrinological features of Graves' disease. We have generated and extended such mouse model. The overall goal of this proposal is to use this Graves'-Iike animal model to investigate critical issues of Graves' disease as is Graves' ophthalmopathy as follows: 1. Graves' ophthalmopathy in the Graves'-Iike mouse model. New observations suggest the immunizing cells used in the model behave as APC that constitutively express B7-1 molecules and bias the immune response to a Th1 type. These APC also have the capacity of presenting non-specific antigens present in culture medium. With this information we have modified our immunization protocol to improve specific (TSHR) antigen presentation and deviate the immune response to a Th2 type characteristic of human Graves'. We propose to: a. Study the development of Graves' disease/ophthalmopathy in both, Th1 and Th2 settings. b. Examine the role of CD40 for orbital fibroblast-B/T cell cross talk. c. Study the regulation of TSHR in orbital fibroblasts/preadipocytes. 2. Characterize TSHR antibodies in their relationship to Graves' ophthalmopathy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CENTRAL NERVOUS SYSTEM MANIFESTATIONS OF THYROID HORMONE DIESEASE Principal Investigator & Institution: Krueger, James M.; Professor of Neurobiology; University of Tennessee Health Sci Ctr Health Science Center Memphis, Tn 38163 Timing: Fiscal Year 2001 Summary: This study will determine whether sleep parameters are altered in hyperthyroid patients and, if so, whether the abnormalities return to normal during the treated, euthyroid state." Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COREPRESSORS AND NEGATIVE REGULATION BY THYROID HORMONE Principal Investigator & Institution: Cohen, Ronald N.; Medicine; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2001; Project Start 05-AUG-1998; Project End 30-JUN-2003 Summary: (Taken from the applicant's Abstract): Thyroid hormone receptors (TRs) bind to thyroid hormone response elements (TREs) in the regulatory regions of genes to stimulate or inhibit gene transcription. TRs bind in the presence or absence of ligand, triiodothyronine (T3). In the absence of ligand, TRs repress transcription of genes that are positively regulated by T3. Ligand-independent repression is mediated by a class of proteins termed co-repressors, including NCoR and SMRT, which bind TR in the absence of T3. TRs also exhibit ligand-independent effects on genes negatively regulated by a thyroid hormone. One these negative TREs, TRs enhance transcription in the absence of ligand. These effects are less well defined, but appear to be mediated by

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members of the co-repressor families, as well. The goals of these studies are (1) to characterize the effects of co-repressors on genes negatively regulated by thyroid hormone; (2) to identify and characterize NCoR isoforms; and (3) to determine how corepressors interact with specific TR complexes. In these studies, we will focus on the interactions between co-repressors and TR-beta-2, a TR isoform that may play a distinct role in negative regulation. In addition, mutant TRs, found clinically in patients with syndromes of resistance to thyroid hormone (RTH) will be used to characterize interactions between TRs and co-repressor isoforms. This information will allow us to define further mechanisms underlying thyroid hormone resistance and thyroid hormone action, which will shed light on the basis of human hypothyroidism and hyperthyroidism. Moreover, an understanding of how TRs regulate gene transcription in the absence of ligand will provide further insight into the mechanisms of gene regulation in general. This project will be performed by Dr. Ronald Cohen under the guidance of Dr. Fredric Wondisford, in the Thyroid Unit and Endocrine Division of the Beth Israel Deaconess Medical Center. Dr. Wondisford has made major contributions to the understanding of the molecular mechanisms governing negative regulation of the TSH and TRH genes. There are also numerous investigators in the Endocrine Division and the surrounding Harvard Medical School community with interests in transcriptional regulation. This will provide an ideal environment to complete this project, and will provide a basis for Dr. Cohen's transition to an independent investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EXPERIMENTAL AUTOIMMUNE GRAVES' DISEASE Principal Investigator & Institution: Prabhakar, Bellur S.; Professor and Head; Microbiology and Immunology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2001; Project Start 01-JUN-1995; Project End 30-NOV-2003 Summary: Autoantibodies to the thyrotropin receptor can either activate thyroid gland causing hyperthyroidism or block TSH mediated activation of thyroid and cause hypothyroidism. Until several years ago, it was not possible to develop an animal mode due to the unavailability of large quantities of purified TSHR. Subsequent to cloning of human TSHR, several laboratories, including our own, have used human recombinant proteins to induce the disease in mice. These studies have provided new insights on the requirements for an optimal immune response to TSHR, resulting in thyroid perturbation. Earlier, we expressed the ectodomain of mouse TSHR (mTSHR) and showed that it is antigenically distinct from human TSHR. Recently, we expressed mTSHR on M12 cells (H-2D) and used them to immunize BALB/c mice. These mice showed significant TBII activity with concomitant raise in T4 levels. In the present study, we propose to use a soluble ectodomain of mTSHR and various cell lines expressing mTSHR, Class-II and Co-stimulatory molecules to define optimal conditions required to induce autoimmunity to TSHR. Sera will be tested for antibody production and hormonal perturbations, and thyroids will be evaluated for pathology and radioiodine uptake. We will carryout studies to evaluate the importance of CD4+ vs. CD8+ and Th1 vs. Th2 T cells. To do this, we will use selective depletion and adoptive transfer experiments, determine the relevance of cytokines, and test the ability of the protein to induce disease in Class-I and II, IFNgamma, and IL4 knockout mice available on BALB/c background. To define TSHR epitopes to which pathogenic antibodies bind, we will carryout epitope mapping studies. For this, we will employ recombinant fragments of TSHR, ectodomains of TSHR-LH/CGR chimeric proteins and cells

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expressing these chimeras. These proteins or their fragments will be tested in a number of different serological and bioassays. Together these studies are expected to allow establishment of an appropriate animal model to study autoimmunity to TSHR. Such a model would facilitate a thorough understanding of the regulation of the immune response to TSHR with implications for the development of novel therapeutics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EYE IN GRAVES DISEASE--ROLE OF ORBITAL FIBROBLASTS Principal Investigator & Institution: Bahn, Rebecca S.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2001; Project Start 01-AUG-1991; Project End 31-JUL-2004 Summary: Graves' ophthalmopathy (GO) is an autoimmune eye disorder closed associated with Graves' hyperthyroidsim. There is convincing experimental evidence that the orbital fibroblast (including the preadipocyte fibroblast subpopulation) is the target cell in GO. However, the autoantigen against which the immune response is directed is unknown. The thyrotropin receptor (TSHr) is a prime candidate to be the orbital autoantigen because its involvement would help to explain the close clinical and laboratory associations between GO and hyperthyroidism. In recent studies, the PI has demonstrated the present of TSHr mRNA and protein in orbital adipose/connective tissues from patients with GO, wile TSHr expression was not apparent in normal orbital tissues. In addition, she showed that orbital preadipocyte fibroblasts, cells lacking fucntional TSHr, can be differentiated in vitro into mature TSHr-bearing adipocytes. These and other findings led to hypothesize that: 1)expression of TSHr in the orbit in GO is linked to the induction of adipogenesis in orbital preadipocyte fibroblasts, and that; 2) the adipocyte TSHr is the orbital autoantigen recognized by orbital-infiltrating lymphocytes in GO. The PI plans to examine these hypotheses using our system of cultured orbital preadipocyte fibroblasts derived from pateints with GO. In specific aim I, she will define the fibroblast-like cells present in the orbit in GO and identify factors that modulate adipogenesis in these cells. Experiments in Aim II are designed to characterize the obital TSHr and to clarify the link between TSHr expression and adipogenesis in the orbi. In Aim III, she will determine whether cloned orbitalinfiltrating lymphocytes from patients with GO recognize TSHr, or other antigens that are processed "naturally" by autologous antigen-presenting cells. The main goal of the research program is to increase understanding of the orbital immune response in GO in order that novel and more specific therapeutic and preventive strategies for this condition might be developed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: FUNCTIONAL RESPONSES OF EXTRAOCULAR EYE MUSCLES TO T3 Principal Investigator & Institution: Rubinstein, Neal A.; Associate Professor; Anatomy; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-DEC-1997; Project End 31-MAR-2003 Summary: Thyroid dysfunction affects some 10 million Americans; and although the extraocular muscles (EOMs) are often involved in thyroid disease, little is known about the effects of T3 on the properties or development of EOM fibers. The effects of dysthyroidisms on the function of appendicular muscle fibers suggest that altered T3 levels should have profound influences on the performance of EOM fibers; however, there unique developmental origin, structural and functional properties and singular

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reactions to diseases suggest that EOMs have unique rules governing gene expression. T3 regulates the contractile properties of muscle fibers by differentially activating or repressing isoforms of the myosin heavy chains (MyHCs). The transcriptional control is mediated by the thyroid receptors (TRs) and the retinoid X receptors (RXRs) which themselves exist as multiple isoforms. Preliminary data, as well as susceptibilities to disease, suggest that the response of genes to T3 in EOMs will differ from that in other muscles. We hypothesize this differential response will be related to unusual distributions of TR and RXR isoforms among fibers; altered T3 levels will lead to the expression of inappropriate MyHC isoforms, abnormal contractile characteristics and impaired vision. Proving this hypothesis requires (a) determining which MyHC genes are expressed in each EOM fiber type during development and in the adult, (b) correlating the MyHC complement of each fiber to the contractile properties of that fiber, (c) determining whether hypo-and hyperthyroidism after the expression of MyHC genes and contractile properties, (d) discriminating the TR and RXR isoforms synthesized in euthyroid and pathological conditions. Studies will isoform-specific cRNA probes and antibodies will be combined with contractile measurements of individual skinned EOM fibers to accomplish these aims. To understand how the eye performs its repertoire of motions under both normal and pathological circumstances, one must understand the synthetic capacity of each fiber and how it defines the functional properties of each fiber. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENETIC BASIS OF ATRIAL FIBRILLATION Principal Investigator & Institution: Ellinor, Patrick T.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 15-JAN-2003; Project End 30-NOV-2007 Summary: (provided by the applicant): The candidate has a basic science background in cellular physiology and has recently completed medical residency, cardiology and electrophysiology fellowship training. He is currently a clinical research fellow and will join the staff of the Cardiology Division at Massachusetts General Hospital in July 2002. The candidate seeks to obtain formal training in clinical research methods while developing a research program to elucidate the molecular basis of atrial fibrillation. Atrial fibrillation is the most common significant arrhythmia, affecting over 2 million Americans. Although rare in youth, the prevalence of atrial fibrillation increases with age and afflicts one in ten individuals over eighty. Atrial fibrillation presents a considerable socioeconomic burden, associated with chronic medication use, nearly one fourth of all strokes in the elderly, and a reduced life expectancy in affected individuals. Most atrial fibrillation is considered secondary to other conditions such as hyperthyroidism, hypertension, cardiomyopathy or valvular disorder; however, a substantial minority of patients without obvious cause are said to have "!one" atrial fibrillation. The clinical heterogeneity of atrial fibrillation has restricted previous attempts to define the genetic etiology of this disorder. We therefore propose use of a complementary strategy of individuals and families to further define the clinical phenotypes, the genetic epidemiology, and the genetic basis of this disorder. Of patients with atrial fibrillation, we hypothesize that individuals with lone atrial fibrillation are the most likely to have a genetic component to their condition. We propose to prospectively study these individuals and their first-degree relatives in order to formally define the genetic architecture of atrial fibrillation while identifying larger kindreds suitable for positional cloning approaches. With this approach, we have characterized over one hundred probands with lone atrial fibrillation and identified

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multiple extended families with inherited atrial fibrillation. Further efforts to identify the causal genes are underway. Identification of these genes will permit definition of the molecular pathways that contribute to atrial fibrillation, while the availability of the probands will enable longitudinal studies using genotypes to predict outcomes and enable detailed evaluation of gene-gene and gene-drug interactions. The ultimate goal of these complementary strategies is to lead to novel therapeutic strategies for the prevention and treatment of this common and morbid condition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HORMONAL REGULATION OF FATTY ACID OXIDATION Principal Investigator & Institution: Park, Edwards A.; University of Tennessee Health Sci Ctr Health Science Center Memphis, Tn 38163 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2007 Summary: (provided by applicant): The metabolism of long chain fatty acids is profoundly altered in diabetes and hyperthyroidism. Carnitine palmitoyltransferase I (CPT-I) regulates the entry of long chain fatty acids into mitochondria and is a rate controlling step in the pathway of fatty acid oxidation. We have examined both the "liver" (CPT-Ialpha) and "muscle" (CPT-Ibeta) isoforms of CPT-I in the liver and heart respectively. Studies from our laboratory have demonstrated that CPT-Ialpha activity and gene expression are elevated in diabetes and hyperthyroidism. Our overall goal is to understand the mechanisms by which the expression of CPT-I gene isoforms and mitochondrial fatty acid oxidation are stimulated in these states. The peroxisomal proliferator activated receptor gamma coactivator-1 (PGC-1) is a transcriptional coactivator that promotes mitochondrial biogenesis. PGC-1 is expressed in metabolically active tissues such as the heart and liver. We propose to investigate the role of PGC-1 in the induction of CPT-I genes. Recently we have discovered that PGC-1 enhances CPTIalpha gene expression. In the liver, the abundance of PGC- 1 is increased in diabetes and by thyroid hormone (T3). In these studies, we will investigate the role of PGC-1 in regulating fatty acid oxidation and define the mechanisms through which PGC-I stimulates CPT-Ialpha gene expression. T3 is a key regulator of lipid metabolism. We have identified a thyroid hormone response element in the CPT-Ialpha promoter and discovered that elements within the first intron are crucial for liver specific induction by T3. We will define the unique role of the first intron in the T3 induction of CPT-Ialpha gene expression. Fatty acids are a primary source of energy for cardiac myocytes, and fatty acid oxidation is increased at the expense of glucose utilization in the diabetic heart. PGC-1 stimulates CPT-Ibeta gene expression. We will examine the mechanisms by which PGC-1 stimulates CPT-Ibeta gene expression in the heart. Disorders of lipid and glucose metabolism contribute to a number of clinical complications observed in diabetes and altered thyroid states. This proposal will examine novel molecular mechanism underlying alterations in the gene expression of critical enzymes in the mitochondrial pathway of beta-oxidation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IDENTIFYING GENES LINKED TO AUTOIMMUNE THYROID DISEASES Principal Investigator & Institution: Tomer, Yaron; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007

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Hyperthyroidism

Summary: (provided by applicant) The autoimmune thyroid diseases (AITD) are very common with a prevalence of - 5 percent. They include Hashimoto's thyroiditis (HT), which manifests by hypothyroidism, and Graves disease (GD), which causes hyperthyroidism. The mechanisms initiating the AITD are not completely understood. Abundant data point to a genetic susceptibility to AITD, and the applicant, has identified linkages for several AITD susceptibility loci. In the past four years we have performed genome scans on two data sets of multiplex families (102 families, 540 individuals), and mapped 8 loci showing evidence for linkage with AITD. In two of the loci we identified and investigated putative AITD susceptibility genes (CTLA-4 and CD4O}. The focus of the current proposal is four of the eight loci which showed the strongest evidence for linkage with AITD. The goals of our study are to identify and characterize the AITD susceptibility genes in these four loci. The specific aims of the proposed study are: 1) To resolve the genetic heterogeneity in our families at the 4 linked loci which are the focus of our studies. At all 4 loci the linkage analysis showed evidence of heterogeneity and resolving it will facilitate identification of the AITD susceptibility genes. We will subdivide the families according to various parameters (e.g. age of onset of disease), analyze these subsets separately for linkage with the four loci, and apply the Predivided-Sample Test. Resolving heterogeneity and identifying subsets of families that are uniformly linked with these loci will amplify the power of the subsequent single nucleotide polymorphism (SNP) and fine mapping analyses (Specific Aims 2 & 3); 2) To analyze two important genes (thyroglobulin and TGFBeta3 which are located at 2 of the linked loci, and are themselves linked and associated with AITD. We will analyze the sequences of the thyroglobulin and TGF-Beta3 genes in order to identify disease-specific SNP's; 3) To fine map two additional linked loci and narrow the linked regions in order to determine appropriate candidate genes for future analyses. We have the capacity and experience to perform these studies. Our flexible relational database (lngresTM) facilitates complex linkage and association analyses. We use two ABI-310 sequencers for genotyping and sequencing, and we have experience at SNPing genes and fine mapping linked regions. We expect that these studies will lead to the identification of gene sequence variations contributing to the expression of AITD. This will allow us to understand the mechanisms initiating these diseases, and hopefully will lead to the development of new therapies targeted at the mechanisms initiating AITD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPACT OF HYPERTHYROIDISM ON SKELETON, MUSCLE STRUCTURE AND FUNCTION Principal Investigator & Institution: Brennan, Michael; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2001 Summary: Clinically apparent muscle weakness and wasting occur commonly in hyperthyroidism. In order to assess the independent contributions to skeletal muscle weakness of both muscle wasting and qualitative changes in muscle contraction, we studied muscle strength and volume in a cohort of hyperthyroid patients. Data regarding the response of these paremters to normalization of serum thyroid hormone levels is currently available in 10 female patients (median age 39 yrs; range 17-92 yrs). Initial measurements were performed prior to treatment of hyperthyroidism. Repeat measurements were made within 6-9 months of the patients achieving a euthyroid state. Muscle strength was determined by Cybex II dynamometric assessment of knee flexion and extension. Lower extremity total muscle volume was measured by dual photon x-

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ray absorptiometry (Lunar DPX-L) and mid-thigh muscle cross sectional area was quantitated by computerized axial tomography. Treatment of hyperthyroidism and restoration of a euthyroid state resulted in mean increases of 10% in thigh muscle cross sectional area (range 1-32%) and 12% in total lower extremity muscle volume (range 131%). Mean thigh muscle strength increased by 57% (range 5-197%). Mean muscle efficiency, defined as the force of muscle contraction per unit of muscle volume (Nm/cm2) is increased by 48% (range 4-183%). This finding suggests that qualitative changes in the force of contraction result in decreased muscle efficiency. Responsible mechanisms remain to be fully elucidated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INTACT AND SCID MOUSE MODELS FOR GRAVES' DISEASE Principal Investigator & Institution: Davies, Terry F.; Professor; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2001; Project Start 01-JAN-1993; Project End 31-AUG-2003 Summary: (Adapted from the applicant's abstract) This is a competing renewal application, seeking support to continue work with models of murine Graves' disease. Two murine models will be explored: 1) A homologous TSHR immunization model. This version of the Shimojo model uses, instead of immunization with hTSHRtransfected fibroblasts, a homologous system of cell surface-expressed mouse TSHR. 2) A transgenic approach to a Graves' disease model. This model involves the scid/scid transgenic mouse expressing human rather than murine TSHR antigen. These scidhTSHR mice will be injected with intrathyroidal lymphocytes and engrafted with thyroid tissue from patients with Graves' disease, allowing the human TSHR-Abs to interact with the transgenic human TSHR and induce thyroid overactivity. The applicant believes that the development of both an intact mouse model for Graves' disease as well as the reproduction of the human disease in scid mice will allow a series of interventional procedures to be developed to further the understanding of autoimmune thyroid disease and will provide potential therapeutic approaches to human ATD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MECHANISM OF ACTION OF THYROID HORMONE RECEPTORS Principal Investigator & Institution: Koenig, Ronald J.; Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-JUL-1991; Project End 30-JUN-2004 Summary: The overall goal is to increase our understanding of how thyroid hormone (T3) regulates gene expression. T3 binds to receptors (TRs), which bind to T3 response elements (TREs) in specific target genes. TREs generally consist of two (or more) binding sites (half sites) arranged as a direct repeat, inverted repeat, or everted repeat. TRs can bind to TREs as homodimers or as heterodimers with retinoid X receptors (RXRs); the relative biological importance of each of these dimer forms is uncertain. TRs regulate transcription via two domains, AF-1 and AF-2. The function of AF-1 is poorly understood. AF-2 functions by interacting with other proteins, generally known as coactivators and corepressors. T3 alters the conformation of the TR, thereby affecting which proteins interact with this receptor. Our data suggest that certain genes are regulated by TR homodimers and others by RXR-TR heterodimers, and that this is determined by the sequence of the TRE. In addition, our data suggest that TR

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homodimers and RXR-TR heterodimers have different coactivator requirements, and that half site orientation further influences coactivator requirements. These issues will be studied in yeast and in mammalian cells. Yeast are uniquely valuable because they lack the above proteins. Hence, TR, RXR, and various coactivators can be added back in defined ways to determine their effects on gene expression. Additionally, yeast are amenable to genetic manipulations that are essentially impossible in mammalian cells. However, confirmation of the findings in yeast must be made in mammalian cells, to demonstrate biological relevance. Three specific aims will be addressed: 1) Assess the mechanism of coactivator-independent (AF-1) TR function in yeast; 2) Assess the role of TRE structure and homodimers versus heterodimers in defining coactivator requirements in yeast; 3) Determine whether the key findings in the above aims apply to mammalian cells. The results should further our understanding of how T3 affects a broad range of metabolic processes in health and disease states such as hyperthyroidism and hypothyroidism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MENTORED DEVELOPMENT AW

PATIENT-ORIENTED

RESEARCH

CAREER

Principal Investigator & Institution: Liu, Zhenqi M.D.; Medicine; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2005 Summary: (Adapted from the applicant's abstract): Many disease states, including glucocorticoid excess and hyperthyroidism, are associated with accelerated protein catabolism, causing chronic muscle wasting and increasing morbidity and mortality. The exact cellular mechanisms responsible remain elusive. One of the possible mechanisms is glucocorticoid- or thyroid hormone-induced resistance to the anabolic agents in skeletal muscle. Insulin, branched chain amino acids (BCAA), balanced amino acid (AA) mixtures and insulin-like growth factor 1 (IGF-1) all have been demonstrated to retard proteolysis and/or enhance protein synthesis. The investigators propose to study the muscle's response to these four anabolic agents in the setting of acute and chronic glucocorticoid and thyroid hormone excess. The studies will be conducted in healthy human subjects with or without dexamethasone or triiodothyronine ingestion and patients with Cushing's syndrome or hyperthyroidism by examining: a) protein turnover in forearm muscle; b) the phosphorylation status of two key regulatory proteins involved in signaling mRNA translation (PHAS-I and p70 S6 kinase); and c) the activity, protein content and expression of several components in the ubiquitinproteasome proteolytic pathway. The results should help to define the mechanisms of accelerated proteolysis associated with glucocorticoid or thyroid hormone excess. They will define: l) whether insulin, BCAA, AA mixtures and IGF-1 increase protein synthesis by stimulating phosphorylation of two key regulatory proteins involved in the protein translation initiation (PHAS-I and p70 S6 kinase); 2) whether insulin, BCAA, AA mixtures and IGF-1 retard proteolysis via blocking the ubiquitin-proteasome proteolytic pathway; and 3) whether glucocorticoid or thyroid hormone excess activates the ubiquitin- proteasome pathway and antagonizes the anabolic actions of insulin, BCAA, AA mixtures and IGF-1. By understanding the cellular mechanisms underlying the accelerated muscle catabolism and the actions of four anabolic agents in muscle, it may be possible to correct the protein wasting and to decrease the associated morbidity and mortality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: METABOLIC DERANGEMENTS IN THYROID DISEASE Principal Investigator & Institution: Haugen, Bryan R.; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MODULATION OF AN ANIMAL MODEL OF HYPERTHYROIDISM Principal Investigator & Institution: Mclachlan, Sandra M.; Professor; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 90048 Timing: Fiscal Year 2001; Project Start 15-FEB-1999; Project End 31-DEC-2002 Summary: Graves' hyperthyroidism, a very common autoimmune disorder affecting primarily women, is caused by TSH receptor (TSHR) autoantibodies that mimic the action of TSH. Very recently, the first animal model has been developed with the hallmarks of Graves' hyperthyroidism. We now propose to use this "Chiba" model to investigate several critical issues in Graves' disease, including exploration of approaches for immune intervention. 1. Addressing critical issues in Graves' disease:- The Chiba mouse model will be used to study the role of thyroid peroxidase (TPO) antibodies (common in Graves' disease), TSHR intramolecular cleavage, gender and iodide ingestion on development and course of hyperthyroidism 2. TSHR Antibody characterization:- TSHR antibodies arising in the Chiba mouse model will be characterized by approaches used for human TSHR autoantibodies, including:- (i) functional assays for TSH binding inhibition (TBI), thyroid stimulating immunoglobulin (TSI) and antibodies that block the biological action of TSH (TSBAb), (ii) epitopes and (iii) flow cytometry with intact cells to examine binding of non-functional TSHR antibodies. 3. TPO antibody characterization:- We will determine whether TPO antibodies in the Chiba model resemble human autoantibodies in terms of their:- (i) affinities, (ii) preferential recognition of native TPO and, (iii) preferential interaction with epitopes in the immunodominant region recognized by human TPO autoantibodies. 4. T Cell responses to TSHR antigen:- With the Chiba model of Graves' disease, we will:- (i) study the role of T cells in providing help in the generation of functional TSHR antibodies, (ii) determine the cytokines secreted by TSHR-specific T cells and, (iii) determine if the proliferative response of TSHR-specific T cell clones will vary depending on the antigen presenting cell (macrophages, B cells or syngeneic TSHRexpressing fibroblasts) 5. Intervention in the immune response in the Chiba model:- The Chiba model now makes feasible studies on the immunotherapy of hyperthyroidism in these animals, a long road that may ultimately provide the basis for immune intervention in human disease. We propose to examine the effect of second signal blockade (anti-CD40L) as a means to:- (i) Prevent the induction of disease and reverse the course of established disease and, (ii) Target a specific antigen (TSHR), rather than employing blanket suppression of the immune response. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NADPH P450 REDUCTASE--THYROID HORMONE REGULATION Principal Investigator & Institution: Waxman, David J.; Professor of Cell and Molecular Biology; Biology; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2003

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Hyperthyroidism

Summary: (Adapted from the Investigator's Abstract) NADPH-cytochrome P450 reductase (P450 reductase) is a microsomal flavoprotein that transfers electrons from NADPH to microsomal cytochrome P450. It is expressed in liver and many extrahepatic tissues and is an obligatory, often rate-limiting component of microsomal P450-linked carcinogen activation and drug and alcohol metabolism reactions. While the influence of endogenous regulators on individual P450 enzymes and their genes have been studied extensively, much less is understood about the regulation of P450 reductase by endogenous hormonal factors. Studies carried out using the rat model have established that normal, physiological levels of thyroid hormone are required for full expression of hepatic P450 reductase mRNA, protein and enzyme activity, as well as P450 reductasedependent xenobiotic metabolism. Moreover, while enhanced gene transcription was found to contribute to the thyroid hormone-dependent expression of P450 reductase mRNA, post-transcriptional mechanisms are key to the regulation of P450 reductase protein and activity. The studies described in this new grant application are designed to elucidate the post-transcriptional regulatory mechanisms by which thyroid hormone modulates P450 reductase expression under conditions of hyperthyroidism and hyperthyroidism, and to evaluate the implications of this modulation for P450 reductase-catalyzed quinone and carcinogen activation via redox cycling. The major goals of this proposal are (a) to elucidate the post-transcriptional mechanisms through which thyroid hormone regulates liver P450 reductase mRNA expression, (b) to characterize the role of thyroid hormone in the translational and post-translational control of P450 reductase protein and activity, and (c) to evaluate the effects of thyroid hormone-dependent alterations in cellular P450 reductase activity on the metabolism and redox cycling of quinones, catechols and related carcinogens, and to elucidate the impact on the cell's adaptive response to oxidative stress. The detailed understanding of the multiple actions of thyroid hormone on P450 reductase expression and foreign chemical metabolism provided by these studies will help elucidate some of the underlying mechanisms through which hormonal environment can influence xenobiotic-induced redox cycling, and may ultimately help to identify individuals who are more susceptible to oxidative stress as a consequence of alterations in thyroid hormone status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DISEASE

NEUROCOGNITIVE EFFECTS OF

SUBCLINICAL THYROID

Principal Investigator & Institution: Samuels, Mary H.; Associate Professor of Medicine; Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): This Pilot and Feasibility Program (R-21) application represents a new research direction for the investigator, Dr. Mary Samuels, in the field of cognitive effects of mild (or "subclinical") thyroid disease in the adult human. 5% of the general population has subclinical thyroid disease, as defined by isolated TSH abnormalities, and 20% of older women have mild hypothyroidism (isolated TSH elevations). Therefore, the question of whether subclinical thyroid disease alters cognition has important public health implications. If subclinical thyroid disease were associated with cognitive deficits, this would be an important treatment indication. This is especially relevant to the older population, which has high rates of incipient dementia that could be worsened by the addition of cognitive deficits due to mild thyroid disease. In order to investigate this question, the investigator has designed a new model of experimentally-induced subclinical thyroid disease, and proposes a series of

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experiments to test and refine this model. Subjects who are currently taking L-thyroxine (L-T4) for chronic replacement therapy will be randomized to their usual doses of L-T4, vs. slightly lower doses (to induce mild subclinical hypothyroidism), or slightly higher doses (to induce mild subclinical hyperthyroidism). Treatment assignment is randomized, placebo-controlled, and double-blinded. Each treatment arm is designed to last 3 months. At the beginning and end of each arm, a battery of cognitive tests is administered. The specific cognitive outcome measures have been chosen to target cognitive domains most likely to be affected by mild thyroid disease. Throughout the studies, subjects are also monitored for safety, quality of life, mood, and other effects of altered thyroid function. The broad specific aims of this application are: 1) To develop and refine a model of experimentally-induced subclinical thyroid disease by testing dose increments of L-T4 in subjects receiving L-T4 replacement therapy; 2) To utilize the model to obtain pilot data on cognitive effects induced by subclinical hypothyroidism in younger and older human subjects; and 3) To utilize the model to obtain pilot data on cognitive deficits induced by subclinical hyperthyroidism in older subjects. Based on these pilot studies, it is the long-term goal of the investigator to investigate specific cognitive effects of altered thyroid status in the adult human. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NONTHYROIDAL SERUM MARKERS THYROGLOBULIN IN THYROID SUPPRESSION

VS

TSH

AND

Principal Investigator & Institution: Spencer, Carole A.; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATHOLOGIC ALTERATIONS OF THYROID FUNCTION Principal Investigator & Institution: Foley, Thomas P.; Children's Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, Pa 15213

Hosp

Timing: Fiscal Year 2001 Summary: Determine etiology and pathogenesis of abnormal thyroid hormone metabolism or secretion in Grave's Disease, Hashimoto's Disease, and congenital hypothyroidism. Hormonal homeostasis is assessed during hypo and hyper- thyroidism to determine the role of altered thyroid hormone secretion in metabolic homeostasis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSIOLOGY OF THYROID HORMONE DEPENDENT GENE EXPRESSION Principal Investigator & Institution: Larsen, Philip R.; Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 15-JAN-1992; Project End 31-MAR-2006 Summary: (Scanned from the applicant's abstract) Our laboratory has focused on the mechanisms regulating triiodothyronine (T3) homeostasis for over 25 years. Critical to this process are the actions of the iodothyronine deiodinases which function in concert to regulate thyroxine (T4) activation and the inactivation of T4 and T3. This proposal continues this theme. In the first Specific Aim we will continue our investigations of a cell type specific negative thyroid hormone response element (nTRE) in the promoter of

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the human Type 1 deiodinase (Dl) gene. This thyroid receptor (TR) binding sequence also binds a novel JEG cell transcription factor (JTF) with high affinity and specificity. JTF increases expression of genes containing this sequence and this effect is enhanced by APO-TRs. T3 eliminates this effect. Using DNA affinity matrix techniques we will isolate and identify this newly discovered protein and determine how TR cooperates with it as an example of a specific mechanism for negative regulation of gene expression by thyroid hormone. Uncontrolled, rapid inactivation of thyroid hormone causes hypothyroidism in a syndrome which we recently identified in infants with large hemangiomas. Infantile hemangiomas express Type 3 iodothyronine deiodinase (D3), the major physiological inactivator of 13 and 14, at levels up to 8-fold that in placenta. Large tumors can deiodinate T4 and T3 more rapidly than the infant's thyroid can secrete them. Specific Aim 2 will elucidate the mechanism for ectopic expression of D3 in these tumors. We will compare hemangioma-derived and normal human capillary endothelial cells to discover pathways which could activate D3 expression analogous to those in placenta. Specific Aim III is to define the mechanism for the myocardial response of the euthyroid heart to the thyrotoxic state such as occurs in patients with hyperthyroidism. We have developed a novel method for inducing chronic myocardial thyrotoxicosis in mice by use of a transgene in which Type 2 iodothyronine deiodinase (D2) is driven by the alpha-MHC promoter. We will first define the mechanism for the two-fold increase in the cAMP response to forskolin in myocardial membranes from these transgenic mice. We will also document the differences n gene expression profiles between euthyroid and thyrotoxic myocardium from both young and old mice. Only a few genes have been identified which increase their expression significantly between the euthyroid and hyperthyroid state. Identifying such genes in the myocardium will be especially critical to the understanding of the effects of T3 excess on the heart in human hyperthyroidism. These studies will provide new information relevant to both basic and clinical thyroid physiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RADIOIODINE TREATMENT AND GRAVE'S DISEASE Principal Investigator & Institution: Sisson, James C.; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 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: REGULATION OF UCP3 ACTIVITY AND EXPRESSION IN MUSCLE Principal Investigator & Institution: Petersen, Kitt F.; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001 Summary: To examine the effects of fasting, moderate hyperthyroidism and fatty acid induced insulin resistance on Uncoupling Protein 3 (UCP-3) nRNA and protein content as well as the metabolic activity of UCP-3 in muscle. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SIMPLIFIED LOW IODINE DIET FOR I 131 RADIOIODINE DIAGNOSTIC IMAGING Principal Investigator & Institution: Lee, Stephanie; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001 Summary: Radioactive iodine is used for the diagnosis of distant and local metastases of thyroid cancer and therapy of thyrotoxicosis and thyroid cancer. Because of the high iodine content of the American diet, the efficacy of radioiodine is diminished unless that patient is placed on a strict low iodine diet. This diet which consists of freshly prepared meals and homemade breads and pastas is nearly impossible to follow with the American dietary habits of eating in restaurants and using convenience foods. After review of the iodine content of currently available foods, the objective of this study is to develop and test a convenient and palatable out-patient diet to decrease iodine intake and excretion to less than 50mcg/24hrs in normal volunteers and patients undergoing routine radioactive iodine diagnostic scanning or therapy for thyrotoxicosis and thyroid cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SYNTHESIS OF NEW LIGANDS FOR NUCLEAR THYROID HORMONE RECEPTOR Principal Investigator & Institution: Chiellini, Grazia; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001 Summary: We have recently designed and synthesized a TR ligand (GC-1) representative of a new class of thyromimetics that has several synthetic advantages over traditional thyromimetics and interesting, potentially useful, thyromimetic properties. Currently, no high affinity antagonist is known for TR, but such a ligand could prove very useful in medicine for treatment of hyperthyroidism and, possibly, cardiac arrhytmia, as well as the study of thyroid hormone signaling pathways. A comparison of the structures of many nuclear receptor agonists and antagonists shows an interesting trend: the antagonists all have the general skeleton of the corresponding agonists plus a large "extension" protruding from the approximate center of the molecule. The recently solved crystal structures of the estrogen receptor complexed with the ER agonist estradiol and with the antagonist raloxifene show that, as a result of the presence of the extension, raloxifene binding impairs receptor folding and prevents the agonist-induced conformational changes in the receptor. The GC-1 thyromimetic scaffold is well suited to generate analogues, several sites are especially amenable of derivatization chemistry. The crystal structures of the ligand binding domains of both TR subtypes (alpha and beta) have been solved. Visual inspection of these structures with the program MidasPlus and using the Computer Graphics Laboratory facilities play an essential role in our effort to make a TR antagonist. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: THYROID ACTION IN THE HEART Principal Investigator & Institution: Dillmann, Wolfgang H.; Professor; Medicine; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2003; Project Start 01-MAY-1979; Project End 31-AUG-2007

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Hyperthyroidism

Summary: (provided by applicant): Thyroid hormone (T3) markedly influences the contractile and electrophysiological function of the heart. Recent results from T3 receptor (TR) knockout (KO) mice indicate that TR alpha KO mice have decreased contractile function and heart rate but TR beta KO mice have normal cardiac function. TR alpha 1 is the predominant TR isoform (TRI) in the heart and the TR alpha KO cardiac phenotype could therefore result from quantitative and overlapping or unique qualitative TR alpha 1 effects. In Aim I we will explore the quantitative and/or qualitative nature of the TR isoform effects on the heart in rescue type of experiments using viral vectors, crosses of TRI KO mice with TRI transgenic mice and TR alpha and TR beta gene promoter knock in mice expressing tagged TR alpha 1 or TR beta 1 in cardiac myocytes. Contractile function and gene expression profiles using conventional mRNA quantitation and DNA microarrays will be determined. In addition we will use TR alpha exon 3 LoxP floxed mice, which allow for myocyte specific inducible deletion of TR alpha, to determine developmental influences and effects of other organs on cardiac function. We recently generated these mice. In Aim II we will determine in wild type mice with pressure overload induced heart failure (HF) exhibiting decreased TR and T3 levels if the diminished contractile phenotype can be rescued using viral vector or transgenic animal based TR alpha 1 or TR beta 1 substitution in combination with TR ligands. With adequate rescue by TR beta 1 novel T3 analogues, with preferred TR beta 1 binding like GC1, can be used which have markedly diminished effects on heart rate compare to T3, potentially allowing for contractile rescue without unwanted electrophysiological effects. These studies will provide new insights into a specific type of non-thyroidal illness syndrome resulting from HF which presents a very significant medical problem. In Aim III the basis for T3 mediated increased in heart rate will be explored by identifying T3 responsive pacemaker ion channels in the sinus node. In addition the mechanisms underlying hyperthyroidism induced atrial fibrillation will be determined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THYROID HORMONE RECEPTOR Principal Investigator & Institution: Baxter, John D.; Professor and Director of Medicine; Metabolic Research Unit; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2002; Project Start 01-AUG-1989; Project End 31-MAR-2007 Summary: Nuclear receptor genes comprise a large family and encode receptors for thyroid and steroid hormones, vitamin D, retinoids, prostaglandins, and other ligands. These receptors regulate most human processes and are important pharmaceutical targets. The receptors contain amino-terminal, DNA-binding and ligand-binding (LBD) domains. Ligand-induced receptor conformational changes induce receptor activities that regulate transcription. Receptors mediate effects through interactions with other proteins, including coactivators and heterodimerizing partners. Central to understanding receptor actions is knowing their atomic structures. The Principal Investigator and colleagues first solved the X-ray structure of a liganded nuclear receptor LBD, that of the thyroid hormone receptor- alpha (TRalpha) that revealed insights into receptor function, and subsequently solved other structures, including TRalpha LBD bound to several ligands, human (h) TRbeta bound to agonists, including one that is TRbeta-selective, hTRbeta bound to a coactivator peptide and mutated hTRbeta forms that cause thyroid hormone resistance. These structures have revealed more information about receptor function, have been useful for designing a ligand that selectively modulates hTRbeta bound to a coactivator peptide and mutated hTRbeta

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forms that cause thyroid hormone resistance. These structures have revealed more information about receptor function, have been useful for designing a ligand that selectively modulates hTRbeta thyroid hormone response sand may be a prototype drug for treating obesity and hypercholesterolemia, and for designing thyroid hormone antagonists that may be prototypes for treating hyperthyroidism. In the proposed studies it is planned to determine the X-ray crystal structure of the hTRbeta PBD bound to several different ligands that perturb the structure in different ways, hTRbeta complexed with a retinoid X-receptor (RXR) heterodimerizing partner, and liganded hTRbeta LBD complexed with a novel coactivator peptide and a cyclized high affinity binding coactivator peptide. It is also planned to determine X-ray structures of RXR and TR DBD-LBD proteins and the full-length TR. The new structures should provide information about hormone-induced conformational changes, mechanisms of receptor interaction with other protein, the multiple receptor domains, and relations between domains. The results should yield insights into TR function and how ligands act as agonists or antagonist, are applicable to nuclear receptors in general, and may facilitate pharmaceutical design. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THYROTOXICOSIS MAY BE ASSOCIATED W/ VITAMIN B & FOLATE DEFICIENCIES Principal Investigator & Institution: Colleran, Kathleen; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TSH HYPERSECRETION IN WKY: POSITIONAL CANDIDATE ANALYSIS Principal Investigator & Institution: Baum, Amber E.; Psychiatry and Behavioral Scis; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2004 Summary: (provided by applicant): The high comorbidity between hypo- and hyperthyroidism and depressive disorders illustrates the influence of hypothalamicpituitary-thyroid (HPT) axis function on behavior. The inbred Wistar-Kyoto (WKY) rat strain has persistently elevated TSH despite elevated thyroid hormone levels and normal negative feedback to the pituitary. Also, WKY are hypoactive in a variety of behavioral tests, including the open-field test. The strain is thus an excellent model for dissecting the relationships between multigenic behavioral traits and complex hormonal control systems using forward genetics. Genetic architectures of these traits will be investigated with quantitative trait locus (QTL) analysis. An F2 intercross population has been created from reciprocal crosses between WKY and the genetically, hormonally and behaviorally polymorphic Fischer-344 strain. The WKYxF344 F2 generation is sufficient to segregate phenotypic traits and create a linkage map to perform a QTL analysis. By demonstrating an association between an extreme expression of these phenotypes and marker alleles whose genetic map position is known, loci will be mapped to specific regions of individual chromosomes, and commonalities between the behavioral and hormonal traits? genetic architectures will be revealed. Significant loci of interest will be introgressed into congenic strains using marker-and phenotype-assisted selection, which will confirm the locus? role in the phenotype and permit its further

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analysis in isolation from other segregating loci that may modify its expression. The loci will also be analyzed using a positional candidate approach utilizing homology maps linking rat, mouse and human genomes. These experiments will contribute to the understanding of HPT regulation, and also illuminate any genetic links that may exist between these phenotypes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VACCINE THERAPY OF CONGENITAL ADRENAL HYPERPLASIA Principal Investigator & Institution: Rivkees, Scott A.; Associate Professor; L2 Diagnostics, Llc Box 8175 New Haven, Ct 94904 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): Congenital virilizing adrenal hyperplasia (CAH) is caused by impaired adrenal steroidogenesis that results in reduced production of cortisol and aldosterone, and excessive production of androgens. Whereas there are consequences of reduced cortisol and aldosterone production, increased androgen is responsible for most of the adverse effects of this condition. In normal conditions and in CAH, excessive androgen production is regulated by pituitary ACTH, which acts via the melanocortin-2 receptor (MC2R) in the adrenal gland to stimulate steroid production. If activation of the MC2R can be inhibited, adrenal activity in CAH will be markedly reduced and management optimized. In this application we propose the development of a novel immunological approach for inducing adrenal insufficiency in patients with CAH by making a vaccine that inhibits ACTH-mediated activation of the MC2R. This application is based on preliminary studies showing that antibodies to the MC2R inhibit the ability of ACTH to activate MC2R function in adrenal cells. We also find that immunizing mice with synthetic peptides that correspond to small regions of the MC2R induces an immune response against the MC2R. Based on these observations, we hypothesize that it is possible to develop a "vaccine" against the MC2R that blocks ACTH action. We also hypothesize that a vaccine against the MC2R will lead to improved treatment of CAH, To test these hypotheses we propose to (1) induce immunity against the MC2R by immunizing mice with modified peptides. (2) Determine if vaccinating mice with modified MC2R peptides leads to adrenal insufficiency. We anticipate that these studies will lead to the development of a novel approach for treating patients with CAH. If these phase I studies are effective, phase II studies will focus on preclinical trials in non-human primates. We also anticipate being able to extend this novel approach to the treatment of other receptor-mediated endocrine disorders, such as hyperthyroidism. 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

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.

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unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “hyperthyroidism” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for hyperthyroidism in the PubMed Central database: •

A mathematical model of optimized radioiodine-131 therapy of Graves' hyperthyroidism. by Doi SA, Loutfi I, Al-Shoumer KA.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=56607

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Recurrent hamburger thyrotoxicosis. by Parmar MS, Sturge C.; 2003 Sep 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=183292

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Soluble interleukin-2 receptor is a thyroid hormone-dependent early-response marker in the treatment of thyrotoxicosis. by Smallridge RC, Tsokos GC, Burman KD, Porter L, Cranston T, Sfikakis PP, Solomon BL.; 1997 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=170601

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Thyrotoxicosis Induced by Thyroid Involvement of Disseminated Aspergillus fumigatus Infection. by Hornef MW, Schopohl J, Zietz C, Hallfeldt KK, Roggenkamp A, Gartner R, Heesemann J.; 2000 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=86235

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

A case of TSH receptor antibody-positive hyperthyroidism with functioning metastases of thyroid carcinoma. Author(s): Ishihara T, Ikekubo K, Shimodahira M, Iwakura T, Kobayashi M, Hino M, Oobayashi M, Kohno K, Kimura K, Kawamura S, Kurahachi H. Source: Endocrine Journal. 2002 April; 49(2): 241-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081245&dopt=Abstract

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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A novel germline mutation in the TSH receptor gene causes non-autoimmune autosomal dominant hyperthyroidism. Author(s): Alberti L, Proverbio MC, Costagliola S, Weber G, Beck-Peccoz P, Chiumello G, Persani L. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 September; 145(3): 249-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11517004&dopt=Abstract

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A novel murine model of Graves' hyperthyroidism with intramuscular injection of adenovirus expressing the thyrotropin receptor. Author(s): Nagayama Y, Kita-Furuyama M, Ando T, Nakao K, Mizuguchi H, Hayakawa T, Eguchi K, Niwa M. Source: Journal of Immunology (Baltimore, Md. : 1950). 2002 March 15; 168(6): 2789-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11884447&dopt=Abstract

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A novel mutation in the mitochondrial 16S rRNA gene in a patient with MELAS syndrome, diabetes mellitus, hyperthyroidism and cardiomyopathy. Author(s): Hsieh RH, Li JY, Pang CY, Wei YH. Source: Journal of Biomedical Science. 2001 July-August; 8(4): 328-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11455195&dopt=Abstract

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A Phe 486 thyrotropin receptor mutation in an autonomously functioning follicular carcinoma that was causing hyperthyroidism. Author(s): Camacho P, Gordon D, Chiefari E, Yong S, DeJong S, Pitale S, Russo D, Filetti S. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 November; 10(11): 1009-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11128715&dopt=Abstract

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A prospective controlled study of the impact of hyperthyroidism on reproductive function in males. Author(s): Krassas GE, Pontikides N, Deligianni V, Miras K. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 August; 87(8): 3667-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161493&dopt=Abstract

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A randomized comparison of radioiodine doses in Graves' hyperthyroidism. Author(s): Leslie WD, Ward L, Salamon EA, Ludwig S, Rowe RC, Cowden EA. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 March; 88(3): 97883. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629071&dopt=Abstract

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A randomized controlled trial to evaluate the adjuvant effect of lithium on radioiodine treatment of hyperthyroidism. Author(s): Bal CS, Kumar A, Pandey RM. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 May; 12(5): 399-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097201&dopt=Abstract

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A rare coexistence of primary hyperparathyroidism and hyperthyroidism due to toxic nodular goiter--a case report. Author(s): Bolko P, Jaskula M, Wasko R, Bednarek J, Sowinski J. Source: Pol Arch Med Wewn. 2003 February; 109(2): 165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12879780&dopt=Abstract

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Acute bulbar muscle dysfunction in hyperthyroidism. Author(s): Garzon R, Murphy JM. Source: Conn Med. 2002 January; 66(1): 3-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11852735&dopt=Abstract

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Acute psychotic state due to hyperthyroidism following excision of a mandible bone tumor: a case report. Author(s): Yang SJ, Wang SY, Chen CC. Source: Kaohsiung J Med Sci. 2003 January; 19(1): 29-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12693723&dopt=Abstract

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Adjuvant effect of lithium on radioiodine treatment of hyperthyroidism. Author(s): Bogazzi F, Bartalena L, Pinchera A, Martino E. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 December; 12(12): 1153-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593732&dopt=Abstract

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Adverse effects of subclinical hyperthyroidism. Author(s): Fatourechi V. Source: Lancet. 2001 September 15; 358(9285): 856-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11567696&dopt=Abstract

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Amiodarone induced hyperthyroidism. Author(s): Sinha MK, Kuriakose B, Aggarwal RK. Source: Postgraduate Medical Journal. 2001 May; 77(907): 358. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11351981&dopt=Abstract

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Amiodarone-induced hyperthyroidism. Author(s): Goichot B, Grunenberger F, Schlienger JL. Source: Archives of Internal Medicine. 2001 January 22; 161(2): 295. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11176750&dopt=Abstract

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An activating mutation of the thyrotropin receptor gene in hereditary nonautoimmune hyperthyroidism. Author(s): Lee YS, Poh L, Loke KY. Source: J Pediatr Endocrinol Metab. 2002 February; 15(2): 211-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874187&dopt=Abstract

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Anti-neutrophil cytoplasmic autoantibody (ANCA) profiles in propylthiouracilinduced lupus-like manifestations in monozygotic triplets with hyperthyroidism. Author(s): Herlin T, Birkebaek NH, Wolthers OD, Heegaard NH, Wiik A. Source: Scandinavian Journal of Rheumatology. 2002; 31(1): 46-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11924649&dopt=Abstract

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Association of hyperthyroidism with serum leptin levels. Author(s): Nakamura T, Nagasaka S, Ishikawa S, Hayashi H, Saito T, Kusaka I, Higashiyama M, Saito T. Source: Metabolism: Clinical and Experimental. 2000 October; 49(10): 1285-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11079817&dopt=Abstract

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Association of the vitamin D receptor genotype BB with low bone density in hyperthyroidism. Author(s): Obermayer-Pietsch BM, Fruhauf GE, Chararas K, Mikhail-Reinisch S, Renner W, Berghold A, Kenner L, Lackner C. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2000 October; 15(10): 1950-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11028447&dopt=Abstract

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Autoimmune hyperthyroidism in multiple sclerosis under treatment with glatiramer acetate--a case report. Author(s): Heesen C, Gbadamosi J, Schoser BG, Pohlau D. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2001 March; 8(2): 199. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11285002&dopt=Abstract

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Autoimmune hyperthyroidism in two adolescents with DiGeorge/velocardiofacial syndrome (22q11 deletion). Author(s): Segni M, Zimmerman D. Source: European Journal of Pediatrics. 2002 April; 161(4): 233-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12014397&dopt=Abstract

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Bilateral gynaecomastia as the primary complaint in hyperthyroidism. Author(s): Tan YK, Birch CR, Valerio D. Source: Journal of the Royal College of Surgeons of Edinburgh. 2001 June; 46(3): 176-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11478017&dopt=Abstract

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Blink reflex in hyperthyroidism. Author(s): Bir LS, Sermez Y, Turk T. Source: Electromyogr Clin Neurophysiol. 2001 January-February; 41(1): 49-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11234567&dopt=Abstract

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Blood coagulation and fibrinolysis in patients with hyperthyroidism. Author(s): Erem C, Ersoz HO, Karti SS, Ukinc K, Hacihasanoglu A, Deger O, Telatar M. Source: J Endocrinol Invest. 2002 April; 25(4): 345-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12030606&dopt=Abstract

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Bone remodelling markers and serum cytokines in patients with hyperthyroidism. Author(s): Akalin A, Colak O, Alatas O, Efe B. Source: Clinical Endocrinology. 2002 July; 57(1): 125-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12100080&dopt=Abstract

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Bone turnover in hyperthyroidism before and after thyrostatic management. Author(s): Isaia GC, Roggia C, Gola D, Stefano MD, Gallone G, Aimo G, Ardissone P, Mussetta M. Source: J Endocrinol Invest. 2000 December; 23(11): 727-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11194705&dopt=Abstract

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Cardiovascular haemodynamics and cardiac autonomic control in patients with subclinical and overt hyperthyroidism. Author(s): Petretta M, Bonaduce D, Spinelli L, Vicario ML, Nuzzo V, Marciano F, Camuso P, De Sanctis V, Lupoli G. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 December; 145(6): 691-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11720892&dopt=Abstract

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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 21-2002. A 21-year-old man with arthritis during treatment for hyperthyroidism. Author(s): Helfgott SM, Smith RN. Source: The New England Journal of Medicine. 2002 July 11; 347(2): 122-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12110741&dopt=Abstract

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Changes of arterial pressure in patients with hyperthyroidism during therapy. Author(s): Marcisz C, Jonderko G, Kucharz E. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 July; 8(7): Cr502-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12118198&dopt=Abstract

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Changes of plasma arginine-vasopressin level in patients with hyperthyroidism during treatment. Author(s): Marcisz C, Jonderko G, Kucharz EJ. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 May-June; 7(3): 409-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11386017&dopt=Abstract

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Chronic infection with Yersinia enterocolitica in patients with clinical or latent hyperthyroidism. Author(s): Wenzel BE, Strieder TM, Gaspar E, Wiersinga WM. Source: Advances in Experimental Medicine and Biology. 2003; 529: 463-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756810&dopt=Abstract

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Circulating soluble Fas ligand correlates with disease activity in Graves' hyperthyroidism. Author(s): Wang CY, Zhong WB, Chang TC, Tsai YF. Source: Metabolism: Clinical and Experimental. 2002 June; 51(6): 769-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037733&dopt=Abstract

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Clinical outcome after standardized versus dosimetric radioiodine treatment of hyperthyroidism: an equivalence study. Author(s): Kok SW, Smit JW, de Craen AJ, Goslings BM, van Eck-Smit BL, Romijn JA. Source: Nuclear Medicine Communications. 2000 November; 21(11): 1071-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11192714&dopt=Abstract

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Clinical practice. Subclinical hyperthyroidism. Author(s): Toft AD. Source: The New England Journal of Medicine. 2001 August 16; 345(7): 512-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519506&dopt=Abstract

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Clinical significance of transient hyperthyroidism in the course of non-Hodgkin's lymphoma. Author(s): Glasspool RM, Vasey PA, Peden N. Source: Clin Oncol (R Coll Radiol). 2001; 13(4): 309-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11554634&dopt=Abstract

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Cloning of the cat TSH receptor and evidence against an autoimmune etiology of feline hyperthyroidism. Author(s): Nguyen LQ, Arseven OK, Gerber H, Stein BS, Jameson JL, Kopp P. Source: Endocrinology. 2002 February; 143(2): 395-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11796491&dopt=Abstract

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Coexistent insulin dependent diabetes mellitus and hyperthyroidism in a patient with Down's syndrome. Author(s): Chen BH, Lee CP, Chao MC. Source: Kaohsiung J Med Sci. 2000 April; 16(4): 210-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10933753&dopt=Abstract

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Constitutively activating TSH-receptor mutations as a molecular cause of nonautoimmune hyperthyroidism in childhood. Author(s): Biebermann H, Schoneberg T, Krude H, Gudermann T, Gruters A. Source: Langenbeck's Archives of Surgery / Deutsche Gesellschaft Fur Chirurgie. 2000 October; 385(6): 390-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11127522&dopt=Abstract

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Current treatment of nodular goiter with hyperthyroidism (Plummer's disease): surgery versus radioiodine. Author(s): Kang AS, Grant CS, Thompson GB, van Heerden JA. Source: Surgery. 2002 December; 132(6): 916-23; Discussion 923. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490836&dopt=Abstract

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Delayed recovery of thyrotropin responsiveness after radioactive iodine therapy for hyperthyroidism. Author(s): Albert SG, Goodgold HM, Chehade J, Kim J. Source: The American Journal of the Medical Sciences. 2000 June; 319(6): 376-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10875293&dopt=Abstract

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Depression and anxiety in hyperthyroidism. Author(s): Demet MM, Ozmen B, Deveci A, Boyvada S, Adiguzel H, Aydemir O. Source: Archives of Medical Research. 2002 November-December; 33(6): 552-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505101&dopt=Abstract

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Determinants of changes in plasma homocysteine in hyperthyroidism and hypothyroidism. Author(s): Diekman MJ, van der Put NM, Blom HJ, Tijssen JG, Wiersinga WM. Source: Clinical Endocrinology. 2001 February; 54(2): 197-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207634&dopt=Abstract

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Development of Graves' hyperthyroidism after radioiodine treatment for a toxic nodule: is the hyperthyroidism always triggered by 1311 therapy? Author(s): Niepomniszcze H, Pitoia F, Goodall C, Manavela M, Bruno OD. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 October; 11(10): 991. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11716050&dopt=Abstract

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Development of hyperthyroidism in a patient with idiopathic nephrotic syndrome. Author(s): Kubota T, Hirai H, Shimizu N, Sawada A, Kondou H, Nakajima S, Harada T, Shima M. Source: Pediatric Nephrology (Berlin, Germany). 2002 May; 17(5): 367-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12042896&dopt=Abstract

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Development of overt autoimmune hyperthyroidism in a patient therapeutically immunosuppressed after liver transplantation. Author(s): Khovidhunkit W, Greenspan FS, Jaume JC. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 September; 10(9): 829-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041462&dopt=Abstract

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Diagnosis and management of juvenile hyperthyroidism in Germany: a retrospective multicenter study. Author(s): Dotsch J, Siebler T, Hauffa BP, Doeker B, Andler W, Bettendorf M, Heinrich U, Gohlke B, Albers N, Willgerodt H, Kiess W. Source: J Pediatr Endocrinol Metab. 2000 July-August; 13(7): 879-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968475&dopt=Abstract

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Difference in symptom profile between generalized anxiety disorder and anxiety secondary to hyperthyroidism. Author(s): Iacovides A, Fountoulakis KN, Grammaticos P, Ierodiakonou C. Source: International Journal of Psychiatry in Medicine. 2000; 30(1): 71-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10900562&dopt=Abstract

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Differential diagnosis of hyperthyroidism: Doppler sonographic quantification of thyroid blood flow distinguishes between Graves' disease and diffuse toxic goiter. Author(s): Saleh A, Cohnen M, Furst G, Godehardt E, Modder U, Feldkamp J. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 2002 January; 110(1): 32-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835123&dopt=Abstract

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Distinction between autoimmune and nonautoimmune hyperthyroidism by determination of thyrotropin-receptor antibodies in patients with the scintigraphic diagnosis of disseminated autonomy. Author(s): Wallaschofski H, Orda C, Fuhrer D, Holzapfel HP, Krohn K, Miehle K, Neumann S, Georgi P, Paschke R. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 July; 11(7): 710-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11484903&dopt=Abstract

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Distinction between autoimmune and non-autoimmune hyperthyroidism by determination of TSH-receptor antibodies in patients with the initial diagnosis of toxic multinodular goiter. Author(s): Wallaschofski H, Orda C, Georgi P, Miehle K, Paschke R. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 2001 August; 33(8): 504-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11544566&dopt=Abstract

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Drug therapy for hyperthyroidism in pregnancy: safety issues for mother and fetus. Author(s): Atkins P, Cohen SB, Phillips BJ. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2000 September; 23(3): 229-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005705&dopt=Abstract

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Early fractures and occult hyperthyroidism: McCune-Albright syndrome? Author(s): Di Candia S, Weber G, Mora S, de Pellegrin M, Chiumello G. Source: Hormone Research. 2001; 56(1-2): 58-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11815729&dopt=Abstract

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Early postmenopausal bone loss in hyperthyroidism. Author(s): Ben-Shlomo A, Hagag P, Evans S, Weiss M. Source: Maturitas. 2001 July 25; 39(1): 19-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11451617&dopt=Abstract

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Eating disorder with hyperthyroidism. Author(s): Nemoto K, Mizukami K, Mizuhiki T, Asada T. Source: Psychiatry and Clinical Neurosciences. 2003 June; 57(3): 341-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753577&dopt=Abstract

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Effect of hyperthyroidism on insulin-like growth factor-I (IGF-I) and IGF-binding proteins in adolescent children. Author(s): Co Ng LL, Lang CH, Bereket A, Purandare A, Smaldone A, Wilson TA. Source: J Pediatr Endocrinol Metab. 2000 September-October; 13(8): 1073-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11085184&dopt=Abstract

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Effect of hypo- and hyperthyroidism on gastric myoelectrical activity. Author(s): Gunsar F, Yilmaz S, Bor S, Kumanlioglu K, Cetinkalp S, Kabalak T, Ozutemiz OA. Source: Digestive Diseases and Sciences. 2003 April; 48(4): 706-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741459&dopt=Abstract

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Effect of maternal hyperthyroidism during late pregnancy on the risk of neonatal low birth weight. Author(s): Phoojaroenchanachai M, Sriussadaporn S, Peerapatdit T, Vannasaeng S, Nitiyanant W, Boonnamsiri V, Vichayanrat A. Source: Clinical Endocrinology. 2001 March; 54(3): 365-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11298089&dopt=Abstract

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Effects of l-thyroxine administration, TSH-receptor antibodies and smoking on the risk of recurrence in Graves' hyperthyroidism treated with antithyroid drugs: a double-blind prospective randomized study. Author(s): Glinoer D, de Nayer P, Bex M; Belgian Collaborative Study Group on Graves' Disease. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 May; 144(5): 475-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331213&dopt=Abstract

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Effects of thyroid hormone on cardiac function: the relative importance of heart rate, loading conditions, and myocardial contractility in the regulation of cardiac performance in human hyperthyroidism. Author(s): Biondi B, Palmieri EA, Lombardi G, Fazio S. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 March; 87(3): 96874. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889145&dopt=Abstract

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Electrophysiological abnormalities of the atrial muscle in patients with paroxysmal atrial fibrillation associated with hyperthyroidism. Author(s): Komiya N, Isomoto S, Nakao K, Hayano M, Yano K. Source: Clinical Endocrinology. 2002 January; 56(1): 39-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11849245&dopt=Abstract

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Elevated regional lipolysis in hyperthyroidism. Author(s): Riis AL, Gravholt CH, Djurhuus CB, Norrelund H, Jorgensen JO, Weeke J, Moller N. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 October; 87(10): 4747-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364469&dopt=Abstract

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Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. Author(s): Biondi B, Palmieri EA, Fazio S, Cosco C, Nocera M, Sacca L, Filetti S, Lombardi G, Perticone F. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 December; 85(12): 4701-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11134131&dopt=Abstract

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Endothelial function in patients with hyperthyroidism before and after treatment with propranolol and thiamazol. Author(s): Burggraaf J, Lalezari S, Emeis JJ, Vischer UM, de Meyer PH, Pijl H, Cohen AF. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 February; 11(2): 153-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288984&dopt=Abstract

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Enhanced activity of the purine nucleotide cycle of the exercising muscle in patients with hyperthyroidism. Author(s): Fukui H, Taniguchi S, Ueta Y, Yoshida A, Ohtahara A, Hisatome I, Shigemasa C. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 May; 86(5): 2205-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11344228&dopt=Abstract

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Enhancement of radioiodine uptake in hyperthyroidism with hydrochlorothiazide: a prospective randomised control study. Author(s): Tepmongkol S. Source: European Journal of Nuclear Medicine and Molecular Imaging. 2002 October; 29(10): 1307-10. Epub 2002 July 31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12271411&dopt=Abstract

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Epidemiological survey on the relationship between different iodine intakes and the prevalence of hyperthyroidism. Author(s): Yang F, Teng W, Shan Z, Guan H, Li Y, Jin Y, Hu F, Shi X, Tong Y, Chen W, Yuan B, Wang Z, Cui B, Yang S. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 May; 146(5): 613-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980615&dopt=Abstract

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Estimating body fat and lean tissue distribution in hyperthyroidism by dual-energy X-ray absorptiometry. Author(s): Acotto CG, Niepomniszcze H, Mautalen CA. Source: Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry. 2002 Fall; 5(3): 305-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12357068&dopt=Abstract

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Evolving electrocardiographic changes in a patient with hyperthyroidism. Author(s): Bhattacharyya A, Kaushal K, Dornan TL. Source: Journal of the Royal Society of Medicine. 2000 November; 93(11): 589-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198691&dopt=Abstract

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Excessive weight gain following therapy for hyperthyroidism--a major problem. Author(s): Ross IL, Levitt NS. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2003 July; 93(7): 515-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939923&dopt=Abstract

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Eyelash loss associated with hyperthyroidism. Author(s): Jordan DR, Ahuja N, Khouri L. Source: Ophthalmic Plastic and Reconstructive Surgery. 2002 May; 18(3): 219-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12021655&dopt=Abstract

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Food choice in hyperthyroidism: potential influence of the autonomic nervous system and brain serotonin precursor availability. Author(s): Pijl H, de Meijer PH, Langius J, Coenegracht CI, van den Berk AH, Chandie Shaw PK, Boom H, Schoemaker RC, Cohen AF, Burggraaf J, Meinders AE. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 December; 86(12): 5848-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11739450&dopt=Abstract

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Fractures in patients with hyperthyroidism and hypothyroidism: a nationwide follow-up study in 16,249 patients. Author(s): Vestergaard P, Mosekilde L. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 May; 12(5): 411-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097203&dopt=Abstract

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Free radical activity and antioxidant defense mechanisms in patients with hyperthyroidism due to Graves' disease during therapy. Author(s): Komosinska-Vassev K, Olczyk K, Kucharz EJ, Marcisz C, Winsz-Szczotka K, Kotulska A. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 2000 October; 300(1-2): 107-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10958867&dopt=Abstract

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Gastrointestinal malformations in two infants born to women with hyperthyroidism untreated in the first trimester. Author(s): Seoud M, Nassar A, Usta I, Mansour M, Salti I, Younes K. Source: American Journal of Perinatology. 2003 February; 20(2): 59-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660909&dopt=Abstract

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Genomic DNA analysis of thyrotropin receptor in a family with hereditary hyperthyroidism. Author(s): Aoshima H, Yoshida T, Kobayashi S, Mizushima Y, Kawai S. Source: Endocrine Journal. 2000 June; 47(3): 365-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11036883&dopt=Abstract

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Haemodynamic changes following treatment of subclinical and overt hyperthyroidism. Author(s): Faber J, Wiinberg N, Schifter S, Mehlsen J. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 October; 145(4): 391-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11580994&dopt=Abstract

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Health effects of therapeutic use of 131I in hyperthyroidism. Author(s): Pauwels EK, Smit JW, Slats A, Bourguignon M, Overbeek F. Source: Q J Nucl Med. 2000 December; 44(4): 333-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11302261&dopt=Abstract

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Hemoperitoneum from spontaneous rupture of a liver cell adenoma in a male with hyperthyroidism. Author(s): Adusumilli PS, Lee B, Parekh K, Dolgopolov S. Source: The American Surgeon. 2002 July; 68(7): 582-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132736&dopt=Abstract

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Hidden hyperthyroidism in a young male patient. Author(s): Eleftheriadis D, Fourla E, Eleftheriadis N, Vrizidis P, Fourlas C. Source: International Journal of Cardiology. 2003 June; 89(2-3): 313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767562&dopt=Abstract

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High dose of (131)I therapy for the treatment of hyperthyroidism caused by Graves' disease. Author(s): Alexander EK, Larsen PR. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 March; 87(3): 10737. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889166&dopt=Abstract

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How should the dose of iodine-131 be determined in the treatment of Graves' hyperthyroidism? Author(s): Kalinyak JE, McDougall IR. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 March; 88(3): 975-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629070&dopt=Abstract

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Hyperplacentosis: a novel cause of hyperthyroidism. Author(s): Ginsberg J, Lewanczuk RZ, Honore LH. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 April; 11(4): 393-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11349840&dopt=Abstract

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Hyperthyroidism after hypothyroidism. Author(s): Al-Sharafi BA, Khardori R. Source: Southern Medical Journal. 2000 July; 93(7): 703-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10923960&dopt=Abstract

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Hyperthyroidism and cardiovascular morbidity and mortality. Author(s): Osman F, Gammage MD, Franklyn JA. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 June; 12(6): 483-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165110&dopt=Abstract

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Hyperthyroidism and concurrent thyroid carcinoma. Author(s): Ruggieri M, Scocchera F, Genderini M, Mascaro A, Luongo B, Paolini A. Source: Eur Rev Med Pharmacol Sci. 1999 November-December; 3(6): 265-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261738&dopt=Abstract

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Hyperthyroidism and criminal behavior. Author(s): Petit JM, Rudoni S, Cannard JF, Vaillant G. Source: The American Journal of Medicine. 2001 April 15; 110(6): 505-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11379570&dopt=Abstract

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Hyperthyroidism and pulmonary hypertension. Author(s): Marvisi M, Brianti M, Marani G, Del Borello R, Bortesi ML, Guariglia A. Source: Respiratory Medicine. 2002 April; 96(4): 215-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999999&dopt=Abstract

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Hyperthyroidism and the management of atrial fibrillation. Author(s): Shimizu T, Koide S, Noh JY, Sugino K, Ito K, Nakazawa H. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 June; 12(6): 489-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165111&dopt=Abstract

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Hyperthyroidism in a patient with TSH-producing pituitary adenoma coexisting with thyroid papillary adenocarcinoma. Author(s): Kishida M, Otsuka F, Kataoka H, Yokota K, Oishi T, Yamauchi T, Doihara H, Tamiya T, Mimura Y, Ogura T, Makino H. Source: Endocrine Journal. 2000 December; 47(6): 731-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11228048&dopt=Abstract

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Hyperthyroidism in an elderly patient. Author(s): Bhattacharyya S, Bhattacharyya A. Source: Postgraduate Medical Journal. 2000 September; 76(899): 597-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11032535&dopt=Abstract

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Hyperthyroidism in ancient Mesopotamia. Author(s): Coleman M. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 September; 12(9): 799. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481945&dopt=Abstract

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Hyperthyroidism in children. Author(s): Mokhashi MH, Desai U, Desai MP. Source: Indian J Pediatr. 2000 September; 67(9): 653-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11028118&dopt=Abstract

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Hyperthyroidism in the setting of gestational trophoblastic disease. Author(s): Narasimhan KL, Ghobrial MW, Ruby EB. Source: The American Journal of the Medical Sciences. 2002 May; 323(5): 285-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018675&dopt=Abstract

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Hyperthyroidism induced by beta-human chorionic gonadotrophin. Author(s): Gama R. Source: Postgraduate Medical Journal. 2001 June; 77(908): 423. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11409388&dopt=Abstract

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Hyperthyroidism is associated with lengthening of ventricular repolarization. Author(s): Colzani RM, Emdin M, Conforti F, Passino C, Scarlattini M, Iervasi G. Source: Clinical Endocrinology. 2001 July; 55(1): 27-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11453949&dopt=Abstract

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Hyperthyroidism is associated with suppressed circulating ghrelin levels. Author(s): Riis AL, Hansen TK, Moller N, Weeke J, Jorgensen JO. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 February; 88(2): 853-7. Erratum In: J Clin Endocrinol Metab. 2003 May; 88(5): 2112. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574224&dopt=Abstract

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Hyperthyroidism with concurrent thyroid cancer. Author(s): Zanella E, Rulli F, Sianesi M, Sciacchitano S, Danese D, Pontecorvi A, Farinon AM. Source: Ann Ital Chir. 2001 May-June; 72(3): 293-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765347&dopt=Abstract

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Hyperthyroidism with increased factor VIII procoagulant protein as a predisposing factor for cerebral venous thrombosis. Author(s): Maes J, Michotte A, Velkeniers B, Stadnik T, Jochmans K. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2002 October; 73(4): 458. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235324&dopt=Abstract

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Hyperthyroidism with interferon-ribavirin therapy for hepatitis C: a case report and proposed treatment algorithm. Author(s): Harris DM, Hespenheide EE, Dalkin AC, Kirk SE, Ellis DS, Caldwell SH. Source: The American Journal of Gastroenterology. 2000 October; 95(10): 2995-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11051394&dopt=Abstract

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Hyperthyroidism with low thyroid hormone. Author(s): Fowler PB. Source: Journal of the Royal Society of Medicine. 2003 June; 96(6): 315. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782707&dopt=Abstract

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Hyperthyroidism with low thyroid hormone. Author(s): Harkness MK, Hardern RD, Barth JH. Source: Journal of the Royal Society of Medicine. 2003 June; 96(6): 314-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782703&dopt=Abstract

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Hyperthyroidism with low thyroid hormone. Author(s): Obuobie K, Jones MK. Source: Journal of the Royal Society of Medicine. 2003 April; 96(4): 185-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668706&dopt=Abstract

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Hyperthyroidism. Author(s): Cooper DS. Source: Lancet. 2003 August 9; 362(9382): 459-68. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927435&dopt=Abstract

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Hyperthyroidism: a “curable” cause of congestive heart failure--three case reports and a review of the literature. Author(s): Riaz K, Forker AD, Isley WL, Hamburg MS, McCullough PA. Source: Congestive Heart Failure (Greenwich, Conn.). 2003 January-February; 9(1): 40-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556677&dopt=Abstract

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Hypertransaminasemia in two children with hyperthyroidism. Author(s): Bader AA, August GP, Austin A. Source: Journal of Pediatric Gastroenterology and Nutrition. 2001 April; 32(4): 484-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396819&dopt=Abstract

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Hypothyroidism after iodine-131 or surgical therapy for Graves' disease hyperthyroidism. Author(s): Gomez JM, Gomez N, Amat M, Biondo S, Rafecas A, Jaurrieta E, Soler J. Source: Annales D'endocrinologie. 2000 September; 61(3): 184-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10970941&dopt=Abstract

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Hypothyroidism and hyperthyroidism in anxiety disorders revisited: new data and literature review. Author(s): Simon NM, Blacker D, Korbly NB, Sharma SG, Worthington JJ, Otto MW, Pollack MH. Source: Journal of Affective Disorders. 2002 May; 69(1-3): 209-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12103468&dopt=Abstract

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I have just been diagnosed with an overactive thyroid. What are the risks to my heart? Author(s): Francis GS. Source: Heart Advis. 2002 October; 5(10): 8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420698&dopt=Abstract

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Impact of hyperthyroidism and its correction on vascular reactivity in humans. Author(s): Napoli R, Biondi B, Guardasole V, Matarazzo M, Pardo F, Angelini V, Fazio S, Sacca L. Source: Circulation. 2001 December 18; 104(25): 3076-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11748103&dopt=Abstract

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Impressive lipid changes following hypolipidaemic drug administration can unveil subclinical hyperthyroidism. Author(s): Liberopoulos E, Miltiadous G, Elisaf M. Source: Diabetes, Obesity & Metabolism. 2001 April; 3(2): 97-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11298731&dopt=Abstract

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Increased adipose tissue secretion of interleukin-6, but not of leptin, plasminogen activator inhibitor-1 or tumour necrosis factor alpha, in Graves' hyperthyroidism. Author(s): Wahrenberg H, Wennlund A, Hoffstedt J. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 May; 146(5): 607-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980614&dopt=Abstract

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Induction of autoimmune hypothyroidism and subsequent hyperthyroidism by TSH receptor antibodies following subacute thyroiditis: a case report. Author(s): Iitaka M, Kakinuma S, Yamanaka K, Fujimaki S, Oosuga I, Wada S, Katayama S. Source: Endocrine Journal. 2001 April; 48(2): 139-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11456259&dopt=Abstract

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Influence of iodine-131 dose on the outcome of hyperthyroidism in children. Author(s): Rivkees SA, Cornelius EA. Source: Pediatrics. 2003 April; 111(4 Pt 1): 745-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671107&dopt=Abstract

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Influence of short-time application of a low sodium diet on blood pressure in patients with hyperthyroidism or hypothyroidism during therapy. Author(s): Marcisz C, Jonderko G, Kucharz EJ. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2001 October; 14(10): 995-1002. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11710792&dopt=Abstract

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Interplay of pregnancy, lactation, and hyperthyroidism leading to severe osteoporosis in a young woman. Author(s): Sekhar RV, Vassilopoulou-Sellin R. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 July-August; 7(4): 2626. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11497477&dopt=Abstract

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Intra-abdominal ectopic thyroid presenting with hyperthyroidism: report of a case. Author(s): Gungor B, Kebat T, Ozaslan C, Akilli S. Source: Surgery Today. 2002; 32(2): 148-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11998943&dopt=Abstract

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Intractable diarrhea in hyperthyroidism: management with beta-adrenergic blockade. Author(s): Bricker LA, Such F, Loehrke ME, Kavanaugh K. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 January-February; 7(1): 28-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11250765&dopt=Abstract

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Iodised salt and hyperthyroidism. Author(s): Wikramanayake TW. Source: Ceylon Med J. 2000 December; 45(4): 173-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293966&dopt=Abstract

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Is antithyroid treatment really relevant for young patients with subclinical hyperthyroidism? Author(s): Yonem O, Dokmetas HS, Aslan SM, Erselcan T. Source: Endocrine Journal. 2002 June; 49(3): 307-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201213&dopt=Abstract

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Late-onset bipolar disorder due to hyperthyroidism. Author(s): Nath J, Sagar R. Source: Acta Psychiatrica Scandinavica. 2001 July; 104(1): 72-3; Discussion 74-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11437754&dopt=Abstract

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Lingual thyroid and hyperthyroidism: a new case and review of the literature. Author(s): Abdallah-Matta MP, Dubarry PH, Pessey JJ, Caron P. Source: J Endocrinol Invest. 2002 March; 25(3): 264-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936471&dopt=Abstract

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Long-term comparative cancer mortality after use of radio-iodine in the treatment of hyperthyroidism, a fully reported multicenter study. Author(s): Singer RB. Source: J Insur Med. 2001; 33(2): 138-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11510511&dopt=Abstract

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Long-term follow-up of myasthenia gravis patients with hyperthyroidism. Author(s): Ratanakorn D, Vejjajiva A. Source: Acta Neurologica Scandinavica. 2002 August; 106(2): 93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12100368&dopt=Abstract

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Management of hyperthyroidism due to Graves' and nodular diseases. Author(s): Okamoto T, Iihara M, Obara T. Source: World Journal of Surgery. 2000 August; 24(8): 957-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865040&dopt=Abstract

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Management of hyperthyroidism in Trinidad and Tobago. Author(s): Teelucksingh S, Akong J, Klijn C, Ramdass M, Naraynsingh V. Source: Int J Clin Pract. 2002 December; 56(10): 746-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12510947&dopt=Abstract

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Management of hypothyroidism and hyperthyroidism in the intensive care unit. Author(s): Ringel MD. Source: Critical Care Clinics. 2001 January; 17(1): 59-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11219235&dopt=Abstract

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McCune-Albright syndrome associated with non-autoimmune type of hyperthyroidism with development of thyrotoxic crisis. Author(s): Isotani H, Sanda K, Kameoka K, Takamatsu J. Source: Hormone Research. 2000; 53(5): 256-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11150888&dopt=Abstract

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Methimazole protection against oxidative stress induced by hyperthyroidism in Graves disease. Author(s): Sewerynek J, Wiktorska J, Nowak D, Lewinski A. Source: Endocrine Regulations. 2000 June; 34(2): 83-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10911409&dopt=Abstract

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Methylprednisolone increases plasma leptin levels in Graves' hyperthyroidism patients with active Graves' ophthalmopathy. Author(s): Song YM, Lee WJ, Chen MD, Kao CH, Sheu WH. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 2000 July; 32(7): 277-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10965934&dopt=Abstract

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Molar pregnancy and hyperthyroidism in a 13 year-old girl. Author(s): Panamonta O, Luanratanakorn S, Thampratankul L. Source: J Pediatr Endocrinol Metab. 2003 June; 16(5): 787-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880130&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Biondi B, Palmieri EA, Filetti S, Lombardi G, Fazio S. Source: Lancet. 2002 March 2; 359(9308): 799-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888625&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Twickler TB, Cramer MJ, Koppeschaar HP, de Vries WR, Erkelens DW. Source: Lancet. 2002 March 2; 359(9308): 799. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888624&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Simon K. Source: Lancet. 2002 March 2; 359(9308): 798-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888622&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Fowler PB. Source: Lancet. 2002 March 2; 359(9308): 798; Author Reply 799. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888621&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Pettila V. Source: Lancet. 2002 March 2; 359(9308): 798; Author Reply 799. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888620&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Diez JJ, Iglesias P. Source: Lancet. 2002 March 2; 359(9308): 797; Author Reply 799. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888619&dopt=Abstract

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Mortality in elderly patients with subclinical hyperthyroidism. Author(s): Toft AD, Beckett GJ. Source: Lancet. 2002 March 2; 359(9308): 797-8; Author Reply 799. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11888618&dopt=Abstract

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Neonatal hyperthyroidism in infants of mothers previously thyroidectomized due to Graves' disease. Author(s): Borras-Perez MV, Moreno-Perez D, Zuasnabar-Cotro A, Lopez-Siguero JP. Source: J Pediatr Endocrinol Metab. 2001 September-October; 14(8): 1169-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11592578&dopt=Abstract

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Neonatal hyperthyroidism. Author(s): Surks M. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 April; 12(4): 346. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034064&dopt=Abstract

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Novel TSHR germline mutation (Met463Val) masquerading as Graves' disease in a large Welsh kindred with hyperthyroidism. Author(s): Fuhrer D, Warner J, Sequeira M, Paschke R, Gregory J, Ludgate M. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 December; 10(12): 1035-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11201847&dopt=Abstract

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Ovarian ultrasound and ovarian and adrenal hormones before and after treatment for hyperthyroidism. Author(s): Skjoldebrand Sparre L, Kollind M, Carlstrom K. Source: Gynecologic and Obstetric Investigation. 2002; 54(1): 50-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12297719&dopt=Abstract

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Oxygen consumption in patients with hyperthyroidism before and after treatment with beta-blockade versus thyrostatic treatment: a prospective randomized study. Author(s): Jansson S, Lie-Karlsen K, Stenqvist O, Korner U, Lundholm K, Tisell LE. Source: Annals of Surgery. 2001 January; 233(1): 60-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11141226&dopt=Abstract

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Palpebral edema as a cutaneous manifestation of hyperthyroidism. Author(s): Higuchi T, Satoh T, Yokozeki H, Katayama I, Nishioka K. Source: Journal of the American Academy of Dermatology. 2003 April; 48(4): 617-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12664031&dopt=Abstract

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Pancytopenia responding to treatment of hyperthyroidism: a clinical case and review of the literature. Author(s): Shaw B, Mehta AB. Source: Clinical and Laboratory Haematology. 2002 December; 24(6): 385-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452820&dopt=Abstract

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Paradoxical changes in cystatin C and serum creatinine in patients with hypo- and hyperthyroidism. Author(s): Jayagopal V, Keevil BG, Atkin SL, Jennings PE, Kilpatrick ES. Source: Clinical Chemistry. 2003 April; 49(4): 680-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651831&dopt=Abstract

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Persistent increase in bone turnover in Graves' patients with subclinical hyperthyroidism. Author(s): Kumeda Y, Inaba M, Tahara H, Kurioka Y, Ishikawa T, Morii H, Nishizawa Y. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 November; 85(11): 4157-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11095447&dopt=Abstract

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Pituitary tumor cosecreting thyrotropin and prolactin causing hyperthyroidism--a case report. Author(s): Song YM, Sheu WH. Source: Kaohsiung J Med Sci. 2000 April; 16(4): 203-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10933752&dopt=Abstract

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Plasma isocitrate dehydrogenase as a marker of centrilobular hepatic necrosis in patients with hyperthyroidism. Author(s): Chung YH, Jung SA, Song BC, Chang WY, Kim JA, Song IH, Kim JW, Choi WB, Shong YK, Lee YS, Suh DJ. Source: Journal of Clinical Gastroenterology. 2001 August; 33(2): 118-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11468437&dopt=Abstract

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Plasmapheresis: an effective therapy for refractory hyperthyroidism in the elderly. Author(s): Ozdemir S, Buyukbese MA, Kadioglu P, Soyasal T, Senturk H, Akin P. Source: Indian Journal of Medical Sciences. 2002 February; 56(2): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508615&dopt=Abstract

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Platelet Na,K-adenosine triphosphatase as a tissue marker of hyperthyroidism. Author(s): Chan AY, Shinde R, Chow CC, Cockram CS, Swaminathan R. Source: Metabolism: Clinical and Experimental. 2001 December; 50(12): 1393-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11735082&dopt=Abstract

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Postpartum recurrence of Graves' hyperthyroidism can be prevented by the continuation of antithyroid drugs during pregnancy. Author(s): Nakagawa Y, Mori K, Hoshikawa S, Yamamoto M, Ito S, Yoshida K. Source: Clinical Endocrinology. 2002 October; 57(4): 467-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354128&dopt=Abstract

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Prediction of remission or relapse for Graves' hyperthyroidism by the combined determination of stimulating, blocking and binding TSH-receptor antibodies after the withdrawal of antithyroid drug treatment. Author(s): Wallaschofski H, Miehle K, Mayer A, Tuschy U, Hentschel B, Paschke R. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 2002 July; 34(7): 383-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12189586&dopt=Abstract

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Predictor of outcome of hyperthyroidism due to Graves disease: serum triiodothyronine/thyroxine ratio. Author(s): Khanna CM, Shankar LR, Jaggi CB, Bansal JK, Chugh P. Source: J Assoc Physicians India. 1996 February; 44(2): 98-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10999059&dopt=Abstract

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Pregnancy with hyperthyroidism. Author(s): Shahid R. Source: J Coll Physicians Surg Pak. 2003 May; 13(5): 255-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12757672&dopt=Abstract

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Prevalence of thyroid cancer in hyperthyroidism treated by surgery. Author(s): Lin CH, Chiang FY, Wang LF. Source: Kaohsiung J Med Sci. 2003 August; 19(8): 379-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12962424&dopt=Abstract

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Prevention of autoantibody-mediated Graves'-like hyperthyroidism in mice with IL4, a Th2 cytokine. Author(s): Nagayama Y, Mizuguchi H, Hayakawa T, Niwa M, McLachlan SM, Rapoport B. Source: Journal of Immunology (Baltimore, Md. : 1950). 2003 April 1; 170(7): 3522-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646613&dopt=Abstract

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Primary hyperthyroidism due to a parathyroid adenoma with subsequent myasthenia gravis. Author(s): Palin SL, Singh BM. Source: Qjm : Monthly Journal of the Association of Physicians. 2000 August; 93(8): 5601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10924542&dopt=Abstract

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Radiation protection issues of treating hyperthyroidism with 131 I in patients on haemodialysis. Author(s): Homer L, Smith AH. Source: Nuclear Medicine Communications. 2002 March; 23(3): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11891485&dopt=Abstract

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Radioactive iodine therapy in Graves' hyperthyroidism. Author(s): Sankar R, Sripathy G. Source: Natl Med J India. 2000 September-October; 13(5): 246-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11190053&dopt=Abstract

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Radio-iodine (NaI131) therapy in hyperthyroidism. Author(s): Chakrabarti B. Source: J Indian Med Assoc. 2001 November; 99(11): 642-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12022208&dopt=Abstract

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Radioiodine treatment of feline hyperthyroidism in Germany. Author(s): Puille M, Knietsch M, Spillmann T, Grunbaum EG, Bauer R. Source: Nuklearmedizin. 2002 December; 41(6): 245-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520661&dopt=Abstract

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Radioiodine treatment of hyperthyroidism at the Tikur Anbessa Hospital. Author(s): Demena S, Abdulkadir J, Jorge Y. Source: Ethiop Med J. 2001 January; 39(1): 39-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11338466&dopt=Abstract

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Radioiodine treatment of hyperthyroidism-prognostic factors for outcome. Author(s): Allahabadia A, Daykin J, Sheppard MC, Gough SC, Franklyn JA. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 August; 86(8): 3611-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502786&dopt=Abstract

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Re: “An activating mutation of the thyrotropin receptor gene in hereditary nonautoimmune hyperthyroidism” by Yung-Seng Lee et al. J Pediatr Endocrinol Metab 2002; 15: 211-215. Author(s): Fuhrer D, Gregory J, Ludgate M. Source: J Pediatr Endocrinol Metab. 2002 November-December; 15(9): 1569; Author Reply 1569-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503868&dopt=Abstract

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Recovery of chronic hepatitis by treatment of concomitant hyperthyroidism. Author(s): Leeuwenburgh I, Stijnen PJ, Verburg GP. Source: European Journal of Gastroenterology & Hepatology. 2001 November; 13(11): 1389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11692069&dopt=Abstract

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Refractory vasomotor angina in subclinical hyperthyroidism demonstrating focal and segmental coronary vasoconstriction. Author(s): DeTommasi A, Rogge S, Houghton JL. Source: J Invasive Cardiol. 2003 May; 15(5): 289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12730640&dopt=Abstract

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Remission of Graves' hyperthyroidism and A/G polymorphism at position 49 in exon 1 of cytotoxic T lymphocyte-associated molecule-4 gene. Author(s): Kinjo Y, Takasu N, Komiya I, Tomoyose T, Takara M, Kouki T, Shimajiri Y, Yabiku K, Yoshimura H. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 June; 87(6): 2593-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12050220&dopt=Abstract

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Remission of Graves' hyperthyroidism predicted by smooth decreases of thyroidstimulating antibody and thyrotropin-binding inhibitor immunoglobulin during antithyroid drug treatment. Author(s): Takasu N, Yamashiro K, Komiya I, Ochi Y, Sato Y, Nagata A. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 October; 10(10): 891-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11081255&dopt=Abstract

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Remission of Graves' hyperthyroidism treated with methimazole. Author(s): Bolanos F, Gonzalez-Ortiz M, Duron H, Sanchez C. Source: Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion. 2002 July-August; 54(4): 307-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415954&dopt=Abstract

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Response of glucose disposal to hyperinsulinaemia in human hypothyroidism and hyperthyroidism. Author(s): Rochon C, Tauveron I, Dejax C, Benoit P, Capitan P, Fabricio A, Berry C, Champredon C, Thieblot P, Grizard J. Source: Clinical Science (London, England : 1979). 2003 January; 104(1): 7-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519082&dopt=Abstract

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Reversible hyperthyroidism and cardiomyopathy caused by consumption of iodocasein. Author(s): Donega P, Gallerani M, Vigna GB, Fellin R. Source: The American Journal of the Medical Sciences. 2000 August; 320(2): 148-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10981492&dopt=Abstract

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Rhabdomyolysis associated with hyperthyroidism. Author(s): Alshanti M, Eledrisi MS, Jones E. Source: The American Journal of Emergency Medicine. 2001 July; 19(4): 317. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11447521&dopt=Abstract

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Right heart failure and hyperthyroidism: a neglected presentation. Author(s): Cohen J, Schattner A. Source: The American Journal of Medicine. 2003 July; 115(1): 76-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867245&dopt=Abstract

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Scleroderma with cardiac tamponade, hyperthyroidism and incidental papillary thyroid carcinoma. Author(s): Gokula RM, Gupta AK, Shirley SE, Coard K, Ramphal PS. Source: The West Indian Medical Journal. 2002 September; 51(3): 188-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12501551&dopt=Abstract

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Serum concentration of androstenediol and androstenediol sulfate in patients with hyperthyroidism and hypothyroidism. Author(s): Tagawa N, Takano T, Fukata S, Kuma K, Tada H, Izumi Y, Kobayashi Y, Amino N. Source: Endocrine Journal. 2001 June; 48(3): 345-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11523906&dopt=Abstract

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Serum concentrations of tumour necrosis factor-alpha (TNF-alpha) and soluble TNFalpha receptor p55 in patients with hypothyroidism and hyperthyroidism before and after normalization of thyroid function. Author(s): Diez JJ, Hernanz A, Medina S, Bayon C, Iglesias P. Source: Clinical Endocrinology. 2002 October; 57(4): 515-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354134&dopt=Abstract

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Serum insulin-like growth factor-I, insulin-like growth factor binding proteins, and bone mineral content in hyperthyroidism. Author(s): Lakatos P, Foldes J, Nagy Z, Takacs I, Speer G, Horvath C, Mohan S, Baylink DJ, Stern PH. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 May; 10(5): 417-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10884189&dopt=Abstract

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Serum level of the circulating angiogenesis inhibitor endostatin in patients with hyperthyroidism or hypothyroidism. Author(s): Kucharz EJ, Kotulska A, Kopec M, Stawiarska-Pieta B, Pieczyrak R. Source: Wiener Klinische Wochenschrift. 2003 March 31; 115(5-6): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741078&dopt=Abstract

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Severe reversible dilated cardiomyopathy and hyperthyroidism: case report and review of the literature. Author(s): Boccalandro C, Boccalandro F, Orlander P, Wei CF. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2003 March-April; 9(2): 1406. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917077&dopt=Abstract

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Short-term hyperthyroidism followed by transient pituitary hypothyroidism in a very low birth weight infant born to a mother with uncontrolled Graves' disease. Author(s): Higuchi R, Kumagai T, Kobayashi M, Minami T, Koyama H, Ishii Y. Source: Pediatrics. 2001 April; 107(4): E57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11335778&dopt=Abstract

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Similarities and differences in the phenotype of members of an Italian family with hereditary non-autoimmune hyperthyroidism associated with an activating TSH receptor germline mutation. Author(s): Arturi F, Chiefari E, Tumino S, Russo D, Squatrito S, Chazenbalk G, Persani L, Rapoport B, Filetti S. Source: J Endocrinol Invest. 2002 September; 25(8): 696-701. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240901&dopt=Abstract

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Solitary adrenal gland metastasis of a follicular thyroid carcinoma presenting with hyperthyroidism. Author(s): Yunta PJ, Ponce JL, Prieto M, Lopez-Aznar D, Sancho-Fornos S. Source: Annales D'endocrinologie. 2001 June; 62(3): 226-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11458174&dopt=Abstract

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Soluble Fas is increased in hyperthyroidism independent of the underlying thyroid disease. Author(s): Feldkamp J, Pascher E, Schott M, Goretzki P, Seissler J, Scherbaum WA. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 September; 86(9): 4250-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549657&dopt=Abstract

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Sporadic nonautoimmune congenital hyperthyroidism due to a strong activating mutation of the thyrotropin receptor gene. Author(s): Tonacchera M, Agretti P, Rosellini V, Ceccarini G, Perri A, Zampolli M, Longhi R, Larizza D, Pinchera A, Vitti P, Chiovato L. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 October; 10(10): 859-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11081252&dopt=Abstract

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Struma ovarii with hyperthyroidism. Author(s): Grandet PJ, Remi MH. Source: Clinical Nuclear Medicine. 2000 October; 25(10): 763-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043711&dopt=Abstract

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Subclinical hyperthyroidism and atrial fibrillation. Author(s): Sawin CT. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 June; 12(6): 501-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165113&dopt=Abstract

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Subclinical hyperthyroidism and the risk of dementia. The Rotterdam study. Author(s): Kalmijn S, Mehta KM, Pols HA, Hofman A, Drexhage HA, Breteler MM. Source: Clinical Endocrinology. 2000 December; 53(6): 733-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11155096&dopt=Abstract

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Subclinical hyperthyroidism as a risk factor for atrial fibrillation. Author(s): Auer J, Scheibner P, Mische T, Langsteger W, Eber O, Eber B. Source: American Heart Journal. 2001 November; 142(5): 838-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11685172&dopt=Abstract

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Subclinical hyperthyroidism detected by screening: look before you treat. Author(s): Helfand M. Source: American Family Physician. 2002 February 1; 65(3): 389-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858623&dopt=Abstract

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Subclinical hyperthyroidism. Author(s): Relimpio F. Source: The New England Journal of Medicine. 2002 January 3; 346(1): 67-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799960&dopt=Abstract

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Subclinical hyperthyroidism. Author(s): Parker L. Source: The New England Journal of Medicine. 2002 January 3; 346(1): 67-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11778009&dopt=Abstract

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Subclinical hyperthyroidism. Author(s): Levy EG, Walfish P, Cobin RH. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 August; 10(8): 721-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11014320&dopt=Abstract

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Subclinical hyperthyroidism: controversies in management. Author(s): Shrier DK, Burman KD. Source: American Family Physician. 2002 February 1; 65(3): 431-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858626&dopt=Abstract

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Surgical treatment of hyperthyroidism: a ten-year experience. Author(s): Werga-Kjellman P, Zedenius J, Tallstedt L, Traisk F, Lundell G, Wallin G. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 February; 11(2): 187-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288990&dopt=Abstract

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Sympathovagal imbalance in hyperthyroidism. Author(s): Burggraaf J, Tulen JH, Lalezari S, Schoemaker RC, De Meyer PH, Meinders AE, Cohen AF, Pijl H. Source: American Journal of Physiology. Endocrinology and Metabolism. 2001 July; 281(1): E190-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11404237&dopt=Abstract

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Symptomatic hyperthyroidism in a patient taking the dietary supplement tiratricol. Author(s): Bauer BA, Elkin PL, Erickson D, Klee GG, Brennan MD. Source: Mayo Clinic Proceedings. 2002 June; 77(6): 587-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12059130&dopt=Abstract

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Systemic vasculitis and hyperthyroidism in a patient with myasthenia gravis. Author(s): Raillard-Gohin H, Leray-Moragues H, Canaud B, Pages M. Source: Journal of Neurology. 2001 June; 248(6): 525-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11499646&dopt=Abstract

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The aftermath of childhood hyperthyroidism. Author(s): Segni M, Gorman CA. Source: J Pediatr Endocrinol Metab. 2001; 14 Suppl 5: 1277-82; Discussion 1297-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11964023&dopt=Abstract

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The effect of methimazole on cure rates after radioiodine treatment for Graves' hyperthyroidism: a randomized clinical trial. Author(s): Braga M, Walpert N, Burch HB, Solomon BL, Cooper DS. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 February; 12(2): 135-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11916282&dopt=Abstract

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The effect of methimazole pretreatment on the efficacy of radioactive iodine therapy in Graves' hyperthyroidism: one-year follow-up of a prospective, randomized study. Author(s): Andrade VA, Gross JL, Maia AL. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 August; 86(8): 3488-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502768&dopt=Abstract

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The effects of early antithyroid therapy for endogenous subclinical hyperthyroidism in clinical and heart abnormalities. Author(s): Sgarbi JA, Villaca FG, Garbeline B, Villar HE, Romaldini JH. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 April; 88(4): 1672-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679455&dopt=Abstract

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The first activating TSH receptor mutation in transmembrane domain 1 identified in a family with nonautoimmune hyperthyroidism. Author(s): Biebermann H, Schoneberg T, Hess C, Germak J, Gudermann T, Gruters A. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 September; 86(9): 4429-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549687&dopt=Abstract

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The incidence and clinical characteristics of symptomatic propylthiouracil-induced hepatic injury in patients with hyperthyroidism: a single-center retrospective study. Author(s): Kim HJ, Kim BH, Han YS, Yang I, Kim KJ, Dong SH, Kim HJ, Chang YW, Lee JI, Chang R. Source: The American Journal of Gastroenterology. 2001 January; 96(1): 165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11197248&dopt=Abstract

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The influence of hyperthyroidism on the hypothalamic-pituitary-gonadal axis. Author(s): Zahringer S, Tomova A, von Werder K, Brabant G, Kumanov P, Schopohl J. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 2000; 108(4): 282-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10961359&dopt=Abstract

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The relationship of psychological factors to the prognosis of hyperthyroidism in antithyroid drug-treated patients with Graves' disease. Author(s): Fukao A, Takamatsu J, Murakami Y, Sakane S, Miyauchi A, Kuma K, Hayashi S, Hanafusa T. Source: Clinical Endocrinology. 2003 May; 58(5): 550-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699435&dopt=Abstract

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The systolic function of the left ventricle of the heart in patients with hyperthyroidism during therapy. Author(s): Marcisz C, Kucharz EJ, Jonderko G, Wojewodka J. Source: Pol Arch Med Wewn. 2001 February; 105(2): 131-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11505747&dopt=Abstract

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The use of oral radiographic contrast agents in the management of hyperthyroidism. Author(s): Fontanilla JC, Schneider AB, Sarne DH. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 June; 11(6): 561-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11442003&dopt=Abstract

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The use of radioactive iodine in the management of hyperthyroidism in children. Author(s): Rivkees SA. Source: Current Drug Targets. Immune, Endocrine and Metabolic Disorders. 2001 November; 1(3): 255-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477291&dopt=Abstract

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Thyroid and sympathetic influences on plasma leptin in hypothyroidism and hyperthyroidism. Author(s): Pinkney JH, Goodrick SJ, Katz JR, Johnson AB, Lightman SL, Coppack SW, Medbak S, Mohamed-Ali V. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 June; 24 Suppl 2: S165-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10997647&dopt=Abstract

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Thyroid Doppler ultrasonography and resistive index in the evaluation of the need for ablative or antithyroid drug therapy in Graves' hyperthyroidism. Author(s): Wang CY, Chang TC. Source: J Formos Med Assoc. 2001 November; 100(11): 753-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11802534&dopt=Abstract

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Thyroidectomy or radioiodine? The value of ultrasonography and cytology in the assessment of nodular lesions in Graves' hyperthyroidism. Author(s): Wang CY, Chang TJ, Chang TC, Hsiao YL, Chen MH, Huang SH. Source: The American Surgeon. 2001 August; 67(8): 721-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11510570&dopt=Abstract

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Thyroid-stimulating antibody is related to Graves' ophthalmopathy, but thyrotropinbinding inhibitor immunoglobulin is related to hyperthyroidism in patients with Graves' disease. Author(s): Noh JY, Hamada N, Inoue Y, Abe Y, Ito K, Ito K. Source: Thyroid : Official Journal of the American Thyroid Association. 2000 September; 10(9): 809-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041459&dopt=Abstract

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Thyroxine hair content in congenital hypothyroidism and hyperthyroidism. Author(s): Zamboni G, Camilot M, Francia G, Lauriola S, Arslanoglu I, Isguven P, Tato L. Source: J Pediatr Endocrinol Metab. 2003 March; 16(3): 379-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705362&dopt=Abstract

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Total thyroidectomy for the treatment of hyperthyroidism in patients with ophthalmopathy. Author(s): Kurihara H. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 March; 12(3): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952051&dopt=Abstract

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Transient hyperthyroidism following L-asparaginase therapy for acute lymphoblastic leukemia. Author(s): Fadilah SA, Faridah I, Cheong SK. Source: Med J Malaysia. 2000 December; 55(4): 513-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11221167&dopt=Abstract

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Transient hyperthyroidism in a patient with rheumatoid arthritis treated by etanercept. Author(s): Allanore Y, Bremont C, Kahan A, Menkes CJ. Source: Clin Exp Rheumatol. 2001 May-June; 19(3): 356-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11407100&dopt=Abstract

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Transient hyperthyroidism in an adolescent with hydatidiform mole. Author(s): Misra M, Levitsky LL, Lee MM. Source: The Journal of Pediatrics. 2002 March; 140(3): 362-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11953736&dopt=Abstract

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Transient hyperthyroidism of hyperemesis gravidarum. Author(s): Tan JY, Loh KC, Yeo GS, Chee YC. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 June; 109(6): 683-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12118648&dopt=Abstract

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TSBAb (TSH-stimulation blocking antibody) and TSAb (thyroid stimulating antibody) in TSBAb-positive patients with hypothyroidism and Graves' patients with hyperthyroidism. Author(s): Takasu N, Yamashiro K, Ochi Y, Sato Y, Nagata A, Komiya I, Yoshimura H. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 2001 April; 33(4): 232-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11383928&dopt=Abstract

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TSH-receptor antibody measurement for differentiation of hyperthyroidism into Graves' disease and multinodular toxic goitre: a comparison of two competitive binding assays. Author(s): Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P. Source: Clinical Endocrinology. 2001 September; 55(3): 381-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11589682&dopt=Abstract

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Update on the management of hyperthyroidism and hypothyroidism. Author(s): Woeber KA. Source: Archives of Family Medicine. 2000 August; 9(8): 743-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10927715&dopt=Abstract

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Use of oral cholecystographic agents in the treatment of amiodarone-induced hyperthyroidism. Author(s): Chopra IJ, Baber K. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 October; 86(10): 4707-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11600529&dopt=Abstract

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Use of oral cholecystography agents in the treatment of hyperthyroidism of subacute thyroiditis. Author(s): Martinez DS, Chopra IJ. Source: Panminerva Medica. 2003 March; 45(1): 53-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682620&dopt=Abstract

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Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebocontrolled clinical trial. Author(s): Benvenga S, Ruggeri RM, Russo A, Lapa D, Campenni A, Trimarchi F. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 August; 86(8): 3579-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11502782&dopt=Abstract

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Validity of self-reported hyperthyroidism and hypothyroidism: comparison of selfreported questionnaire data with medical record review. Author(s): Brix TH, Kyvik KO, Hegedus L. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 August; 11(8): 769-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525270&dopt=Abstract

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Weathering the storm: beta-blockade and the potential for disaster in severe hyperthyroidism. Author(s): Fraser T, Green D. Source: Emergency Medicine (Fremantle, W.A.). 2001 September; 13(3): 376-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11554873&dopt=Abstract

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Weight gain following treatment of hyperthyroidism. Author(s): Dale J, Daykin J, Holder R, Sheppard MC, Franklyn JA. Source: Clinical Endocrinology. 2001 August; 55(2): 233-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11531931&dopt=Abstract

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Weight gain in patients after therapy for hyperthyroidism. Author(s): Brunova J, Bruna J, Joubert G, Koning M. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2003 July; 93(7): 529-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939927&dopt=Abstract

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

Finding Nutrition Studies on Hyperthyroidism 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 “hyperthyroidism” (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 “hyperthyroidism” (or a synonym): •

A randomized controlled trial to evaluate the adjuvant effect of lithium on radioiodine treatment of hyperthyroidism. Author(s): Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India. [email protected] Source: Bal, C S KuMarch, A Pandey, R M Thyroid. 2002 May; 12(5): 399-405 1050-7256

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An approach to the mechanisms of laser acupuncture in treatment of exophthalmic hyperthyroidism. Source: Ge, T Y Du, J Shi, X Q J-Tradit-Chin-Med. 1988 June; 8(2): 85-8 0254-6272

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Brown adipose tissue cell respiration in hypo- and hyperthyroidism after stimulation with selective and non selective beta-adrenergic agonists. Author(s): Pediatric Department of University Medical School, Debrecen, Hungary. Source: Ilyes, I Yahata, T Stock, M Acta-Biol-Hung. 1991; 42(4): 345-55 0236-5383

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Changes of arterial pressure in patients with hyperthyroidism during therapy. Author(s): Department of Internal Medicine, Tychy. Source: Marcisz, C Jonderko, G Kucharz, E Med-Sci-Monit. 2002 July; 8(7): CR502-7 1234-1010

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Changes of plasma arginine-vasopressin level in patients with hyperthyroidism during treatment. Author(s): Department of Internal Medicine and Rheumatology, Medical University of Silesia, Katowice, Poland. Source: Marcisz, C Jonderko, G Kucharz, E J Med-Sci-Monit. 2001 May-June; 7(3): 409-14 1234-1010

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Comparative analysis of therapeutic effects of acupuncture in the treatment of hyperthyroidism. Source: He, J S Jin, S B Heng, J S Chen, H P Gui, J S Guo, X L Li, H Y Yin, Z F Ma, J X Xiang, K S J-Tradit-Chin-Med. 1988 June; 8(2): 79-82 0254-6272

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Effects of subclinical hyperthyroidism on renal handling of water and electrolytes in patients with nodular goiter. Author(s): Departamento de Medicina, Unidades de Endocrinologia y Nefrologia, Universidad de Salamanca, Spain. Source: Corrales, J J Tabernero, J M Miralles, J M Hernandez, M T Klin-Wochenschr. 1991 January 4; 69(1): 19-24 0023-2173

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Effects of vitamin E and vitamin C supplementation on plasma lipid peroxidation and on oxidation of apolipoprotein B-containing lipoproteins in experimental hyperthyroidism. Author(s): Department of Biochemistry, Uludag University Medical School, Turkey. Source: Dirican, M Tas, S J-Med-Invest. 1999 February; 46(1-2): 29-33 1343-1420

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Efficacy of oral iodide therapy on neonatal hyperthyroidism caused by maternal Graves' disease. Author(s): Institute of Pediatrics, Department of Neonatology, Catholic University of the Sacred Heart, Rome, Italy. Source: Maragliano, G Zuppa, A A Florio, M G Scapillati, M E Girlando, P Crescimbini, B Cafforio, C Noia, G Cavaliere, A F Tortorolo, G Fetal-Diagn-Ther. 2000 Mar-April; 15(2): 122-6 1015-3837

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Evaluation of antioxidant status in liver tissues: effect of iron supplementation in experimental hyperthyroidism. Author(s): Department of Physiology, Cerrahpasa Medical Faculty, Istanbul University, Turkey. [email protected] Source: Seymen, H O Seven, A Civelek, S Yigit, G Hatemi, H Burcak, G J-Basic-ClinPhysiol-Pharmacol. 1999; 10(4): 315-25 0792-6855

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Graves' hyperthyroidism after postpartum thyroiditis. Author(s): University of Toronto Medical School, Ontario, Canada. Source: Shorey, S Badenhoop, K Walfish, P G Thyroid. 1998 December; 8(12): 1117-22 1050-7256

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Hyperthyroidism facilitates cardiac fatty acid oxidation through altered regulation of cardiac carnitine palmitoyltransferase: studies in vivo and with cardiac myocytes. Author(s): Department of Biochemistry, St. Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College (University of London), UK. [email protected] Source: Sugden, M C Priestman, D A Orfali, K A Holness, M J Horm-Metab-Res. 1999 May; 31(5): 300-6 0018-5043

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Incidence and causes of hyperthyroidism in blacks. Author(s): Department of Medicine, University of the Witwatersrand, Johannesburg. Source: Kalk, W J Kalk, J S-Afr-Med-J. 1989 February 4; 75(3): 114-7 0038-2469

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Insulin secretion and sensitivity in hyperthyroidism. Author(s): Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China. Source: Jap, T S Ho, L T Won, J G Horm-Metab-Res. 1989 May; 21(5): 261-6 0018-5043

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Interplay of pregnancy, lactation, and hyperthyroidism leading to severe osteoporosis in a young woman. Author(s): Section of Endocrine Neoplasia and Hormonal Disorders, Department of Internal Medicine Specialties, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. Source: Sekhar, R V Vassilopoulou Sellin, R Endocr-Pract. 2001 Jul-August; 7(4): 262-6 1530-891X

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Intractable diarrhea in hyperthyroidism: management with beta-adrenergic blockade. Author(s): Department of Internal Medicine, Kalamazoo Center for Medical Studies, Michigan State University School of Medicine, 49008, USA. Source: Bricker, L A Such, F Loehrke, M E Kavanaugh, K Endocr-Pract. 2001 JanFebruary; 7(1): 28-31 1530-891X

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Iodine excess and hyperthyroidism. Author(s): Universita di Parma, Cattedra di Endocrinologia, Italy. Source: Roti, E Uberti, E D Thyroid. 2001 May; 11(5): 493-500 1050-7256

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Iodine-induced hyperthyroidism: occurrence and epidemiology. Author(s): International Council for the Control of Iodine Deficiency Disorders, Chestnut Hill, Massachusetts USA. Source: Stanbury, J B Ermans, A E Bourdoux, P Todd, C Oken, E Tonglet, R Vidor, G Braverman, L E Medeiros Neto, G Thyroid. 1998 January; 8(1): 83-100 1050-7256

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Lingual thyroid and hyperthyroidism: a new case and review of the literature. Author(s): Department of Endocrinology and Metabolic Diseases, CHU Rangueil, Toulouse, France.

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Source: Abdallah Matta, M P Dubarry, P H Pessey, J J Caron, P J-Endocrinol-Invest. 2002 March; 25(3): 264-7 0391-4097 •

Long-term outcomes of treatment of hyperthyroidism in Ireland. Author(s): Department of Medicine, Cork University Hospital. Source: Leary, A C Grealy, G Higgins, T M Buckley, N Barry, D G Murphy, D Ferriss, J B Ir-J-Med-Sci. 1999 Jan-March; 168(1): 47-52 0021-1265

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Low incidence rate of overt hypothyroidism compared with hyperthyroidism in an area with moderately low iodine intake. Author(s): Department of Endocrinology and Medicine, Aalborg Hospital, Denmark. Source: Laurberg, P Bulow Pedersen, I Pedersen, K M Vestergaard, H Thyroid. 1999 January; 9(1): 33-8 1050-7256

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Neonatal hyperthyroidism in infants of mothers previously thyroidectomized due to Graves' disease. Author(s): Paediatric Department, Hospital General Granollers, Barcelona, Spain. Source: Borras Perez, M V Moreno Perez, D Zuasnabar Cotro, A Lopez Siguero, J P JPediatr-Endocrinol-Metab. 2001 Sep-October; 14(8): 1169-72

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Outcome of treatment of hyperthyroidism. Author(s): Department of Internal Medicine University Hospital Rotterdam, The Netherlands. Source: Bringmann, I M van Leeuwen, B L Hennemann, G Beckett, G J Toft, A D JEndocrinol-Invest. 1999 April; 22(4): 250-6 0391-4097

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Oxidative stress and anti-oxidant metabolites in patients with hyperthyroidism: effect of treatment. Author(s): Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Universita di Bologna, Policlinico S. Orsola, Italy. [email protected] Source: Bianchi, G Solaroli, E Zaccheroni, V Grossi, G Bargossi, A M Melchionda, N Marchesini, G Horm-Metab-Res. 1999 November; 31(11): 620-4 0018-5043

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Plasma C-peptide response to oral glucose load in hyperthyroidism. Author(s): Cattedra di Malattie del Metabolismo, Universita di Verona, Italy. Source: Bonora, E Manicardi, V Zenere, M Moghetti, P Coscelli, C Muggeo, M JEndocrinol-Invest. 1990 Jul-August; 13(7): 555-8 0391-4097

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Radioactive iodine therapy for feline hyperthyroidism: efficacy and administration routes. Source: Mooney, C.T. J-small-anim-pract. London : British Veterinary Association. June 1994. volume 35 (6) page 289-294. 0022-4510

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Recurrence of hyperthyroidism after thyroidectomy in cats. Author(s): University of Georgia, Athens, GA Source: Swalec, K.M. Birchard, S.J. The-Journal-of-the-American-Animal-HospitalAssociation (USA). (Jul-August 1990). volume 26(4) page 433-437. cats endocrine diseases thyroid gland surgical operations 0587-2871

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Regional curare test in the study of neuromuscular transmission in hyperthyroidism. Source: Witoonpanich, R Vejjajiva, A Limpisvasti, S J-Med-Assoc-Thai. 1989 January; 72 Suppl 1187-91 0125-2208

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Relationship between Graves' ophthalmopathy and type of treatment of Graves' hyperthyroidism. Author(s): Istituto di Endocrinologia, Universita di Pisa, Italy. Source: Marcocci, C Bartalena, L Bogazzi, F Bruno Bossio, G Pinchera, A Thyroid. 1992 Summer; 2(2): 171-8 1050-7256

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Remission of Graves' hyperthyroidism treated with methimazole. Author(s): Clinica de Tiroides, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jal, Mexico. Source: Bolanos, F Gonzalez Ortiz, M Duron, H Sanchez, C Rev-Invest-Clin. 2002 JulAugust; 54(4): 307-10 0034-8376

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Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt. Author(s): International Council for Control of Iodine Deficiency Disorders, Brussels, Belgium. [email protected] Source: Delange, F de Benoist, B Alnwick, D Thyroid. 1999 June; 9(6): 545-56 1050-7256

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Syndromes of thyrotoxicosis with low radioactive iodine uptake. Author(s): Thyroid Unit, Massachusetts General Hospital, Boston, Massachusetts, USA. Source: Ross, D S Endocrinol-Metab-Clin-North-Am. 1998 March; 27(1): 169-85 08898529

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The effect of methimazole on the oxidant and antioxidant system in patients with hyperthyroidism. Author(s): Department of Biochemistry, Istanbul Faculty of Medicine, University of Istanbul, Turkey. Source: Ademoglu, E Gokkusu, C Yarman, S Azizlerli, H Pharmacol-Res. 1998 August; 38(2): 93-6 1043-6618

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The incidence of hyperthyroidism in Austria from 1987 to 1995 before and after an increase in salt iodization in 1990. Author(s): L. Boltzmann Institut fur Nuklearmedizin, Wilhelminenspital, Vienna, Austria. Source: Mostbeck, A Galvan, G Bauer, P Eber, O Atefie, K Dam, K Feichtinger, H Fritzsche, H Haydl, H Kohn, H Konig, B Koriska, K Kroiss, A Lind, P Markt, B Maschek, W Pesl, H Ramschak Schwarzer, S Riccabona, G Stockhammer, M Zechmann, W Eur-JNucl-Med. 1998 April; 25(4): 367-74 0340-6997

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The management of hyperthyroidism due to Graves' disease in the former USSR in 1991: results of a survey. Author(s): National Endocrinology Research Centre, Moscow, Russia. Source: Gerasimov, G Judenitch, O Zdanova, E Jurieva, N Korostishevskaja, I Mushinskaja, K Dedov, I Glinoer, D J-Endocrinol-Invest. 1992 Jul-August; 15(7): 513-7 0391-4097

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The prevention and management of iodine-induced hyperthyroidism and its cardiac features. Author(s): Division of Endocrinology, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA. Source: Dunn, J T Semigran, M J Delange, F Thyroid. 1998 January; 8(1): 101-6 1050-7256

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The use of antithyroid drugs in the medical management of feline hyperthyroidism. Source: Trepanier, L.A. Probl-Vet-Med. Hagerstown, Md. : J.B. Lippincott Co. December 1990. volume 2 (4) page 668-682. 1041-0228

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Treatment of feline hyperthyroidism using orally administered radioiodine: a study of 40 consecutive cases. Source: Malik, R. Lamb, W.A. Church, D.B. Aust-vet-j. Brunswick, Vic. : Australian Veterinary Association, 1927-. June 1993. volume 70 (6) page 218-219. 0005-0423

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Update on the management of hyperthyroidism and hypothyroidism. Author(s): UCSF/Mount Zion, San Francisco, CA 94143-1640, USA.

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Source: Woeber, K A Arch-Fam-Med. 2000 August; 9(8): 743-7 1063-3987

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

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

•

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

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

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

•

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Nutrition

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

Minerals Iodine Source: Integrative Medicine Communications; www.drkoop.com

•

Food and Diet Beef Source: Healthnotes, Inc.; www.healthnotes.com Monounsaturated Fats Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE HYPERTHYROIDISM

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Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to hyperthyroidism. 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 hyperthyroidism 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 “hyperthyroidism” (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 hyperthyroidism: •

A psychophysiological investigation of hyperthyroidism. Author(s): Flagg GW, Clemens TL, Michael EA, Alexander F, Wark J. Source: Psychosomatic Medicine. 1965 November-December; 27(6): 497-507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4159063&dopt=Abstract

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A randomized controlled trial to evaluate the adjuvant effect of lithium on radioiodine treatment of hyperthyroidism. Author(s): Bal CS, Kumar A, Pandey RM. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 May; 12(5): 399-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097201&dopt=Abstract

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Abnormal personality and thyrotoxicosis: a follow-up study. Author(s): Paykel ES. Source: Journal of Psychosomatic Research. 1966 September; 10(2): 143-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5969509&dopt=Abstract

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Adjuvant effect of lithium on radioiodine treatment of hyperthyroidism. Author(s): Bogazzi F, Bartalena L, Pinchera A, Martino E. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 December; 12(12): 1153-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593732&dopt=Abstract

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An approach to the mechanisms of laser acupuncture in treatment of exophthalmic hyperthyroidism. Author(s): Ge TY, Du J, Shi XQ. Source: J Tradit Chin Med. 1988 June; 8(2): 85-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3412018&dopt=Abstract

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Antioxidant status in experimental hyperthyroidism: effect of vitamin E supplementation. Author(s): Seven A, Seymen O, Hatemi S, Hatemi H, Yigit G, Candan G. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1996 December 9; 256(1): 65-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8960788&dopt=Abstract

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Antithyroid drug therapy for Graves' hyperthyroidism: is long-term administration of a small maintenance dose necessary? Author(s): Tajiri J, Noguchi S, Morita M, Tamaru M, Murakami N. Source: Endocrinol Jpn. 1991 April; 38(2): 223-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1684322&dopt=Abstract

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Autosomal dominant nonautoimmune hyperthyroidism. Clinical features-diagnosistherapy. Author(s): Fuhrer D, Mix M, Willgerodt H, Holzapfel HP, Von Petrykowski W, Wonerow P, Paschke R. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 1998; 106 Suppl 4: S10-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9867189&dopt=Abstract

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Cardiac arrest following minor surgery in unrecognized thyrotoxicosis: a case report. Author(s): Wolfson B, Smith K.

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Source: Anesthesia and Analgesia. 1968 November-December; 47(6): 672-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4177608&dopt=Abstract •

Choice of treatment for thyrotoxicosis. Author(s): Lamberg BA. Source: Ann Chir Gynaecol. 1983; 72(3): 96-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6194733&dopt=Abstract

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Comparative analysis of therapeutic effects of acupuncture in the treatment of hyperthyroidism. Author(s): He JS, Jin SB, Heng JS, Chen HP, Gui JS, Guo XL, Li HY, Yin ZF, Ma JX, Xiang KS. Source: J Tradit Chin Med. 1988 June; 8(2): 79-82. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3412016&dopt=Abstract

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Differential TCM treatment of hyperthyroidism. Author(s): Wei Z. Source: J Tradit Chin Med. 1997 September; 17(3): 178-83. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10437190&dopt=Abstract

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D-xylose tolerance test; studies in so-called functional disorders, thyrotoxicosis, chronic colitis, and obesity. Author(s): VARTIO T. Source: Ann Med Intern Fenn. 1963; 52: 183-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14070296&dopt=Abstract

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Effects of vitamin E and vitamin C supplementation on plasma lipid peroxidation and on oxidation of apolipoprotein B-containing lipoproteins in experimental hyperthyroidism. Author(s): Dirican M, Tas S. Source: J Med Invest. 1999 February; 46(1-2): 29-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10408154&dopt=Abstract

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Evaluation of antioxidant status in liver tissues: effect of iron supplementation in experimental hyperthyroidism. Author(s): Seymen HO, Seven A, Civelek S, Yigit G, Hatemi H, Burcak G. Source: J Basic Clin Physiol Pharmacol. 1999; 10(4): 315-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10631595&dopt=Abstract

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High dose of (131)I therapy for the treatment of hyperthyroidism caused by Graves' disease. Author(s): Alexander EK, Larsen PR.

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Source: The Journal of Clinical Endocrinology and Metabolism. 2002 March; 87(3): 10737. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889166&dopt=Abstract •

Hyperthyroidism associated with mercury poisoning. Author(s): McCann M, Sheckner S. Source: Clin Pharm. 1991 October; 10(10): 742-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1742959&dopt=Abstract

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Hyperthyroidism in Tasmania following iodide supplementation: measurements of thyroid-stimulating autoantibodies and thyrotropin. Author(s): Adams DD, Kennedy TH, Stewart JC, Utiger RD, Vidor GI. Source: The Journal of Clinical Endocrinology and Metabolism. 1975 August; 41(2): 2218. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=51028&dopt=Abstract

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Hyperthyroidism treated with “yiqiyangyin” decoction. Author(s): Xia SN, Xu ZZ, Zhang ZH, Zhao WK, Wan SY, Gu WC, Zhou YP. Source: J Tradit Chin Med. 1986 June; 6(2): 79-82. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3773562&dopt=Abstract

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Hyperthyroidism with metastatic follicular thyroid carcinoma. Author(s): Chapman CN, Sziklas JJ, Spencer RP, Bower BF, Rosenberg RJ. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1984 April; 25(4): 466-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6152721&dopt=Abstract

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Hyperthyroidism. Author(s): DUCE V. Source: J Am Inst Homeopath. 1965 May-June; 58: 177. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14326078&dopt=Abstract

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Hypothyroidism and hyperthyroidism in the elderly. Author(s): Mintzer MJ. Source: J Fla Med Assoc. 1992 April; 79(4): 231-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1588294&dopt=Abstract

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Iodine-induced subclinical hypothyroidism in euthyroid subjects with a previous episode of amiodarone-induced thyrotoxicosis. Author(s): Roti E, Minelli R, Gardini E, Bianconi L, Gavaruzzi G, Ugolotti G, Neri TM, Braverman LE.

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Source: The Journal of Clinical Endocrinology and Metabolism. 1992 November; 75(5): 1273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1331165&dopt=Abstract •

Iodised salt and hyperthyroidism. Author(s): Wikramanayake TW. Source: Ceylon Med J. 2000 December; 45(4): 173-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293966&dopt=Abstract

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Large doses of radioiodine in the treatment of thyrotoxicosis. Author(s): Ingbar SH. Source: The New England Journal of Medicine. 1968 December 19; 279(25): 1395-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5754913&dopt=Abstract

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Lipid peroxidation and vitamin E supplementation in experimental hyperthyroidism. Author(s): Seven A, Seymen O, Hatemi S, Hatemi H, Yigit G, Candan G. Source: Clinical Chemistry. 1996 July; 42(7): 1118-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8674204&dopt=Abstract

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Modification of the effects of hyperthyroidism by concurrent ascorbic acid supplementation. Author(s): Binderman A, Goldman HM, Ruben MP, Gould BS. Source: J Periodontol. 1968 January; 39(1): 42-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5244512&dopt=Abstract

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Myasthenia gravis associated with hyperthyroidism in childhood. Author(s): Schlezinger NS, Corin MS. Source: Neurology. 1968 December; 18(12): 1217-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5750705&dopt=Abstract

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Pancytopenia responding to treatment of hyperthyroidism: a clinical case and review of the literature. Author(s): Shaw B, Mehta AB. Source: Clinical and Laboratory Haematology. 2002 December; 24(6): 385-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452820&dopt=Abstract

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Parathyroid function after 131-I therapy for hyperthyroidism. Author(s): Adams PH, Chalmers TM. Source: Clin Sci. 1965 October; 29(2): 391-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4953950&dopt=Abstract

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Parathyroid hormone secretory reserve in patients submitted to 131-iodine therapy for hyperthyroidism. Author(s): Vieira JG, Brandao CM, Kasamatsu TS, Furlanetto RP. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 1991; 24(11): 1103-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1822999&dopt=Abstract

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Radioactive iodine treatment of a functional thyroid carcinoma producing hyperthyroidism in a dog. Author(s): Peterson ME, Kintzer PP, Hurley JR, Becker DV. Source: J Vet Intern Med. 1989 January-March; 3(1): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2926718&dopt=Abstract

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Some aspects of the diagnosis of thyrotoxicosis. Author(s): Crown S, Crisp AH, Ellis JP. Source: Journal of Psychosomatic Research. 1966 September; 10(2): 209-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5969514&dopt=Abstract

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Symptomatic hyperthyroidism in a patient taking the dietary supplement tiratricol. Author(s): Bauer BA, Elkin PL, Erickson D, Klee GG, Brennan MD. Source: Mayo Clinic Proceedings. 2002 June; 77(6): 587-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12059130&dopt=Abstract

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Thyroid imaging using positron emission tomography--a comparison with ultrasound imaging and conventional scintigraphy in thyrotoxicosis. Author(s): Flower MA, Irvine AT, Ott RJ, Kabir F, McCready VR, Harmer CL, Sharma HL, Smith AG. Source: The British Journal of Radiology. 1990 May; 63(749): 325-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2198979&dopt=Abstract

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Thyrotoxicosis and the psychological state; a case report. Author(s): BOWERS M Jr, SINGER D. Source: Psychosomatics. 1964 September-October; 204: 322-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14235750&dopt=Abstract

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Thyrotoxicosis caused by functioning metastatic thyroid carcinoma. A rare and elusive cause of hyperthyroidism with low radioactive iodine uptake. Author(s): Ober KP, Cowan RJ, Sevier RE, Poole GJ. Source: Clinical Nuclear Medicine. 1987 May; 12(5): 345-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3581618&dopt=Abstract

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Thyrotoxicosis incidence in Switzerland and benefit of improved iodine supply. Author(s): Burgi H, Kohler M, Morselli B. Source: Lancet. 1998 September 26; 352(9133): 1034. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9759751&dopt=Abstract

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Transient hyperthyroidism in a patient taking dietary supplements containing kelp. Author(s): Eliason BC. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1998 November-December; 11(6): 478-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9876004&dopt=Abstract

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Treatment of 51 cases of hyperthyroidism by puncturing effective points. Author(s): Zhang Y, Wang X. Source: J Tradit Chin Med. 1994 September; 14(3): 167-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7799647&dopt=Abstract

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Use of beta-adrenoceptor blocking drugs in hyperthyroidism. Author(s): Feely J, Peden N. Source: Drugs. 1984 May; 27(5): 425-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6144501&dopt=Abstract

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

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

•

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

•

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

•

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

•

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

General Overview Angina Source: Healthnotes, Inc.; www.healthnotes.com Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Congestive Heart Failure Source: Healthnotes, Inc.; www.healthnotes.com Hyperthyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Healthnotes, Inc.; www.healthnotes.com Hypothyroidism Source: Integrative Medicine Communications; www.drkoop.com Morning Sickness Source: Healthnotes, Inc.; www.healthnotes.com Pulmonary Edema Source: Integrative Medicine Communications; www.drkoop.com Serum Sickness Source: Integrative Medicine Communications; www.drkoop.com Thyroid Inflammation Source: Integrative Medicine Communications; www.drkoop.com Thyroiditis Source: Integrative Medicine Communications; www.drkoop.com Vitamin B12 Deficiency Source: Healthnotes, Inc.; www.healthnotes.com

•

Herbs and Supplements Astragalus Source: Prima Communications, Inc.www.personalhealthzone.com Bugleweed Alternative names: Lycopus virginicus Source: Healthnotes, Inc.; www.healthnotes.com

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Camellia Sinensis Source: Integrative Medicine Communications; www.drkoop.com Ephedra Alternative names: Ephedra sinica, Ephedra intermedia, Ephedra equisetina Source: Healthnotes, Inc.; www.healthnotes.com Ephedra Source: Prima Communications, Inc.www.personalhealthzone.com Green Tea Alternative names: Camellia sinensis Source: Integrative Medicine Communications; www.drkoop.com Kava Source: Prima Communications, Inc.www.personalhealthzone.com Kelp Source: Healthnotes, Inc.; www.healthnotes.com Lemon Balm Alternative names: Melissa officinalis Source: Healthnotes, Inc.; www.healthnotes.com Melissa Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10043,00.html Potentilla Alternative names: Cinquefoil, Silverweed; Potentilla sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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. CLINICAL TRIALS AND HYPERTHYROIDISM Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning hyperthyroidism.

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

Evaluation of Patients with Thyroid Disorders Condition(s): Hyperthyroidism; Hypothyroidism; Pituitary Neoplasm Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: Participants in this study will be patients diagnosed with or suspected to have a thyroid function disorder. These conditions may include: hypothyroidism, hyperthyroidism, thyroid hormone resistance, Graves' Dermopathy, and thyroid-stimulating hormone (TSH) secreting pituitary adenomas. The main purpose of this study is to further understand the natural history, clinical presentation, and genetics of thyroid function disorders. Many of the tests performed are in the context of standard medical care that is offered to all patients with thyroid function disorders. In addition, blood and tissue samples may be taken for research and genetic studies. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001159

8

These are listed at www.ClinicalTrials.gov.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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CHAPTER 5. PATENTS ON HYPERTHYROIDISM Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “hyperthyroidism” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hyperthyroidism, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Hyperthyroidism By performing a patent search focusing on hyperthyroidism, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 9Adapted

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

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The following is an example of the type of information that you can expect to obtain from a patent search on hyperthyroidism: •

Compositions and methods of inhibiting thyroid activity Inventor(s): Doerge; Daniel (Little Rock, AR) Assignee(s): University of Hawaii (Honolulu, HI) Patent Number: 5,371,102 Date filed: August 6, 1993 Abstract: Methods of using N,N'-disubstituted thiocarbamide compounds for reversibly inhibiting hyperthyroidism are provided. Active compounds reversibly inhibit catalytic iodination without producing sulfenic acid intermediates which can permanently inactivate thyroid peroxidase. By preventing sulfenic acid formation, side effects due to toxicity in liver and bone marrow can be reduced compared to currently used drugs. The compounds can be formulated for administration to a hyperthyroid patient until remission occurs with less risk of possible everdosing. Excerpt(s): The invention relates to anti-hyperthyroid therapy. In particular, the invention involves methods for reversibly inhibiting thyroid activity with N,N'disubstituted thiocarbamide compounds. The thyroid gland, located in front of the windpipe, secretes the hormone thyroxine into the blood to regulate heart rate, body temperature and calorie consumption. When excess thyroid hormone is produced, a condition known as hyperthyroidism results. Hyperthyroidism is usually caused by Graves' disease, a condition in which the body overproduces antibodies that specifically stimulate the thyroid gland. The majority of hyperthyroid patients are women. The typical patient becomes nervous, irritable, warm and has difficulty sleeping. The patient's skin is soft and velvety. Although appetite may increase, the patient still loses weight. Other symptoms include tremors, heavier periods and increased frequency of miscarriage. Fluid accumulation behind the eyeballs may move them forward, creating a wide-eyed appearance. Hyperthyroidism is lift-threatening if not treated. Web site: http://www.delphion.com/details?pn=US05371102__

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Method for treating hypercalcemia Inventor(s): Donovan; Stephen (Capistrano Beach, CA) Assignee(s): Allergan Sales, Inc. (Irvine, CA) Patent Number: 6,447,785 Date filed: November 2, 2000 Abstract: A method for treating hypothyroidism by local administration of a neurotoxin, such as a botulinum toxin, to a thyroid, thereby reducing an inhibitory effect upon thyroid hormone secretion. A method for treating hyperthyroidism by local administration of a neurotoxin, such as a botulinum toxin, to a sympathetic ganglion which innervates the thyroid, thereby reducing a stimulatory effect upon thyroid hormone secretion. Methods for treating calcium metabolism disorders by local administration of a neurotoxin to modulate calcitonin secretion are also disclosed. Excerpt(s): The present invention relates to methods for treating thyroid disorders. In particular the present invention relates to methods for treating thyroid disorders by

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administration of a neurotoxin to a patient. It has been estimated that at least about two hundred million people worldwide are afflicted with a thyroid disorder and women are affected disproportionaly, as compared to men, by a ratio of about ten to one. In the United States, about ten million persons, including ten percent of all women over age 45, have either overactive or underactive thyroid glands. Bayliss et al., Thyroid Disease The Facts, preface, Oxford University Press (1998). The thyroid is an endocrine gland comprised of follicle cells and non-follicular or C cells. The follicle cells are capable of making two hormones, triiodothyronine (T.sub.3) which contains three iodine atoms and thyroxine (T.sub.4) which contains four. The action of thyroid hormone is concerned principally with the regulation of metabolic rate by, for example, increasing energy production and oxygen consumption by most normal tissues. Synthesis and release of T.sub.3 and T.sub.4 by thyroid cells in influenced by thyroid stimulating hormone (TSH, also called thyrotrophin) made by the pituitary. The C cells can make calcitonin which appears to influence calcium metabolism. Significantly, calcitonin is a potent hypocalcemic agent. Disorders of the thyroid include autoimmune disorders (such as Graves' disease), thyroiditis (inflammation or infection of the thyroid), and cancer, all of which conditions can result in hypothyroidism (as can occur in Hashimoto's thyroiditis) or hyperthyroidism (thyroidtoxicosis, as can occur in Graves' disease). An enlarged thyroid (goiter) can by euthyroid, or a symptom of either hyperthyroidism (thyroidtoxicosis) or hypothyroidism. Web site: http://www.delphion.com/details?pn=US06447785__ •

Peptide or its salt for autoimmune hyperthyroidism containing it Inventor(s): Mori; Toru (Kyoto, JP), Sugawa; Hideo (Kyoto, JP), Ueda; Yoshimichi (Kusatsu, JP), Yamada; Nobutoshi (Kusatsu, JP) Assignee(s): Ishihara Sangyo Kaisha Ltd. (Osaka, JP) Patent Number: 5,446,129 Date filed: August 4, 1994 Abstract: A peptide having the formula:A--B--Cwherein A is a hydrogen atom, Glu, Phe Glu--, Phe Phe Glu-- or an amino acid sequence as shown by SEQ ID NO:1 in the Sequence Listing, B is an amino acid sequence as shown by SEQ ID NO:2, and C is a hydroxyl group, Glu, --Glu Ile, --Glu Ile Ile or an amino acid sequence as shown by SEQ ID NO:3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 or 16, and containing from 6 to 25 amino acids; or its salt. Excerpt(s): The present invention relates to a novel peptide or its salt and a diagnostic or therapeutic agent for autoimmune hyperthyroidism, which contains, as active ingredient, a peptide or its salt useful against thyroid stimulating antibody (TSAb), i.e. one of thyroid stimulating hormone (TSH) receptor autoantibodies, which is considered to be one of important causes for autoimmune hyperthyroidism. The above-mentioned TSAb which is considered to be one of causes for autoimmune hyperthyroidism, relates directly to pathogenesis. Its quantitative change is considered to be an important marker for activity of the disease. Heretofore, for the measurement of the above-mentioned autoantibodies, a stimulation assay method wherein production of cyclic adenosin 3',5'monophosphate (cAMP) by the activation of adenylate cyclase, is used as an index, and a binding inhibition assay method which is a radioimmunoassay using.sup.125 I-TSH (thyroid stimulating hormone), have been widely employed. As the stimulation assay method, a method by S. Kosugi et al. (Endocrinology, Vol. 125, No. 1, p 410 (1989)) is known. According to this method, rat established thyroid cell line FRTL5 is employed to

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measure the produced cAMP by the activation of adenylate cyclase which in turn is induced by the binding of TSAb with TSH receptor. The activity of TSAb is determined by the measured amount as an index. On the other hand, B. R. Smith et al. have established a standard binding assay method (Clinical Endocrinology, Vol. 17, p 409 (1982)). This method utilizes.sup.125 I-TSH and its principle is the quantification of inhibition by TSH receptor autoantibodies against the binding of.sup.125 I-TSH with solubilized TSH receptor from porcine thyroid. The TSH receptor autoantibodies include TSAb and TBII (TSH-binding inhibitory immunogloblin), but the results of these methods do not tell which one or both are bound with the TSH receptor. The conventional methods involve cumbersome operations in the measurement, and it is desired to develop a simpler method. Web site: http://www.delphion.com/details?pn=US05446129__ •

Sustained release thyroactive composition Inventor(s): Hennemann; Georg (Rotterdam, NL), Krenning; Eric P. (Rotterdam, NL) Assignee(s): Akzo N.V. (Arnhem, NL) Patent Number: 5,324,522 Date filed: December 28, 1992 Abstract: Disclosed are sustained release dosage forms of liothyronine, in combination with normal or sustained release of thyroxine in a molar ratio of about 1 to 50:1, especially 5 to 20:1, useful in thyroid hormone replacement therapy. Surprisingly, it is found that by incorporating liothyronine and optionally thyroxine into a prolonged action dosage form in the described ratios, that the side effects associated with thyroid hormone replacement therapy are greatly reduced or eliminated. The preparation can be a dosage form containing salts of both thyroxine and liothyronine which release in a sustained manner. The preparations will typically contain 5 to 25.mu.g of liothryronine. Also disclosed are processes of manufacturing the pharmaceutical preparations. The compositions are useful in treating disease states such as hypothyroidism, hyperthyroidism (in combination with thyrostatic drugs), so-called "TSH" suppressive therapy, and depression. Excerpt(s): The invention relates to pharmaceutical preparations generally, and more specifically to a preparation useful in replacement therapy for thyroactive material normally supplied by the thyroid gland. The thyroid gland, among other things, modulates a body's energy metabolism. It does so by releasing various iodinated thyronines. Two of these iodinated thyronines are thyroxine (3,5,3',5'-tetraiodothyronine or "T-4") and liothyronine (3,5,3'-triiodothyronine or "T-3"). Various diseases affecting the thyroid or pituitary gland can result in hypothyroidism. Hypothyroidism can also result from thyroid surgery or treatment with radioactive iodine. In a "hypothyroid" state, the body's basal metabolic state drops, and growth and development may be impaired. Web site: http://www.delphion.com/details?pn=US05324522__

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•

Therapeutic composition for treating hyperthyroidism Inventor(s): Hsieh; Ming T. (Taipei, TW), Wu; Long Y. (Taipei, TW) Assignee(s): National Science Council of Republic of China (Taipei, TW) Patent Number: 5,242,926 Date filed: May 28, 1992 Abstract: The composition includes dl-tetrahydropalmatine mixed with its carrier having pharmaceutical therapeutical effect for treating hyperthyroidism. The dltetrahydropalmatine may be purified from a chloroform layer extracted from a Corydalis tuber. Excerpt(s): The thyroid is a major endocrine gland for maintaining a human metabolism equilibrium. Phenomena such as nervous tension, dietary imbalance, environmental pollution, misuse of drugs and disease infection may cause abnormal function of the thyroid. The current methods for treating thyroid symptoms include: surgery, radiation with radioactive isotopes and treatment with thyroid inhibitors. There are two mechanisms of conventional anti-thyroxin medicines, one being a peroxidase for inhibiting iodide for reducing the synthesis of thyroxin; and the other for interfering the catching of iodide ions or inhibiting a combination of iodide ions with thyroid globulin, thereby reducing the concentration of thyroxin in the blood. However, conventional medicines may stimulate the thyrotropine-stimulating hormone (TSH) to enlarge thyroid cells to decrease the white blood cells and may inhibit the thyroid hormone especially in a pregnant mother, thereby influencing the brain growth of a baby and causing stunting and cretinism or even leading a worse side effect such as a deformed baby. In view of these considerations, we therefore invent a therapeutic composition for treating hyperthyroidism but without causing side effects to the user. Web site: http://www.delphion.com/details?pn=US05242926__

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Treatment of hyperthyroidism with 1,3-dihydro-1[2-(2-thienyl)alkyl]-2H-imidazole-2thiones Inventor(s): Yarrington; John T. (Worthington, OH) Assignee(s): Merrell Dow Pharmaceuticals Inc. (Cincinnati, OH) Patent Number: 5,198,457 Date filed: April 17, 1992 Abstract: The use of 1-(thienylalkyl)imidazole-2-thione derivatives as antihyperthyroid agents are described herein. These compounds may be administered as a preparatory adjunct procedure when thyroidectomy or radioactive iodine therapy is the recommended therapy or as a primary therapy when surgical procedures is not recommended or long term therapy is advisabe. Excerpt(s): This invention relates to a novel method for the treatment of hyperthyroidism by means of the administration of the dopamine beta-hydroxylase inhibitors which are derivatives of 1-(thienylalkyl)imidazole-2-thiol. As disclosed in U.S. Pat. No. 5,057,613, these compounds were previously known to show a dopamine betahydroxylase (DBH) inhibiting activity and to be useful in the treatment of hypertension at dosages of about 1 mg to 100 mg per kilogram body weight. Subsequent studies have shown that these compounds have a profound effect on the thyroid, rendering them useful for treating hyperthyroidism at doses equivalent to or lower than

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their blood pressure lowering dosages. Assays indicating the activity of compounds of this invention as DBH inhibitors and antihypertensive agents are described in U.S. Pat. No. 5,057,613, which is incorporated herein by reference. It has now been discovered that the compounds of this invention are also potent antihyperthyroid agents. This activity is not normally associated with DBH inhibitors having antihypertensive activity. One compound combining antihyperthyroid activity with DBH inhibitory activity is methimazole (Tapazole.RTM., Lilly). Methimazole, 1-methyl-2-mercaptoimidazole, is administered for treatment of hyperthyroidism in dosages of 15-60 mg/day divided into 3 doses for administration at 8-hour intervals (Physicians' Desk Reference, 1992). Studies by Ray W. Fuller, et al., (Advances in Enzyme Regulation, 1977, V15, pp. 267281), have shown that methimazole's DBH-inhibiting activity is less pronounced than that of methimazole analogs bearing larger 1-alkyl substituents in place of the methyl group, while the greatest DBH inhibition was measured for 1-cyclohexyl-2mercaptoimidazole (CHMI) which showed only slight antithyroid activity. Web site: http://www.delphion.com/details?pn=US05198457__ •

Use of platelet factor 4 to inhibit osteoblast proliferation Inventor(s): Tatakis; Dimitris N. (Louisville, KY) Assignee(s): University of Louisville Research Foundation, Inc. (Louisville, KY) Patent Number: 5,304,542 Date filed: August 28, 1992 Abstract: The invention features a method for inhibiting proliferation of osteoblasts in a mammal in need of such inhibition. The method entails administering PF4. PF4 can be used to treat both diseases characterized by primary changes in osteoblastic cell function/activity (e.g., ossifying fibroma and fibrous dysplasia, osteoblastoma and osteoid osteoma, and osteosarcoma) and diseases or systemic conditions affecting bone in which abnormal osteoblastic cell function/activity is a secondary effect (e.g., acromegaly, hypercalcemia, primary or secondary hyperparathyroidism, hyperthyroidism, osteoporosis, or Paget's disease of bone). In addition, PF4 may be used to treat diseases associated with localized changes in bone metabolism in which abnormal osteoblastic cell function/activity contributes to pathogenic bone changes. For example, PF4 can be used to treat periodontal disease (localized, inflammation-induced bone loss), rheumatoid arthritis and osteoarthritis (localized, inflammation-induced bone loss) localized osteoporosis, mastocytosis, multiple myeloma, and bone metastases of various tumors. Because of its inhibitory effect on osteoblastic cell proliferation, PF4 can be used to treat bone abnormalities associated with either undesired osteoblastic cell proliferation or undesired osteoblastic cell function or activity. Excerpt(s): Platelet factor 4 (PF4) is a well-known protein which has been completely sequenced (Deuel et al. Proc. Natl. Acad. Sci. USA 78:4585, 1981). It is a 70-residue secretable platelet protein with a molecular weight of approximately 7.8 Kd which is released during platelet aggregation. It has been suggested that PF4 may inhibit growth of Kaposi sarcoma cells in vitro (Zucker et al. (1991) Proc. Soc. Exp. Biol. Med. 198:693702; Miles et al. (1991) [abstract] VII International Conference on Aids (1991) Florence, Italy). Hiti-Harper et al. (Science 199:99, 1978) report that PF4 inhibits collagenase derived from cultured human skin or human granulocytes. Web site: http://www.delphion.com/details?pn=US05304542__

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

Method for treating and preventing hyperparathyroidism Inventor(s): Knutson, Joyce C.; (Madison, WI), Mazess, Richard B.; (Madison, WI), Strugnell, Stephen A.; (Madison, WI) Correspondence: Michael Best & Friedrich, Llp; One South Pinckney Street; P O Box 1806; Madison; WI; 53701 Patent Application Number: 20020183288 Date filed: April 19, 2002 Abstract: This invention relates to a method for treating or preventing hyperthyroidism associated with aging and/or with Aging-Related Vitamin D Deficiency (ARVDD) syndrome by administering a sufficient amount of an active vitamin D compound utilizing a variety of effective treatment protocols. The invention further relates to treating or preventing one or more of the following conditions, e.g., (1) primary vitamin D deficiency, (2) 1,25-(OH).sub.2D.sub.3 deficiency, and (3) 1,25-(OH).sub.2D.sub.3 resistance included within the syndrome of ARVDD. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/501,093 filed Feb. 9, 2000 which is a continuation-in-part of U.S. patent application Ser. No. 09/086,969, filed May 29, 1998 which is a continuation-in-part of U.S. patent application Ser. No. 08/907,659 filed Aug. 8, 1997, now U.S. Pat. No. 5,869,473, and this application is a continuation-in-part of U.S. patent application Ser. No. 08/907,660 filed Aug. 8, 1997 which is a divisional of U.S. patent application Ser. No. 08/798,958, filed Feb. 11, 1997, now U.S. Pat. No. 5,707,980, which is a continuation of U.S. patent application Ser. No. 08/415,488, filed Apr. 3, 1995, now U.S. Pat. No. 5,602,116. Not Applicable. This invention relates to a method for treating or preventing hyperparathyroidism associated with aging by administering a sufficient amount of an active vitamin D compound utilizing a variety of effective treatment protocols. The method also relates to treating or preventing hyperparathyroidism associated with Aging-Related Vitamin D Deficiency (ARVDD) syndrome. Included within the syndrome of ARVDD are one or more of the following conditions, (1) primary vitamin D deficiency, (2) 1,25-(OH).sub.2D.sub.3 deficiency, and (3) 1,25-(OH).sub.2D.sub.3 resistance due to decreased responsiveness of target organs. ARVDD typically produces elevated blood parathyroid hormone levels, i.e., hyperparathyroidism. The invention is also a method of treating one or more of the conditions included within the syndrome of ARVDD. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

10

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

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Methods for diagnosing thyroid conditions and for monitoring thyroxine therapy Inventor(s): Hourihan, Joachim; (Dorchester, MA), Salhanick, Hilton A.; (Brookline, MA) Correspondence: Cooper & Dunham, Llp; 1185 Avenue OF The Americas; New York; NY; 10036; US Patent Application Number: 20020076827 Date filed: July 26, 2001 Abstract: This invention provides a method of diagnosing a thyroid condition in a subject which comprises: determining the concentration of thyroid stimulating hormone in a urine sample by a method which is not a radioimmunoassay; and comparing the concentration of thyroid stimulating hormone with a urinary concentration of thyroid stimulating hormone in a normal subject; wherein: i) a concentration of thyroid stimulating hormone which is higher than the urinary concentration of thyroid stimulating hormone in the normal subject diagnoses hypothyroidism in the subject; and ii) a concentration of thyroid stimulating hormone which is lower than the urinary concentration of thyroid stimulating hormone in the normal subject diagnoses hyperthyroidism in the subject. This invention also proves a method of monitoring thyroxine therapy. Excerpt(s): This application is a continuation-in-part of U.S. Provisional Application No. 60/220,894, filed Jul. 26, 2000, the contents of which are hereby incorpoated by reference into this application. Throughout this application, various publications are referenced by Arabic numerals. Full citations for these publications may be found at the end of the specification immediately preceding the claims. The disclosure of these publications is hereby incorporated by reference into this application to describe more fully the art to which this invention pertains. The subject invention relates to the development of urine tests for thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4), that will detect abnormal thyroid states and monitor therapy. The invention relates to the validation biochemically and clinically that urinary thyroid stimulating hormone (TSH) is a reliable screening procedure for hypothyroidism and is useful in monitoring therapy. The invention relates to the validation biochemically and clinically that urinary tri-iodothyronine (T3) and/or thyroxine (T4) are reliable screening procedure for hyperthyroidism. The invention relates to the development of methodology for urinary TSH, T3 and T4 tests that can be applied in the physician's office or clinic (i.e. point of care) to yield results within the time interval of a patient's visit. The invention relates to the development of methodologies which utilize application of TSH, T3 and T4 that are simple, inexpensive and conveniently rapid so that the tests can also be performed at home. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Thyromimetic organic compounds Inventor(s): Kukkola, Paivi J.; (Whitehouse Station, NJ) Correspondence: Thomas Hoxie; Novartis Corporation; Patent And Trademark Dept; 564 Morris Avenue; Summit; NJ; 079011027 Patent Application Number: 20020107390 Date filed: August 16, 2001

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Abstract: Compounds of the formula 1in which W is O, S, S(O) or S(O).sub.2; X is --SR4, --S(O)R4, or --S(O).sub.2R4, --S(O).sub.2NR5R6; or X is --C(O)NR5R6 provided that -C(O)NR5R6 is located at the 3', 4' or 5' position; Y is O or H.sub.2; Z is hydrogen, halogen, hydroxy, optionally substituted alkoxy, aralkoxy, acyloxy or alkoxycarbonyloxy; R is hydrogen, halogen, trifluoromethyl, lower alkyl or cycloalkyl; R1 is hydroxy, optionally substituted alkoxy, aryloxy, heteroaryloxy, aralkyloxy, cycloalkoxy, heteroaralkoxy or -NR5R6; R2 is hydrogen, halogen or alkyl; R3 is halogen or alkyl; R4 is optionally substituted alkyl, aryl, aralkyl, heteroaralkyl or heteroaryl; R5, R6 and R7 are independently hydrogen, optionally substituted alkyl, cycloalkyl, aryl, aralkyl, heteroaryl, or heteroaralkyl; or R5 and R6 combined are alkylene optionally interrupted by O, S, S(O), S(O).sub.2 or NR7 which together with the nitrogen atom to which they are attached form a 5- to 7-membered ring; n represents zero or an integer from 1 to 4; pharmaceutically acceptable salts thereof; pharmaceutical compositions comprising said compounds; a method to prevent and treat diseases associated with an imbalance of thyroid hormones, such as hypo- and hyperthyroidism, obesity, osteoporosis and depression; and, a method of lowering LDL cholesterol and Lp(a) levels in mammals using such compounds. Excerpt(s): This application claims the benefit of provisional application No. 60/______ filed Mar. 29, 1999, which was converted from application Ser. No. 09/280,105. n represents zero or an integer from 1 to 4; and pharmaceutically acceptable salts thereof. The compounds of the invention are thyromimetic agents which can be used to prevent and/or treat diseases associated with an imbalance of thyroid hormones, such as hypoand hyper-thyroidism, obesity, osteoporosis and depression. The compounds of the invention are, in particular, hypolipedemic agents which enhance the clearance of cholesterol from circulation, particularly the clearance of cholesterol in the form of low density lipoproteins (LDL). They, inter alia, upregulate hepatic LDL receptor function in mammals. Thus, they are useful for reducing total cholesterol plasma levels in mammals, in particular for reducing levels of LDL-cholesterol. Furthermore, such compounds also lower elevated lipoprotein (a) [Lp(a)] levels, an independent cardiovascular risk factor, in mammals. The compounds of the invention can therefore be used for the prevention and/or treatment of occlusive cardiovascular conditions in which hyperlipidemia and hyperlipoproteinemia are implicated, such as atherosclerosis and coronary heart disease in mammals. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Use of proteasome inhibitors for treating cancer, inflammation, autoimmune disease, graft rejection and septic shock Inventor(s): Wang, Xin; (Montreal, CA), Wu, Jiangping; (Brossard, CA) Correspondence: Merchant & Gould PC; P.O. Box 2903; Minneapolis; MN; 55402-0903; US Patent Application Number: 20020049157 Date filed: July 12, 2001 Abstract: The present invention relates to compositions comprising proteasome inhibitors, such as lactacystin, DPBA and their analogs. These compositions are used for the following purposes: (1) to disrupt mitochondrial function (useful aganst cancer, inflammation, adverse immune reaction and hyperthyroidism), (2) to disrupt nitric oxide synthesis (useful against inflammation and septic shock), and (3) to reverse ongoing adverse immune reactions, such as autoimmune diseases and graft rejection. In

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the later case, the compositions can be administered once the patients' T cells are mostly activated. Proteasome inhibitors can also be combined to immuno-suppressinve drugs like rapamycin, cyclosporin A and FK506. Finally, a method for screening a compound having a proteasome inhibition activity is also disclosed and claimed. Excerpt(s): This application is based on U.S. application Ser. No. 60/218,145, filed on Jul. 14, 2000, and is a continuation in part of U.S. application Ser. No. 09/341,009, filed on Jun. 29, 1999, which is a US national application derived from PCT/CA98/01010, filed Oct. 29, 1998. The present invention relates to the use of proteasome inhibitors for targetting different cellular functions implicated in cancer, inflammation, autoimmune disease, graft rejection and septic shock. The proteasome is a large protease complex. It is the main nonlysosomal proteolytic system in the cell, and resides in the cytoplasm as well as in the nucleus (Jentsch et al., 1995, Cell 82:881). The proteasome possesses up to five different peptidase activities, in different catalytic domains (Ciechanover, 1994, Cell 79:13; Orlowski et al., 1993, Biochemistry 32:1563), and the best characterized ones are chymotrypsin-like, trypsin-like and peptidylglutamyl-peptide hydrolyzing (PGPH) activities (Orlowski et al., 1981, Biochem & Biophys. Res. Com. 101:814; Wilk et al., 1983, J. Neurochem 40:842). 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 hyperthyroidism, 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 “hyperthyroidism” (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 hyperthyroidism. You can also use this procedure to view pending patent applications concerning hyperthyroidism. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON HYPERTHYROIDISM Overview This chapter provides bibliographic book references relating to hyperthyroidism. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on hyperthyroidism 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 “hyperthyroidism” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “hyperthyroidism” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “hyperthyroidism” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Diagnosis of hyperthyroidism Statistical evaluation of laboratory and clinical criteria; ISBN: 8774940120; http://www.amazon.com/exec/obidos/ASIN/8774940120/icongroupinterna

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Hyperthyroidism: Use of Radioiodine in Management (1995); ISBN: 1860160239; http://www.amazon.com/exec/obidos/ASIN/1860160239/icongroupinterna

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The Various Types of Hyperthyroidism by D. Reinwein (Editor), P.C. Scriba (Editor); ISBN: 3541131519; http://www.amazon.com/exec/obidos/ASIN/3541131519/icongroupinterna

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Thyrotoxicosis: proceedings of an international symposium, Edinburgh, May 1967; ISBN: 0443005354; http://www.amazon.com/exec/obidos/ASIN/0443005354/icongroupinterna

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The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “hyperthyroidism” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •

A study of the isotopic labeling of the protein bound iodine in patients with hyperthyroidism. Author: Miller, J. Martin (John Martin),; Year: 1960; [Minneapolis] 1951

•

Antithyroid drug therapy in hyperthyroidism: recurrence, hypothyroidism and thyroid antibodies Author: Stege, Reinhard.; Year: 1964; Stockholm: [s.n.]: Distributed by Almqvist; Wiksell Periodical Co., 1980

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Cholinesterase activity of red cells of geriatric patients and patients with thyrotoxicosis, by Eeva Jalavisto and H. Salmela. Author: Jalavisto, Eeva.; Year: 1963; Helsinki, 1962

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Creatine-creatinine metabolism; general review with a contribution to the study of creatinuria in hyperthyroidism. Author: Kepler, Edwin John.; Year: 1946; [Minneapolis] 1929

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Hyperthyroidism Author: Toft, Anthony D.; Year: 1949; London: Saunders, c1985

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Hyperthyroidism. Author: Rawson, Rulon Wells,; Year: 1964; Chicago, Year Book Publishers, 1955

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Hyperthyroidism: concept and controversy. Author: Hamburger, Joel I.,; Year: 1962; Springfield, Ill., Thomas [c1972]; ISBN: 0398023042 http://www.amazon.com/exec/obidos/ASIN/0398023042/icongroupinterna

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On the morphology of blood and bone-marrow in thyrotoxicosis. Author: Biström, O.; Year: 1963; Helsingfors, 1946

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Social stress and thyrotoxicosis Author: Agrawal, Shashi Rani.; Year: 1952; Varanasi: Vishwavidyalaya Prakashan, 1983

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Studies on peripheral circulatory and metabolic consequences of thyrotoxicosis Author: Frey, Harald Martin Maarud.; Year: 1964; [Oslo]: Universitetsforlaget, [1967?]

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Studies on radioiodine treatment of thyrotoxicosis with special reference to the behaviour of the radioiodine tracer tests. Author: Larsson, Lars Gunnar.; Year: 1967; Stockholm, 1955

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The clinical picture of thyrotoxicosis. Author: McEwan, Peter.; Year: 1970; Edinburgh, Oliver and Boyd, 1948

11

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

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Thyrotoxicosis; proceedings of an international symposium, Edinburgh, May 1967. Edited by W. James Irvine. Author: Irvine, W. James (William James); Year: 1967; Edinburgh, Livingstone, 1967

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Vitamin B12 in hyperthyroidism and the clinical role of oxidative phosphorylation and electron transport; a preliminary study. Author: George, William Kelley.; Year: 1968; [Galveston] 1959

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

Systemic Disease: Oral Manifestations and Effects on Oral Health Source: in Wray, D., et al. Textbook of General and Oral Medicine. Edinburgh, Scotland: Churchill Livingstone. 1999. p. 307-328. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $50.00 plus shipping and handling. ISBN: 0443051895. Summary: Oral lesions and symptoms are usually the result of local disease, but can be the earliest indication of, or in some instances the main features in, patients with systemic disease. Indeed, oral manifestations can sometimes lead to the diagnosis of systemic disease. This chapter on the oral manifestations of systemic disease is from an undergraduate dentistry textbook that covers both general medicine and surgery, and oral medicine, emphasizing the overlap between them. The authors note that there are surprisingly few diseases, or their treatments, that are not capable of causing some oral signs or symptoms or affecting oral health care. Topics include blood disorders, including anemia, the thalassemias, lymphoreticular malignancy, myeloproliferative disorders, plasma cell tumors (myeloma), and porphyria; hemorrhagic diseases, including platelet disorders, Von Willebrand's disease, clotting disorders, and acquired clotting defects; cardiovascular disease, including patients with cardiac pacemakers, and oral reactions to drugs used for heart disease; endocrine (hormone) disorders, including acromegaly, adrenocortical insufficiency, corticosteroid treatment, diabetes mellitus, hyperthyroidism, hypothyroidism, hyperparathyroidism, and hypoparathyroidism; gastrointestinal disorders, including celiac disease (gluten sensitive enteropathy), Crohn's disease, Gardner's syndrome, and pyostomatitis vegetans; granulomatous diseases, including foreign body reactions, midline granuloma syndromes, orofacial granulomatosis, and sarcoidosis; immunological disorders, including allergy that may manifest as angioedema, aphthae, contact cheilitis, erythema multiforme, lichen planus, orofacial granulomatosis, and plasma cell gingivitis; nutritional deficiencies, including vitamin A, riboflavin (vitamin B2), nicotinamide, vitamin B12 and folic acid, vitamin C, and vitamin D; pregnancy; and renal disease. Clinical points to remember are highlighted in text boxes. 16 figures. 31 tables.

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Endocrine Conditions Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 263-297. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail: [email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: The endocrine system is a widespread system consisting of glands that exert their effects, usually at some distance, by means of chemicals (hormones) secreted into the circulation. Endocrine and nervous system mechanisms thus normally maintain homeostasis. This chapter on endocrine conditions is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. Topics include the hypothalamus and pituitary, posterior pituitary hypofunction, anterior pituitary hypo and hyperfunction, adrenocortical hypofunction, systemic corticosteroid therapy, acute adrenal insufficiency, adrenocortical hyperfunction (including Cushing's syndrome), hyperaldosteronism, pheochromocytoma, the thyroid, goiter, lingual thyroid, hypo and hyperthyroidism, the parathyroids, hypo and hyperparathyroidism, the pancreas, diabetes mellitus, hormone-secreting pancreatic tumors, the gonads, oral contraceptives, pregnancy, lactation, prematurity, menopause, hormone replacement therapy, multiple endocrine adenoma (MEA), and endocrine and metabolic manifestations of cancer and other diseases. For each condition, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. 1 appendix. 5 figures. 23 tables. 53 references.

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How Vocal Abilities Can Be Limited by Endocrine System Diseases and Disorders Source: in Thurman, L. and Welch, G., eds. Bodymind and Voice: Foundations of Voice Education, Volumes 1-3. 2nd ed. Collegeville, MN: VoiceCare Network. 2000. p. 556-563. Contact: Available from National Center for Voice and Speech (NCVS). Book Sales, 334 Speech and Hearing Center, University of Iowa, Iowa City, IA 52242. Website: www.ncvs.org. PRICE: $75.00 plus shipping and handling. ISBN: 0874141230. Summary: This chapter on endocrine system diseases and disorders is from a multivolume text that brings a biopsychosocial approach to the study of the voice. The authors use the phrase 'bodyminds' to describe the interrelationship of perception, memory, learning, behavior, and health, as they combine to affect all environmental interactions, adaptations, and learning. The books are written for teachers, voice professionals, people who use their voices on an avocational basis, and interested members of the general public. This chapter describes how the hormones produced by the endocrine system stimulate or inhibit the body's organs and systems during physical growth and development, and they participate in the metabolic ecology of the body. When abnormal fluctuations occur in the endocrine system, unfortunate consequences to human neuropsychobiological functioning are common. Topics include general endocrine imbalances, diabetes mellitus, thyroid gland disorders (hyperthyroidism, hypothyroidism), adrenal gland disorders, sexual hormones (processes, imbalances, and disorders), the menstrual cycle, pregnancy, and menopause. 54 references.

•

Metabolic and Genetic Jaw Diseases Source: in Regezi, J.A. and Sciubba, J.J. Oral Pathology: Clinical Pathologic Correlations. 3rd ed. Philadelphia, PA: W.B. Saunders Company. 1999. p. 417-452.

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Contact: Available from W.B. Saunders Company. Book Order Fulfillment Department, 6277 Sea Harbor Drive, Orlando, FL 32821-9854. (800) 545-2522. Fax (800) 874-6418. Website: www.wbsaunders.com. PRICE: $63.95. ISBN: 0721677312. Summary: This chapter on metabolic and genetic jaw diseases is from a pathology textbook that presents current concepts of oral and maxillofacial pathology in order to enhance the reader's diagnostic skills through the use of differential diagnosis strategies. The text offers readers detailed guidance of etiology, pathogenesis, clinical features, histopathology, differential diagnosis, and treatment of oral diseases of the mucosa, submucosa, and bone. This chapter covers metabolic conditions, including Paget's disease, hyperparathyroidism, hyperthyroidism, hypophosphatasia, infantile cortical hyperostosis, phantom bone disease, and acromegaly; and genetic abnormalities, including cherubism, osteopetrosis, osteogenesis imperfecta, cleidocranial dysplasia, Crouzon's syndrome (craniofacial dysostosis), Treacher Collins syndrome (mandibulofacial dysostosis), Pierre Robin syndrome, Marfan's syndrome, Ehlers Danlos syndrome, Down syndrome (trisomy 21), hemifacial atrophy, hemifacial hypertrophy, clefts of the lip and palate, and Fragile X syndrome. 32 figures. 142 references. •

Prevalence and Incidence of Secondary and Other Types of Diabetes Source: in Harris, M.I., et al., eds., for the National Diabetes Data Group (NDDG). Diabetes in America. 2nd ed. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. 1995. p. 69-84. Contact: Available from National Diabetes Information Clearinghouse (NDIC). 1 Information Way, Bethesda, MD 20892-3560. (800) 860-8747 or (301) 654-3327. Fax (301) 634-0716. E-mail: [email protected]. Also available at http://www.niddk.nih.gov/. PRICE: Full-text book and chapter available online at no charge; book may be purchased for $20.00. Order number: DM-96 (book). Summary: This chapter on the prevalence and incidence of secondary and other types of diabetes is from a compilation and assessment of data on diabetes and its complications in the United States. The prevalence of these secondary types is approximately 1 to 2 percent of all diabetes. The extent of glucose intolerance in patients with secondary forms of diabetes can vary widely, presenting as overt diabetes that is insulin-requiring or noninsulin-requiring, simulating IDDM or NIDDM, or as milder forms such as impaired glucose tolerance (IGT) or minimally abnormal glucose tolerance. Topics include diabetes secondary to pancreatic diseases, malnutrition-related diabetes, hemochromatosis, acromegaly, isolated growth hormone deficiency, Cushing's syndrome, pheochromocytoma, primary hyperaldosteronism, hyperthyroidism, tumors of endocrine pancreas or gut, polyendocrine autoimmunity syndromes, and POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, Skin changes) syndrome. The author also discusses diabetogenic drugs, chemical agents, and toxins, including diuretics and beta-adrenergic antagonists, diphenylhydantoins, glucocorticoids, oral contraceptives, progestins, pentamidine, Vacor, nicotinic acid, cyclosporin, and opiates. The author concludes with a discussion of genetic syndromes related to secondary diabetes. 2 figures. 7 tables. 147 references. (AA-M).

•

Non-Insulin-Dependent Diabetes Mellitus Secondary to Other Endocrine Disorders Source: in LeRoith, D.; Taylor, S.I.; Olefsky, J.M., eds. Diabetes Mellitus: A Fundamental and Clinical Text. Philadelphia, PA: Lippincott-Raven Publishers. 1996. p. 496-502.

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Contact: Available from Lippincott-Raven Publishers. 12107 Insurance Way, Hagerstown, MD 21740-5184. (800) 777-2295. Fax (301) 824-7390. PRICE: $199.00. ISBN: 0397514565. Summary: This chapter, from a medical textbook on diabetes, covers diabetes mellitus that occurs in association with a variety of other disorders, known as secondary diabetes. Endocrine causes of secondary diabetes occur in association with the therapeutic administration or excessive secretion of one of the counter-regulatory hormones: growth hormone, glucocorticoids, glucagon, or catecholamines. The authors describe endocrine conditions associated with secondary diabetes, including acromegaly or gigantism, growth hormone administration, Cushing's syndrome and glucocorticoid therapy, glucagonoma, pheochromocytoma, hyperthyroidism, androgen excess, hyperprolactinemia, hyperaldosteronism, and carcinoid tumor. 5 figures. 72 references. •

Metabolic and Endocrine Disorders Source: in Grundy, M.C.; Shaw, L.; and Hamilton, D.V. Illustrated Guide to Dental Care for the Medically Compromised Patient. St. Louis, MO: Mosby-Year Book, Inc. 1993. p. 51-59. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-9934. (800) 426-4545 or (314) 872-8370; Fax (800) 535-9935 or (314) 4321380; E-mail: [email protected]; http://www.mosby.com. PRICE: $24.95 plus shipping and handling. ISBN: 0815140223. Summary: This chapter, from an illustrated guide to dental care for medically compromised patients, discusses metabolic and endocrine disorders. The chapter's topics include diabetes mellitus (insulin-dependent and noninsulin-dependent), including hypoglycemia and hyperglycemia; phenylketonuria; adrenocortical diseases; Addison's disease, including secondary adrenal insufficiency and Cushing's syndrome; thyroid disorders, including hyperthyroidism and hypothyroidism; and parathyroid disorders. For each condition, the authors provide a brief description, the components of medical management, and suggestions for dental care. Illustrations, including photographs, are included. 5 figures.

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

Bibliography: Multimedia on Hyperthyroidism The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in hyperthyroidism (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on hyperthyroidism: •

Diagnosis and management of thyrotoxicosis [slide] Source: [presented by] the Ohio Medical Education Network; Year: 1987; Format: Slide; [Columbus, Ohio]: The Network, [1987]

•

Hyperthyroidism [slide] Source: Department of Continuing Medical Education School of Medicine State University of New York at Buffalo, and the Department of Medical Education Millard Fillmore Hospital; Year: 1975; Format: Slide; [Buffalo]: Communications in Learning, 1975

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Hyperthyroidism [videorecording] Source: Department of Medicine, Emory University, School of Medicine; Year: 1980; Format: Videorecording; Atlanta: Emory Medical Television Network: [for loan or sale by A. W. Calhoun Medical Library], 1980

•

Hyperthyroidism [videorecording] Source: [presented by] Medical Video Library; coproduced by IMS, Faculty of Medicine, University of Toronto and Medical Productions and Associates; Year: 1989; Format: Videorecording; [Toronto, Ont.]: Burn-Shield, [1989]

•

Spontaneously resolving hyperthyroidism [videorecording] Source: Marshfield Medical Foundation, in cooperation with Marshfield Clinic & St. Joseph's Hospital; Year:

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1982; Format: Videorecording; Marshfield, WI: Marshfield Regional Video Network, 1982 •

Subtotal hemithyroidectomy for severe primary hyperthyroidism (exopthalmic goitre) [motion picture]: technic of the Lahey Clinic Source: [produced by Lahey Clinic]; Year: 1940; Format: Motion picture; [United States: s.n., 1940]

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Surgical management of primary hyperthyroidism [motion picture] Source: by Frank H. Lahey; presented through courtesy of Davis & Geck, Inc., Brooklyn, N.Y; Year: 1951; Format: Motion picture; United States: Davis & Geck, 1951

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Therapy of hyperthyroidism [slide]: approach of the thyroidology community Source: Society of Nuclear Medicine; Year: 1985; Format: Slide; [Chicago, Ill.]: The Society, [1985]

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CHAPTER 8. PERIODICALS HYPERTHYROIDISM

AND

NEWS

ON

Overview In this chapter, we suggest a number of news sources and present various periodicals that cover hyperthyroidism.

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

Therapy for subclinical hyperthyroidism may help heart Source: Reuters Industry Breifing Date: May 05, 2003

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

Maybe It's Your Thyroid. Source: Consumer Reports on Health. 13(5):8-10. May 2001. Contact: Consumers Union of United States, Inc., 101 Truman Avenue, Yonkers, NY 1073-1057. Summary: The thyroid gland adjusts the body's metabolism by secreting energyregulating hormones. Disease, viral infections, surgery, and other factors can cause the thyroid to secrete too few hormones, called hypothyroidism, or too many, termed hyperthyroidism. Each disease causes various symptoms and complications. Hypothyroidism can bring about modest weight gain, while hyperthyroidism can produce moderate-to-severe weight loss. The article reviews who should be screened for thyroid function, who should be treated for hypothyroidism, and how and when to treat hyperthyroidism. A sidebar discusses a screening test for thyroid disease.

Academic Periodicals covering Hyperthyroidism Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to hyperthyroidism. In addition to these sources, you can search for articles covering hyperthyroidism 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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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for hyperthyroidism. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with hyperthyroidism. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to hyperthyroidism: Amiodarone •

Systemic - U.S. Brands: Cordarone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202029.html

Anabolic Steroids •

Systemic - U.S. Brands: Anadrol-50; Deca-Durabolin; Durabolin; Durabolin-50; Hybolin Decanoate; Hybolin-Improved; Kabolin; Oxandrin; Winstrol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202035.html

Androgens •

Systemic - U.S. Brands: Andro L.A. 200; Androderm; AndroGel 1%; Android; Android-F; Andronate 100; Andronate 200; Andropository 200; Andryl 200; Delatest; Delatestryl; Depotest; Depo-Testosterone; Everone 200; Halotestin; ORETON Methyl; T-Cypionate; Testamone 100; Testaqua; Te http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202036.html

Androgens and Estrogens •

Systemic - U.S. Brands: Andrest 90-4; Andro-Estro 90-4; Androgyn L.A.; DeComberol; Deladumone; Delatestadiol; depAndrogyn; Depo-Testadiol; Depotestogen; Duo-Cyp; Duo-Gen L.A.; Dura-Dumone 90/4; Duratestin; Estratest; Estratest H.S.; Halodrin; Menoject-L.A.; OB; Premarin with http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202037.html

Antithyroid Agents •

Systemic - U.S. Brands: Tapazole http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202067.html

Ascorbic Acid (Vitamin C) •

Systemic - U.S. Brands: Ascorbicap; Cecon; Cee-500; Cemill; Cenolate; Cetane; Cevi-Bid; Flavorcee; Ortho/CS; Sunkist http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202071.html

Beta-Adrenergic Blocking Agents •

Systemic - U.S. Brands: Betapace; Blocadren; Cartrol; Corgard; Inderal; Inderal LA; Kerlone; Levatol; Lopressor; Normodyne; Sectral; Tenormin; Toprol-XL; Trandate; Visken; Zebeta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202087.html

Cholecystographic Agents, Oral •

Diagnostic - U.S. Brands: Bilivist; Bilopaque; Cholebrine; Oragrafin Calcium; Oragrafin Sodium; Telepaque http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202136.html

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Estrogens •

Systemic - U.S. Brands: Alora; Aquest; Climara; Clinagen LA 40; Delestrogen; depGynogen; Depo-Estradiol; Depogen; Dioval 40; Dioval XX; Dura-Estrin; Duragen-20; E-Cypionate; Estinyl; Estrace; Estraderm; Estragyn 5; Estragyn LA 5; Estra-L 40; Estratab; Estro-A; Estro-Cyp; Estro http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202226.html

•

Vaginal - U.S. Brands: Estrace; Estring; Ogen; Ortho Dienestrol; Premarin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202227.html

Estrogens and Progestins (Ovarian Hormone Therapy) •

Systemic - U.S. Brands: Activella; Note: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500070.html

Estrogens and Progestins Oral Contraceptives •

Systemic - U.S. Brands: Alesse; Brevicon; Demulen 1/35; Demulen 1/50; Desogen; Estrostep; Estrostep Fe; Genora 0.5/35; Genora 1/35; Genora 1/50; Intercon 0.5/35; Intercon 1/35; Intercon 1/50; Jenest; Levlen; Levlite; Levora 0.15/30; Lo/Ovral; Loestrin 1.5/30; Loestrin 1/20; Lo http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202228.html

Heparin •

Systemic - U.S. Brands: Calciparine; Liquaemin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202280.html

Iodine •

Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202280.html

Isoxsuprine •

Systemic - U.S. Brands: Vasodilan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202310.html

Niacin (Vitamin B 3 ) •

Systemic - U.S. Brands: Endur-Acin; Nia-Bid; Niac; Niacels; Niacor; Nico-400; Nicobid Tempules; Nicolar; Nicotinex Elixir; Slo-Niacin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202405.html

Potassium Iodide •

Systemic - U.S. Brands: Pima http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202472.html

Pyridoxine (Vitamin B 6 ) •

Systemic - U.S. Brands: Beesix; Doxine; Nestrex; Pyri; Rodex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202493.html

Rifampin •

Systemic - U.S. Brands: Rifadin; Rimactane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202511.html

104 Hyperthyroidism

Rifampin and Isoniazid •

Systemic - U.S. Brands: Rifamate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202512.html

Rifampin, Isoniazid, and Pyrazinamide •

Systemic - U.S. Brands: Rifater http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202775.html

Salicylates •

Systemic - U.S. Brands: Acuprin 81; Amigesic; Anacin Caplets; Anacin Maximum Strength; Anacin Tablets; Anaflex 750; Arthritis Pain Ascriptin; Arthritis Pain Formula; Arthritis Strength Bufferin; Arthropan; Aspergum; Aspirin Regimen Bayer Adult Low Dose; Aspirin Regimen Bayer R http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202515.html

Sodium Iodide •

Systemic - U.S. Brands: Iodopen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202621.html

Thiamine (Vitamin B 1 ) •

Systemic - U.S. Brands: Biamine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202560.html

Thyrotropin •

Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202621.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.

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Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

109

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 Institute12: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

12

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

110 Hyperthyroidism

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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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.13 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:14 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

13

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). 14 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 Gateway15 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.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “hyperthyroidism” (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 31042 249 884 5 0 32180

HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 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.19 Simply search by “hyperthyroidism” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

15

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

16

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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19

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 Biologists20 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.21 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.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

The Genome Project and Hyperthyroidism In the following section, we will discuss databases and references which relate to the Genome Project and hyperthyroidism. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).23 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information.

20 Adapted 21

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. 22 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. 23 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

114 Hyperthyroidism

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

Hyperthyroidism, Familial, Due To Inappropriate Thyrotropin Secretion Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?145650

•

Graves Disease Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?275000

•

Hyperthyroidism, Familial Gestational Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?603373 Genes and Disease (NCBI - Map)

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

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

•

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

•

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

•

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

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome,

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Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html •

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “hyperthyroidism” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database25 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “hyperthyroidism” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission. 24

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

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

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•

Other guides Alpha-1 Antitrypsin Deficiency http://www.nlm.nih.gov/medlineplus/alpha1antitrypsindeficiency.html Autoimmune Diseases http://www.nlm.nih.gov/medlineplus/autoimmunediseases.html Endocrine Diseases http://www.nlm.nih.gov/medlineplus/endocrinediseases.html Heart Valve Diseases http://www.nlm.nih.gov/medlineplus/heartvalvediseases.html Hepatitis C http://www.nlm.nih.gov/medlineplus/hepatitisc.html Hodgkin's Disease http://www.nlm.nih.gov/medlineplus/hodgkinsdisease.html Hormones http://www.nlm.nih.gov/medlineplus/hormones.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Lymphoma http://www.nlm.nih.gov/medlineplus/lymphoma.html Parathyroid Disorders http://www.nlm.nih.gov/medlineplus/parathyroiddisorders.html Pituitary Disorders http://www.nlm.nih.gov/medlineplus/pituitarydisorders.html Thyroid Cancer http://www.nlm.nih.gov/medlineplus/thyroidcancer.html Thyroid Diseases http://www.nlm.nih.gov/medlineplus/thyroiddiseases.html

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

General/Overviews Thyroid Disease Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZDMMPX77C &sub_cat=501 Thyroid Disorders Source: National Women's Health Information Center http://www.4woman.gov/faq/thyroid_disease.htm Your Thyroid Gland Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/thyroid/thyroid_gland.cfm

Patient Resources

•

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Diagnosis/Symptoms Calcium Pentagastrin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/calciumpentagastri.pdf Neck Swelling: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/514.html T3 (Triiodothyronine): The Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/t3/test.html T4 (Thyroxine): The Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/t4/test.html Thyroid Scan/Thyroid Uptake Study Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/thyroidupt.pdf TRH Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/trh.pdf TSH (Thyroid-Stimulating Hormone) Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/tsh/test.html

•

Treatment Antithyroid Drugs Source: UpToDate http://patients.uptodate.com/frames.asp?page=topic.asp&file=endo_hor/5036 Thyroid Surgery http://www.nlm.nih.gov/medlineplus/tutorials/thyroidsurgeryloader.html Thyroidectomy Source: InteliHealth http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20758.html

•

Nutrition Preparing to Receive I-131: The Low-Iodine Diet Source: National Institutes of Health http://www.cc.nih.gov/ccc/patient_education/pepubs/lowio.pdf

•

Specific Conditions/Aspects Goiter Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00217

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Graves' Dermopathy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00605 Graves' Disease http://www.thyroid.org/patients/brochures/Graves_brochure.pdf Hashimoto's Disease and the Flu Shot Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00676 Hashimoto's Disease: What It Is and How It's Treated Source: American Academy of Family Physicians http://familydoctor.org/handouts/548.html Hormonal Causes of Ovulatory Disorders Source: Resolve http://www.resolve.org/main/national/treatment/diagnosis/thyroid.jsp?name=t reatment&tag=diagnosis Hypothyroidism Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00353 Hypothyroidism: Can It Cause Joint Pain? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00069 Soy: Does It Adversely Affect the Thyroid? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00454 Subacute (Viral) Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00331 Thyroglossal Duct Cyst Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00265 Thyroid Disease and the Eye Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/thyroid.html Thyroid Nodules Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00491 Thyrotoxic Myopathy Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/thyrotoxic_myopathy. htm What Is an Endocrinologist? Source: Hormone Foundation http://www.hormone.org/publications/what_is_endocr.html

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Children Clinical Hypothyroidism Source: MAGIC Foundation http://www.magicfoundation.org/clinhypo.html Congenital Hypothyroidism Source: MAGIC Foundation http://www.magicfoundation.org/congthyr.html Thyroid Disorders Source: Nemours Foundation http://kidshealth.org/kid/health_problems/gland/thyroid.html Thyroid through the Ages: Birth and Early Childhood (Growth) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-birth.php

•

Men Postpartum Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00153 Thyroid through the Ages: Midlife (Menopause) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-midlife.php Thyroid through the Ages: The Reproductive Years (Pregnancy) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-reproyrs.php

•

Organizations American Thyroid Association http://www.thyroid.org/ Hormone Foundation http://www.hormone.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

•

Pictures/Diagrams Atlas of the Body: The Endocrine System Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZW5TZ46JC &sub_cat=514

•

Prevention/Screening How to Take the Thyroid “Neck Check” http://www.aace.com/pub/tam2001/neckcheck3.pdf

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•

Research Are Thyroid Nodules That Grow Cancerous? Source: American College of Physicians http://www.annals.org/cgi/content/full/138/4/I-60 Botox Effective in Treating Upper Eyelid Retraction Associated with Thyroid Disease Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZM6LR552D& sub_cat=2 CDC Releases Hanford Thyroid Disease Study Final Report Source: Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r020621.htm Effects of Removing Thyroid Antigens in Patients with Autoimmune Thyroid Disease Source: American College of Physicians http://www.annals.org/cgi/content/full/139/5_Part_1/I-75

•

Statistics Facts about Thyroid Disease Source: American Medical Women's Association http://www.amwa-doc.org/healthtopics/thyroid2.html

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Teenagers Thyroid Disease and Teens Source: Nemours Foundation http://kidshealth.org/teen/diseases_conditions/growth/thyroid.html

•

Women Postpartum Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00153 Thyroid through the Ages: Midlife (Menopause) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-midlife.php Thyroid through the Ages: The Reproductive Years (Pregnancy) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-reproyrs.php

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.

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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 hyperthyroidism. 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: •

Postpartum depression: Incidence, risk factors, diagnosis, treatment, and resources Source: Baltimore, MD: Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene. 2001. 6 pp. Contact: Available from Maryland Department of Health and Mental Hygiene, 201 West Preston Street, Baltimore, MD 21201. Telephone: (410) 767-6500 or (877) 463-3464 / Web site: http://www.dhmh.state.md.us. Available at no charge; also available from the Web site at no charge. Summary: This booklet for pregnant women and new mothers discusses postpartum depression, reality versus myth, incidence, making the diagnosis, risk factors, screening for hyperthyroidism, and treatments for postpartum depression and psychosis. Two organizational resources are provided.

•

Questions And Answers about Fibrous Dysplasia Source: New York, NY: The Paget 's Disease Foundation, Inc. 1996. 11 p. Contact: Paget Foundation For Paget 's Disease of Bone and Related Disorders. 200 Varick Street, Suite 1004, New York, NY 10014-4810. (212) 229-1582 or FAX (212) 2291502. PRICE: $2.00 postage and handling. Summary: This brochure responds to questions concerning fibrous dysplasia (FD), what it is and who gets it; its symptoms, causes, and diagnosis; whether there is a genetic link; its prognosis; and its treatment. It explains that FD is a bone disease that can cause bone pain, deformity, and fracture. FD can cause hormonal problems such as early puberty, hyperthyroidism, overactivity of the adrenal glands, and oversecretion of pituitary hormones. While the cause of FD is now known, it is known that it is usually diagnosed, through X-ray analysis, in children and young adults and it is not inherited. Surgical and drug treatments are available.

•

About Vitiligo Source: Tyler, TX: National Vitiligo Foundation. 199x. 8 p. Contact: National Vitiligo Foundation. 611 South Fleishel Avenue, Tyler, TX 75701. (903) 531-0074. Fax (903) 525-1234. E-mail: [email protected]. Website: www.vitiligofoundation.org. PRICE: Single copy free; donation or membership requested. Summary: This pamphlet uses a question and answer format to provide information to people who have vitiligo. In this disease, the skin loses pigment as a result of the destruction of pigment cells. Common sites of pigment loss include skin in body folds; skin around body openings; and skin on the hands, face, and other exposed areas. People who have vitiligo face a greater risk of having hyperthyroidism,

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hypothyroidism, pernicious anemia, Addison's disease, alopecia areata, and uveitis. The cause of vitiligo is unknown, but it may have hereditary, immunologic, and neurogenic components. Vitiligo may begin with a rapid loss of pigment which is followed by a lengthy period when the skin color does not change. However, there is no way of predicting whether or where vitiligo will spread. The basic methods of treating vitiligo are restoring the normal pigment or destroying the remaining pigment. In repigmentation therapy, the patient is given psoralen and then exposed to ultraviolet light. Total depigmentation may be attempted in severe cases of vitiligo to give the patient an even color. Cosmetic coverups may also be effective in minimizing the visibility of vitiligo. The pamphlet outlines the requirements for repigmentation therapy and highlights the activities of the National Vitiligo Foundation. •

Constipation: Getting Relief Source: San Bruno, CA: StayWell Company. 1998. [2 p.]. Contact: Available from StayWell Company. Order Department, 1100 Grundy Lane, San Bruno, CA 94066-9821. (800) 333-3032. Fax (650) 244-4512. E-mail: [email protected]. Website: www.staywell.com. PRICE: $17.95 for pack of 50; plus shipping and handling. Summary: This patient education brochure describes constipation and its treatment. Written in nontechnical language, the brochure first defines constipation as bowel movements that occur less often than usual or the need to strain to pass hard, dry stool. Symptoms of constipation include a feeling of fullness in the rectum, bloating and gas, feeling the urge but being unable to pass stool, abdominal pain and cramping, and nausea. One of the main causes of constipation is a diet that is too low in dietary fiber and water. Other causes can include travel (and changes in diet and bowel habits), pregnancy, too little exercise, misuse of laxatives, side effects of certain medications, systemic diseases (diabetes or hyperthyroidism, for example), and ignoring the urge to have a bowel movement. Diagnosis will include the patient's medical history and some diagnostic tests such as sigmoidoscopy and barium enema. Most treatment plans focus on increasing dietary fiber, getting regular exercise, and avoiding chronic laxative use. One section of the brochure illustrates and describes the physiology of normal bowel movements and what happens in constipation. The last page of the brochure summarizes the recommendations for increasing dietary fiber. The brochure is illustrated with full color line drawings. 7 figures.

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 “hyperthyroidism” (or synonyms). The following was recently posted: •

American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1996 (revised 2002); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3525&nbr=2751&a mp;string=hyperthyroidism

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

Hyperthyroidism Summary: This mini-fact sheet provides basic information about hyperthyroidism and lists the symptoms that are common to this disorder of the thyroid gland. Source: American Thyroid Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3852 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 hyperthyroidism. 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. PEDBASE Similar to NORD, PEDBASE covers relatively rare disorders, limited mainly to pediatric conditions. PEDBASE was designed by Dr. Alan Gandy. To access the database, which is more oriented to researchers than patients, you can view the current list of health topics covered at the following Web site: http://www.icondata.com/health/pedbase/pedlynx.htm. 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

126 Hyperthyroidism

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to hyperthyroidism. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with hyperthyroidism. 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 hyperthyroidism. 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 “hyperthyroidism” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “hyperthyroidism”. 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 “hyperthyroidism” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “hyperthyroidism” (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.26

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

26

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)27: •

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

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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

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

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

•

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/

27

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

134 Hyperthyroidism

•

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

135

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Hyperthyroidism Diabetes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001214.htm Goiter Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001178.htm Hyperthyroidism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000356.htm Plummer's disease Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000317.htm

•

Signs & Symptoms for Hyperthyroidism Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm

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Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Blood pressure - high Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Blushing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm Bone pain or tenderness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003180.htm Clubbing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003282.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Exophthalmos Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003033.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Frequent bowel movements Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Hair loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm Hand tremor Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003192.htm Heartbeat sensations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Heat intolerance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003094.htm Increased appetite Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003134.htm Increased sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Itching - overall Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm

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Menstrual irregularities Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003263.htm Menstruation - absent Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003149.htm Movement - uncoordinated Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Muscle atrophy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm Muscle cramps Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Muscle weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Onycholysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003247.htm Paleness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003244.htm Palpitations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Protruding eyes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003033.htm Pulse - bounding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Rapid heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Restlessness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Skin - abnormally dark or light Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003242.htm Skin - clammy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003216.htm Skin blushing/flushing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm

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Sleeping difficulty Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Tearing - increased Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003036.htm Thirst - excessive Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003085.htm Tongue problems Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003047.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Wasting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for Hyperthyroidism ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Antithyroglobulin antibody Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003557.htm Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Cholesterol test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003492.htm Glucose test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003482.htm Heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm

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Hyperplasia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003441.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm Radioactive iodine uptake Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003689.htm RAIU Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003689.htm RT3U Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm Serum TSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm Systolic blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm T3 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003687.htm T4 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003517.htm Thyroid resin uptake Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm Thyroid stimulating immunoglobulin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003685.htm Thyrotropin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm Triglycerides Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003493.htm Triiodothyronine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003687.htm TSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm TSI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003685.htm •

Nutrition for Hyperthyroidism Vitamin B-12 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002403.htm

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•

Surgery and Procedures for Hyperthyroidism Thyroidectomy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002933.htm

•

Background Topics for Hyperthyroidism Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Endocrine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002351.htm Metabolism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002257.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Testes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002334.htm Vital signs Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002341.htm

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

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

•

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

•

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

•

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

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HYPERTHYROIDISM 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] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actin: Essential component of the cell skeleton. [NIH] 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] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adoptive Transfer: Form of passive immunization where previously sensitized immunologic agents (cells or serum) are transferred to non-immune recipients. When

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transfer of cells is used as a therapy for the treatment of neoplasms, it is called adoptive immunotherapy (immunotherapy, adoptive). [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal insufficiency: The reduced secretion of adrenal glands. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic Agonists: Drugs that bind to and activate adrenergic receptors. [NIH] Adrenergic Antagonists: Drugs that bind to but do not activate adrenergic receptors. Adrenergic antagonists block the actions of the endogenous adrenergic transmitters epinephrine and norepinephrine. [NIH] Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic betaantagonists are used for treatment of hypertension, cardiac arrythmias, angina pectoris, glaucoma, migraine headaches, and anxiety. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] 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]

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Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allogeneic: Taken from different individuals of the same species. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Cell: A type of cell in the pancreas (in areas called the islets of Langerhans). Alpha cells make and release a hormone called glucagon, which raises the level of glucose (sugar) in the blood. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino-terminal: The end of a protein or polypeptide chain that contains a free amino group (-NH2). [NIH] Amiodarone: An antianginal and antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting Na,K-activated myocardial adenosine triphosphatase. There is a resulting decrease in heart rate and in vascular resistance. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In

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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] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiogenesis inhibitor: A substance that may prevent the formation of blood vessels. In anticancer therapy, an angiogenesis inhibitor prevents the growth of blood vessels from surrounding tissue to a solid tumor. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antianginal: Counteracting angina or anginal conditions. [EU] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] 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] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue

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cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Antihypertensive Agents: Drugs used in the treatment of acute or chronic hypertension regardless of pharmacological mechanism. Among the antihypertensive agents are diuretics (especially diuretics, thiazide), adrenergic beta-antagonists, adrenergic alpha-antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, ganglionic blockers, and vasodilator agents. [NIH] 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] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Approximate: Approximal [EU] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH]

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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] Articular: Of or pertaining to a joint. [EU] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] 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] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringents: Agents, usually topical, that cause the contraction of tissues for the control of bleeding or secretions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls,

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multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium enema: A procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Beta Rays: A stream of positive or negative electrons ejected with high energy from a disintegrating atomic nucleus; most biomedically used isotopes emit negative particles (electrons or negatrons, rather than positrons). Cathode rays are low-energy negative electrons produced in cathode ray tubes, also called television tubes or oscilloscopes. [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] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioassays: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biogenesis: The origin of life. It includes studies of the potential basis for life in organic compounds but excludes studies of the development of altered forms of life through mutation and natural selection, which is evolution. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived

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constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blushing: Involuntary reddening, especially of the face, associated with feelings of embarrassment, confusion, or shame. [NIH] Body Fluids: Liquid components of living organisms. [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 metastases: Cancer that has spread from the original (primary) tumor to the bone. [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] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It

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uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU] 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] Calcium Metabolism Disorders: Disorders in the processing of calcium in the body, including absorption, transport, storage, and utilization. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [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] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs.

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[NIH]

Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Catalytic Domain: The region of an enzyme that interacts with its substrate to cause the enzymatic reaction. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catechols: A group of 1,2-benzenediols that contain the general formula R-C6H5O2. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH]

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Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Cherubism: A fibro-osseous hereditary disease of the jaws. The swollen jaws and raised eyes give a cherubic appearance; multiple radiolucencies are evident upon radiographic examination. [NIH] Chimeras: Organism that contains a mixture of genetically different cells. [NIH] Chimeric Proteins: Proteins in individuals that are derived from genetically different zygotes. [NIH] Chloroform: A commonly used laboratory solvent. It was previously used as an anesthetic, but was banned from use in the U.S. due to its suspected carcinogenecity. [NIH] Cholecystography: Radiography of the gallbladder after ingestion of a contrast medium. [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] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Choriocarcinoma: A malignant tumor of trophoblastic epithelium characterized by secretion of large amounts of chorionic gonadotropin. It usually originates from chorionic products of conception (i.e., hydatidiform mole, normal pregnancy, or following abortion), but can originate in a teratoma of the testis, mediastinum, or pineal gland. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur

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along the sympathetic nerves, in the adrenal gland, and in various other organs. [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] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Chymotrypsin: A serine endopeptidase secreted by the pancreas as its zymogen, chymotrypsinogen and carried in the pancreatic juice to the duodenum where it is activated by trypsin. It selectively cleaves aromatic amino acids on the carboxyl side. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [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

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differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Coloboma: Congenital anomaly in which some of the structures of the eye are absent due to incomplete fusion of the fetal intraocular fissure during gestation. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [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] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH]

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Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH]

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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 heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] 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] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Cricoid Cartilage: The small thick cartilage that forms the lower and posterior parts of the laryngeal wall. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein,

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cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] 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] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Depigmentation: Removal or loss of pigment, especially melanin. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or

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esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [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 movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Diuretic: A drug that increases the production of urine. [NIH] Diuretics, Thiazide: Diuretics characterized as analogs of 1,2,4-benzothiadiazine-1,1dioxide. All have a common mechanism of action and differ primarily in the dose required to produce a given effect. They act directly on the kidney to increase the excretion of sodium chloride and water and also increase excretion of potassium ions. [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

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its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysostosis: Defective bone formation. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear

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particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinologist: A doctor that specializes in diagnosing and treating hormone disorders. [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endostatin: A drug that is being studied for its ability to prevent the growth of new blood vessels into a solid tumor. Endostatin belongs to the family of drugs called angiogenesis inhibitors. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enteropeptidase: A specialized proteolytic enzyme secreted by intestinal cells. It converts trypsinogen into its active form trypsin by removing the N-terminal peptide. EC 3.4.21.9. [NIH]

Environmental Health: The science of controlling or modifying those conditions, influences, 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] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers:

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1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]

Epitope Mapping: Methods used for studying the interactions of antibodies with specific regions of protein antigens. Important applications of epitope mapping are found within the area of immunochemistry. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

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

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in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraocular: External to or outside of the eye. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibroma: A benign tumor of fibrous or fully developed connective tissue. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Flexor: Muscles which flex a joint. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the

162 Hyperthyroidism

excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Forskolin: Potent activator of the adenylate cyclase system and the biosynthesis of cyclic AMP. From the plant Coleus forskohlii. Has antihypertensive, positive ionotropic, platelet aggregation inhibitory, and smooth muscle relaxant activities; also lowers intraocular pressure and promotes release of hormones from the pituitary gland. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Ganglionic Blockers: Agents having as their major action the interruption of neural transmission at nicotinic receptors on postganglionic autonomic neurons. Because their actions are so broad, including blocking of sympathetic and parasympathetic systems, their

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therapeutic use has been largely supplanted by more specific drugs. They may still be used in the control of blood pressure in patients with acute dissecting aortic aneurysm and for the induction of hypotension in surgery. [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] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

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

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germline mutation: A gene change in the body's reproductive cells (egg or sperm) that becomes incorporated into the DNA of every cell in the body of offspring; germline mutations are passed on from parents to offspring. Also called hereditary mutation. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational trophoblastic disease: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic tumor, gestational trophoblastic neoplasia, molar pregnancy, or choriocarcinoma. [NIH] Gestational trophoblastic neoplasia: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic tumor, molar pregnancy, or choriocarcinoma. [NIH] Gestational trophoblastic tumor: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic neoplasia, molar pregnancy, or choriocarcinoma. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gigantism: The condition of abnormal overgrowth or excessive size of the whole body or any of its parts. [NIH]

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Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glossitis: Inflammation of the tongue. [NIH] Glucagonoma: Glucagon-secreting tumor of the pancreatic alpha cells characterized by a distinctive rash, weight loss, stomatitis, glossitis, diabetes, hypoaminoacidemia, and normochromic normocytic anemia. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH]

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Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynaecomastia: Excessive development of the male mammary glands, even to the functional state. [EU] Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a haemodialyzer. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [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] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood

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clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis B: Hepatitis caused by hepatitis B virus. It may be transmitted by transfusion of contaminated blood or blood products. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Hereditary mutation: A gene change in the body's reproductive cells (egg or sperm) that becomes incorporated into the DNA of every cell in the body of offspring; hereditary mutations are passed on from parents to offspring. Also called germline mutation. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Antagonists: Chemical substances which inhibit the function of the endocrine glands, the biosynthesis of their secreted hormones, or the action of hormones upon their specific sites. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydatidiform Mole: A trophoblastic disease characterized by hydrops of the mesenchymal portion of the villus. Its karyotype is paternal and usually homozygotic. The tumor is indistinguishable from chorioadenoma destruens or invasive mole ( = hydatidiform mole, invasive) except by karyotype. There is no apparent relation by karyotype to choriocarcinoma. Hydatidiform refers to the presence of the hydropic state of some or all of the villi (Greek hydatis, a drop of water). [NIH]

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Hydrochlorothiazide: A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It has been used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperaldosteronism: Aldosteronism. [EU] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperemesis: Excessive vomiting. [EU] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hyperostosis: Increase in the mass of bone per unit volume. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] 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

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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] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

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

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH]

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Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH]

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Insulin-like: Muscular growth factor. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intramuscular injection: IM. Injection into a muscle. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Iodine-131: Radioactive isotope of iodine. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for

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channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isocitrate Dehydrogenase: An enzyme of the oxidoreductase class that catalyzes the conversion of isocitrate and NAD+ to yield 2-ketoglutarate, carbon dioxide, and NADH. It occurs in cell mitochondria. The enzyme requires Mg2+, Mn2+; it is activated by ADP, citrate, and Ca2+, and inhibited by NADH, NADPH, and ATP. The reaction is the key ratelimiting step of the citric acid (tricarboxylic) cycle. (From Dorland, 27th ed) (The NADP+ enzyme is EC 1.1.1.42.) EC 1.1.1.41. [NIH] Karyotype: The characteristic chromosome complement of an individual, race, or species as defined by their number, size, shape, etc. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the

172 Hyperthyroidism

regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] 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] Levothyroxine: Levo isomer of the thyroid hormone thyroxine. It is used for replacement therapy in reduced or absent thyroid function. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [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] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

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Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

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] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [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] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] 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] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH]

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Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibulofacial Dysostosis: A rare congenital anomaly characterized by antimongoloid oblique palpebral fissures, coloboma of the lower eyelids, hypoplasia of the facial bones, malformations of the external ears and sometimes middle and inner ears, an abnormally large mouth. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastocytosis: A group of diseases resulting from proliferation of mast cells. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental 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] Mental Health: The state wherein the person is well adjusted. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the

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atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] 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] Methimazole: A thioureylene antithyroid agent that inhibits the formation of thyroid hormones by interfering with the incorporation of iodine into tyrosyl residues of thyroglobulin. This is done by interfering with the oxidation of iodide ion and iodotyrosyl groups through inhibition of the peroxidase enzyme. [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] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microsomal: Of or pertaining to microsomes : vesicular fragments of endoplasmic reticulum formed after disruption and centrifugation of cells. [EU] 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] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [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] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molar pregnancy: A rare cancer in women of child-bearing age in which cancer cells grow in the tissues that are formed in the uterus after conception. Also called gestational trophoblastic disease, gestational trophoblastic neoplasia, gestational trophoblastic tumor, or choriocarcinoma. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two

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hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myeloproliferative Disorders: Disorders in which one or more stimuli cause proliferation of hemopoietically active tissue or of tissue which has embryonic hemopoietic potential. [NIH] 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] 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] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Natural selection: A part of the evolutionary process resulting in the survival and reproduction of the best adapted individuals. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: 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] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH]

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Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] 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] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Oral Health: The optimal state of the mouth and normal functioning of the organs of the

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mouth without evidence of disease. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orofacial: Of or relating to the mouth and face. [EU] 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: Degeneration of articular cartilage. Primary osteoarthritis is very common in older persons, especially affecting weight-bearing joints. Articular cartilage becomes soft, frayed and thinned. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteogenesis Imperfecta: A collagen disorder resulting from defective biosynthesis of type I collagen and characterized by brittle, osteoporotic, and easily fractured bones. It may also present with blue sclerae, loose joints, and imperfect dentin formation. There are four major types, I-IV. [NIH] Osteogenic sarcoma: A malignant tumor of the bone. Also called osteosarcoma. [NIH] Osteopetrosis: Excessive formation of dense trabecular bone leading to pathological fractures, osteitis, splenomegaly with infarct, anemia, and extramedullary hemopoiesis. [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] Osteosarcoma: A cancer of the bone that affects primarily children and adolescents. Also called osteogenic sarcoma. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Phosphorylation: Electron transfer through the cytochrome system liberating free energy which is transformed into high-energy phosphate bonds. [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress,

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1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [EU] 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] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pentamidine: Antiprotozoal agent effective in trypanosomiasis, leishmaniasis, and some fungal infections; used in treatment of Pneumocystis carinii pneumonia in HIV-infected patients. It may cause diabetes mellitus, central nervous system damage, and other toxic

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effects. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] 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] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] 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] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have

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grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Pituitary Hormones: Hormones secreted by the anterior and posterior lobes of the pituitary gland and the pars intermedia, an ill-defined region between the two. Their secretion is regulated by the hypothalamus. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet Factor 4: A high-molecular-weight proteoglycan-platelet factor complex which is released from blood platelets by thrombin. It acts as a mediator in the heparin-neutralizing capacity of the blood and plays a role in platelet aggregation. At high ionic strength (I=0.75), the complex dissociates into the active component (molecular weight 29,000) and the proteoglycan carrier (chondroitin 4-sulfate, molecular weight 350,000). The molecule exists in the form of a dimer consisting of 8 moles of platelet factor 4 and 2 moles of proteoglycan. [NIH]

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Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]

Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] 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] Post-translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] 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] Preclinical: Before a disease becomes clinically recognizable. [EU] 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] 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

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in the population at a given time. [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] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [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] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein 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]

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Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]

Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Psoralen: A substance that binds to the DNA in cells and stops them from multiplying. It is being studied in the treatment of graft-versus-host disease and is used in the treatment of psoriasis and vitiligo. [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] 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] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH]

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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]

Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [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] Quiescent: Marked by a state of inactivity or repose. [EU] Quinones: Hydrocarbon rings which contain two ketone moieties in any position. They can be substituted in any position except at the ketone groups. [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] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] 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] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Raloxifene: A second generation selective estrogen receptor modulator (SERM) used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist on mammary gland and uterine tissue. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH]

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Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU] 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] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Reproductive cells: Egg and sperm cells. Each mature reproductive cell carries a single set of 23 chromosomes. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Response Elements: Nucleotide sequences, usually upstream, which are recognized by specific regulatory transcription factors, thereby causing gene response to various regulatory agents. These elements may be found in both promotor and enhancer regions. [NIH]

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Responsive pacemaker: Any pacemaker that varies its rate in response to changes in the activity of a biological parameter that varies in parallel with the need for greater cardiac output, thus providing heart rate adaptability. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] 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] Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] 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] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH]

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Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Sclerae: A circular furrow between the sclerocorneal junction and the iris. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] 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] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH]

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Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [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] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shame: An emotional attitude excited by realization of a shortcoming or impropriety. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and

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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 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] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sperm: The fecundating fluid of the male. [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] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] 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]

Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH]

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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] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] 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] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tamponade: The inserting of a tampon; a dressing is inserted firmly into a wound or body cavity, as the nose, uterus or vagina, principally for stopping hemorrhage. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and

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the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] 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] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrostatic: Antithyroid agent. [EU] 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

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thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] 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] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] 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] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH]

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Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]

Trypanosomiasis: Infection with protozoa of the genus Trypanosoma. [NIH] Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tsh: A glycoprotein secreted by the pars distalis of the pituitary gland in vertebrates that has hormonal activity. It stimulates the growth of the thyroid gland, as well as the secretion of thyroid hormone. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ubiquitin: A highly conserved 76 amino acid-protein found in all eukaryotic cells. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye,

196 Hyperthyroidism

and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villous: Of a surface, covered with villi. [NIH] Villus: Cell found in the lining of the small intestine. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral vector: A type of virus used in cancer therapy. The virus is changed in the laboratory and cannot cause disease. Viral vectors produce tumor antigens (proteins found on a tumor cell) and can stimulate an antitumor immune response in the body. Viral vectors may also be used to carry genes that can change cancer cells back to normal cells. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] 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

Dictionary 197

kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [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] Weight Gain: Increase in body weight over existing weight. [NIH] Weight-Bearing: The physical state of supporting an applied load. This often refers to the weight-bearing bones or joints that support the body's weight, especially those in the spine, hip, knee, and foot. [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] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

199

INDEX A Abdominal, 39, 124, 135, 141, 171, 180, 188 Abdominal Pain, 124, 141, 171 Acceptor, 141, 172, 179 Acetylcholine, 141, 178 Actin, 141, 176, 177 Acute lymphoblastic leukemia, 53, 141 Acute lymphocytic leukemia, 141 Adaptability, 141, 188 Adenine, 141 Adenocarcinoma, 35, 141 Adenoma, 33, 35, 44, 92, 141 Adenosine, 43, 141, 143, 181 Adenovirus, 22, 141 Adenylate Cyclase, 81, 141, 162 Adipocytes, 7, 141, 154, 171 Adipose Tissue, 38, 58, 141 Adjuvant, 23, 58, 65, 66, 141 Adoptive Transfer, 6, 141 Adrenal Cortex, 142, 155, 160, 184 Adrenal Glands, 123, 142 Adrenal insufficiency, 20, 92, 94, 142 Adrenergic, 39, 58, 59, 93, 102, 142, 145, 158, 160, 184, 192 Adrenergic Agonists, 58, 142 Adrenergic Antagonists, 93, 142 Adrenergic beta-Antagonists, 142, 145 Adverse Effect, 20, 142, 190 Aerobic, 142, 175 Afferent, 142, 172 Affinity, 16, 17, 19, 142, 191 Age of Onset, 10, 142 Agonist, 17, 142, 158, 186 Aldosterone, 20, 142 Algorithms, 142, 148 Alimentary, 142, 157 Alkaline, 142, 147, 149, 193 Alleles, 19, 143 Allogeneic, 143, 164 Alopecia, 124, 143 Alpha Cell, 143, 164 Alpha Particles, 143, 186 Alternative medicine, 98, 143 Amino Acid Sequence, 81, 143, 144, 160 Amino Acids, 12, 81, 143, 152, 181, 183, 184, 188, 190, 194 Amino-terminal, 18, 143 Amiodarone, 23, 24, 54, 68, 102, 143

Anabolic, 12, 102, 143, 157 Anaesthesia, 143, 169 Analogous, 16, 143, 194 Analytes, 119, 143 Anaphylatoxins, 143, 153 Androgens, 20, 102, 142, 143, 155 Anemia, 91, 144, 162, 164, 176, 179, 181 Anesthesia, 67, 144, 155 Angina, 46, 72, 142, 144, 184 Angina Pectoris, 142, 144, 184 Angiogenesis, 48, 144, 159 Angiogenesis inhibitor, 48, 144, 159 Angiotensin-Converting Enzyme Inhibitors, 144, 145 Animal model, 5, 7, 13, 144 Anions, 144, 171, 190 Antiallergic, 144, 155 Antianginal, 143, 144 Antiarrhythmic, 143, 144 Antibodies, 5, 6, 8, 13, 20, 29, 30, 38, 44, 80, 90, 144, 146, 160, 165, 166, 168, 173, 182 Anticoagulant, 144, 184 Antigen, 5, 7, 11, 13, 142, 144, 145, 153, 163, 166, 167, 168, 169, 174, 186 Antigen-Antibody Complex, 145, 153 Antigen-presenting cell, 7, 145 Antihypertensive, 84, 145, 162 Antihypertensive Agents, 84, 145 Anti-infective, 145, 167, 170 Anti-inflammatory, 145, 155, 156, 164 Anti-Inflammatory Agents, 145, 155 Antimetabolite, 145, 188 Antineoplastic, 145, 155 Antioxidant, 32, 59, 61, 66, 67, 145, 146, 179 Antiviral, 145, 170, 188 Anus, 145, 147, 148, 159 Anxiety, 27, 28, 37, 136, 142, 145, 184 Anxiety Disorders, 37, 145 Aorta, 145, 196 Apolipoproteins, 145, 172 Aponeurosis, 145, 162 Approximate, 17, 145 Aqueous, 145, 147, 156, 167, 171 Arachidonic Acid, 145, 184 Arginine, 26, 58, 143, 145, 178, 195 Aromatic, 145, 152 Arrhythmia, 8, 144, 145

200 Hyperthyroidism

Arterial, 26, 58, 146, 151, 167, 184, 192 Arteries, 145, 146, 148, 155, 173, 175, 176, 185 Arterioles, 146, 148, 149, 196 Articular, 146, 172, 179 Ascorbic Acid, 69, 102, 146 Asparaginase, 53, 146 Aspartate, 146 Assay, 81, 146, 186 Astringents, 146, 175 Atrial, 8, 18, 30, 35, 49, 143, 146 Atrial Fibrillation, 8, 18, 30, 35, 49, 146 Atrium, 146, 196 Atrophy, 93, 137, 146 Autoantibodies, 5, 6, 13, 68, 81, 146 Autoantigens, 146 Autoimmune disease, 87, 88, 146, 176 Autoimmunity, 6, 93, 146 Autologous, 7, 146 Autonomic, 25, 32, 141, 146, 162, 178, 191, 192 Autonomic Nervous System, 32, 146, 191, 192 Autosuggestion, 146, 168 B Bacteria, 144, 146, 159, 161, 175, 196 Barium, 124, 147 Barium enema, 124, 147 Basal Ganglia, 147, 162 Base, 141, 147, 156, 171 Basophils, 147, 165, 172 Benign, 141, 147, 149, 161, 162, 177, 186 Benign tumor, 147, 161 Benzene, 147, 150 Beta Rays, 147, 158 Bile, 147, 162, 173, 191 Binding Sites, 11, 147 Bioassays, 7, 147 Biochemical, 143, 145, 147, 162, 190 Biogenesis, 9, 147 Biological response modifier, 147, 170 Biosynthesis, 145, 147, 162, 166, 179, 190 Biotechnology, 20, 21, 90, 98, 111, 147 Bipolar Disorder, 39, 148 Bladder, 148, 162, 176, 177, 195 Blastocyst, 148, 154, 182 Bloating, 124, 148, 171 Blood Cell Count, 148, 181 Blood Coagulation, 148, 149, 193 Blood Platelets, 148, 182, 190 Blood pressure, 38, 84, 136, 138, 139, 145, 148, 150, 163, 167, 176, 185, 191

Blood vessel, 144, 148, 149, 150, 151, 152, 159, 171, 173, 175, 181, 190, 191, 192, 193, 196 Blushing, 136, 137, 148 Body Fluids, 148, 191 Bone Density, 24, 148 Bone Marrow, 80, 141, 147, 148, 164, 168, 173, 176, 191 Bone metastases, 84, 148 Bone scan, 148, 189 Bowel, 124, 136, 148, 157, 159, 170, 171, 192 Bowel Movement, 124, 136, 148, 157, 192 Brachytherapy, 148, 170, 171, 186, 197 Bradykinin, 149, 178 Branch, 133, 149, 158, 180, 185, 191, 193 Breakdown, 149, 157, 163 Buccal, 149, 173, 192 Bulbar, 23, 149 C Calcium, 80, 81, 102, 119, 145, 149, 152, 153, 167, 180, 193 Calcium channel blocker, 145, 149 Calcium Channel Blockers, 145, 149 Calcium Metabolism Disorders, 80, 149 Capillary, 16, 149, 196 Capsules, 149, 158 Carbohydrate, 149, 155, 164, 183 Carbon Dioxide, 149, 171, 182, 187 Carcinogen, 14, 149 Carcinogenic, 147, 149, 169, 184, 191 Carcinoid, 94, 149 Carcinoma, 21, 22, 34, 47, 48, 68, 70, 149 Cardiac, 9, 17, 18, 25, 30, 31, 47, 59, 61, 66, 91, 142, 144, 146, 150, 160, 176, 180, 188, 191 Cardiac Output, 150, 188 Cardiology, 8, 33, 150 Cardiomyopathy, 8, 22, 47, 150 Cardioselective, 150, 184 Cardiovascular, 25, 34, 87, 91, 150, 190, 191 Cardiovascular disease, 91, 150 Carnitine, 9, 55, 59, 150 Carrier Proteins, 150, 186 Case report, 23, 24, 36, 37, 38, 43, 48, 66, 70, 150, 152 Catabolism, 12, 150 Catalytic Domain, 88, 150 Catecholamine, 150, 157 Catechols, 14, 150 Cathode, 147, 150, 158

Index 201

Cations, 150, 171 Caudal, 150, 157, 167, 183 Causal, 9, 150 Celiac Disease, 91, 150 Cell Division, 147, 150, 182 Cell proliferation, 84, 150 Cell Respiration, 58, 150, 175, 187 Cell Size, 151, 162 Central Nervous System, 141, 146, 147, 151, 162, 164, 176, 180, 190 Centrifugation, 151, 175 Cerebellar, 151, 195 Cerebellar Diseases, 151, 195 Cerebral, 36, 147, 151, 160, 193 Cerebrovascular, 149, 150, 151 Cerebrum, 151 Cervix, 151, 161 Character, 144, 151, 156, 164 Cheilitis, 91, 151 Chemotactic Factors, 151, 153 Cherubism, 93, 151 Chimeras, 7, 151 Chimeric Proteins, 6, 151 Chloroform, 83, 151 Cholecystography, 55, 151 Cholesterol, 87, 138, 147, 151, 152, 155, 167, 172, 173, 186, 191 Cholesterol Esters, 151, 172 Choriocarcinoma, 151, 163, 166, 175 Chromaffin System, 151, 159 Chromosome, 152, 171, 172, 195 Chronic, 8, 12, 15, 16, 26, 46, 67, 124, 145, 152, 157, 169, 185, 192 Chylomicrons, 152, 172 Chymotrypsin, 88, 152 Circulatory system, 152, 159 Citric Acid, 152, 171 Citrus, 146, 152 Clinical Medicine, 152, 183 Clinical study, 152, 154 Clinical trial, 4, 75, 76, 111, 152, 154, 158, 176, 185, 186 Cloning, 6, 8, 27, 148, 152 Coagulation, 25, 148, 152, 165, 193 Coenzyme, 146, 152 Cofactor, 152, 184, 193 Cognition, 14, 152 Colitis, 67, 152, 171 Collagen, 152, 161, 179, 182 Coloboma, 153, 174 Comorbidity, 19, 153 Complement, 8, 143, 153, 163, 171

Complementary and alternative medicine, 65, 73, 153 Complementary medicine, 65, 153 Complete remission, 153, 187 Computational Biology, 111, 153 Computed tomography, 148, 154, 189 Computerized axial tomography, 11, 154, 189 Computerized tomography, 154 Conception, 151, 154, 161, 163, 175 Concomitant, 6, 46, 154 Confusion, 148, 154 Congestion, 154, 160 Congestive heart failure, 37, 154 Conjugated, 154, 156 Connective Tissue, 7, 146, 148, 152, 154, 161, 162, 173, 175, 185, 188, 189 Connective Tissue Cells, 154 Consciousness, 154, 156, 157 Constipation, 124, 154, 162, 171 Constitutional, 154, 176 Constriction, 154, 171, 196 Constriction, Pathologic, 154, 196 Consumption, 42, 47, 80, 154, 180 Contractility, 30, 144, 154 Contraindications, ii, 154 Controlled clinical trial, 55, 154 Controlled study, 22, 154 Coordination, 154, 176 Cornea, 155, 189, 196 Coronary, 46, 87, 144, 150, 155, 175, 176 Coronary heart disease, 87, 150, 155 Coronary Thrombosis, 155, 175, 176 Cortex, 155 Cortical, 93, 155, 189 Corticosteroid, 91, 92, 155 Cortisol, 20, 155 Cortisone, 155, 157 Creatinine, 43, 90, 155 Cricoid Cartilage, 155, 197 Curare, 60, 155 Curative, 155, 193 Cutaneous, 42, 155, 171, 173 Cyclic, 81, 141, 155, 162, 165, 178, 183 Cytochrome, 14, 155, 179 Cytokine, 44, 156 Cytoplasm, 88, 147, 156, 159, 165, 176, 188 Cytotoxic, 46, 156, 186 D Databases, Bibliographic, 111, 156 Decidua, 156, 182 Defense Mechanisms, 32, 156

202 Hyperthyroidism

Degenerative, 156, 166 Deletion, 18, 24, 156 Delusions, 156, 185 Dementia, 14, 49, 156 Density, 87, 148, 151, 156, 162, 172, 178 Dental Care, 94, 156 Depigmentation, 124, 156, 197 Depressive Disorder, 19, 156, 172 Dermal, 156, 172 Deuterium, 156, 167 Dexamethasone, 12, 156 Diabetes Insipidus, 157, 167 Diabetes Mellitus, 22, 27, 91, 92, 93, 94, 157, 164, 165, 180 Diagnostic procedure, 79, 98, 157 Diarrhea, 39, 59, 136, 157, 162, 171 Diastolic, 157, 167 Diencephalon, 157, 167, 193 Dietary Fiber, 124, 157 Diffusion, 157, 165 Digestion, 142, 147, 148, 157, 170, 173, 192 Digestive system, 76, 157 Dihydrotestosterone, 157, 187 Dilated cardiomyopathy, 48, 157 Diploid, 157, 182, 195 Direct, iii, 11, 101, 152, 157, 158, 187 Dissociation, 142, 157 Diuretic, 157, 167 Diuretics, Thiazide, 145, 157 Dopamine, 83, 157 Dorsal, 158, 160, 183 Dorsum, 158, 162 Dosage Forms, 82, 158 Double-blinded, 15, 158 Drug Interactions, 9, 104, 158 Drug Tolerance, 158, 194 Duodenum, 147, 152, 158, 180, 192 Dysostosis, 93, 158 Dysphoric, 156, 158 Dysplasia, 84, 93, 123, 158 E Ectopic, 16, 39, 158 Edema, 42, 72, 158, 167, 177 Effector, 141, 153, 158, 177 Efficacy, 17, 51, 58, 60, 158 Electrocoagulation, 152, 158 Electrolyte, 142, 155, 158, 175, 183, 191 Electrons, 14, 145, 147, 150, 158, 171, 179, 186 Electrophysiological, 18, 30, 158 Elementary Particles, 158, 178, 185 Embryo, 148, 159, 169, 179

Endocrine Glands, 159, 166, 180 Endocrine System, 92, 121, 159 Endocrinologist, 4, 120, 159 Endometrium, 156, 159, 174 Endostatin, 48, 159 Endothelial cell, 16, 159, 193 Endothelium, 159, 178, 182 Endothelium-derived, 159, 178 Endotoxic, 159, 172 Endotoxins, 153, 159 Enema, 159 Energy balance, 159, 172 Enhancer, 159, 187 Enteropeptidase, 159, 195 Environmental Health, 110, 112, 159 Enzymatic, 149, 150, 153, 159, 161 Eosinophils, 159, 165, 172 Epidermal, 159, 172 Epidermis, 159, 172 Epigastric, 160, 180 Epinephrine, 142, 157, 160, 178, 195 Epithelial, 141, 156, 160, 166 Epitope, 6, 160 Epitope Mapping, 6, 160 Erythema, 91, 160 Erythema Multiforme, 91, 160 Erythrocytes, 144, 148, 160 Esophagus, 157, 160, 192 Estradiol, 17, 103, 160 Estrogen, 17, 160, 184, 186, 189 Estrogen receptor, 17, 160 Eukaryotic Cells, 160, 179, 195 Evacuation, 154, 160, 171, 186 Excitation, 160, 162 Exocrine, 160, 180 Exon, 18, 46, 160 Extensor, 160, 185, 197 External-beam radiation, 160, 171, 186, 197 Extracellular, 154, 160, 161, 179, 191, 193 Extracellular Matrix, 154, 160, 161, 179 Extraocular, 7, 161 Extrapyramidal, 157, 161 Extremity, 10, 161 Eye Infections, 141, 161 F Facial, 161, 174, 180, 191 Family Planning, 111, 161 Fat, 31, 141, 145, 148, 155, 161, 172, 176, 188, 191, 195 Fatigue, 136, 161, 165 Fatty acids, 9, 161, 184

Index 203

Feces, 154, 161, 192 Fetus, 29, 161, 182, 195 Fibrillation, 8, 161 Fibrin, 148, 161, 182, 193 Fibrinogen, 161, 182, 193 Fibrinolysis, 25, 161 Fibroblasts, 5, 7, 11, 13, 154, 161, 170 Fibroma, 84, 161 Fibrosis, 161, 188, 189 Flatus, 161, 163 Flexion, 10, 161 Flexor, 160, 161, 172 Flow Cytometry, 13, 161 Fluorescence, 161, 162 Fluorescent Dyes, 161, 162 Flushing, 137, 162 Folate, 162 Fold, 16, 162 Folic Acid, 91, 162 Forearm, 12, 148, 162 Forskolin, 16, 162 Functional Disorders, 67, 162 Fundus, 161, 162 G Gallbladder, 141, 151, 157, 162 Ganglia, 141, 162, 177, 192 Ganglion, 80, 162 Ganglionic Blockers, 145, 162 Gas, 124, 149, 157, 161, 162, 163, 167, 171, 178 Gastric, 30, 150, 158, 163 Gastrin, 163, 166 Gastrointestinal, 4, 33, 91, 147, 149, 160, 163, 190, 191, 192 Gastrointestinal tract, 4, 147, 163, 190 Gene, 5, 8, 9, 10, 11, 14, 16, 18, 22, 24, 45, 46, 49, 90, 141, 143, 148, 163, 166, 167, 178, 187 Gene Expression, 8, 9, 11, 16, 18, 163 Genetic Engineering, 148, 152, 163 Genetics, 19, 75, 163 Genotype, 24, 163, 181 Geriatric, 90, 163 Germline mutation, 22, 42, 48, 163, 166 Gestation, 153, 163, 182 Gestational, 35, 163, 175 Gestational trophoblastic disease, 35, 163, 175 Gestational trophoblastic neoplasia, 163, 175 Gestational trophoblastic tumor, 163, 175 Giant Cells, 163, 188

Gigantism, 94, 163 Gland, 20, 48, 80, 81, 82, 83, 92, 118, 121, 142, 151, 152, 155, 164, 173, 180, 182, 186, 189, 191, 193, 194 Glossitis, 164 Glucagonoma, 94, 164 Glucocorticoid, 12, 94, 156, 164 Glucose, 9, 46, 60, 93, 138, 143, 146, 157, 164, 165, 169, 187, 188 Glucose Intolerance, 93, 157, 164 Glucose tolerance, 93, 164 Glucose Tolerance Test, 164 Glutamic Acid, 162, 164 Gluten, 91, 150, 164 Glycoprotein, 161, 163, 164, 193, 195 Goiter, 4, 23, 27, 28, 29, 58, 81, 92, 119, 135, 164 Gonad, 164 Gonadal, 52, 164, 191 Governing Board, 164, 183 Graft, 87, 88, 164, 166, 168, 185 Graft Rejection, 87, 88, 164, 168 Graft-versus-host disease, 164, 185 Granulocytes, 84, 165, 197 Granuloma, 91, 165 Grasses, 162, 165 Gravis, 40, 44, 50, 69, 165 Guanylate Cyclase, 165, 178 Gynaecomastia, 25, 165 H Haemodialysis, 45, 165 Haptens, 142, 165, 186 Heart attack, 150, 165 Heart failure, 18, 47, 144, 165 Heme, 155, 165, 183 Hemochromatosis, 93, 165 Hemoglobin, 144, 148, 160, 165, 183 Hemorrhage, 158, 165, 192 Hemostasis, 165, 190 Heparin, 103, 165, 182 Hepatic, 14, 43, 51, 87, 164, 166, 183 Hepatitis, 36, 46, 118, 166 Hepatitis B, 46, 166 Hepatocytes, 166 Hereditary, 24, 33, 45, 48, 124, 151, 163, 166, 181 Hereditary mutation, 163, 166 Heredity, 163, 166 Heterodimers, 11, 166 Heterogeneity, 8, 10, 142, 166 Homeostasis, 15, 92, 166, 191 Homologous, 11, 143, 166

204 Hyperthyroidism

Hormonal, 3, 6, 14, 15, 19, 59, 120, 123, 146, 155, 166, 195 Hormone Antagonists, 19, 166 Hormone Replacement Therapy, 82, 92, 166 Host, 166, 168, 196 Humoral, 164, 166 Hybridomas, 166, 170 Hydatidiform Mole, 54, 151, 166 Hydrochlorothiazide, 31, 167 Hydrogen, 81, 87, 141, 147, 149, 156, 167, 172, 176, 178, 179, 181, 185 Hydrogen Peroxide, 167, 172 Hydrolysis, 167, 172, 183, 185, 195 Hydrophobic, 167, 172 Hyperaldosteronism, 92, 93, 94, 167 Hypercalcemia, 4, 80, 84, 167 Hypercholesterolemia, 19, 167 Hyperemesis, 54, 167 Hyperglycemia, 94, 167 Hyperlipidemia, 87, 167 Hyperlipoproteinemia, 87, 167 Hyperostosis, 93, 167 Hyperplasia, 20, 139, 167, 172 Hypersensitivity, 167, 188 Hypertension, 8, 38, 83, 142, 144, 145, 149, 150, 167, 184 Hypertrophy, 167 Hypoglycemia, 94, 167 Hypoplasia, 167, 174 Hypothalamic, 4, 19, 52, 167 Hypothalamus, 92, 146, 157, 167, 182, 193 I Iatrogenic, 55, 168 Id, 62, 71, 119, 120, 121, 122, 124, 125, 132, 134, 168 Idiopathic, 28, 168, 188 Imaging procedures, 168, 194 Imidazole, 83, 168 Immune response, 5, 6, 7, 13, 20, 141, 144, 145, 146, 155, 164, 165, 168, 192, 196 Immune Sera, 168 Immune system, 145, 146, 168, 173, 176, 196, 197 Immunity, 20, 168, 194 Immunization, 5, 11, 141, 168 Immunochemistry, 160, 168 Immunogenic, 168, 172, 186 Immunoglobulin, 13, 46, 53, 139, 144, 168, 176 Immunologic, 124, 141, 151, 168, 186 Immunology, 6, 22, 44, 141, 142, 162, 168

Immunosuppressive, 164, 168 Immunosuppressive therapy, 168 Immunotherapy, 13, 142, 168 Impairment, 161, 168, 174, 185 Implant radiation, 169, 170, 171, 186, 197 In vitro, 7, 84, 169 In vivo, 59, 166, 169 Indicative, 89, 169, 180, 196 Induction, 7, 9, 13, 38, 143, 163, 169, 184 Infancy, 169 Infantile, 16, 93, 169 Infarction, 169 Infection, 21, 26, 81, 83, 147, 151, 161, 168, 169, 171, 173, 188, 192, 195, 197 Inflammation, 72, 81, 84, 87, 88, 145, 151, 152, 161, 164, 166, 169, 188, 192, 193, 195, 196 Ingestion, 12, 13, 151, 164, 169, 183, 193 Inhalation, 169, 183 Initiation, 12, 169, 184, 194 Inlay, 169, 188 Inner ear, 169, 174 Inotropic, 158, 169 Insight, 6, 169 Insulator, 169, 176 Insulin, 12, 16, 27, 29, 47, 59, 93, 94, 164, 169, 170 Insulin-dependent diabetes mellitus, 169 Insulin-like, 12, 29, 47, 170 Intensive Care, 40, 170 Interferon, 36, 170, 173 Interferon-alpha, 170 Interleukin-2, 21, 170 Interleukin-6, 38, 170 Internal radiation, 170, 171, 186, 197 Interstitial, 148, 170, 171, 197 Intestinal, 150, 159, 164, 170, 173 Intestine, 148, 170, 171 Intoxication, 170, 197 Intracellular, 149, 169, 170, 178, 183, 187 Intramuscular, 22, 170 Intramuscular injection, 22, 170 Intraocular, 153, 162, 170 Intraocular pressure, 162, 170 Intrinsic, 142, 170 Invasive, 46, 166, 168, 170, 173 Involuntary, 148, 161, 170, 176, 187 Iodine, 4, 17, 27, 31, 34, 37, 38, 40, 45, 51, 52, 59, 60, 61, 63, 68, 70, 71, 81, 82, 83, 90, 103, 119, 139, 170, 175 Iodine-131, 34, 37, 38, 170 Ion Channels, 18, 170, 177

Index 205

Ions, 83, 147, 157, 158, 167, 171 Irradiation, 4, 171, 197 Irritable Bowel Syndrome, 162, 171 Ischemia, 144, 146, 171 Isocitrate Dehydrogenase, 43, 171 K Karyotype, 166, 171 Kb, 110, 171 L Labile, 153, 171 Lactation, 39, 59, 92, 171, 184 Large Intestine, 157, 170, 171, 187, 190 Latent, 26, 171 Laxative, 124, 171 Leishmaniasis, 171, 180 Lens, 171, 187 Leptin, 24, 38, 41, 52, 171 Lesion, 165, 172 Lethargy, 167, 172 Leukemia, 172 Leukocytes, 147, 148, 151, 159, 165, 170, 172, 176, 181 Levothyroxine, 4, 172 Libido, 144, 172 Library Services, 132, 172 Lichen Planus, 91, 172 Life Expectancy, 8, 172 Ligaments, 155, 172 Ligands, 18, 172 Linkage, 10, 19, 172 Lip, 93, 172 Lipid, 9, 38, 58, 67, 69, 145, 169, 172, 176, 179, 195 Lipid A, 9, 172 Lipid Peroxidation, 58, 67, 172, 179 Lipolysis, 30, 172 Lipopolysaccharides, 172 Lipoprotein, 87, 172, 173 Lithium, 23, 58, 65, 66, 172 Liver, 9, 14, 28, 33, 59, 67, 80, 141, 145, 147, 150, 157, 161, 162, 164, 165, 166, 173, 188, 189 Liver scan, 173, 189 Liver Transplantation, 28, 173 Localized, 84, 169, 172, 173, 182 Longitudinal Studies, 9, 173 Low-density lipoprotein, 172, 173 Lupus, 24, 173 Lutein Cells, 173, 184 Lymph, 152, 159, 173, 188 Lymph node, 173, 188 Lymphatic, 159, 169, 173, 175, 191, 193

Lymphoblastic, 173 Lymphoblasts, 141, 173 Lymphocyte, 46, 145, 173, 174 Lymphoid, 144, 173 Lymphoma, 26, 118, 173 Lysine, 173, 195 M Magnetic Resonance Imaging, 173, 189 Malabsorption, 150, 173 Malignancy, 91, 173 Malignant, 141, 145, 151, 173, 176, 177, 179, 186, 189 Malignant tumor, 151, 173, 176, 179 Malnutrition, 93, 146, 174 Mammary, 165, 174, 186 Mandible, 23, 174 Mandibulofacial Dysostosis, 93, 174 Manic, 148, 172, 174, 185 Manic-depressive psychosis, 174, 185 Manifest, 5, 91, 174 Mastocytosis, 84, 174 Mediate, 18, 157, 174 Mediator, 170, 174, 182, 190 Medical Records, 174, 188 Medical Staff, 158, 174 MEDLINE, 111, 174 Megaloblastic, 162, 174 Melanin, 156, 174, 195 Membrane, 153, 160, 161, 165, 171, 174, 176, 179, 181, 183, 188, 194 Memory, 92, 156, 174 Menopause, 92, 121, 122, 174, 183, 184 Menstrual Cycle, 92, 174, 184 Menstruation, 137, 156, 174 Mental Disorders, 77, 174, 185 Mental Health, iv, 4, 77, 110, 112, 174, 185 Mercury, 68, 162, 174 Mesenchymal, 166, 175 Metastasis, 48, 175 Metastatic, 68, 70, 175, 189 Methimazole, 40, 46, 51, 61, 84, 175 MI, 140, 175 Microbe, 175, 194 Microsomal, 14, 175 Milliliter, 148, 175 Mineralocorticoids, 142, 155, 175 Miscarriage, 80, 175 Mitochondria, 9, 171, 175, 179 Mitochondrial Swelling, 175, 177 Modification, 69, 163, 175, 186 Molar pregnancy, 41, 163, 175

206 Hyperthyroidism

Molecular, 6, 8, 9, 13, 27, 31, 84, 111, 113, 148, 153, 161, 165, 175, 182, 184, 187 Molecule, 17, 46, 145, 147, 152, 153, 157, 158, 159, 160, 167, 175, 179, 182, 185, 186, 187, 196 Monitor, 26, 86, 155, 176, 178 Monoclonal, 93, 166, 171, 176, 186, 197 Monocytes, 170, 172, 176 Mononuclear, 165, 176 Monophosphate, 81, 176 Morphology, 31, 90, 176 Motility, 162, 176, 190 Motion Sickness, 176, 177 Mucinous, 162, 176 Mucosa, 93, 150, 173, 176, 184, 192 Multicenter study, 28, 40, 176 Multiple Myeloma, 84, 176 Multiple sclerosis, 24, 176 Muscle Contraction, 10, 176 Muscle Fibers, 7, 176, 177 Myasthenia, 40, 44, 50, 69, 176 Myelin, 176 Myeloma, 91, 176 Myeloproliferative Disorders, 91, 176 Myocardial infarction, 155, 175, 176, 184 Myocardium, 16, 144, 175, 176 Myopathy, 120, 177 Myosin, 8, 176, 177 N Natural selection, 147, 177 Nausea, 124, 137, 158, 177 NCI, 1, 76, 109, 177 Necrosis, 38, 43, 47, 169, 175, 176, 177, 188 Need, 3, 53, 84, 91, 99, 124, 126, 142, 177, 188, 194 Neonatal, 4, 30, 42, 58, 60, 177 Neoplasm, 75, 177, 189, 195 Neoplastic, 166, 173, 177 Nephrosis, 177 Nephrotic, 28, 177 Nephrotic Syndrome, 28, 177 Nerve, 142, 144, 162, 174, 176, 177, 180, 188, 189, 191, 194 Nervous System, 92, 142, 146, 151, 174, 177, 192 Neurogenic, 124, 177 Neuromuscular, 60, 141, 177 Neurosecretory Systems, 159, 177 Neurotoxin, 80, 81, 177 Neurotransmitters, 176, 177, 191 Neutrons, 143, 171, 178, 186 Neutrophil, 24, 178

Nitric Oxide, 87, 178 Nitrogen, 87, 144, 178, 195 Norepinephrine, 142, 157, 178 Nuclear, 17, 18, 26, 31, 45, 49, 58, 68, 70, 96, 147, 158, 160, 162, 177, 178 Nuclei, 143, 158, 163, 173, 178, 185 Nucleic acid, 178, 188 Nucleus, 88, 147, 155, 156, 159, 160, 176, 178, 185, 191 O Occult, 29, 178 Ointments, 158, 178 Opacity, 156, 178 Operon, 178, 184, 187 Optic Chiasm, 167, 178 Oral Health, 91, 92, 178 Oral Manifestations, 91, 179 Orbit, 7, 179 Orbital, 5, 7, 179 Organelles, 151, 156, 176, 179 Orofacial, 91, 179 Ossification, 179 Osteoarthritis, 84, 179 Osteoblasts, 84, 179 Osteogenesis, 93, 179 Osteogenesis Imperfecta, 93, 179 Osteogenic sarcoma, 179 Osteopetrosis, 93, 179 Osteoporosis, 39, 59, 84, 87, 179, 186 Osteosarcoma, 84, 179 Ovary, 160, 164, 179 Ovum, 156, 163, 179, 184 Oxidation, 9, 58, 59, 67, 141, 145, 155, 172, 175, 179 Oxidative Phosphorylation, 91, 179 Oxidative Stress, 14, 40, 179 Oxygen Consumption, 81, 180, 187 P Pacemaker, 180, 188 Palate, 93, 180, 192 Palliative, 180, 193 Pancreas, 92, 93, 141, 143, 152, 157, 165, 169, 180, 195 Pancreatic, 92, 93, 150, 152, 164, 180 Pancreatic Juice, 152, 180 Papilla, 180 Papillary, 35, 47, 180 Paralysis, 149, 155, 180 Parathyroid, 4, 44, 69, 70, 85, 94, 118, 180, 193 Parathyroid Glands, 4, 180 Parathyroid hormone, 70, 85, 180

Index 207

Parotid, 180, 188 Paroxysmal, 30, 144, 180 Partial remission, 180, 187 Parturition, 180, 184 Pathogenesis, 5, 15, 81, 93, 180 Pathologic, 92, 155, 167, 180, 185 Patient Education, 123, 124, 130, 132, 140, 180 Pentamidine, 93, 180 Peptide, 18, 60, 81, 88, 159, 171, 181, 183, 184, 185, 193 Perception, 92, 181, 189 Perfusion, 181, 194 Periodontal disease, 84, 181 Pernicious, 124, 174, 181 Pernicious anemia, 124, 181 Peroxidase, 13, 80, 83, 172, 175, 181 Peroxide, 181 PH, 10, 31, 32, 39, 47, 50, 69, 148, 181 Pharmaceutical Preparations, 82, 181 Pharmaceutical Solutions, 158, 181 Pharmacologic, 144, 181, 194 Phenotype, 18, 19, 48, 181 Phospholipids, 161, 172, 181 Phosphorus, 149, 180, 181 Phosphorylation, 12, 181 Photocoagulation, 152, 181 Physical Examination, 4, 182 Physiologic, 142, 147, 174, 182, 187, 195 Physiology, 8, 16, 50, 59, 124, 150, 158, 182 Pigment, 123, 156, 182 Pituitary Gland, 82, 155, 162, 182, 195 Pituitary Hormones, 123, 182 Placenta, 16, 160, 182, 184 Plants, 149, 152, 164, 176, 178, 182, 188, 194 Plasma cells, 144, 176, 182 Plasmin, 182 Plasminogen, 38, 182 Plasminogen Activators, 182 Platelet Aggregation, 84, 143, 162, 178, 182 Platelet Factor 4, 84, 182 Platelets, 178, 182, 183, 193 Poisoning, 68, 170, 175, 177, 183 Polymerase, 183, 184, 187 Polymorphic, 19, 183 Polymorphism, 10, 46, 183 Polypeptide, 143, 152, 161, 182, 183, 184, 197 Polysaccharide, 145, 183, 185 Porphyria, 91, 183 Porphyrins, 183

Posterior, 92, 155, 158, 180, 182, 183, 189 Postmenopausal, 29, 179, 183, 186 Post-translational, 14, 183 Potassium, 103, 142, 157, 167, 175, 183 Practice Guidelines, 112, 124, 183 Preclinical, 20, 183 Precursor, 32, 145, 157, 158, 159, 178, 182, 183, 195 Prevalence, 8, 10, 31, 44, 93, 183 Progesterone, 184, 191 Prognostic factor, 45, 184 Progression, 144, 184 Progressive, 156, 158, 165, 177, 184, 195 Projection, 156, 178, 184 Prolactin, 43, 184 Promoter, 9, 15, 18, 184 Promotor, 184, 187 Propranolol, 31, 184 Prostaglandins, 18, 145, 184 Protease, 88, 184 Protein Binding, 184, 194 Protein C, 12, 16, 143, 145, 172, 184 Protein Conformation, 143, 184 Protein S, 12, 90, 148, 184, 188 Proteinuria, 176, 177, 185 Proteoglycan, 182, 185 Proteolytic, 12, 88, 153, 159, 161, 182, 185 Protocol, 5, 185 Protons, 143, 167, 185, 186 Pruritic, 172, 185 Psoralen, 124, 185 Psoriasis, 185 Psychosis, 123, 163, 185 Puberty, 123, 185 Public Health, 14, 112, 185 Public Policy, 111, 185 Publishing, 21, 185 Pulmonary, 34, 72, 148, 154, 185, 196 Pulmonary Artery, 148, 185, 196 Pulmonary hypertension, 34, 185 Pulse, 137, 139, 176, 186 Purgative, 171, 186 Q Quality of Life, 15, 31, 186 Quiescent, 186, 197 Quinones, 14, 186 R Radiation, 45, 83, 144, 159, 160, 162, 170, 171, 186, 189, 197 Radiation therapy, 160, 170, 171, 186, 197 Radioimmunoassay, 81, 86, 186 Radioisotope, 186, 194

208 Hyperthyroidism

Radiolabeled, 171, 186, 197 Radiotherapy, 148, 171, 186, 197 Raloxifene, 17, 186, 189 Randomized, 15, 22, 23, 30, 42, 51, 55, 58, 65, 158, 186 Randomized clinical trial, 51, 186 Reabsorption, 167, 187 Reality Testing, 185, 187 Receptors, Serotonin, 187, 190 Recombinant, 6, 187, 196 Recombinant Proteins, 6, 187 Rectum, 124, 145, 147, 148, 157, 161, 163, 171, 187 Recurrence, 30, 44, 60, 90, 148, 174, 187 Reductase, 14, 187 Refer, 1, 149, 153, 178, 185, 187 Reflex, 25, 187 Refractory, 43, 46, 158, 187 Regimen, 104, 158, 187 Relapse, 44, 187 Relaxant, 162, 187 Remission, 44, 46, 61, 80, 148, 174, 187 Repressor, 6, 178, 187 Reproductive cells, 163, 166, 187 Resolving, 10, 95, 187 Respiration, 149, 155, 176, 187 Response Elements, 5, 11, 187 Responsive pacemaker, 18, 188 Restoration, 11, 188 Retina, 171, 178, 188, 196 Retinoid, 8, 11, 19, 188 Retroperitoneal, 142, 188 Retrospective, 28, 51, 188 Retrospective study, 51, 188 Rheumatism, 188 Rheumatoid, 54, 84, 188 Rheumatoid arthritis, 54, 84, 188 Ribavirin, 36, 188 Riboflavin, 91, 188 Ribose, 141, 188 Ribosome, 188, 194 Risk factor, 49, 87, 123, 188 S Salivary, 157, 188 Salivary glands, 157, 188 Saponins, 188, 191 Sarcoidosis, 91, 188 Sarcoma, 84, 189 Scans, 10, 189 Schizoid, 189, 197 Schizophrenia, 189, 197 Schizotypal Personality Disorder, 189, 197

Sclera, 189, 196 Sclerae, 179, 189 Sclerosis, 176, 189 Screening, 49, 86, 88, 99, 123, 152, 189 Secondary tumor, 175, 189 Secretion, 15, 38, 59, 80, 94, 142, 151, 155, 168, 169, 171, 175, 182, 189, 195 Secretory, 70, 189 Segmental, 46, 189 Segmentation, 189 Seizures, 180, 189 Selective estrogen receptor modulator, 186, 189 Sella, 158, 182, 190 Senile, 179, 190 Septic, 87, 88, 190 Sequencing, 10, 190 Serine, 152, 190, 195 Serotonin, 32, 187, 190, 195 Serum, 10, 24, 25, 43, 44, 47, 48, 72, 139, 141, 143, 153, 168, 173, 175, 186, 190 Serum Albumin, 186, 190 Sex Characteristics, 143, 185, 190, 193 Shame, 148, 190 Shock, 87, 88, 190, 195 Side effect, 4, 80, 82, 83, 101, 124, 142, 190, 194 Sigmoid, 190 Sigmoidoscopy, 124, 190 Signs and Symptoms, 3, 187, 190 Skeletal, 4, 10, 12, 144, 155, 176, 190 Skeleton, 17, 141, 190 Skull, 179, 190 Small intestine, 152, 158, 166, 170, 190, 195, 196 Smooth muscle, 143, 149, 154, 162, 190, 192 Social Environment, 186, 190 Sodium, 38, 102, 104, 142, 157, 167, 175, 187, 191 Soft tissue, 148, 190, 191 Solid tumor, 144, 159, 191 Solitary Nucleus, 146, 191 Solvent, 147, 151, 181, 191 Specialist, 126, 191 Species, 143, 155, 160, 171, 176, 191, 194, 195, 196, 197 Specificity, 16, 142, 191, 194 Sperm, 143, 152, 163, 166, 187, 191 Spinal cord, 151, 162, 177, 187, 191, 192 Spleen, 173, 188, 191 Splenomegaly, 179, 191

Index 209

Staging, 189, 191 Sterile, 180, 191 Steroid, 18, 20, 155, 188, 191 Stimulus, 154, 160, 170, 187, 191, 193 Stomach, 141, 157, 160, 162, 163, 164, 166, 177, 190, 191, 192 Stomatitis, 164, 192 Stool, 124, 171, 192 Stress, 14, 60, 90, 138, 146, 150, 155, 162, 171, 177, 179, 188, 192 Stroke, 77, 110, 120, 150, 192 Subacute, 38, 55, 120, 169, 192 Subclinical, 14, 23, 25, 26, 31, 33, 38, 39, 41, 42, 43, 46, 49, 50, 51, 58, 68, 97, 169, 189, 192 Subcutaneous, 141, 158, 192 Substance P, 189, 192 Substrate, 150, 192 Supplementation, 58, 59, 66, 67, 68, 69, 192 Suppression, 13, 155, 192 Suppressive, 82, 192 Sympathetic Nervous System, 144, 146, 192 Sympathomimetic, 158, 160, 178, 192 Symptomatic, 50, 51, 70, 192 Synergistic, 184, 192 Systemic disease, 91, 124, 192 Systolic, 52, 139, 167, 192 T Tamponade, 47, 192 Testis, 151, 160, 192 Testosterone, 102, 187, 193 Tetany, 180, 193 Therapeutics, 7, 105, 193 Thigh, 11, 193 Third Ventricle, 167, 193 Thoracic, 193, 197 Threshold, 167, 193 Thrombin, 161, 182, 184, 193 Thrombolytic, 182, 193 Thrombomodulin, 184, 193 Thrombosis, 184, 192, 193 Thrombus, 155, 169, 182, 193, 196 Thymus, 168, 173, 193 Thyroid Gland, 3, 6, 60, 80, 81, 82, 92, 99, 118, 125, 164, 167, 180, 193, 194, 195 Thyroid Hormones, 4, 87, 175, 193, 195 Thyroiditis, 4, 10, 38, 55, 59, 72, 81, 120, 121, 122, 193 Thyrostatic, 25, 42, 82, 193 Thyrotoxicosis, 16, 17, 21, 61, 66, 67, 68, 69, 70, 71, 89, 90, 91, 95, 193

Thyrotropin, 6, 7, 22, 24, 27, 29, 33, 43, 45, 46, 49, 53, 68, 104, 139, 168, 193 Thyroxine, 15, 30, 44, 53, 80, 81, 82, 86, 119, 172, 194 Tissue Distribution, 31, 194 Tolerance, 67, 93, 141, 164, 194 Tomography, 70, 194 Toxic, iv, 4, 23, 28, 29, 54, 147, 155, 165, 168, 180, 194 Toxicity, 80, 158, 175, 194 Toxicology, 29, 112, 194 Toxins, 93, 144, 159, 169, 194 Tracer, 90, 194 Trachea, 193, 194 Transcription Factors, 187, 194 Transfection, 148, 194 Transfer Factor, 168, 194 Transfusion, 166, 194 Translation, 12, 194 Translational, 14, 194 Transmitter, 141, 157, 171, 174, 178, 194 Transplantation, 168, 194 Trauma, 177, 195 Tremor, 136, 195 Triglyceride, 167, 195 Trisomy, 93, 195 Trypanosomiasis, 180, 195 Trypsin, 88, 152, 159, 195, 197 Tryptophan, 153, 190, 195 Tsh, 119, 195 Tuberculosis, 154, 173, 195 Tumour, 38, 47, 162, 195 Tyrosine, 157, 195 U Ubiquitin, 12, 195 Ultrasonography, 53, 195 Unconscious, 156, 168, 195 Urethra, 195 Urinary, 86, 195 Urine, 86, 148, 155, 157, 185, 188, 195 Uterus, 151, 156, 159, 161, 162, 163, 174, 175, 184, 192, 195, 196 Uvea, 195 Uveitis, 124, 195 V Vaccine, 20, 141, 185, 196 Vagina, 151, 174, 192, 196 Vascular, 38, 143, 149, 159, 169, 178, 182, 193, 195, 196 Vascular Resistance, 143, 196 Vasculitis, 50, 196 Vasoconstriction, 46, 160, 196

210 Hyperthyroidism

Vasodilator, 145, 149, 158, 196 Vasomotor, 46, 196 Vector, 18, 196 Vein, 178, 180, 196 Venous, 36, 148, 184, 196 Venous Thrombosis, 36, 196 Ventricle, 52, 185, 186, 192, 193, 196 Ventricular, 36, 143, 196 Venules, 148, 149, 196 Vesicular, 175, 196 Veterinary Medicine, 111, 196 Villi, 166, 196 Villous, 150, 196 Villus, 166, 196 Viral, 18, 99, 120, 163, 196 Viral vector, 18, 196 Virulence, 194, 196 Virus, 159, 163, 166, 170, 196 Visceral, 146, 171, 197 Visceral Afferents, 146, 197

Vitiligo, 123, 185, 197 Vitro, 166, 197 Vivo, 197 W Weight Gain, 32, 99, 197 Weight-Bearing, 179, 197 White blood cell, 83, 141, 144, 172, 173, 176, 178, 182, 197 Windpipe, 80, 193, 197 Withdrawal, 44, 197 X Xenograft, 144, 197 X-ray, 11, 18, 31, 123, 147, 148, 150, 154, 162, 171, 178, 186, 189, 197 X-ray therapy, 171, 197 Y Yeasts, 181, 197 Z Zymogen, 152, 184, 197

Index 211

212 Hyperthyroidism

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