HYPOTHERMIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Hypothermia: 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: 0-597-83986-7 1. Hypothermia-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.
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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 hypothermia. 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 HYPOTHERMIA ......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Hypothermia ................................................................................. 5 E-Journals: PubMed Central ....................................................................................................... 67 The National Library of Medicine: PubMed ................................................................................ 68 CHAPTER 2. NUTRITION AND HYPOTHERMIA .............................................................................. 113 Overview.................................................................................................................................... 113 Finding Nutrition Studies on Hypothermia .............................................................................. 113 Federal Resources on Nutrition ................................................................................................. 117 Additional Web Resources ......................................................................................................... 118 CHAPTER 3. ALTERNATIVE MEDICINE AND HYPOTHERMIA ....................................................... 119 Overview.................................................................................................................................... 119 National Center for Complementary and Alternative Medicine................................................ 119 Additional Web Resources ......................................................................................................... 135 General References ..................................................................................................................... 136 CHAPTER 4. DISSERTATIONS ON HYPOTHERMIA ......................................................................... 137 Overview.................................................................................................................................... 137 Dissertations on Hypothermia ................................................................................................... 137 Keeping Current ........................................................................................................................ 138 CHAPTER 5. CLINICAL TRIALS AND HYPOTHERMIA .................................................................... 139 Overview.................................................................................................................................... 139 Recent Trials on Hypothermia ................................................................................................... 139 Keeping Current on Clinical Trials ........................................................................................... 139 CHAPTER 6. PATENTS ON HYPOTHERMIA .................................................................................... 141 Overview.................................................................................................................................... 141 Patents on Hypothermia ............................................................................................................ 141 Patent Applications on Hypothermia ........................................................................................ 159 Keeping Current ........................................................................................................................ 185 CHAPTER 7. BOOKS ON HYPOTHERMIA ........................................................................................ 187 Overview.................................................................................................................................... 187 Book Summaries: Online Booksellers......................................................................................... 187 The National Library of Medicine Book Index ........................................................................... 189 Chapters on Hypothermia .......................................................................................................... 190 CHAPTER 8. MULTIMEDIA ON HYPOTHERMIA ............................................................................. 195 Overview.................................................................................................................................... 195 Video Recordings ....................................................................................................................... 195 Bibliography: Multimedia on Hypothermia............................................................................... 196 CHAPTER 9. PERIODICALS AND NEWS ON HYPOTHERMIA .......................................................... 199 Overview.................................................................................................................................... 199 News Services and Press Releases.............................................................................................. 199 Newsletter Articles .................................................................................................................... 203 Academic Periodicals covering Hypothermia............................................................................. 204 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 205 Overview.................................................................................................................................... 205 U.S. Pharmacopeia..................................................................................................................... 205 Commercial Databases ............................................................................................................... 206 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 211 Overview.................................................................................................................................... 211 NIH Guidelines.......................................................................................................................... 211
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NIH Databases........................................................................................................................... 213 Other Commercial Databases..................................................................................................... 215 APPENDIX B. PATIENT RESOURCES ............................................................................................... 217 Overview.................................................................................................................................... 217 Patient Guideline Sources.......................................................................................................... 217 Finding Associations.................................................................................................................. 220 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 223 Overview.................................................................................................................................... 223 Preparation................................................................................................................................. 223 Finding a Local Medical Library................................................................................................ 223 Medical Libraries in the U.S. and Canada ................................................................................. 223 ONLINE GLOSSARIES................................................................................................................ 229 Online Dictionary Directories ................................................................................................... 232 HYPOTHERMIA DICTIONARY................................................................................................ 233 INDEX .............................................................................................................................................. 327
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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 hypothermia 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 hypothermia, 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 hypothermia, 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 hypothermia. 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 hypothermia, 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 hypothermia. 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 HYPOTHERMIA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on hypothermia.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and hypothermia, 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 “hypothermia” (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: •
Mandible Fracture in a Child with Menkes' Kinky Hair Syndrome Source: Journal of Oral and Maxillofacial Surgery. 54(1): 105-107. January 1996. Summary: In this article, the authors present the case of a 26-month-old toddler with Menke's kinky hair syndrome who suffered mandibular fractures. Menke's kinky hair syndrome is a rare, X-linked recessive disorder that affects copper absorption and metabolism. The disorder is characterized by growth failure, psychomotor retardation, seizures, hypothermia, cerebrocellular atrophy, generalized osteoporosis, and kinky hair. The authors describe the preoperative assessment; surgical technique; and postoperative care of the child. They also provide a general discussion of Menke's syndrome and its treatment. They note that the combination of copper-histidine injections (provided to the child since diagnosis at 4 months of age) and longer fixation
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of the mandibular fracture seem to have allowed more complete healing of the fracture than was anticipated. 5 figures. 10 references. (AA-M). •
Getting up in the World Source: Diabetes Forecast. 48(5): 40-47. May 1995. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: The author of this article extols the virtues of hiking and mountain climbing. Presented as an ideal sport for people with diabetes, the different types of hiking are described. Topics covered include mountain hiking; risk factors and cautions; backpacking; peak bagging; judging the peak; the Sierra Club class and grade system; aid climbing; snow and ice climbing; rock climbing; top-rope climbing; levels of physical fitness; the mountain environment, including considerations of hypothermia, altitude, and dehydration; and diabetes essentials, including sunwear, footwear, food, insulin or medication, glucose, a companion, blood glucose monitoring, a log book, and emergency preparedness. The author includes lists of outdoor programs for people with diabetes, and hiking organizations. One sidebar provides definitions for mountain climbing terms, including belay, carabinner, frind, nut, and rappel.
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Cross-Country Skiing: A Wonderful Winter Workout Source: Diabetes Forecast. 45(1): 64-68. January 1992. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article encourages readers to consider cross-country skiing as a winter component of their regular exercise plan. The author describes the different types of skiing; how to get started; where to ski; equipment; appropriate clothing; the importance of skiing at a level appropriate to one's degree of fitness and conditioning; diabetes management before, during and after skiing; and the danger signs of hypothermia.
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Fever: Thermal Regulation and Alteration in End Stage Renal Disease Patients Source: American Nephrology Nurses Association Journal. 19(1): 13-18. February 1992. Summary: This article presents an overview of thermoregulatory mechanisms, the pathophysiology of fever, and alterations of the febrile response in end-stage renal disease (ESRD) patients. Topics include definitions of fever; mechanisms of thermal regulation, including hypothalamic control of temperature; the pathophysiology of fever; fever management; uremia and body temperature; the possible mechanisms of hypothermia; and infection in ESRD patients. The author stresses that many ESRD patients do not exhibit the expected rise in white blood cell count or body temperature during clinical and laboratory-confirmed infections. Therefore, leukocytosis and fever cannot be relied on for the diagnosis of bacterial infection in ESRD patients. 3 figures. 4 tables. 16 references. (AA-M).
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Is Presentation of Bacteremia in the Elderly the Same as in Younger Patients? Source: American Journal of Medicine. 100(1): 65-70. January 1996. Summary: This article reports on a study to compare the presentation of bacteremia in young and elderly patients. Seventy-one elderly (mean age 80.4 years) and 34 younger
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patients (mean age 45.7 years) with bacteremia were prospectively studied. These were compared with a control group of 187 geriatric patients (mean age 81.3 years) with clinical signs of bacteremia but in whom blood cultures were negative. Only 3 clinical findings of the 16 studied were found in at least 70 percent of the bacteremic elderly patients: fever, increased erythrocyte sedimentation rate, and a clinical indication of the source of infection. Seven other signs (hypothermia, chills, sweating, splenomegaly, recently altered mental state, leukopenia, and lymphopenia) had a specificity above 80 percent. Younger infected patients had more chills, sweating, altered general state, altered mental state, or lymphopenia than did the bacteremic elderly patients. The authors conclude that, in elderly patients with early stage bacteremia, most of the signs or symptoms that are considered typical in the literature appear irregularly. 1 figure. 5 tables. 26 references. (AA-M). •
Acute Liver Failure Source: Current Opinion in Gastroenterology. 15(3): 270-277. May 1999. Contact: Available from Lippincott Williams and Wilkins Publishers. 12107 Insurance Way, Hagerstown, MD 21740. (800) 637-3030. Fax (301) 824-7390. Summary: This article reviews the advances and research on acute liver failure (ALF) over the past year. Severe hepatitis A is an infrequent but well recognized cause of ALF that can now be effectively prevented with vaccination against hepatitis A virus. Bromfenac and troglitazone hepatotoxicity, as well as various herbal remedies, are some of the newly identified causes of ALF. The recently identified transfusion transmitted virus has been implicated in some case of idiopathic ALF but hepatitis G virus does not appear to be a causative agent. Recognizing, monitoring, and treating patients with life threatening cerebral edema remain critically important but difficult aspects of the clinical care of ALF. Hypothermia and N acetylcysteine are promising experimental approaches to cerebral edema, but emergency liver transplantation is the only proven means of improving patient survival. Although recent changes in organ allocation may reduce the waiting time for transplantation, more reliable and validated markers of liver regeneration and prognosis are needed to triage patients. The potential application and limitations of novel technologies, including bioartificial liver devices and auxiliary liver transplantation, continue to evolve from pioneering work in animal models and human subjects. 2 figures. 2 tables. 56 references (19 annotated).
Federally Funded Research on Hypothermia The U.S. Government supports a variety of research studies relating to hypothermia. 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 hypothermia. 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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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 hypothermia. The following is typical of the type of information found when searching the CRISP database for hypothermia: •
Project Title: ACUTE/SUBACUTE METABOLIC & HEMODYNAMIC TRAUMATIC BRAIN INJURY DETERMINANTS Principal Investigator & Institution: Ginsberg, Myron D.; Professor; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2001 Summary: We propose to investigate in detail the interrelationships between local brain glucose metabolism (ICMRgl) and blood flow (ICBF) in the acute and subacute periods following cortical fluid-percussion injury (FPI) in the rat. Exciting pilot data obtained using novel 3D autoradiographic image- averaging strategies developed by us have disclosed marked metabolism > flow uncoupling in the acute period after FPI, which we believe imposes a severe metabolic stress upon the tissue. In contrast, hyperemia was observed at five days. Using matched animal groups and the disparity analysis algorithm, we shall comprehensively characterize ICBF, ICMRgl and the ICMRgl/ICBF ratio over the first five days following FPI. We hypothesize that uncoupling persists during the first few hours but remits after 1-2 days. Next, we shall ascertain how these perturbations are influenced by post-traumatic therapeutic hypothermia, administered either early (first 3 h). or initiated somewhat later (3-5 h) following trauma. We hypothesize that therapeutic hypothermia reverse uncoupling and thereby protects the tissue. We shall establish the role of the nitric oxide/nitric oxide synthase (NOS) system in post-traumatic ICBF changes, either via diminished vascular NO production acutely or by expression of iNOS at later time. This will be studied via in situ hybridization, immunohistochemistry, and enzymatic activity assays, coupled with assessment of cyclic GMP production in the traumatic brain. As endothelin and/or serotonin are potential modulators of ICBF following trauma, these will also be assessed via intracerebral microdialysis and the use of specific pharmacologic anatagonists. Finally, we intend to characterize more fully the relationship between the localized evidence of metabolic stress (metabolism > uncoupling) and the temporal and spatial features of gene expression: we shall concentrate on hsp7O, immediate early genes, glial fibrillary acidic protein, and the neurotrophin, brain- derived neurotrophic factor. Our pilot data, in each instance, have revealed trauma-related changes in gene expression. The relationship of these patterns of gene expression to apoptosis will be assessed. Finally, we shall investigate the effect of specific therapeutic interventions, including NMDA and non-NMDA antagonism, and the scavenging of oxygen radicals, on CMRgl/CBF interrelationships and gene expression. These studies will provide a comprehensive overview of hemodynamics and metabolism in the acute and subacute periods. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ADENYLYL CYCLASE TRANSGENIC MICE AND ALCOHOLISM Principal Investigator & Institution: Yoshimura, Masami; Pharmacology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2002 Summary: The cAMP signal transduction system may play an important role in the development of alcohol sm. The long-term goal of this research is twofold: 1) To elucidate the molecular and cellular mechanisms underlying ethanol's effects on the
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cAMP signaling pathway in the central nervous system, and 2) To determine the role that the cAMP signaling pathway plays in the physiological and behavioral responses to alcohol abuse. If a change in cAMP signaling is one of the determinants of an alcoholic phenotype, it is conceivable that alterations in the cAMP signaling system in an animal model may change the animal's response to ethanol. The hypothesis to be evaluated is that the response of animals to ethanol can be altered by the modification of adenylyl cyclase (AC) expression. To test this hypothesis, transgenic mice that overexpress type VII AC (AC7: the most ethanol sensitive isoform) and knockout mice that lack expression of AC7 will be generated. Once changes in the expression of AC7 are confirmed, the ethanol sensitivity of AC activity in the brain of the mutant mice will be examined. Ethanol's effect on the firing rate of the cerebellar Purkinje neurons of the mutant mice will be examined by electrophysiological recording. The sensitivity of the mutant mice to acute ethanol intoxication will be examined by measuring the duration of loss of righting reflex (sleep time) and the changes in body temperature (hypothermia). The development of tolerance in the mutant mice chronically treated with ethanol will be examined by measuring the decrease in the hypnotic and hypothermic effects of ethanol. The development of physical dependence in the mutant mice to ethanol will be examined by assessing the intensity of handling-induced convulsions after ethanol withdrawal. The proposed studies will generate valuable animal models for alcoholism research. These animals will also be useful for a widerange of physiological and behavioral research dealing with cAMP signal transduction. The proposed studies will also provide information critical to the determination of whether abnormal cAMP signaling is one of the determinants of an alcoholic phenotype. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADOLESCENT ALCOHOL ADAPTATION: TOLERANCE & STRESS Principal Investigator & Institution: Spear, Linda P.; Distinguished Professor and Chair; Psychology; State University New York Binghamton Vestal Pky E Binghamton, Ny 13901 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: Adolescents differ from adults in responsivity to a number of ethanol effects. Their insensitivity to the motor incapacitating and sedating effects of ethanol may increase consumption capacities and support higher levels of adolescent drinking, thereby contributing to the unique risks associated with alcohol drinking during adolescence. It has yet to be established whether this unique pattern of alcohol responsivity during adolescence is a function of age-related differences in initial neural sensitivity to alcohol or in the magnitude of tolerance developing within ethanol exposure periods (acute tolerance) or across exposures (rapid and chronic tolerance). There are, however, recent observations of notable ontogenetic alterations in the expression of these ethanol adaptations. Such ontogenetic differences in ethanol tolerance may be particularly pronounced under stressful circumstances, given evidence that vulnerability to stressors may be increased during adolescence and that development of ethanol tolerance is enhanced by stressors. Consequently, the work outlined in this proposal will explore the contribution of tolerance to the unique pattern of alcohol responsivity during adolescence, and the effects of stressors on these adaptational processes. Studies will compare the expression of acute, rapid and chronic tolerance to various characteristic effects of ethanol and the impact of stressors on these ethanol adaptations in male and female, adolescent and adult (as well as weanlings, where feasible) Sprague-Dawley rats. It is predicted that age-related attenuations in sensitivity to specific ethanol effects will be associated with greater acute tolerance but
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less rapid and chronic tolerance to those effects, with adolescents being particularly vulnerable to stress-induced facilitation of acute, rapid and chronic tolerance. Characterizing the ontogeny of ethanol tolerance and the effects of stressors on these adaptational processes is not only critical for assessing determinants of the unique pattern of alcohol responsivity seen during adolescence, but also may contribute to our understanding of the long-term consequences of adolescent alcohol exposure for later alcohol use and abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADOLESCENT ETOH EXPOSURE: EFFECT ON ADULT ETOH RESPONSE Principal Investigator & Institution: Diaz-Granados, Jaime L.; Associate Professor; Psychology and Neuroscience; Baylor University Waco, Tx 76798 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2004 Summary: Alcohol use and abuse is prevalent among adolescents. Alcohol remains to be the primary drug of choice among this population. However, due to ethical considerations, it is impossible to investigate the effects of adolescent alcohol exposure in the human population. Therefore, animal models must be utilized to examine the effects of alcohol exposure during this developmental period. Recent preliminary data from our laboratory suggests that exposure to alcohol during adolescent development attenuates the adult's initial response to ethanol-induced ataxia. In addition, preliminary results from our laboratory suggest that adolescent alcohol exposure exacerbates the alcohol withdrawal response in adulthood. The overall objective of this proposal is to investigate more fully whether exposure to alcohol during the adolescent period will alter the pharmacological response to alcohol in adulthood. Specifically, the proposed work will examine the effect of adolescent alcohol exposure on (1) the adult's initial response to the intoxicating effects of alcohol, (2) the development of rapid tolerance to the intoxicating effects of alcohol, (3) the development of chronic tolerance to the ataxic and hypothermic effects of alcohol, and (4) the severity of the alcohol withdrawal reaction. Specific aim 1 will address the sensitivity of these responses to the level of intoxication achieved during adolescence. The second specific aim will examine whether exposure to alcohol during early, middle, and late periods of adolescent development will result in differential effects on the adult response to alcohol. Specific aim 3 will investigate whether the pattern of alcohol exposure (i.e., chronic versus intermittent) will differentially alter the adult response to alcohol. Findings from these studies will significantly characterize the effects of the dose, timing, and pattern of alcohol exposure during adolescence on later responsiveness to ethanol in adulthood. This requisite characterization of adolescent developmental alcohol effects, coupled with the known ontogeny of neural systems during the adolescent period, should lead to further investigation of possible alcohol-induced perturbations of the developing central nervous system which may underlie an altered adult response to alcohol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ADRENERGIC DEVELOPMENT
RECEPTORS
DURING
PERIADOLESCENT
Principal Investigator & Institution: Bylund, David B.; Professor and Chair; Pharmacology; University of Nebraska Medical Center Omaha, Ne 681987835 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 30-JUN-2006
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Summary: (provided by applicant): The up-regulation or down-regulation of neurotransmitter receptors has become one of the major, proposed mechanisms for a variety of therapeutic drugs. Drug-induced regulation of central catecholamine receptors has been extensively studied in adults, but little is known about their regulation in young animals. It is particularly important to understand the nature of drug-induced regulation of adrenergic receptors in young animals for two reasons. First, adrenergic agents are used clinically in children and adolescents. Our preliminary data show that the effects of adrenergic agents on the young adrenergic system are qualitatively different from their effects on the adult. Second, because the adrenergic system is late developing, and is still changing during periadolescent development, perturbations in this system are more likely to have greater, qualitatively different, and longer-lasting effects than on a mature system. The central hypothesis of the proposed studies is that CNS alpha-2 and beta adrenergic receptors are differentially regulated in periadolescent as compared to adult rats, as reflected by responses to two drugs that effect the noradrenergic and serotonin systems (the selective re-uptake inhibitors desipramine and fluvoxamine). The first specific hypothesis, that central adrenergic receptors will be up-regulated in periadolescent animals rather than down-regulated as observed in adult animals, will be tested using quantitative autoradiography to determine alpha-2 and beta adrenergic receptor density. The second hypothesis, that the functional coupling between the adrenergic receptors and their G proteins will be increased in the young animals as compared to adults, will be tested using cyclic AMP accumulation and GTPyS binding assays. The third hypothesis, that the functional responses to agonist stimulation will be increased in periadolescent animals as consequences of these alterations in regulation and coupling, will be studied using regulation of immediate early gene expression and agonist induced-hypothermia. These studies in rats will help provide the necessary foundation for understanding the regulation of the adrenergic receptor systems in young animals leading to an eventual understanding of the effects of chronic drug treatment in children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AGE AND CONTROL OF HUMAN SKIN BLOOD-FLOW Principal Investigator & Institution: Kenney, W. L.; Professor of Physiology and Kinesiology; Noll Physiological Res Ctr; Pennsylvania State University-Univ Park 201 Old Main University Park, Pa 16802 Timing: Fiscal Year 2003; Project Start 30-SEP-1987; Project End 31-AUG-2008 Summary: (provided by applicant): This competitive renewal of R01 AG07004 continues our systematic investigations into mechanisms underlying altered thermoregulatory control of skin blood flow (SkappaBF) with primary human aging, and the consequences thereof. Both cutaneous vasodilation (VD) in response to hyperthermic stimuli and cutaneous vasoconstriction (VC) in response to hypothermic stimuliare significantlyattenuated in aged skin. The previous funding cycle involved a systematic investigation of the mechanisms related to altered cutaneous VD in older men and women (briefly summarized in Section C of this proposal). The next sequence of proposed studies is the logical extension of this line of investigation, i.e., examining the mechanisms and consequences of altered cutaneous VC in aged skin, since (1) primary aging is associated with both a larger decrease in core temperature with cold stress and an increased incidence of clinical hypothermia, (2) these untoward outcomes are primarily the result of a relative inability to vasoconstrict the skin vasculature leading to an increased core-to-skin heat transfer, (3) several plausible sites of age-related changes exist in the efferent VC control pathway which have not been tested in vivo.
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Furthermore, older men and women with a low body mass and lean muscle mass are at ever) greater risk of hypothermia because of the combined effects of reduced VC and decreased core-to-skin thermal resistance. Specific Aims 1-3 examine basic efferent mechanisms of attenuated reflex VC in aged skin at the sympathetic nerve transmission, neurotransmitter/receptor, and end-organ response levels, respectively. These studies make use of new and recently refined techniques that allow for the in vivo examination of age-related changes in human skin. Specific Aim 1 quantifies the skin sympathetic nerve activity (SSNA) during progressive skin cooling in older vs. young men and women and its relation to VC. Specific Aim 2 addresses the relative contributionsof noradrenergic and nonnoradrenergic mechanisms in reflexVC inyoung and older subjects. Follow-up experiments are described that will determine the potential role of neuropeptide Y in this age-specific VC response. Specific Aim 3 will examine the dose response characteristics of noradrenergicVC to assess the responsiveness of the aged cutaneous vasculature to norepinephrine. Finally, Specific Aim 4 involves a series of whole-body chamber experiments designed to determine and model the effects of altered VC on the resistance to core-to-skin heat transfer, i.e., tissue resistance (insulation) in the fully vasoconstricted state. Resistance to heat loss is a function of both physiological adjustments (VC) and characteristics of the passive system (e.g., muscle mass). Because a common sequelae of human aging is a progressive loss of muscle mass (sarcopenia), sarcopenic elderly men and women may be at even greater risk of hypothermia and hypothermia-related problems. Therefore, the proposed studies under Specific Aim 4 will include differences in muscle mass within age groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AGING AND GENDER EFFECTS ON RESPONSES TO COLD IN RATS Principal Investigator & Institution: Horwitz, Barbara A.; Vice Provost of Academic Personnel; Neurobiol/Physiol & Behavior; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2001; Project Start 01-APR-1988; Project End 31-JUL-2003 Summary: The unprecedented growth in number of persons over 65 yrs of age will place an increasing percentage of our population at risk for poor health. It has been suggested that this increased risk can be explained in part by the aging organisms' blunted ability to adapt to internal or external stress. That is, aging may be characterized by a general decline in the ability to maintain homeostasis. One such homeostatic response is the ability to maintain homeothermy which is compromised in older cold-exposed humans and rodents. Of special interest is the observation that this effect of age appears to be more pronounced in males than in females (in humans and in rats). Thus, the effect of aging on the ability to maintain homeothermy in particular and homeostasis in general may be gender dependent. Our study of thermoregulatory function in aging rats will provide a model by which we will gain a clearer understanding of these effects of aging and gender on homeostasis. A major objective of this project is to evaluate the physiological/biochemical basis for the attenuated effectiveness of thermoregulatory responses in older male/female rats. As a model system for studying the aging/gender effects on homeostatic alterations, we will use brown adipose tissue (BAT) for which we have demonstrated blunted thermogenic responses in older vs younger males and in older males vs their female counterparts. Since BAT function is regulated by the sympathetic nervous system and modulated by several hormones, our proposal examines the Interaction of gender and aging on BAT thermogenic capacity (uncoupling protein), adrenergic receptors, signal transduction, substrate availability and
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mobilization, availability of insulin and thyroid hormone, and sensitivity to Insulin. We will also examine possible alterations in skeletal muscle, whose thermogenesis may also be attenuated in aging animals. Procedures include membrane and cell isolations, Scatchard plot analysis, immunobinding, in vitro and in vivo uptake of 2-deoxyglucose, radioimmunoassays, euglycemic clamp, hindlimb perfusion, and variety of enzyme assays. These studies should provide considerable insight into gender/aging interactions relevant to neural and hormonal modulation of metabolic regulation, thermoregulation, and homeostatic maintenance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANNUAL RHYTHMS OF ENERGY BALANCE AND BEHAVIOR Principal Investigator & Institution: Dark, John G.; Psychology; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2001; Project Start 16-SEP-1996; Project End 31-MAR-2003 Summary: The overall goal of this proposal is to further characterize the neuroendocrine mechanisms that underlie the initiation and expression of daily torpor, an extreme form of temperature regulation that evolved to help animals contend with limited food availability. The relation of torpor to overall energy balance and body fat stores will be explored. Annual rhythms of daily torpor are well documented in the Siberian hamster (Phodopus sungorus), the model species in all experiments. Specific aims include: 1) clarifying the relation between decreases in body fat stores and its feedback mechanisms in the initiation of torpor; 2) characterizing the role of leptin as a metabolic signal inhibiting initiation of torpor; 3) exploring the role of NPY in torpor; 4) determining the role of diencephalic mechanisms in initiation of daily torpor There is much that we still do not understand about the physiological mechanisms underlying the control of energy balance and thermoregulation. Delineating the interaction between metabolic feedback signals and daily torpor in a model system like the Siberian hamster could provide important insights into the regulation of these processes for mammals in general and humans in particular. A better understanding of the mechanisms of reversible hypothermia is of medical import. The reduced metabolism, blood flow, etc. coincident with hypothermia may be very beneficial during many types of major surgery. At this time, we know little of the mechanism that allows Siberian hamsters and several other mammalian species to undergo hypothermia which is lethal to humans and most other mammals. The proposed research addresses fundamental questions in regulatory biology and, thereby, affords the opportunity of establishing general principles applicable to all mammals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AXONAL RESPONSE TO TRAUMATIC BRAIN INJURY Principal Investigator & Institution: Povlishock, John T.; Professor and Chair; Anatomy and Neurobiology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2003; Project Start 01-DEC-1983; Project End 30-NOV-2006 Summary: (provided by applicant): This application seeks to continue 20 years of support focusing on the microvascular, neuronal somatic, axonal and deafferentationmediated responses to traumatic brain injury. In previous funding periods, we have shown that the injury does not tear axons. Rather, it triggers local axonal damage that leads to continued alteration and ultimate disconnection. It has been assumed by all that once disconnected the proximal axonal tip swells, due to the delivery of substances via anterograde transport, with the resulting axonal bulb formation becoming the
12
Hypothermia
universally recognized endpoint for all contemporary forensic, neuropathological and experimental studies. Recently, our laboratory has suggested that many injured axons may not progress to bulb formation, which suggests differing modes of pathogenesis and potential therapeutic modulation. In this application we focus on this issue using different animal models of TBI, employing lissencephalic and gyrencephalic species. The resulting TAI will be followed over time by double label immunocytochemical strategies targeting various cytoskeletal, axolemmal and axonal transport abnormalities. Quantitative, computer-assisted EM analysis will be used to better understand the precise subcellular changes associated with TIA as well as the mechanisms related thereto. Moving on the premise that we will observe different populations of injured axons, with differing forms of pathogenesis, we will also pursue descriptive and mechanistic studies related to their response to agents reported to attenuate TAI. Cyclosporin A and FK506 will be used in addition to hypothermia to assess their impact on these differing forms of TAI via the same strategies noted above. These studies will be interfaced with electrophysiological and neurochemical assessments to examine any therapeutic modulation of action potentials, calcineurin activity or mitochondrial function. The successful conduct of these studies should provide new insight into the complex pathobiology of TAI and its therapeutic modulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAIN AS TARGET FOR ANTISENSE PEPTIDE NUCLEIC ACID DRUGS Principal Investigator & Institution: Richelson, Elliott; Professor; Mayo Clinic Jacksonville 4500 San Pablo Rd Jacksonville, Fl 32224 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2002 Summary: (Applicant's Abstract) The goal of the proposed research is to characterize in rat the pharmacokinetics and pharmacodynamics of three antisense polyamide ("peptide") nucleic acids (PNAs) directed toward three different proteins in rat brain: the neurotensin receptor subtype 1 (NTR1), the morphine receptor subtype (MOR1), and the serotonin transporter (SERT). The long term goal of this research is to develop PNAs as antisense and antigene drugs to treat a variety of diseases, especially those affecting brain. In different experiments, different PNAs (either in unlabeled or in radioactivelylabeled or fluorescently-labeled forms) will be administereed to rats by intravenous, intraperitoneal, or oral routes. From measurement of concentrations of PNAs in blood over time, pharmacokinetic variables, including absolute bioavailability of PNAs by the oral route, will be determined. The kinetics of entry of these PNAs into brain (as well as other organs) and their distributions within the brain will also be determined by various techniques, including histological. The kinetics of entry into brain will be correlated with the time course for the onset of and the recovery from their functional effects from behavioral, physiological, biochemical, and molecular biological experiments. Behavioral studies will measure antinociception (NTR1 and MOR1); physiological studies, hypothermia (NTR1); biochemical studies, binding sites for NTR1, MOR1, and SERT, as well as brain levels of serotonin and its metabolite, and molecular biological studies, levels of mRNA for each targeted protein. This research represents the initial studies that might lead to viable antisense and antigene therapies for many types of diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BRAIN ADAPTATION
CANNABINOID
SIGNALING:
SELECTIVITY
13
AND
Principal Investigator & Institution: Sim-Selley, Laura J,.; Assistant Professor; Pharmacology and Toxicology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2007 Summary: (provided by applicant): Cannabinoid (CB1) receptors in brain mediate the effects of delta 9-tetrahydrocannabinol (THC) and endocannabinoids, primarily by activation of inhibitory G-proteins of the Gi/Go family. However, it is our premise that CB1 receptor- G-protein coupling is not uniform throughout the brain, and CB1 receptors may couple to multiple G-proteins to account for the multiplicity of cannabinoid effects. Indeed, our progress to date demonstrates regional differences in CB1 receptor-mediated G-protein activity in both normal brain and in adaptive responses to chronic THC administration. Moreover, the pattern of tolerance development is not identical for all THC effects, a finding we hypothesize is related to these regional differences in CB1 receptor-G-protein coupling. The proposed studies will investigate the relationship between cannabinoid tolerance and CB1 receptor desensitization and downregulation, and examine whether selective coupling of CB1 receptors to specific G-protein subtypes is correlated with regional differences in CB1 receptor adaptation. We propose examining in a systematic manner the role of CB1 receptor- G-protein coupling in neuroadaptation not only as a means of understanding cannabinoid tolerance but as a way of characterizing the endocannabinoid system. In order to address the role of receptor occupancy in adaptation, the magnitude of THC tolerance will be varied by administering different doses of THC. We will then assess 1) tolerance to cannabinoid-mediated hypoactivity, antinociception, hypothermia and memory impairment in behavioral assays and 2) CB1 receptor downregulation and desensitization using radiolabeled ligand and agonist- stimulated [35S]GTPgammaS autoradiography. We also hypothesize that differences in CB1 receptor-G-protein coupling throughout the brain account for differences in recovery of tolerance to separate THC-mediated behavioral effects. Therefore, the temporal relationship between recovery of tolerance and CB1 receptor function will be evaluated by treating mice with THC, then evaluating tolerance and downregulation/desensitization at different times after cessation of treatment. We will also conduct experiments to determine whether CB1 receptor coupling to different G-protein subtypes is responsible for variations in cannabinoid actions in different brain regions. We will examine co-localization of CB1 receptors and specific G-beta and G-gamma subtypes using immunocytochemistry to determine whether there is selective co-localization of CB1 receptors and specific subunits in different regions. We will then examine whether chronic THC administration selectively alters CB1 receptor coupling to specific G-alpha subtypes using agoniststimulated [35S]GTPgammaS binding with subsequent immunprecipitation of activated G-alpha subtypes. These studies will contribute to elucidation of the mechanisms of action of CB1 receptors in brain, as well as determine the effects of chronic cannabinoid administration on cellular function during tolerance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAIN COOLING AND REPERFUSION INJURY IN STROKE Principal Investigator & Institution: Nowak, Thaddeus S.; Professor; Neurology; University of Tennessee Health Sci Ctr Health Science Center Memphis, Tn 38163 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2005
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Summary: (Verbatim from the Applicant's Abstract) Early reperfusion is of proven benefit in stroke but intervention is only effective after brief ischemia, and it is critical that methods be found to extend its therapeutic window. Delayed, brief hypothermia can reduce infarct volume after focal ischemia in several rat models, provided cooling is initiated prior to or soon after the onset of recirculation. Preliminary results indicate significant strain differences in this effect, with a more prolonged window for intervention in Long-Evans rats, suggesting that cooling is particularly protective against "reperfusion injury" that is an established feature of this model. A novel approach is the selective cooling of blood reperfusing the previously ischemic territory, specifically targeting tissue at risk and reducing the potential for complications associated with deep systemic hypothermia. This robust model provides an opportunity to both define the practical limits of hypothermic protection and identify mechanisms by which hypothermia impacts postischemic injury cascades. Proposed studies will: 1) fully define the range of insult duration and temperature modulation over which protection can be achieved; 2) determine the impact of protective cooling on molecular markers of postischemic injury in neurons and other cell types; and 3) elucidate the impact of cooling on intravascular injury mechanisms that may contribute to infarct evolution. These results will establish the relative accessibility of intravascular vs. parenchymal injury cascades to hypothermic protection, and define critical targets for pharmacological intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CARDIAC ARREST AND RESUSCITATION--MECHANISMS OF BRAIN INJURY Principal Investigator & Institution: Traystman, Richard J.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001 Summary: Severe hypoxia and complete asphyxia are the most common causes of cardiac arrest in newborn and infant children and can result in cerebral palsy, mental retardation and severe seizures. We have developed a model of asphyxic cardiac arrest in the immature pig that resembles the clinical course of birth asphyxia with selective injury to basal ganglia, cortex and thalamus and with emergence of clinical seizures one day after resuscitation. Our preliminary data indicate that injury to neurons and astrocytes, accompanied by loss of their respective glutamate transporter isoforms, is dense in putamen by 24 hours, whereas neurodegeneration is largely delayed until 48 hours in primary sensorimotor cortex and until 96 hours in thalamic sensory nuclei. Our goal is to understand the mechanism of injury at each step of recovery so that specific therapeutic modalities can be designed to prevent the maturation of injury at each location. We will determine if decreased capacity of the glutamate reuptake transporters occurs during the early hours of reoxygenation when bursts of electrical activity are seen. Mild hypothermia and the glutamate release inhibitor lamotrigine will be used to reduce the overflow of glutamate into the extracellular space as monitored by microdialysis during the first day of recovery. We will determine if suppressing glutamate overflow after resuscitation reduces early neuronal and astrocyte loss in putamen, delayed loss in cortex and thalamus, and neurobehavioral deficits. A component of the delayed neuronal loss in sensorimotor cortex and thalamus may be apoptotic in nature resulting from a) target deprivation secondary to loss of other neurons in the sensorimotor axis, and b) seizures. We will use various morphological and biochemical markers of apoptosis to determine when and where programmed cell death occurs. Phenobarbital loading, as used clinically to suppress birth asphyxia
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seizures in newborns, will be used to determine the role of seizure activity in the progression of the injury process. The integrative approach of systems neuropathology, immunocytochemical localization, microdialysis and EEG spectral analysis will generate unique mechanistic insights in a model of neonatal brain injury. In mature brain, transgenic mice have been useful for investigating focal ischemic injury, but this approach has not been applied to cardiac arrest. In a model of cardiac arrest and resuscitation in mice, we will test the hypothesis that the combination of neuronal nitric oxide (NO) synthase gene deletion with overexpression of Cu, Zn- superoxide dismutase provides better neuroprotection and improve memory and learning than either gene alteration alone. This study provides a novel approach for understanding the role of NO and oxygen radicals in delayed neuronal injury after cardiac arrest/CPR. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CARDIAC SURGICAL ISCHEMIA: BIOPHYSICAL ASPECTS Principal Investigator & Institution: Krukenkamp, Irvin B.; Director, Heart Center; Surgery; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Most cardiac surgical procedures require induction and management of myocardial ischemia and reperfusion. Preconditioning by a brief period of unprotected ischemia and reperfusion confers myocardial protection subsequent to a more prolonged insult. The central hypothesis of this application is that understanding the changes in sarcolemmal membrane currents which underlie the ability of the myocyte to maintain excitability consequent to preconditioning may provide an avenue for new approaches to myocardial protection that would improve myocyte function as well as survival. Our novel models use guinea pig myocytes isolated preischemically, prior to metabolic inhibition by NaCN, and rabbit myocytes first exposed to global ischemia, and then isolated during reperfusion. Studies of intracellular calcium and pH, and sarcolemmal current-voltage relations demonstrate an increase in an outward potassium current that appears either during prolonged ischemia, or during reperfusion. This current is not blocked by glybenclamide, indicating an identity other than i(kATP) Ischemic preconditioning shortens the time to appearance of the current during ischemia, and prevents its expression during reperfusion. Using these biological markers, our specific aims are to study, 1.) whether preconditioning triggers intracellular calcium, pH, or potassium conductance changes evident during preischemia, 2.) whether depolarizing (K+ or K+/Mg ++) and/or hyperpolarizing (pinacidil or ACh) cardioplegic ischemia imparts protection by sarcolemmal conductance and intracellular ionic changes similar to preconditioning evident during reperfusion, and 3.) whether maintenance of a specific membrane potential during ischemia limits deleterious biophysical changes, and whether i(kl) or other inward rectifiers may act as mediators of the observed K+ current changes. This translational research effort supports our long-term aim to understand the biophysical mechanisms and triggers that will direct the development of specific methods to enhance the clinical conduct and outcome of cardiac ischemia for patients who must undergo surgical repair. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CELLULAR AND NEUROCHEMICAL MECHANISMS OF REM SLEEP Principal Investigator & Institution: Datta, Subimal; Professor; Psychiatry; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118
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Hypothermia
Timing: Fiscal Year 2003; Project Start 01-APR-1999; Project End 31-MAR-2008 Summary: (provided by applicant): The long-term objective of this application is to further our understanding of cellular and neurochemical mechanisms of REM sleep. More specifically, the goal is to identify Pedunculo Pontine Tegmentum (PPT) intracellular signal transduction pathways involved in the receptor activation-mediated regulation of REM sleep in the freely moving rat. Recent evidence indicates that novel compounds designed to modify intracellular transduction pathways have therapeutic potential for endogenous depression, cancer, hypothermia, and pathological aggregation of platelets, thus the identification of the intracellular molecules involved in normal regulation of REM sleep may lead to the design of the future generation of drugs to treat REM sleep disorders in humans (e.g. endogenous depression, schizophrenia, panic attacks, bipolar disorders, narcolepsy, excessive daytime sleepiness).The central hypothesis of this proposal is that the activity of REM sleep generating cells in the PPT cholinergic cell compartment is regulated by the activation of specific glutamate and GABA receptors. These particular receptors convey their message via cAMP-dependent protein kinase A (PKA) to regulate normal and glutamate-induced REM sleep. To test this hypothesis systematically, there are four specific aims: 1. Test the hypothesis that cAMP-PKA intracellular signaling molecules in the PPT cholinergic cell compartment are involved in natural and glutamate-microinjection-induced REM sleep. Microinjecting cAMP and PKA inhibitors directly into the PPT to block spontaneous and glutamate-induced REM sleep will achieve this goal. 2. Test the hypothesis that the activation of specific GABA-receptors in the PPT cholinergic cell compartment suppresses REM sleep. This goal will be achieved by microinjecting selective GABA receptor agonists into the PPT to block REM sleep. 3. Test the hypothesis that the induction of GABA-receptor-mediated suppression of REM sleep is due to the inhibition of the cAMP-PKA signal transduction pathway. Microinjecting selective cAMP-PKA activator into the PPT to block the REM sleep suppressing effect of GABA receptor agonist will achieve this goal. 4. Test the hypothesis that the activation of specific GABA receptors suppresses REM sleep by suppressing the activity of REM-on and Wake-REMon cells in the PPI. This aim will be achieved by applying the REM sleep suppressing GABA receptor agonist to identified REM-on and Wake-REM-on PPT cells while recording single cell activity in freely moving rats. These studies are relevant not only to questions about the basic neurobiology of sleep but also to questions of sleep disorders and mental illness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CEREBRAL FUNCTION AFTER HYPOTHERMIC CIRCULATORY ARREST Principal Investigator & Institution: Griepp, Randall B.; Chief, Div of Cardiothoracic Surgery; Cardiothoracic Surgery; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2001; Project Start 01-SEP-1991; Project End 31-JUL-2004 Summary: This proposal is for ongoing study of ways to improve cerebral protection during operations on the heart and great vessels which require arrest of antegrade circulation. Clinical and experimental data suggest that subtle cerebral injury occurs if the duration of hypothermic circulatory arrest (HCA) is more than 30 minutes even under optimal circumstances, and some complex procedures cannot reliably be completed in so short a time. In our porcine experimental model, the effect of strategies such as retrograde cerebral perfusion (RCP) can be studied to see whether they can be used to extend the safe duration of HCA to 60 minutes. In this clinically relevant model,
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the effect of changes in the implementation of HCA and RCP on cerebral blood flow, cerebral metabolism, intracranial pressure, electrophysiological recovery, behavioral outcome (including preservation of ability to learn conditioned reflexes) and cerebral histopathology can be used to see whether new approaches, such as use of lower temperatures, postoperative ultrafiltration, cold reperfusion, and treatment with various pharmacological agents are likely to improve neurological outcome after operations requiring HCA. The hypothesis that some of the cerebral injury following HCA/RCP is occurring as a consequence of apoptosis, or programmed cell death, opens up the possibility of arresting this suicidal cascade using specific inhibitors of the proteases and endonucleases which participate in this process as well as inhibitors of protein synthesis, all of which have had dramatic success in reducing injury in rodent models of cerebral ischemia. The results of this study will make a significant contribution toward improving long-term outcome of complex surgery on the heart and great vessels in both infants and adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE FUNCTION AFTER INTRACRANIAL ANEURYSM SURGERY Principal Investigator & Institution: Samra, Satwant K.; Anesthesiology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 30-NOV-2005 Summary: (provided by applicant): This is an ancillary study to be conducted in conjunction with a multicenter trial of mild intraoperative hypothermia on neurological outcome (IHAST), already funded by NINDS (NS38554), which is currently in progress. This will be a multicenter, prospective, partially blinded clinical study of the rate of recovery of cognitive function in patients who have undergone craniotomy for clipping of intracranial aneurysms. Specific aim of this investigation is to study the effects of intraoperative hypothermia and anatomical location of aneurysm on the rate of recovery of neurocognitive function. Patients in IHAST are randomized to normothermic (36.5 degrees C) and hypothermic (33 degrees C) groups based on the core body temperature at the time of aneurysm clip application. Patients, neurosurgeons, neurological examiners and study coordinators are blinded to the group assignments. Long term outcome is assessed 3 months after surgery, which is the end point of current study. We propose to do two additional tests of neuropsychological function and prolong the period of follow up to 1 year in a subset of English speaking patients, enrolled in IHAST. Patients will be recruited for this study, at the time of last visit for IHAST, therefore this study can not possibly interfere with IHAST protocol. In consenting patients, an assessment of neuropsychological function will be done at 3, 6 and 12 months after surgery. Neuropsychologists, administering/scoring these tests will be blinded to the group assignment (hypothermia/normothermia) and location of the aneurysm. The effect of hypothermia and location of aneurysm (anterior communicating, anterior cerebral, middle cerebral, posterior communicating and basilar arteries) on performance and rate of recovery of neuropsychological function will be studied by appropriate statistical analyses. We hypothesize that intraoperative hypothermia will result in better preservation of neurocognitive function and aneurysm location will have significant effect on rate of recovery of cognitive function. Information gained from this investigation will be important in giving a prognosis for returning back to work as well as planning rehabilitation of patients suffering from aneurysmal SAH in future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COMPUTATIONAL ASPECTS OF PRIMATE MEMORY Principal Investigator & Institution: Fuster, Joaquin M.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 30-APR-2005 Summary: Active short-term memory plays a critical role in the temporal organization of behavior, reasoning, and language. It is impaired in a variety of mental disorders, notably in the psychoses, major affective disorders and syndromes resulting from pathological aging of the brain. Recent experimental evidence indicates that active shortterm memory consists in the sustained activation of an extensive network of interconnected neuronal assemblies of the cerebral cortex. Memory networks are widely distributed, extending beyond the boundaries of anatomically defined cortical areas. The mechanisms of active memory are believed to include the sustained circulation of neuronal impulses within one such network. This research will attempt to substantiate the distributed nature of active short-term memory and the reentry of neural impulses presumed to be the basis of short-term memory retention. Experiments with that objective will be conducted in nonhuman primates trained to perform auditory, tactile, and cross-modal memory tasks. Fields potentials and cell discharge will be recorded from frontal and parietal regions of the cortex during performance-and also to some extent during learning-of those tasks. Frequency and pattern of cell discharge will be analyzed for evidence of neuronal interactions within and between those cortical regions during the short-term memorization of sensory information. Special computational methods of time-series analysis will be used to explore those interactions. Some of the interactions will be further explored by reversible functional depression (by local cooling) of frontal cortex and the study of its effects on parietal cell discharge and the animal's performance of haptic memory tasks. The results of these studies are expected to shed light on the functional architecture of cortical memory networks and on the mechanisms of encoding, retention, and retrieval of memory. A better understanding of the neural dynamics of memory may help us better understand the pathogenesis of memory disorders in the mentally ill and thus lead to better treatments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORE--ANIMAL MODELING AND OUTCOMEN Principal Investigator & Institution: Kochanek, Patrick M.; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001 Summary: We propose to operate a core facility that performs the necessary procedures related to Animal Modeling and Outcome Assessment for the University of Pittsburgh Brain Trauma Research Center program project grant (PPG). The facilities in this core will be used by the following principal investigators (PIs) involved in the individual proposals in this PPG application: 1) Steven Graham, M.D., Ph.D., Project #1, "bcl-2 family genes in traumatic brain injury (TBI)", 2) Steven Dekosky., Project $2, "IL-1beta, APP metabolism and hypothermia in head injury", 3) Patrick Kochanek, M.D., Project #3, "iNOS and TBI", 4) Edward Dixon, Ph.D., Project #4 "Dopaminergic mechanisms of TBI," and 5) Robert Clark, M.D., Project #5 "PARS activation after TBI." The core facility will address the following Specific Aims 1) To provide a centralized facility for surgery and anesthesia for all of the proposed experimental manipulations of mice and rats within the PPG, 2) To provide uniform injury for all studies in mice and rats in the PPG (controlled cortical impact [CI] model, and CCI model with secondary insult) and ensure consistency by performing quality control analysis, 3) To provide a centralized
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facility for the standardized assessment of functional outcome parameters (motor and cognitive) within the PPG, 4) To provide a centralized facility for the standardized assessment of histological outcome parameters (contusion volume and hippocampal neuron counting) within the PPG, 5) To facilitate interaction between the PIs within the PPG, and facilitate interaction with collaborating investigators at the Pittsburgh NMR Center for Biomedical Research (Carnegie Mellon University), and 6) To provide a standardized hypothermia regimen for all studies using this therapy in rats in the PPG. The successful execution of these specific aims will provide for optimal resource utilization by the investigators include the use of 1) technician time, 2) laboratory space, 3) equipment, 4) supplies, 5) animals, and 6) Magnetic Resonance Imaging time. At the same time, quality control will be ensured for all of the studies in mice and rats, and a structured environment for interaction between the PIs within the PPG will be provided. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DELAYED PRECONDITIONING
TOLERANCE
AFTER
HYPOTHERMIC
Principal Investigator & Institution: Lee, Kevin S.; Professor and Chair; Neurosurgery; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 30-APR-2004 Summary: (Adapted from applicant's abstract): Ischemic injury is a common complication in a wide range of surgical procedures. Hypothermia administered during and/or after an ischemic event has proven to be clinically beneficial, and its effects rival or exceed those of other therapeutic strategies. This application describes a novel therapeutic strategy in which brief hypothermic preconditioning is used to induce a delayed form of ischemic tolerance that persists for a few days. Evidence is presented demonstrating that hypothermic preconditioning substantially reduces cerebral infarction elicited by transient focal ischemia, that this tolerance phenomenon is protein synthesis dependent and that it occurs in cells located in the brain parenchyma. The proposed work will characterize therapeutic, cellular and molecular features of hypothermia-induced tolerance by addressing the following specific issues: 1) What are the optimal hypothermic conditions for inducing tolerance? 2) Can hypothermiainduced tolerance complement the protective effects of intraischemic hypothermia? 3) Which cell types contribute to hypothermia-induced tolerance? 4) a. What are the candidate genes for mediating tolerance? b. What cell types express the candidate genes? c. What role do these genes play in ischemic neuroprotection? The ultimate goal of this project is to develop a new therapeutic strategy wherein a simple preconditioning treatment, administered well before surgery, can be used to limit subsequent ischemic injury. A parallel goal is to identify cellular sites and molecular mechanisms responsible for tissue tolerance. In as much as hypothermia is already used safely during human surgery, it is plausible that this new strategy could be implemented rapidly in the clinical setting. Hypothermic preconditioning could provide a low risk approach for improving surgical outcome after virtually any form of invasive surgery, including high-risk neurological and cardiovascular procedures. Moreover, because of the relatively benign nature of hypothermic preconditioning, it will also be possible to refine the search for salient cellular and molecular events responsible for neural tolerance. This approach will ultimately facilitate the development of novel gene-based therapies for limiting ischemic injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DETERMINANTS HYPOTHERMIA
OF
TOLERANCE
TO
NITROUS
OXIDE
Principal Investigator & Institution: Kaiyala, Karl J.; Doctor; Dental Public Health Sciences; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2002; Project Start 15-MAR-2002; Project End 31-JAN-2005 Summary: (provided by applicant): This is an R21 proposal to investigate the physiological mechanisms of tolerance development to nitrous oxide (N2O)-induced hypothermia. Influential theories of drug tolerance contend that CNS-mediated drugopposing responses underlie the etiology of drug tolerance and dependence. Evidence for such responses is primarily based on the observation of withdrawal effects when the drug is discontinued (or antagonized) as well as on the elicitation of the responses by conditioned stimuli. This proposal uses a novel approach for measuring these responses directly, while the drug is present, during both an initial drug administration as well as over repeated administrations. This research will also determine bow individual differences in the identity, latency and/or intensity of these responses are related to individual differences in initial sensitivity and acute tolerance to N2O hypothermia. Using a rat model that combines direct and indirect calorimetry with implanted temperature sensors, synchronous measures of core temperature and the dynamic processes of metabolic heat production and heat loss will be made during a steady-state administration of 60 percent N20. In an initial experiment, experimental (N2O) and control (placebo gas) rats will receive a 5-hour gas exposure during which core temperature and the components of heat balance are measured. The same rats will be retested 2 weeks later to determine the reliability of the mechanisms that determine core temperature. In a second experiment, individual rats given an initial N2O exposure will be classed as: a) insensitive to N2O-induced hypothermia, b) sensitive to N2O-induced hypothermia and develop acute tolerance, or c) sensitive to N2O-induced hypothermia with little or no acute tolerance. Rats in each group will be randomly assigned to receive either N2O or placebo during three additional five-hour gas exposures at one-week intervals to determine how the physiological responses controlling heat balance change as chronic tolerance develops. These studies have theoretical importance for understanding the mechanisms of drug tolerance and will begin to suggest the physiological basis of individual differences in vulnerability to addiction and drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EARLY EXPERIENCE AND ADOLESCENTS' RESPONSES TO ETHANOL Principal Investigator & Institution: Spear, Norman E.; Distinguished Professor of Psychology; Psychology; State University New York Binghamton Vestal Pky E Binghamton, Ny 13901 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2004 Summary: In both humans and animals prenatal exposure to ethanol increases susceptibility to subsequent ethanol abuse and alters related aspects of responsiveness to ethanol. Postnatal exposure to ethanol also has been found to increase later ethanol intake and related aspects of responsiveness to ethanol in animals. Early onset of ethanol use in adolescence or even pre-adolescence has been shown to be associated with a greater probability of ethanol abuse in adulthood, although causality in these studies with humans has yet to be demonstrated. One determinant of ingestion and related responsiveness to ethanol during early adolescence may be still earlier exposure to
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ethanol, a possibility to be explored in the present experiments. Toward improvement over previous experimental procedures in which early ethanol exposure occurs in relatively stressful circumstances, we propose to provide early exposure to ethanol in relatively nonstressful, ecologically representative circumstances and assess the consequences for responsiveness to ethanol in adolescence. Our preliminary results indicate that as adolescents, the offspring of dams living with their litter in large enclosures and free to consume ethanol ad libitum chose to drink relatively large amounts of ethanol. The present proposal is to determine the ontogenetic locus of this effect -- whether exposure during gestation, lactation or weaning is differentially effective -- and to determine controlling parameters of this effect. The second proposed step is to assess the breadth of consequences from these forms of early exposure for several key indices of responsiveness to ethanol during adolescence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENHANCED PRESERVATION
GLYCOLYSIS
FOR
HYPOTHERMIC
HEART
Principal Investigator & Institution: Chien, Sufan; Associate Professor; Surgery; University of Louisville University of Louisville Louisville, Ky 40292 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-JUL-2004 Summary: The ultimate goal of this project is to develop a safe and effective technique for long-term organ preservation. The specific aim of this study is to enhance glycolytic energy production during hypothermic heart storage. Despite more than three decades of extensive research, safe preservation times for the heart remain very short. This is the result of two major deficiencies: 1) the critical energy requirement for the heart during ischemia has been mostly ignored, and 2) little attention has been paid to the fact that there are many rate-limiting factors in glycolysis, and, therefore, the use of a single chemical may not be effective. The investigators propose a new approach for improving heart protection. Their general hypothesis is that hypothermic heart preservation times can be extended by enhancing glycolytic energy production. This goal is achieved by using a glycolytic intermediate, fructose-1,6-diphosphate (FDP), to bypass two ATPconsuming steps, by adding AMP precursors to facilitate ATP re-synthesis, and by using insulin to reduce lactate production. They have evidence that adding FDP to EuroCollins or St. Thomas solution can substantially enhance hypothermic heart preservation in rats and rabbits, and that FDP can cross the cell membrane in a dosedependent fashion. Although FDP has been used in tissue ischemia with impressive results, it has not been used in heart preservation, and studies on its mechanism of action are surprisingly superficial and scarce. The hypothesis will be evaluated using three different approaches: 1) in cardiomyocytes in normoxia and hypoxia at normal temperature and during hypothermia, 2) in hypothermic rabbit heart preservation, and 3) in rabbit and dog heart transplantation. Cardiomyocyte function, FDP uptake and metabolism, pyruvate dehydrogenase (PDH) activity, pyruvate and lactate production, and membrane and mitochondrial integrity will be examined in cardiomyocyte culture. Mechanical performance, tissue biochemical integrity, enzyme release, adenine nucleotide production and consumption, pyruvate and lactate production, and histological changes will be quantified in heart preservation. This project will greatly enhance our understanding of ischemia and tissue protection, and provide a mechanism that could significantly increase heart preservation times for transplantation. These glycolytic modulators might produce a synergistic effect and serve potentially as effective tissue-protective agents during ischemia, not only in heart preservation and
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Hypothermia
cardioplegia, but also in other ischemic conditions, such as shock, stroke, coronary heart disease, and cardiopulmonary bypass. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ETHANOL SENSITIVITY IN BETA ENDORPHIN DEFICIENT MICE Principal Investigator & Institution: Grisel, Judith E.; Psychology; Furman University Poinsett Hwy Greenville, Sc 29613 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2004 Summary: (provided by applicant): The influence of opioid peptides on alcohol sensitivity has been studied for a number of years, and the endogenous opioid system is hypothesized to be an important substrate for alcohol actions. The experiments proposed in this application will utilize transgenic mice that differ in their ability to synthesize B-endorphin in order to study the way that B-endorphin affects the response to alcohol. We have shown that these mice differ with respect to self-administration of alcohol. Other preliminary data indicate that mice lacking B-endorphin have an enhanced alcohol-mediated reduction in anxiety - in spite of the fact that under basal conditions anxiety increases as B-endorphin levels decrease. In addition, B-endorphin deficient mice show increased sensitivity to EtOH-induced ataxia and analgesia. These data support the hypothesis, deriving from both clinical and basic research, that Bendorphin affects sensitivity to alcohol. The overarching aim of these studies is to more fully characterize alcohol's differential effect on behavior in mice possessing varying amounts of B-endorphin. Moreover, we are hopeful that a better understanding of the relationship between alcohol and B-endorphin levels will lead to studies in which the mechanism of interaction can be elucidated. Because this peptide appears to differ between humans with varying genetic risk for alcoholism, a greater understanding of its relationship to alcohol sensitivity will contribute to our knowledge of the mechanisms underlying excessive alcohol use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ETHANOLS ACTIONS IN GAMMA PKC NULL MUTANTS Principal Investigator & Institution: Wehner, Jeanne M.; Professor; Inst of Behavioral Genetics; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2001; Project Start 01-MAR-1999; Project End 28-FEB-2003 Summary: Protein phosphorylation is a basic regulator of cellular processes. One gene family, the calcium/lipid activated protein kinase C (PKC) encodes at least 11 isotypes. Among these isotypes the y-PKC isotype is the only PKC solely expressed in neurons of the brain and spinal cord. Until the creation of null mutant mice ("knock-outs") that carry a disrupted y-PKC gene, it has been difficult to analyze the role of specific isotypes in behavioral, biochemical, and physiological processes. We have previously demonstrated that y-PKC null mutants are less sensitive to the hypothermia-inducing and sedative-hypnotic effects of alcohol compared to their wild-type littermates. We provide data here showing that y-PKC mutants do not develop tolerance to some of alcohol's effects. Therefore, it appears that the y-isotype of PKC may play a role in the mediation of ethanol's action. The goal of this proposal is to investigate the role of yPKC in determining behavioral responses to acute and chronic ethanol treatment. In specific aim #1, the y-PKC null mutants will be compared to mice that are either wildtype or heterozygous for the mutations using several measures of initial sensitivity and tolerance. In specific aim #2, transgenic mouse lines over-expressing y-PKC will be created and characterized for initial sensitivity and tolerance to ethanol. A genetic rescue
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of the y-PKC null mutants will also be performed by a genetic cross between transgenics and null mutants. The results of these studies will establish whether y-PKC plays a role in the pharmacological actions of ethanol that underlie the determination of ethanol sensitivity and tolerance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EVALUATION OF COOLING THERAPY FOR MULTIPLE SCLEROSIS Principal Investigator & Institution: Schwid, Steven R.; Assistant Professor of Neurology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 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: EXCITOTOXICITY IN CIRCULATORY ARREST--BRAIN INJURY Principal Investigator & Institution: Baumgartner, William A.; Professor; Surgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-DEC-1992; Project End 30-NOV-2004 Summary: (Verbatim from Applicant's Abstract): The goal of the project is to define the mechanisms of excitotoxic neuronal injury caused by hypothermic circulatory arrest (HCA) and to develop the means to prevent it. In our canine survival model of HCA, replicating clinical experience during cardiac operations, dogs subjected to 2 hours of circulatory arrest at 18degreesC sustain a consistent neurologic deficit and histologic pattern of selective neuronal death. We originally showed that administration of selective glutamate receptor antagonists before and after HCA-induced injury reduced the neuronal necrosis. We have now shown that neuronal death can occur by apoptotic or necrotic mechanisms. We showed that glutamate release after HCA results in accumulation of nitric oxide (NO), which mediates neuronal death and that inhibition of neuronal nitric oxide synthase (NOS) reduces production of NO in the brain and prevents apoptosis. We hypothesize that mitochondrial dysfunction determines the mechanism of delayed excitotoxic neuronal injury after HCA by apoptosis or necrosis and that neuronal apoptosis can be prevented by ischemic preconditioning (IPC), achieved pharmacologically by opening ATP-dependent potassium channels on the inner mitochondrial membrane. We further hypothesize that NO may act as a mediator both of neuronal injury and neuronal protection by IPC. In preliminary experiments we have shown that diazoxide, an ATP-dependent potassium channel opener can produce pharmacologic IPC and that that this agent can prevent apoptosis in cardiomyocytes acting on the inner mitochondrial membrane. In our canine model, diazoxide has shown near total elimination of neurologic deficit following HCA, with reduction in apoptosis in select neuronal populations. We also showed that hypoxia can activate HIF-1 with induction of iNOS and production of NO, a putative molecular pathway of the late form of IPC. We propose to: (1) measure metabolic indicators of mitchondrial dysfunction in specific brain regions using 'H and 'P MRSI following HCA in our canine model and (2) correlate these with neuronal survival, apoptosis and necrosis; (3) to examine pharmacologic IPC with diazoxide as means of neuroprotection and (4) determine how opening the potassium channels in the mitochondrion alters its function to effect IPC; (5) to establish how NO can act as mediator of both injury and protection in the brain. This research will expedite the clinical use of inhibitors in the excitotoxic cascade and facilitate exploitation of IPC by pharmacologic means to provide cerebral protection resulting in better patient outcomes after HCA in cardiovascular operations.
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Hypothermia
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FEVER RESPONSES AND THEIR REGULATION IN AGED RATS Principal Investigator & Institution: Satinoff, Evelyn; Professor; Psychology; University of Delaware Newark, De 19716 Timing: Fiscal Year 2001; Project Start 01-MAR-1986; Project End 31-DEC-2003 Summary: Old female and male rats are heterogeneous in their fever responses to lipopolysaccharide (LPS); some get moderately good fevers, some no fevers, and some become hypothermic. LPS stimulates the immune system to produce proinflammatory cytokines, such as interleukin-1beta (IL-1beta), which induce fever by causing synthesis and release of prostaglandin E2(PGE2). Old rats have very high levels of these cytokines. yet do not get good fevers. We have evidence that if IL-1 beta or PGE2 is infused into the brains of old rats, they show very good fever responses. Therefore, the problem must be in the periphery, but it cannot be in the lack of production of proinflammatory cytokines. We will measure the PGE2 released in the hypothalamus after LPS, which we predict will be lower than that induced in young rats after the same procedure. Old rats also have very high plasma levels of corticosterone (CORT), and CORT inhibits cytokine action and fever. Possibly the overproduction of cytokines in old animals is an attempt by the CNS to overcome the inhibiting effects of excess CORT. If so, then old rats injected with a CORT receptor antagonist should get higher fevers than controls will, and may need to generate lower levels of proinflammatory cytokines. It may also be that old rats do not get as high a fever as do young rats because they are generating higher levels of anti-inflammatory cytokines. One goal of this proposal is to measure brain, tissue, and plasma pro- and anti-inflammatory cytokine and hypothalamic-pituitaryadrenal (HPA) axis product levels in old rats to determine differences in the profiles that might explain differences in responses to LPS. We have recently found that when young rats were injected with LPS and left at an ambient temperature (Ta) of 23 C for three hr, they all developed fevers, as expected. Similarly treated old rats either had blunted fevers, no fever, or became hypothermic, also as anticipated. Unexpectedly, three hr post-injection. when the old rats were placed in a thermal gradient, they chose warm positions and became febrile. Thus, the drive towards fever was present in the old rats but could not be expressed without behavioral choice. We want to understand the basis of this surprising result. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FIELD COOLING SYSTEM FOR THERPEUTIC HYPOTHERMIA Principal Investigator & Institution: Izenson, Michael G.; Creare, Inc. Box 71, Etna Rd Hanover, Nh 03755 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-MAR-2004 Summary: (provided by applicant): Recent clinical research indicates a significant benefit to neurological outcomes associated with mild therapeutic hypothermia after cardiac arrest. Presumably, the sooner such treatment can begin, the greater the potential benefit and the greater the number of patients who might benefit. However, there is presently no practical way for paramedics or first responders to provide cooling for hypothermia in the field. Mechanical cooling systems are power hungry, heavy, and expensive. Ice and chemical ice packs have many obvious practical problems with field storage, transport, patient treatment when wet, and lack of temperature control. In the proposed effort, a novel spacesuit cooling technology will be adapted to provide a reliable, lightweight, inexpensive, very low power, easily controlled cooling source that
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will enable mild therapeutic hypothermia treatment to begin early in the field immediately after cardiac resuscitation. The proposed cooling system is based on regenerable heat absorption. During Phase I, a proof-of-concept cooler with a capacity of approximately 200 W-hr of refrigeration and a cooling pad will be fabricated and demonstrated in bench top and animal experiments. During Phase I, a complete prototype will be developed and demonstrated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FORMATION, INTERACTION & FUNCTION OF SPINDLE COMPONENTS Principal Investigator & Institution: Rieder, Conly L.; Professor; Wadsworth Center Empire State Plaza Albany, Ny 12237 Timing: Fiscal Year 2001; Project Start 20-JAN-1988; Project End 31-DEC-2005 Summary: (applicant's description): The broad objectives of this proposal are to determine how entry and exit from mitosis is controlled, how centrosomes and kinetochores function and interact to form the spindle, and how the forces for chromosome motion and positioning are generated and regulated. In Aim #1 time-lapse video light microscopy (VLM), GFP-imaging and 3-D electron microscopy (3D-EM) will be used to: a) test the hypothesis that microtubules are involved in the checkpoint regulating progression through prophase in vertebrates; and to determine b) if prophase cells, induced by hypothermia to revert to G2, fail to re-enter mitosis after 24 hrs because they lack cyclin A or Cdc25; and c) the etiology of chromosome segregation abnormalities in such revertants when induced to re-enter mitosis after 16 hrs in G2. In Aim #2 we will use cell fusion, GFP-imaging, 3D EM and antibody injection to evaluate the hypotheses that in vertebrate cells: a) the numbers and length of astral microtubules, formed by centrosomes not associated with chromosomes, changes during prometaphase; b) that separating asters interact during prometaphase in the absence of associated chromosomes; c) that the acentrosomal pathway for spindle assembly is a constitutive component of mitosis; and d) that centrosomes and/or centrioles are required for the completion of cytokinesis. In Aim #3 we will use antibody injection, VLM and 3D-EM to test the hypotheses that: a) the kinetochore associated motor responsible for fast poleward motion during kinetochore attachment is no longer functional during anaphase, and b) that ZW- 10 is involved in kinetochore re-orientation during mitosis and meiosis in Drosophila. In Aim #4 we will use laser microsurgery to determine: a) if "polar winds" are present during meiosis and mitosis in Drosophila spermatocytes and neuroblasts and if so whether they are present in neuroblasts lacking functional Klp3 Sb and/or Nod proteins. We will also test the hypotheses that: b) destroying part of one kinetochore does not inhibit chromosome congression in vertebrates, and c) that a chromosome, bioriented on a spindle formed from two poles that nucleate vastly different numbers of microtubules, congresses closer to the weak spindle pole. Finally, in Aim #5 we will use laser microsurgery and GFP-imaging to test the hypotheses: a) that the mitotic arrest induced in vertebrate cells by nocodazole or Taxol is due to kinetochores; b) that C-anaphase in these cells requires a functional centrosome; c) that C-anaphase is correlated temporally with the destruction of cyclin B; and d) that Drosophila spermatocytes lack a spindle assembly checkpoint. The knowledge obtained from these studies is required to better understand the etiology of various birth defect syndromes and cancers, to design new therapeutic strategies for the control of cell proliferation, and for the treatment of other disease states involving microtubules including arthritis, metastasis and Alzheimer' s. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Hypothermia
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Project Title: GENETICS OF ACUTE TOLERANCE Principal Investigator & Institution: Deitrich, Erwin; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001 Summary: The focus of this component of the Alcohol Research Center is on acute functional tolerance. We now have lines of mice selectively bred for High Acute Functional Tolerance (LAFT1 and 2). These mice will be used to study the mechanisms of this acute tolerance and to define its relationship to other forms that are being studied in this component, ie, Very Rapid Acute Functional Tolerance (VRAFT) and Rapid Tolerance. Over components are investigating the mechanisms of chronic tolerance. By processes well established in this center we will correlate the various forms of tolerance with other behavioral aspects of ethanol's action such as sleep time, hypothermia, ethanol consumption, and locomotor activity. By utilizing the LS X SS recombinant inbred strains of mice, we have identified potential QTLs for AFT and will do the same for VRAFT. By selectively breeding for AFT we have generated lines of animals (HAFT and LAFT) from which QTLs can be determined for AFT as well as for VRAFT in F2 crosses of these lines. Other studies will investigate the neurochemical mechanisms responsible for these forms of tolerance. This will be accomplished by determining the specificity of AFT and VRAFT for ethanol by use of other CNS active drugs , specific for various receptor systems, and also investigate the ability of agonists and antagonists to influence development of AFT and VRAFT. Recent studies point to initial sensitivity and tolerance as important determinants of the risk of alcoholism in humans. These studies should provide a road map to studies in humans in these areas. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HEPATOCYTE GENE EXPRESSION UNDER HYPOTHERMIC STORAGE Principal Investigator & Institution: Kosari, Kambiz; Surgery; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 11-FEB-2002 Summary: (provided by applicant):L Recent advances in tissue engineering have made possible the creation of a xenogeneic bioartificial liver (BAL) as part of an effort to improve the survival of patients with acute liver failure (ALF). A major obstacle that faces this and most other tissue-engineered cell based products is the problem of storage. Potentially, hypothermic conditions may be utilized to allow the viable storage of the BAL from point of production to delivery. Indeed previous experiments using the BAL have shown that up to a 24-hour period of cold storage is feasible. However, longer storage time as well as improved viability and function is vital for its successful widespread application. Examination of the cellular mechanisms, specifically the gene expression patterns associated with the early phases of hypothermic damage, need to be examined in order to discover and subsequently test "protective" factors. New techniques in tissue culture and molecular/cellular biology make this goal attainable. We propose that exposure to hypothermia will cause an up-regulation in the expression of common motifs present in the cluster of co-regulated genes dealing with apoptosis and stress; furthermore, that these expression patterns are modified in the presence of "protective" factors. Our specific aims include establishment of gene expression patterns in cold-exposed mouse hepatocytes using microarray technology as well as suppression subtractive hybridization, studying modification of such patterns in the presence of a protective factor (sublethal pre-stress heat exposure), and finally, determination of the
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ideal cold-storage conditions in an "optimized" micro-BAL. We hope that our findings will facilitate prolongation of the cold storage period and improve the viability and function of the BAL. Even though the immediate benefit of this proposal will be for the BAL, we strongly believe that it will have significant implications for most xenogeneicbased, tissue-engineered artificial organs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HIGH EFFICIENCY HYPO/HYPERTHERMIA SYSTEM Principal Investigator & Institution: Ohley, William J.; Professor; Life Recovery Systems, Inc. 34 Hidden Glen Dr Sparta, Nj 07004 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JUL-2003 Summary: (provided by applicant): Sudden cardiac arrest remains a serious public health issue. Approximately 350,000 individuals are stricken in the U.S. annually, with overall survival rates on the order of only 5%. Even with the immediate availability of the most advanced care currently available, a survival rate of 25% appears to be the bestcase scenario. Improved therapies to deal with this situation are clearly needed. Prior studies have shown that moderate hypothermia (approximately 3-5 C degrees) provided during and after cardiac arrest can reduce the level of damage to vital organs, including the brain. However, conventional noninvasive means that are available for cooling (such as water-filled cooling blankets and cool air-emitting coverings) are too slow for optimal treatment. Furthermore, they are not well suited to being used during administration of cardiopulmonary resuscitation (CPR). Life Recovery Systems (LRS) intends to develop an advanced, noninvasive Therapeutic Hypothermia Device (THD) for rapid and controlled reduction of core body temperature. To achieve this goal, this system will combine the use of components, which will provide highly efficient and regulated cooling of the skin. The THD will be designed in such a manner that it can be used in combination with advanced forms of CPR, so that cooling can be efficiently delivered even while the subject is in a state of cardiac arrest. Initial swine tests of a THD prototype have shown that it is capable of reducing body core temperature approximately twice as quickly as can be done by covering the animal with packed ice. The THD cooling rate was approximately fifty times greater than that reported in recent clinical testing in which a cooled air system was applied to patients. LRS plans to initially conduct tests using a physical model of the body to optimize the design of the THD. It will then conduct animal studies (50 Kg swine) to further optimize the system, to evaluate the repeatability of the cooling which can be delivered, to compare the performance of the device to other cooling methods (such as standard cooling blankets), and to evaluate the ability of the THD to operate simultaneously with the delivery of CPR. During cooling experiments, temperatures will be monitored in the animal's pulmonary artery, auditory canal, and skin. In addition, EKG, blood pressures, and other key physiologic parameters will be monitored. The tests described in this proposal will be followed in the future by other tests (in both animals and humans) investigating the ability of the THD, in combination with other measures such as CPR, to improve neurologically intact survival following cardiac arrest. Long term, LRS believes that the THD has the potential to significantly increase the chances of neurologically intact survival following cardiac arrest. It also plans to evaluate the effectiveness of the THD in the treatment of other conditions, such as stroke. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HIGH EFFICIENCY MAPPING OF ALCOHOL SENSITIVITY GENES Principal Investigator & Institution: Johnson, Thomas E.; Professor; Inst of Behavioral Genetics; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2001; Project Start 01-MAR-2000; Project End 29-FEB-2004 Summary: We propose to complete the construction of a large number of recombinant inbred strains (RIs) from the inbred Long Sleep (ILS) and the inbred Short Sleep (ISS) strains and to map genetically eight traits involved in alcohol action. This newly generate RI series will be useful in dozens of different behavioral analyses, while only one set of genotypic assessment swill need to be performed. From the single assessment of genotype will flow mapping results applicable to a myriad of various phenotypes that have been assessed in the parental strains (ILS and ISS) or in the LS and SS selected lines. The major disadvantages. associated with RI strains (lack of power in QTL identification and lack of resolution in mapping) are overcome through the use of such a large set of strains. The RI construction has already begun, funded by internal resources of the University of Colorado and the Institute for Behavioral Genetics and we propose to carry these RIs to the F22, which will allow greater than 98% fixation. At the completion of this project we will create an electronic data base allowing all alcohol researchers easy access to all of our results. We will also begin making arrangements to distribute these mice to searchers who wish to use them. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HSPS, CYTOSKELETAL AND SURVIVAL RESISTANCE TO HEAT TO LOW PH ADAPTED CELLS Principal Investigator & Institution: Coss, Ronald A.; Thomas Jefferson University Office of Research Administration Philadelphia, Pa 191075587 Timing: Fiscal Year 2001 Summary: This project is designed to test if a causal relationship exists between upregulation of Heat Shock Proteins (HSPs) and heat resistance in cells grown in an acid environment. The long term objective is to develop approaches for the identification and the selective killing of tumor cells adapted to growth in low pH environments. The two hypotheses are: 1) Growth of human melanoma cells in an acidic environment induces elevated levels of HSPs, including HSP27 and HSP72, which, in turn, contribute to protection of the cytoplasm and nucleus from heat-induce protein aggregation and disruption, allowing for enhanced synthesis of HSPs and enhanced thermotolerance (TT). Cytoplasmic protection includes protection of the cytoskeleton (CSK) and proton pumps responsible for maintenance of intracellular pH (pHi). 2) The protection of the CSK, pHi homeostasis machinery and the nucleus by HSPs can be overcome by an acute reduction of pHi prior to an during hyperthermia. Specific Aims designed to test the model will examine: i) the interrelationships between levels of HSPs, the phosphorylation of HSP27, the resistance of the CSK to heat-induced collapse & the accumulation of heat-induced nuclear-associated proteins (NAPs), heat-induced synthesis of HSPs and survival in adapted cells; ii) the importance of an intact CSK for realkalinization during hyperthermia following an acid load; and iii) the sensitization of adapted cells by an acute extracellular acidification alone, and by an acute acidification of 0.3 pHe unit combined with inhibitors (DIDS, CNCn, HOE642 and mIBG) that further reduce pHi. HSP levels and phosphorylation of HSP27 will be monitored by Western blot analysis, CSK organization by morphometric and biochemical analyses, NAPs by FCM, and survival by colony formation. Project 2 will be perform all pHi measurements. A translational objective will determine if some of the endpoints will be useful as
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indicators of the presence of adapted cells in fresh xenograft explants and sections of the xenografts provided by Project 4. This study will contribute to our understanding of the importance of HSP27 and HSP72 for resistance of the CSK and nucleus in adapted cells during hypothermia, and the importance of an intact CSK for efficient function of proton pumps during hyperthermia. Successful accomplishment of the goals may lead to new approaches for identifying and sensitizing acidotic regions of solid tumors to thermoradiotherapy using inhibitors that reduce pHi and/or destabilize the CSK. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERTHERMIC RESPONSE OF THE RESPIRATORY NEURAL NETWORK Principal Investigator & Institution: Tryba, Andrew K.; Organismal Biology and Anatomy; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2001; Project Start 01-JUN-2001 Summary: (Applicant's abstract): Breathing is modulated as the result of changes in the internal and external environment (e.g. ionic concentration, pH, pCO2 and temperature) and the behavioral state of the animal. In response to these challenges, respiratory neural network activity is modified to affect the timing and intensity of respiratory events. While these changes are specific to respiration, the issue of how neural networks adapt a behavior during environmental changes is of interest to those studying many motor systems. In mammals, hyperthermia causes an initial increase in respiration frequency (RF) that serves to enhance heat loss through evaporative cooling, but heat loss mechanisms are not always effective. For example, hyperthermia associated with conditions such as fever and heat-stroke may lead to cardiac arrest, cessation of breathing (apnea) and death. In fact, hyperthermia is a major risk factor for sudden infant death syndrome. Despite these implications, little is known about the neural mechanisms underlying the temperature-induced changes in respiratory activity. In this proposal: 1) I will determine the effects of hyperthermia on respiratory activity generated in the isolated brain-stem respiratory neural network. The response of the pre- Botzinger Complex (pBC) respiratory network to hyperthermia will be characterized by integrating population pBC neural activity and quantifying changes in RF. 2) I will use patch-clamp recordings from pBC neurons to test whether changes in RF during hypothermia result from modulation of pacemaker neurons or the emergent properties of the respiratory neural network. 3) I will also use patch-clamp recordings from pBC neurons to examine if membrane properties and/or synaptic inputs in respiratory pacemaker neurons are modulated during hypothermia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HYPOTHERMIA Principal Investigator & Institution: Lyden, Patrick D.; Professor; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2003; Project Start 19-MAY-2003; Project End 30-APR-2008 Summary: Among putative neuroprotection strategies, hypothermia has long been recognized as the most potent. Recent insights in understanding ischemia and reperfusion suggest that hypothermia may be an ideal modality for extending the stroke therapy time window. Although difficulties cooling patients limited testing of this potentially effective therapy, recent developments in technology allow us to mount a Phase 1 clinical trial of intravascular cooling for patients presenting beyond 3 hours. The purpose of this study is to confirm the performance of an endovascular cooling device
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and to establish the parameters for a larger clinical study, such as sample size and indices of measurement. Preliminary effectiveness of hypothermia treatment in combination with thrombolysis for stroke will also be evaluated in this limited patient population. To do this, we will address 2 specific aims: 1) Characterize the safety profile of hypothermia in stroke patients who initiate cooling between 3 and 6 hours after stroke. Substantial pre-clinical data supports the hypothesis that the window for effective hypothermia may be longer that 3 hours. We will establish safety of the cooling device, and collect outcome data to be used for estimating sample size in larger, Phase 2 trials. 2) Establish the safety of thrombolysis and hypothermia used together between 3 to 6 hours after stroke onset. Thrombolysis trials failed to demonstrate benefit to patients treated later that 3 hours following stroke onset. In each trial, however, there was a trend toward benefit, and meta-analyses suggest that there is a positive, but small effect in later treated patients. We hypothesize that hypothermia, combined with thrombolysis, may prove effective in such patients. We will establish the safety of invasive, endovascular-cooling catheter in combination with thrombolysis. We will collect safety and outcomes data to aid in the design of larger, controlled Phase 2 trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOTHERMIA AND GENE EXPRESSION AFTER CARDIAC ARREST Principal Investigator & Institution: Callaway, Clifton W.; Associate Director; Emergency Medicine; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2006 Summary: (provided by applicant): Neurological injury after resuscitation from cardiac arrest is a major impediment to improving survival for victims who experience sudden cardiopulmonary collapse. Induction of hypothermia after restoration of circulation improves neurological recovery and is being advanced clinically. However, mild hypothermia does not completely reverse brain injury and a rational approach to improve this intervention is required. This project will employ a rat model of cardiac arrest that mimics the whole-brain injury, and that replicates the beneficial effects of post-resuscitation hypothermia. Preliminary studies indicate that hypothermia increases intracellular signaling in the brain via the extracellular signal regulated kinase, ERK (a mitogen activated protein kinase), and also increases brain tissue levels of brainderived neurotrophic factor (BDNF). The time course of ERK and BDNF activation as well as the time window during which induction of hypothermia is beneficial suggest that induced hypothermia may affect new gene expression via these signaling systems. This proposal will expand our understanding of the beneficial effects of induced hypothermia and the by examining the relationship between BDNF, ERK and new gene expression in brain after cardiac arrest and resuscitation. This project will be divided into three specific aims: (1) The first aim will determine the role of neurotrophic factors in the control of ERK signaling after resuscitation and hypothermia. To accomplish this aim, we will employ neutralizing antibodies or antisense oligonucleotides or administration of exogenous neurotrophic factors after ischemia and hypothermic reperfusion. We will determine the localization and time-course of increased levels of particular neurotrophic factors in brain during hypothermic reperfusion. (2) The second aim will be to determine the participation of the downstream effectors of the ERK signaling pathway after resuscitation and hypothermia. We hypothesize that hypothermic reperfusion will increase activation of ERK-regulated transcription factors and expression of particular ERK-regulated gene products. Conversely, blockade of ERK
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activation is hypothesized to decrease expression of these same genes. (3) The final aim of the project will determine the participation of ERK and BDNF signaling in the hypothermia-induced improvement of neuronal survival and behavioral recovery after resuscitation. These pathways will be blocked and stimulated during hypothermic reperfusion, and behavioral and histological outcome for cardiac arrest will be measured. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOTHERMIA DURING INTRACRANIAL ANEURYSM SURGERY Principal Investigator & Institution: Todd, Michael M.; Anesthesia; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 05-SEP-1999; Project End 31-MAY-2004 Summary: Aneurysmal subarachnoid hemorrhage (SAH) remains a major cause of morbidity and mortality. Since the incidence peaks in mid-life, and since many survivors are permanently damaged, the human and economic costs are immense. Much of the death and disability is the acute and delayed result of blood in the subarachnoid space (e.g. vasospasm). However, an unknown - but we believe substantial - fraction of the adverse outcomes are a complication of surgery performed to obliterate the source of bleeding; as many as 25 percent of patients who undergo craniotomy for aneurysm clipping will have a new neurologic deficit when examined 12-24hrs postoperatively. This danger is well known, and almost all surgical teams utilize some method to protect patients during surgery, including barbiturates, etomidate, steroids, mannitol or varying degrees of hypothermia. Unfortunately, in spite of the popularity of such interventions, none has ever been systematically tested in humans (other than deep hypothermia and circulatory arrest), and none are known to provide any benefit at all. Of the aforementioned therapies, we believe the best laboratory evidence supports the use of hypothermia. Our goal, therefore, is to perform a prospective, randomized clinical trial to evaluate the safety and efficacy of intraoperative hypothermia (t=33 degrees C) as a means of reducing early and longterm postoperative neurologic morbidity following surgery for clipping of intracranial aneurysm. Control patients will remain normothermic during and after surgery; in hypothermic patients, body temperature will be normalized as quickly as possible after the aneurysm clip is in place. All other aspects of pre- and postoperative care will be managed routinely. We hypothesize that hypothermia, even when limited to the intraoperative period, will result in an improvement in neurologic outcome as measured by Glasgow Outcome Scale at 3months following surgery, and will also result in more rapid improvement during the first postoperative week. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HYPOTHERMIA FOR ACUTE BRAIN INJURY IN CHILDREN Principal Investigator & Institution: Cox, Charles S.; Surgery; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2003; Project Start 08-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): The Traumatic Brain Injury (TBI) Consortium at the University of Texas-Houston Medical School has a major commitment to multicenter clinical investigation. The PI, Charles Cox, M.D., is the Children's Fund for Pediatric Trauma Associate Professor of Surgery and Pediatrics and the Co-PI, Kevin Lally, M.D., the A.G. McNeese Professor and Chief of Pediatric Surgery. The TBI consortium has a track record for identifying and recruiting TBI patients for clinical studies across
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multiple points of care. The PI and Co-PI are board certified in both pediatric surgery and surgical critical care, which allows control of the acute care management of TBI patients. The group also includes a nationally recognized inpatient and outpatient rehabilitation center (The Institute for Rehabilitation and Research, TIRR). TIRR admits approximately 750 patients per year and has a 36-bed inpatient brain injury unit. TIRR also has a track record of NIH/NIDRR funded clinical research involving TBI patients. Post-rehabilitation outcomes follow-up is an established and mature component of the TBI component with outcome studies since 1982. Longitudinal studies of children with TBI are now in their 5th-9th year. UT-Houston provides: (A) A large patient population Approximately 4,500 patients are admitted to the UT-Houston/Memorial Hermann Trauma Service per year (958 with a GCS of < 12), of which 1,400 are pediatric patients (167 with a GCS <12 between the ages 12-21). This application offers the rare combination of expertise in the management of patients with severe TBI and a very large, eligible patient population. (B) Methodological and multidisciplinary expertise The Pls have extensive experience in basic and clinical research. The TBI team members have a unique combination of clinical expertise across the continuum of acute care, combined with extensive experience in TBI clinical intervention protocols, rehabilitation and the design of neuropsychiatric developmental outcome measures within the institution. (C) Supportive leadership and institutional commitment - The departments in the TBI consortium have all demonstrated a commitment to the support of collaborative clinical research. This is evidenced by the large number of past and ongoing multicenter trials and the establishment of the two NICHD-funded clinical research (Neonatal Intensive Care Units and Maternal Fetal Medicine Units) networks at UT-Houston. There is an active NIH sponsored Clinical Research Curriculum and Mentorship Program (K30 HL 04137) designed to train clinical investigators as well as a University Clinical Research Center (M01 RR02558) with a track record in clinical research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOTHERMIA FOR PEDIATRIC CARDIAC ARREST PLANNING GRANT Principal Investigator & Institution: Moler, Frank W.; Pediatrics & Communicable Dis; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 24-JUL-2003; Project End 30-JUN-2005 Summary: (provided by the applicant): Cardiopulmonary arrest with apnea and loss of palpable pulse (CA) in childhood is a tragic event that very often results in either death or poor quality long-term neurological survival. Recent randomized clinical trials (RCT) in adult populations have reported improved neurologic outcome and survival in groups that received short term mild hypothermia following out of hospital ventricular fibrillation (VF) arrest. The efficacy of hypothermia in children following cardiac arrest is not known. CA in children is commonly secondary to a respiratory etiology that results in hypoxia, which after a period of time results in cardiac arrest. Asystole or pulseless electrical activity are the most common presenting cardiac rhythms when resuscitation is initiated. In adults by contrast, a sudden cardiac event (without a preceding period of hypoxia) most often occurs with VF or ventricular tachycardia, the common presenting rhythms. In this clinical trial planning grant application, 15 Pediatric Emergency Care Applied Research Network (PECARN) children's hospitals with intensive care units will obtain pilot data from the medical records of patients who have sustained a CA with return of spontaneous circulation in either the outpatient or
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inpatient setting. Characterization of this population will include arrest specific events and etiology, patient characteristics, hospital course, interventions received, hospital survival, and neurologic outcome. This information will be used to create inclusion and exclusion criteria, and to calculate sample size requirements for a future RCT of hypothermia following pediatric cardiac arrest. Duration of time to successfully enroll patients from this cohort of 15 children's hospitals for a future RCT will be estimated. This application will also result in creation of multiple documents needed to perform a RCT of hypothermia after cardiac arrest in childhood including study related data forms, study protocols, manuals of operation, institutional review board and informed consent related documents, and other materials. The PECARN will support all phases of this application with its existing clinical trials research infrastructure that includes a steering committee, five clinical trials supporting subcommittees, and a central data management coordinating center (CDMCC). The CDMCC will make operational all data and analysis related tasks of this application, and assure all study sites are compliant with regulations concerning data security and confidentiality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOTHERMIC TREATMENT OF NEONATAL ASPHYXIC BRAIN INJURY Principal Investigator & Institution: Agnew, Dawn M.; None; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 22-MAY-2001 Summary: Perinatal hypoxia-ischemia (HI) has potential lifelong consequences for infants and children including movement disorders, epilepsy, and developmental delay. Therapeutic and pharmacologic interventions are either unsuccessful or controversial, limiting treatment to supportive care. Hypothermia is a potential intervention suggested to provide protection in some newborn animal models of HI, however through unclear mechanisms. Its long-term protection is unknown. HI injury leads to brain damage through a variety of pathways, including excitotoxicity mediated via glutamate pathways, and energy failure. Therefore, the purpose of this study is to investigate in a clinically relevant animal model of HI, the effects of hypothermia related to I) neuroprotection at 14-days 2) extra-cellular glutamate concentrations and glutamate transporters (GLT1, EAAC1), and 3) energy metabolism (glucose consumption and mitochondrial function). One-week old anesthetized piglets will be subjected to asphyxic cardiac arrest. After cardiopulmonary resuscitation animals will be randomly assigned to undergo mild hypothermia or normothermia for 24 hrs. Neuronal cell density will be counted at 14-days of survival. Microdialysate determination of extracellular glutamate concentrations, expression of glutamate reuptake transporters measured by western immunoblots and immunocytochemistry, autoradiographic determination of regional glucose consumption, and cytochrome oxidase histochemistry will be investigated during the transition from hypothermia to normothermia when cortical electrical activity emerges and when seizure activity often occurs. Neurological assessment will be performed daily. Through investigation of hypothermia in a clinically relevant animal model of HI, it is expected that the findings from this study will contribute to the understanding of potential mechanisms of protecting the human newborn from the sequelae of HI encephalopathy and for optimizing protocols for clinical implementation of hypothermia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IL-6 IN HERPES SIMPLEX VIRUS TYPE 1 OCULAR REACTIVATION Principal Investigator & Institution: Kriesel, John D.; Associate Professor; Internal Medicine; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: There are approximately 50,000 cases of new or recurrent ocular HSV disease per year in the U.S., with stromal scarring of the cornea leading to reduced visual acuity in about 6,000 patients per year. Acute and recurrent herpes simplex keratitis are leading indications for corneal transplantation in this country. Ultraviolet light (UV) exposure, fever, hyperthermia, hypothermia, dental trauma and surgical manipulation of the trigeminal ganglion are stimuli associated with reactivation of HSV-1. The sequence of HSV gene activation during productive infection is well known, but the mechanism by which reactivation stimuli, including UV light, stimulate latent virus to replicate is unknown. Studies by the principal investigator have shed new light on this mysterious process, implicating the inflammatory cytokine interleukin-6 (IL-6) and its associated cellular transcription factor STAT3 in the pathogenesis of ocular HSV reactivation. New supporting data presented in this application demonstrates that ocular UV exposure induces IL-6 production in explanted corneas. By contrast, the same UV stimulus induces and activates the transcription factor STAT3 in the trigeminal ganglion, the site of the latent viral infection, where this factor is hypothesized to initiate HSV-1 gene transcription. This specific aims of this proposal are to: 1)Investigate the role of IL-6 in the murine keratitis model by: a) directly injecting IL-6 into the conjunctiva of latently infected mice and b) studying the ability of IL-6 knockout mice to reactivate HSV-1. 2)Explore the hypothesized IL-6STAT mechanism of induced HSV ocular reactivation. Based on supporting data, studies are proposed: a) to detect activated, phosporylated STAT transcription factors and b) determine whether these factors specifically bind important HSV-1 genes. 3)Directly investigate the hypothesis that IL-6 drives HSV-1 gene transcription. A collaborative effort is outlined to study this using HSV-1 transient expression and/or reporter construct assays. Novel and specific viral mutants will be constructed based on the results of HSV-DNA binding and transient expression assays. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INDUCED HYPOTHERMIC ARREST IN TRAUMATIC SHOCK Principal Investigator & Institution: Alam, Hasan B.; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2006 Summary: (provided by applicant): Hemorrhagic shock that leads to cardiovascular collapse does not respond well to conventional methods of cardiopulmonary resuscitation. Even when the source of bleeding can be controlled and circulation restored, cerebral ischemia lasting 5 minutes or longer results in severe brain damage. Overall survival remains about 5% despite aggressive surgical interventions and open chest cardiac resuscitation. Often the underlying injury is reparable but the patient dies of irreversible shock. In such patients, strategies to maintain cerebral and cardiac viability long enough to gain control of hemorrhage could be life saving. This requires an entirely new approach, with emphasis on rapid total body preservation, repair of injuries during metabolic arrest and delayed resuscitation. Currently, hypothermia is the most effective modality for preservation of cellular viability during periods of ischemia. However, its role in the setting of traumatic hemorrhage has not been established. We plan to use clinically relevant large animal models to test the
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therapeutic application of induced hypothermia following exsanguinating shock. LONG TERM HYPOTHESIS: Hypothermic arrest can be induced in the setting of traumatic lethal hemorrhagic shock to maintain organ viability during periods of total body ischemia. LONG TERM GOALS: Establish the optimal strategy for induction, maintenance and reversal of total body hypothermia in the setting of lethal uncontrolled hemorrhagic shock. Utilize the period of hypothermic arrest for repair of complex injuries. SPECIFIC AIM 1: Determine the optimal rate of induction and reversal of total body hypothermia. Sub aim: Develop and utilize large animal cognitive function models to test neurologic outcome. SPECIFIC AIM 2: Establish the maximum depth and duration for which hypothermic metabolic arrest can be maintained with complete neurologic recovery. Sub aim: Study the role of optimal a cellular organ preservation fluids in extending the duration of hypothermic metabolic arrest. SPECIFIC AIM 3: Determine the duration of uncontrolled hemorrhagic shock, prior to induction of hypothermic arrest, that is compatible with good neurologic outcome. Sub aim 1: Demonstrate that the hypothermic arrest period can be used to repair complex multiple organ injuries. Sub aim 2: Develop and test methods and techniques that can facilitate the induction of hypothermic arrest in the setting of traumatic shock. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFANT HEART SURGERY--CNS SEQUELAE OF CIRCULATORY ARREST, 8 YEAR FOLLOW UP Principal Investigator & Institution: Newburger, Jane W.; Associate Cardiologist-InChief; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2001 Summary: This study is a prospective, randomized, single-center trial comparing the incidence of brain injury after use of the 2 major methods of vital organ support during repair of congenital heart disease in infants: deep hypothermia with total circulatory arrest vs. deep hypothermia with continuous low-flow cardiopulmonary bypass. Study population is comprised of children with D-transposition of the great arteries who had corrective surgery within the first 3 months of life. This study re-evaluates the developmental and neurologic status of the study population at age 8 years. The aims are as follows: 1) To compare the effects of the two intraoperative support methods with respect to developmental and neurologic status at age eight years. 2) To compare the academic and intellectual performance of the cohort at age eight years to population norms and to characterize specific patterns of relative strengths and weaknesses. 3) To utilize the longitudinal data available on this cohort to identify correlates of the children's eight-year outcomes, as well as their developmental trajectories between ages one and eight years. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INFLAMMATION AFTER TRAUMATIC BRAIN INJURY Principal Investigator & Institution: Dietrich, W. Dalton.; Professor; Neurology; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2002; Project Start 15-APR-2002; Project End 31-MAR-2007 Summary: (Verbatim from applicant's abstract) Traumatic brain injury (TBI) initiates a cascade of inflammatory processes that can serve to exacerbate the initial injury. Recent experimental data indicate that post-traumatic temperature manipulations significantly influence the inflammatory responses, including the accumulation of polymorphonuclear leukocytes (PMNL) and inducible nitric oxide synthase activity. The
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proposed studies will build on these previous results and investigate the cellular, biochemical, and molecular mechanisms underlying the temperature-sensitive inflammatory events seen after TBI. Three specific aims are proposed that focus on specific questions regarding this investigative issue. In the first specific aim, experiments will focus on inducers of post-traumatic inflammation, with emphasis on inflammatory cytokines. These investigations will determine the importance of injury severity on the cytokine response to TBI as well as determining for the first time the effects of posttraumatic temperature manipulations of these inflammatory inducers. In the second aim, we will investigate the primary actions of these inflammatory molecules on stress signals, including p38 mitogen-activated protein kinase, the transcriptional factor, NFkB, as well as the expression of endothelial adhesion molecules (ICAM-1, P-selectin). These studies are felt to be important because they will determine whether posttraumatic hypothermia in contrast to affecting the production and release of the proinflammatory cytokines, have a primary effect on secondary signaling pathways. In the final aim, we will determine the differential effects of hypothermia on selective aspects of the inflammatory cascade. For this aim, transgenic and knockout mice will be investigated under normothermic and hypothermic conditions. These studies will target injury processes investigated in Aims I and II and assess both the acute and more chronic structural and functional consequences of specific injury processes in hypothermia protection. Established quantitative methods of ELISA's, histophatological analysis, in situ hybridization, molecular techniques, as well as a large battery of behavioral tasks in rats and mice, will be used to complement the overall proposal. This new approach to trauma research should provide important data concerning interactions between inflammatory processes and temperature. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFLAMMATION AND NEONATAL ISCHEMIC BRAIN INJURY Principal Investigator & Institution: Silverstein, Faye S.; Professor; Pediatrics & Communicable Dis; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-JUN-1997; Project End 30-JUN-2005 Summary: (adapted from applicant's abstract): The long-term goal of the research is to understand the roles of inflammatory mediators in the pathogenesis of neonatal brain injury. The investigators' research focuses primarily on understanding how inflammation, initiated by acute ischemic brain injury, influences the ultimate expression of tissue damage, and how critical components of this inflammatory response can be modulated to improve neurological outcome. The primary hypothesis underlying this research proposal is that pro-inflammatory mediators play pivotal roles in determining the impact of hypoxic-ischemic insults on the developing brain. Experiments will be performed in well characterized neonatal rodent (rat and mouse) models of hypoxic-ischemic brain injury (unilateral carotid artery ligation + timed exposure to moderate hypoxia). The original research focus was on the role of the proinflammatory cytokine Interleukin-1beta in neonatal brain injury. Their findings in the initial funding period prompted them to broaden the scope of the work to include studies of several related pathogenetically relevant inflammatory mediators. They propose to delineate specific mechanisms of inflammation-mediated neuronal and oligodendroglial injury in the neonatal brain, and to determine if anti-inflammatory treatment interventions can reduce neonatal hypoxic-ischemic brain injury. Aim 1 will focus on the pathogenetic roles of 2 beta-chemokines (monocyte chemoattractant protein-1 and monocyte inflammatory protein 1-alpha) and their cellular targets. Aim 2
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will evaluate the contribution of complement system activation in the brain in the pathogenesis of neonatal hypoxic-ischemic brain injury. Aim 3 will evaluate the influence of pro-inflammatory mediators on the vulnerability of oligodendroglia to hypoxia-ischemia. Aim 4 will evaluate the long-term outcome of anti-inflammatory interventions with respect to tissue integrity and behavioral measures. The proposed experiments could identify some of the critical cellular/molecular mechanisms in the acute post injury inflammatory cascade that determine the extent of neuronal and glial injury, and ultimately provide novel treatment approaches to improve long-term neurodevelopmental outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFLAMMATORY MECHANISMS IN CEREBRAL ISCHEMIA Principal Investigator & Institution: Yenari, Midori A.; Assistant Professor; Neurology & Neurological Scis; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 15-AUG-2001; Project End 31-JUL-2004 Summary: At the experimental level, hypothermia has consistently been an effective means of reducing cerebral ischemic injury. Although the mechanisms underlying this neuroprotection have been attributed to the preservation of metabolic stores and reducing excitatory amino acid release, this cannot explain the equally robust protection seen with only small decreases in brain temperature, or when brain cooling is delayed by a few hours. Recent work in the area of stroke has also shown that inflammatory processes are activated and exacerbate injury by the release of reactive oxygen species (ROS), proteases, and lipases leading to increases in cerebral edema and local tissue destruction. Inflammatory stimuli upregulate inflammatory cytokines, which activate microglia and stimulate expression of adhesion molecules. These latter proteins are involved in attracting leukocytes to activated and damaged endothelium, which then enter damaged tissue. We, and a few other groups have found that inhibition of neutrophil migration reduces ischemic injury following experimental stroke, and that mild hyopthermia attenuates neutrophil infiltration into ischemic brain regions. We purpose to further explore the mechanisms known to mediate this inflammatory response, and determine whether mild hypothermia alters them. Using models of brain ischemia and inflammation, we will first test the hypothesis that mild hypothermia attenuates cerebral infiltration of leukocyte subpopulations, and suppresses microglial activation. We will then study whether mild hypothermia alters expression of inflammatory mediators such as the inflammatory cytokines IL- 1beta (interleukin1beta) and TNF-alpha (tumor necrosis factor- alpha), and adhesion molecules. We will then determine whether mild hypothermia attenuates inflammatory cell generation of potentially toxic substances such as ROS, inducible nitric oxide synthase (iNOS), and excitatory amino acids. To further confirm the temperature dependence of inflammation and its effects on brain injury, we will determine whether mice deficient in ICAM-1 are protected against hyperthermia. The results of this study should provide insight into the protective role of hypothermia, and may suggest anti-inflammatory targets for stroke treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: JUVENILE CONSEQUENCES
ALCOHOL
EXPOSURE:
NEUROBEHAVIORAL
Principal Investigator & Institution: Sircar, Ratna; Psychiatry and Behavioral Scis; Yeshiva University 500 W 185Th St New York, Ny 10033
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Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): Alcohol is the number one abused substance among adolescents. Several studies have shown that when adolescents use alcohol, they become excessive users of alcohol, and of other substances of abuse, later in life. Adolescents differ from adults in their response to alcohol in exhibiting less sensitivity to the sedative and motor impairing effects. Adolescent rats exhibit more tolerance to alcoholinduced hypothermia, and greater impairments in spatial memory than adult rats. In adolescent rats, the N-methyI-D-aspartate (NMDA) receptor-mediated synaptic plasticity in the hippocampus is more sensitive to alcohol than adults. Although differences in alcohol sensitivity between adolescent and adult rats have been established, the temporal effect of acute and repeated alcohol exposure during the adolescent period on spatial learning and memory remains unknown. The goal of the proposed study is to investigate the short- and long-term effects of alcohol exposure during the adolescent period on spatial memory. Hypotheses to be tested are: (1) alcohol exposure in adolescent rats cause impairments in spatial memory, (2) behavioral effects of repeated alcohol exposure in adolescent rats are long-term, (3) behavioral effects of alcohol exposure in adolescent rats differ from those in immature and adult rats, and (4) deficits in adolescent alcohol-induced spatial memory are associated with alterations in the NMDA receptor-channel complex. Rats will be exposed to acute and repeated alcohol treatments during the adolescent period and tested for deficits in the reference and visual spatial memory tasks in the Morris Water Maze. Others have already identified specific interactions between alcohol and the major neurotransmitter systems such as glutamate, GABA, dopamine, serotonin, endogenous opioids. In this proposal, adolescent alcohol exposure on the NMDA receptor-channel complex will be investigated. The proposed studies will identify neuroadaptive changes of early alcohol exposure and define the plasticity of the central nervous system during the adolescent period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LIMBIC EXCITABILITY AFTER FEBRILE SEIZURES Principal Investigator & Institution: Soltesz, Ivan; Assistant Professorr; Anatomy and Neurobiology; University of California Irvine Irvine, Ca 926977600 Timing: Fiscal Year 2001; Project Start 15-APR-1999; Project End 31-MAY-2002 Summary: (Applicant's abstract) Febrile (fever-induced) seizures are the most common forms of childhood seizures, affecting 3%-5% of infants and young children in the United States and worldwide. In spite of the extremely high incidence of fever-induced seizures, whether and how febrile seizures in the developing brain alter neuronal circuits is not well understood. Indeed, one of the most controversial issues in epilepsy is the relationship of convulsions in infancy to the subsequent development of temporal lobe epilepsy. Retrospective clinical studies indicated that a large fraction of patients with intractable temporal lobe epilepsy have a history of febrile seizures as infants. However, prospective studies have failed to find this association. Recently, an appropriate-aged rodent model of hyperthermia-induced seizures have been introduce, suitable for studying the mechanisms and sequelae of febrile seizures. We propose to use this model of hyperthermia-induced for studying the mechanisms and sequelae of febrile seizures. We propose to use this model of hyperthermia-induced seizure to test the central hypothesis that hyperthermia-induced seizures early I life cause long-lasting alterations in limbic neuronal excitability, and we propose to identify mechanisms which may contribute to long- lasting pot-seizure changes in limbic excitability. The central hypothesis will be tested by the three specific aims, using path clamp
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electrophysiological techniques in brain slice preparations of the hippocampus and dentate gyrus of the rat. Two types of controls will be used: 1) age-matched, normothermic sham controls, and 2) age-matched, hyperthermic controls, in which the seizures were blocked using pharmacological agents. Preliminary data indicate that the fee-forward GABA A receptor mediated inhibitory control of hippocampus pyramidal cells is enhanced in a long-term manner following hypothermia-induced seizures, but not following hyperthermia alone. Further more, preliminary experiments suggest that the excitatory drive onto hippocampal interneurons is increased following febrile seizures, which, together with a persistently unregulated hyperpolarization-activated depolarizing current(a ubiquitous regulator of excitability, often referred to as the "pacemaker": current for rats role in cardiac and thalamic membrane potential oscillations), may greatly contribute to the seizure-induced long-term potential of GABAergic inhibition. The data obtained from the proposed experiments will unequivocally determine whether hyperthermia-induced seizures in the developing brain cause long-term alterations in limbic excitability in this modes, and will help to identify novel mechanisms which could be targeted for anti-epileptic drug therapies in children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LOCAL HEMORRHAGE
PROFOUND
HYPOTHERMIA
IN
INTRACRANIAL
Principal Investigator & Institution: Larnard, Donald J.; Seacoast Technologies, Inc. 38 Depot Rd Hampton Falls, Nh 03844 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 14-FEB-2004 Summary: (provided by applicant): In most hemorrhagic strokes, cerebral vessels may bleed into brain tissue producing an intracranial hemorrhage (ICH). The presence of clot causes irritation of brain tissue, causing ischemia, necrosis, and edema. Currently, there is very little treatment available to a patient with ICH. Hypothermia treatment, as with whole body hypothermia, is impractical and involves significant complications. We propose to use local, profound hypothermia (15-18 C) to teat such ICH insults. This involves placement of a cooling device through a burr hole and coolinga local region of brain near the ICH to profound hypothermia levels. ICH occurs in about 85,000 cases in the US annually with poor outcomes: 58 percent of patients die within 30 days, while the majority of survivors suffer major neurological deficits. In Phase I, prototype devices will be designed, built, tested in vitro and used in a porcine animal model of ICH to test for efficacy. Functional assessment, histological measurements as well as imaging methods will be used. In clinical practice, the devices would allow for treatment of ICH patents in lobar hemorrhages, which make up about 40 percent of all ICH. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MATERNAL EFFECTS ON ETHANOL RESPONSES IN MICE Principal Investigator & Institution: Gabriel, Kara I.; Behavioral Neuroscience; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 24-SEP-2002 Summary: (provided by applicant): The proposed research is designed to investigate the effects of strain-dependent differences in maternal behavior on responses to ethanol with high and low levels of heritability. The central hypothesis is that maternal factors will influence ethanol responses but will have greater effects on responses with low heritability due to the larger influence of environment on those phenotypes. This
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research will examine maternal effects on ethanol responses in F, hybrids from reciprocal crosses of two inbred mouse strains with well-characterized differences in ethanol responses, C57BU6J (B6) and DBA/2J (D2). I will determine if F, hybrids reared by B6 dams and F, hybrids reared by D2 dams show differences in their responses to ethanol, thereby assessing the ability of maternal behavior to contribute to phenotype variation. Toward achievement of these aims, experiments will involve physiological and behavioral measurements. Ethanol responses with high levels of heritability that will be examined in B6, D2 and F, hybrid male and female offspring include locomotor responses to ethanol, ethanol drinking, and ethanol-induced conditioned taste aversion. Ethanol responses with low levels of heritability that will be investigated include hypothermic responses to ethanol and ethanol-induced conditioned place preference. Furthermore, I will investigate sex differences on ethanol responses in male and females B6, D2 and F, hybrid animals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS CONTROLLING LEUKOCYTE TRAFFICKING BY FEVER RANGE THERMAL STRESS Principal Investigator & Institution: Evans, Sharon S.; Roswell Park Cancer Institute Corp Buffalo, Ny 14263 Timing: Fiscal Year 2003; Project Start 20-JUL-2003; Project End 30-JUN-2008 Summary: (Revised Abstract) (provided by applicant): Successful anti-tumor immunotherapy ultimately depends on the ability of immune effector cells to gain access to malignant tissues. In this project, adhesive interactions between tumor-specific cytotoxic T lymphocytes (CTL) and tumor microvessels are considered to be a locus of action for promoting tumor immunity. This research proposal addresses the hypothesis that the proinflammatory cytokine, interleukin-6 (IL-6), plays a central role in stimulating a4b7 integrin-dependent delivery of CTL to tumor tissues in response to fever-range thermal stress. This hypothesis is formulated on the basis of new information from our laboratory demonstrating that fever-range hyperthermia stimulates the binding function of the a4b7 integrin homing receptor in tumorspecific CD8+ human CTL by altering 11-6 bioactivity. Initial data indicate that fever-range whole body hyperthermia (WBH) also acts on blood vessels in murine tumor tissues to stimulate the expression of functional endothelial ligands for a4b7 integrin (i.e., MAdCAM- 1, VCAM-1). Experiments are designed to address the following specific aims: (1) To define the requirement for IL-6 in recruitment of tumorreactive CTL to tumor tissues in response to fever-range whole body hyperthermia (WBH). The role of multiple lymphocyte-endothelial molecular pairs (a4b7 integrin/MAdCAM- 1, VCAM1; LFA-1/ICAM- 1; PSGL-1/E-selectin, P-selectin; CCR7/SLC; CXCR3/MIG, IP-10) will be investigated. These studies focus on a novel model system in which a4b7 integrindependent trafficking of human CTL to autologous lung tumor xenografts will be evaluated in SCID mice. (2) To identify novel IL-6 macromolecular soluble complexes induced by thermal stress that promotes a4b7 integrin-dependent leukocyte-endothelial cell adhesion. (3) To elucidate contributions of a4b7 integrin and endogenous IL- 6 in promoting tumor-specific cytotoxic immunity in response to combination fever range WBH and hsp110/grp170 vaccination. This project is highly interactive with Project 1 (John Subjeck) and Project 2 (Elizabeth Repasky) in which novel tumor vaccination strategies are developed using hsp 110 and grp 170 to initiate tumor-specific CTL responses in mouse models. Moreover, the success of this proposal is dependent on support from the core resources for administrative support and scientific leadership, hyperthermia treatment of mice, analysis of cytokine levels and CTL responses, and
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biostatistical analysis. Results of this integrated program are expected to support our long-term goal to develop new immunotherapies for the intervention in cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MILD HYPOTHERMIC NEUROPROTECTION FOR CEREBRAL ISCHEMIA Principal Investigator & Institution: Steinberg, Gary K.; Professor and Chairman; Neurosurgery; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 01-JAN-1991; Project End 31-AUG-2005 Summary: Mild hypothermia is the most effective therapy against experimental ischemic cerebral damage that currently exists. Mild hypothermia is already being successfully used in the treatment of acute traumatic brain injury and the feasibility of using it to treat stroke patients is currently being evaluated in some clinical trials. While multiple mechanisms for hypothermia-induced neuroprotection have been suggested, these mechanisms remain unclear and several key issues still need to be addressed. This project using a fresh approach using molecular biology techniques to test the hypothesis that mild hypothermia's neuroprotective benefit is due in part to a) attenuation of deleterious reactive oxygen species (ROS) and b) to inhibition of apoptotic cell death. Models of focal and global cerebral ischemia will be used and mild hypothermia will be applied to intraischemically and in a delayed fashion to mimic clinically relevant paradigms. A series of experiments will systemically examine the effects of mild hypothermia on 1) the generation of ROS in various brain regions during early reperfusion and at the peak of the inflammatory process; 2) the expression of endogenous antioxidants such as superoxide dismutases (SOD1 and SOD2), and glutathione peroxidase; 3) the expression of a death promoting (Bax) and death suppressing gene (Bcl-2); 4) the release of cytochrome c and caspase expression (ICE, CPP32); 5) DNA fragmentation characteristic of programmed cell death. This proposal will further test whether mild hypothermia can attenuate the increased neuronal damage observed in SOD-deficient mice and whether it does so by reducing ROS production, by altering the cytosolic translocation of cytochrome c, and/or by altering the regulation of Bcl-2 and Bax. The ability of post-ischemic administration of an antioxidant to extend the therapeutic window of mild hypothermia will also be tested. The knowledge gained from this project will elucidate novel cellular and molecular mechanisms underlying mild hypothermia's neuroprotective benefit, contribute to understanding the pathophysiology of ischemic cerebral injury, and may have important implications for the treatment of clinical stroke in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MRI AND MRS OF MODEL STROKE IN PERFUSED CELL CULTURES Principal Investigator & Institution: Trouard, Theodore P.; Assistant Professor; Radiology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2004 Summary: MRI is playing an important and expanding role in the diagnosis and evaluation of acute stroke. In particular, the apparent diffusion coefficient (ADC) of water, as measured by diffusion-weighted MRI (DWI), provides a means to quickly evaluate ischemic stroke in a clinical setting. Although changes in the ADC of ischemic tissue are well documented and are already clinically useful, their full potential will not be realized until the underlying physiologic mechanisms responsible for such changes
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Hypothermia
are better understood. The primary goal of this project is to develop and implement a perfused cell culture system (bioreactor) to investigate changes in MRI and MRS parameters due to model ischemia. Most work in the area of MRI and MRS investigations of model cerebral ischemia involves experimental stroke in animal models. These models provide extremely useful in vivo data but are complicated by unavoidable animal variability, tissue heterogeneity, lack of experimental control and spatial resolution. Bioreactor systems, on the other hand, allow cells to be grown to high density and studied in a relatively homogeneous and easily controlled environment. Perfusion constituents and flow rates in the bioreactor can be easily controlled, monitored and manipulated. Ischemic conditions can be experimentally induced within bioreactors and the cellular response can be studied in detail using MRI and magnetic resonance spectroscopy (MRS) methods. The bioreactor system will nicely fill a void that exist between simpler (non-perfused) cell cultures, and more complicated animal models. Within this project, ischemia induced changes in the ADC of water will be correlated with changes of in pH, ATP, PCr, Pi, Na+ and cell volume using MR methods. Initial studies will employ hollow fiber bioreactor (HFBR) cultures of rat C6 glials cells and will be compared to the ischemic response of normal rat brain. Further studies will the the ischemic response, in terms of MR observables, of human glial and neural cell lines. The consequences of hypoperfusion, pre-ischemic hyperglycemia, postischemic hypothermia will also be determined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MULTICENTER NETWORK OF NEONATAL INTENSIVE CARE UNITS Principal Investigator & Institution: Lemons, James A.; Pediatrics; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2001; Project Start 01-APR-1991; Project End 31-MAR-2006 Summary: Indiana University Medical Center has been an active member of the Neonatal Research Network since 1991. Particular strengths of the Indiana Center include a large patient population, design of new randomized trials for the Network, effective enrollment of subjects in Network protocols, eighteen neonatology faculty with extensive experience and expertise in basic and clinical research, an established newborn follow-up program, excellent infrastructure and support staff, and important collaborative research programs with other departments and university centers. Since 1995 (starting year of the second competitive renewal of the Network grant) the faculty within the Section of Neonatal-Perinatal Medicine has had 20 NIH grants and 49 other extramural awards, and has published over 200 manuscripts during that period. Indiana University School of Medicine is the only medical school and the site of the only comprehensive children's hospital in Indiana. The Medical Center serves as the principal referral center for pediatric subspecialty care for the entire state, which has a population of 5.9 million and 87,000 births annually. Further, the Indiana Center expanded in 1997 when Methodist Hospital (a large community hospital with a high risk obstetric service and NICU) merged with the Medical Center. Indiana has a strong record of participation in and contribution to the Neonatal Research Network. During the past four years Indiana enrolled an average of 334 VLBW infants yearly in the generic data base, and 390 infants in 1999 (the largest of any center). Indiana has participated in 12 trials since 1995, contributing 34/235 subjects to the Neonatal Inhaled Nitric Oxide Study 45/170 and 24/115 infants to the two Erythropoietin trials, 3/16 infants to date in the Hypothermia and Hypoxic Ischemic Encephalopathy study, and 65 of 300 to date in the Glutamine Trial. Indiana faculty chaired and developed the Newborn Follow-up
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Program, the Glutamine Trial, the Magnesium Sulfate Subcommittee and the Protocol Review Subcommittee, chaired the GDB Subcommittee, and served on nine other subcommittees. The clinical and basic research of the neonatology faculty is focused on molecular immunology, developmental hematopoiesis, and fetal/neonatal nutrition and metabolism. These research programs lend themselves to ancillary studies of the Neonatal Network; one currently active and six other ancillary studies were designed and initiated by Indiana faculty. Collaborative support has been provided by other investigators, departments and centers when additional expertise and/or resources could benefit Network protocols. Indiana University brings to the Neonatal Network a large patient population, a uniquely balanced program of clinical service and research, and a strong record of participation and accomplishment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MULTICENTER NETWORK OF NEONATAL INTENSIVE CARE UNITS Principal Investigator & Institution: Shankaran, Seetha; Professor; Pediatrics; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2001; Project Start 01-APR-1991; Project End 31-MAR-2006 Summary: (Provided by Applicant) The Wayne State University School of Medicine at the Detroit Medical Center is submitting an application for renewal in the NICHD Multicenter Neonatal Research Network. The Division of Neonatal-Perinatal Medicine has both an inborn service at Hutzel Hospital (6000 deliveries, 55 bed NICU/Progressive Care Nursery) and an outborn service at Children?s Hospital of Michigan (45 bed NICU). The Division of Maternal-Fetal Medicine at Wayne State is currently a member of the NICHD Multicenter Materna/-Fetal Research Network (MFM). The Division of Clinical Pharmacology at Wayne State is currently a member of the NICHD Pediatric Pharmacology Research Unit (PPRU). The Wayne State site has additional capabilities of including two more Detroit Medical Center inborn hospitals (Sinai-Grace Hospital, 4000 deliveries and Huron Valley Hospital, 2000 deliveries) into the Neonatal Research Network with the site PI who is the Regional Director of the Detroit Medical Center?s Neonatal Programs. The Wayne State site has actively participated in the current NICHD Neonatal Research Network studies by contributing a greater number of subjects than the average enrollment per site. These studies include 1134 subjects enrolled in the Generic Database Study, 366 in the Follow-up Study, 28 in the Erythropoiten Study, 157 in the Magnesium Sulfate Study, and 61 in the Vitamin A Study. In two studies, the Wayne State site has far exceeded enrollment. These include the Early Inhaled Nitric Oxide Study, Wayne State has enrolled 32 of 203 subjects and the Network study on Hypothermia for Encephalopathy where Wayne State has enrolled 4 of 22 subjects. In the Maternal Lifestyle Study (4 sites), Wayne State has enrolled 43% of all infants enrolled in Phase II and III of the study. I n the current grant period, the Principal Investigator at the Wayne State University site, Dr. Seetha Shankaran, served as PI for the Antenatal Phenobarbital to Prevent IVH Study and is currently PI of the Induced Hypothermia for Encephalopathy Study. Strengthens of the Wayne State site include neonatal imagining abilities (PET and MRI), obstetric imaging capabilities, the fetal diagnosis and therapy program and ongoing collaboration with the NICHD MFMU Network and the NICHD PPRU Network. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Hypothermia
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Project Title: MYOCARDIAL CALCIUM HANDLING DURING AND AFTER HYPOTHERMIA Principal Investigator & Institution: Stowe, David F.; Anesthesiology; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2001; Project Start 15-JAN-1999; Project End 31-DEC-2002 Summary: Mild (27 degrees C) to moderate (17 degrees C) hypothermia is used to reduce myocardial energy consumption and function by slowing metabolism during valve, coronary vessel, and ascending aortic surgery; severe (3 degrees C) hypothermia is used to protect donor hearts prior to transplant. But cardiac function on reperfusion after hypothermia often remains impaired. It is known that mild to moderate hypothermia increases myocardial contractility per beat and severe hypothermia causes arrest with diastolic contracture and results in impaired contractility and relaxation on warm reperfusion. Altered Ca2+ handling by Ca2+ pumps, voltage-regulated Ca2+ conductance, Ca2+ linked exchanger activity, and altered Ca2+ sensitivity ultimately underlie these contractile effects. It is not known how disturbances in overall cation homeostasis during cooling lead to altered Ca2+. The mechanisms underlying Ca2+ deregulation and poor reperfusion function are likely temperature dependent. The aim is to investigate the mechanisms of interaction of specific cations responsible for changes in cardiac action potential and contractility during 4 hrs of graded hypothermia, and particularly during 2 hrs of reperfusion. It is proposed that hypothermia alters Ca2+ homeostasis via mechanisms linked to regulation of a) [Na+]i, via the Na+ K+ pump, Na+ influx, and Na+ H+ and Na+ Ca2+ exchangers, b) [Ca2+]i, mediated via the Ca2+ pump, c) myofilament Ca2+ sensitivity, and d) K+ efflux. The objectives are to discover how cation equilibrium and contractile function are altered by hypothermia; to find if mild and moderate hypothermia alter cation equilibrium and contractile function differently than severe hypo-thermia; to find if low-flow cold perfusion is better than cold storage, and to determine which treatment strategies are best to counteract deleterious contractile effects during reperfusion. Three guinea pig cardiac models will be used to measure: intracellular concentrations of Na+ and H+ mitochondrial Ca2+, and phasic diastolic and systolic myoplasmic Ca+ fluorometrically, with left ventricular pressure (LVP) and other functional and metabolic variables in intact beating hearts; whole cell voltage-clamped Na+, Ca+, and K+ATP channel currents in isolated cardio myocytes, and; AP's in sub endocardial cells. Hypothermia and rewarming effects on Ca2+ sensitivity will be assessed by plotting LVP vs diastolic and systolic [Ca2+] at increasing external Ca. These studies will lead to a better understanding of Ca2+ loading and therapies to protect hypothermic hearts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NA+/H+ EXCHANGER AND CARDIAC HYPOTHERMIA: ROLE ROS Principal Investigator & Institution: Camara, Amadou K.; Anesthesiology; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Hypothermia is a very powerful temperaturedependent method to protect against clinical cardiac ischemia and reperfusion (I/R) injury. Hypothermia decreases energy utilization and preserves mechanisms to rapidly generate ATP on reperfusion. But hypothermia does not provide complete protection and has deleterious effects; cold perfusion can result in elevated cytosolic (cyt) Ca2+ and cause hyper-contracture and reduced compliance. Formation of reactive oxygen species, (ROS) and, mitochondrial (m) Ca2+ loading are major factors that cause reperfusion
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stunning and permanent damage after normothermic ischemia. The roles of mROS formation, m Ca2+ loading, mNADH, and other indices of mitochondrial bioenergetics during hypothermic perfusion and I/R have not been studied. Increased cellular sodium-hydrogen exchange (NHE) activity observed during I/R is an attractive candidate to link increased ROS production and m Ca2+ overload. These studies will assess hypothermic ischemia -induced effects on cyt Na+ and m Ca2+ loading, formation of ROS, KAav channels, and mitochondrial bioenergetics (NADH, ATP synthesis, O2 consumption) to determine the mechanism of protection by hypothermia and inhibition of NHE. Major aims are: 1) To Assess the deleterious effects of hypothermia on mitochondrial function and to evaluate the cardio protective role of cardioplegia, NHE inhibition, ROS scavengers, and Kxav channel opening during and after hypothermic ischemia. 2) To determine the mechanisms of cold perfusion and I/R induced Na+ and m Ca2+ loading on mitochondrial and myocardial dysfunction using alkalosis, ROS generators and mKAav blockers alone and together with NIIE inhibition. We will use unique on-line fluorescence techniques to assess ROS formation, redox balance, cyt [Na+], and m [Ca2+] at 37 and 27 degrees C in intact guinea pig hearts and ROS release in coronary effluent. Protection will be evidenced in intact hearts by reduced global infarct size, enzyme release, and better mechanical and metabolic function. The mechanism of hypothermic protection will be further investigated in isolated mitochondria measured for NADH, membrane potential, ATP synthesis, and 02 consumption. Emphasis will be placed on the effects of drug-induced blockade of mitochondrial ROS formation, NHE activity and KAav channel opening on cellular cation balance and mitochondrial bioenergetics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NATIONAL ACUTE BRAIN INJURY STUDY: HYPOTHERMIA II Principal Investigator & Institution: Clifton, Guy L.; Professor and Chairman; Neurosurgery; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 30-JUN-2007 Summary: (provided by applicant): This proposed project, the National Acute Brain Injury Study: Hypothermia II (NABIS:H In will be a multi-center, prospective, randomized Phase III clinical trial in which standard management at hypothermia (33 degrees C) for 48 hours is tested against standard management at normothermia in patients with severe brain injury (GCS<8), age 16-45 years, and with admission temperature less than or equal to 35 degrees C. The primary outcome measure will be the dichotomized Glasgow Outcome Scale at 6 months after injury (Good Recovery/Moderate Disability vs. Severe Disability/Vegetative/Dead). The sample size of 220 patients will detect an absolute difference of 17% in the percentage of poor outcomes in the two groups at a power of 80%. The selection of this population was based on findings from the original National Acute Brain Injury Study: Hypothermia (NABIS:H I). In that study, with a sample size of 392, hypothermia was induced beginning 45 years, there were more poor outcomes in the hypothermia group (Hypothermia 89%, Normothermia 69%, p=0.08) due to increased medical complications. However, in 81 patients (22% of 366 patients with complete data) who were age 16-45 years with admission temperature less than or equal to 35 C, maintenance of hypothermia was associated with a marked decrease in the percentage of poor outcomes (Hypothermia, 52%, Normothermia 76%, p=0.02) with no difference in complication rates. The effect was found in all of the 4 high-enrollment centers, and there were no confounding variables that could have explained the difference in outcomes. The entire treatment effect in this subgroup was to shift patients from Severe
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Hypothermia
Disability (poor outcome) to Moderate Disability (good outcome). We believe that the finding is related to a very short treatment window for hypothermia induction. The proposed study prospectively tests whether maintenance of hypothermia present on admission results in better outcome than current management. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEAR OXYGENATION
INFRARED/MR
SYSTEM
FOR
IMAGING
BRAIN
Principal Investigator & Institution: Dunn, Jeffrey F.; Associate Professor of Radiology and Phy; Diagnostic Radiology; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2005 Summary: We will design, and construct a combined near infrared (NIR) and magnetic resonance (MR) imaging system for studying brain oxygenation, and apply it to the study of brain hypoxia/ischemia. Normal function of brain, as well as pathologies such as stroke, birth asphyxia, tumors, hydrocephalus and epilepsy all induce changes in oxygenation. Imaging methods which provide high spatial and temporal information concerning brain oxygenation would be of significant use. This NIR/MR imager will provide spatially resolved data on cerebral oxygen utilization, extraction, blood volume and blood saturation. The main goal is to show that, by using structural information from the MRI, one can constrain the reconstruction of NIR data to obtain true NIR images. We can then co-register these oxygenation images with any MR imaging modality including diffusion, perfusion and BOLD (blood oxygen level dependent imaging). NIR provides accurate information on hemoglobin content and saturation but, without the developments which we propose, NIR data are difficult to reconstruct into an image. We will verify NIRS reconstruction algorithms for a range of study diameters. Then we will construct appropriate NMR hardware compatible with the NIBS imaging system and combine the two to create the hybrid imaging modality. We will test this on phantoms and on animal models. After developing the system, we have two hypothesis driven aims designed to show the potential of the imager, as well as to provide unique data on hypoxia/ischemia. We will test the hypothesis that the hippocampus has a high oxygen extraction during normoxia, and reduced capacity to increase extraction during hypoxia. This difference in extraction may be one of the mechanisms of increased hypoxia sensitivity in the hippocampus. We also hypothesize that the brain has a reduced extraction, and cerebral blood flow during reperfusion after hypothermic ischemia. Such a pattern of oxygenation has been implicated in neurological impairment after cardiopulmonary bypass. On the other hand, this is the period of increased oxidative damage post-ischemia, and so reduced oxygenation during reperfusion may be beneficial under some situations. We will assess brain tissue oxygenation and blood flow (using MR perfusion imaging) during ischemia/reperfusion during normoxia and hypothermia. This grant will produce a novel imaging modality which can noninvasively monitor cerebral oxygenation, structure, and blood flow. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEONATAL BRAIN ISCHEMIA AND REPERFUSION Principal Investigator & Institution: Keller, Richard W.; Ctr/Neuropharmacology/Neurosci; Albany Medical College of Union Univ Union University Albany, Ny 12208 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2004
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Summary: Stroke is among the most common neurological disorders in the US. Most strokes involve a blockage of one of the blood vessels of the brain, thus depriving a region of brain tissue of its much needed oxygen and nutrients. In many cases, at least some blood flow is restored (reperfusion). Whereas restoration of blood flow sounds very positive, unfortunately providing significant levels of oxygen to a compromised tissue can also lead to the generation of reactive oxygen species. Both of the damaging aspects of the two main components of stroke - acute ischemia and reperfusion - have been reproduced in adult rat models, and the pathways and mechanisms of damage are beginning to emerge. Several observations suggest that the neonatal brain is more tolerant to ischemic events than the adult brain. Most current ischemia research in neonates is focused on the hypoxia associated with child birth and these models lack the reperfusion component studied in stroke. Ischemic strokes in infants and children are rare compared to strokes in adults, yet they do occur and are probably under diagnosed. When strokes occur in children they are frequently in the same brain regions as in adults. Our studies will examine important basic mechanisms of brain damage in an infant rat model of transient focal ischemia with reperfusion. We will determine the presence, sources and persistence of several known mediators of ischemic damage, namely: excitatory amino acids, immediate early genes, and hydroxyl radical. Our studies will focus on the mechanisms that regulate the levels of these mediators and the interactions between and among them. We will also investigate the changes that occur in various regions of the infarct - the core, the penumbra and the extra-penumbra areas. Understanding how these mediators are regulated in the infant brain will provide insights into the differences in ischemic responses in the infant and the adult, and will promote rational treatment of both juvenile and adult ischemic events. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEONATAL ENCEPHALOPATHY TREATED BY MODERATE HYPOTHERMIA Principal Investigator & Institution: Eicher, Dorothea J.; Pediatrics; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 30-JUN-2003 Summary: Perinatal hypoxia-ischemia (HI) remains a serious problem in the care of newborns. Interruption in the supply of oxygenated blood to the brain may result in neuronal injury, encephalopathy and possibly death. Neonatal encephalopathy (NE) occurs in 3-9 of every 1000 term infants. Hypothermia decreases or inhibits many of the cellular events that lead to neuronal damage after reperfusion, and offers the advantage of an early and relatively uncomplicated intervention in a potentially devastating disease process. The safety and efficacy of short-term systemic hypothermia during HI has been established in adult and neonatal populations undergoing cardiac and neurosurgical procedures. The safety and efficacy of longer-term systemic hypothermia (1-5 days) has been substantiated in adult head trauma patients and in 17 newborns with junctional tachyarrhythmias, but not in this population of HI newborns. Before a full-scale clinical trial of this intervention is designed and conducted, we need to validate the uniformity of the intervention protocol and define outcome measures. In this pilot study we will enroll 72 successive newborns within 6 hours of an HI event, and randomly assign them to hypothermia (33 C) or normothermia (37.5 C) for 48 hours after HI insult. This study will test a degree of systemic hypothermia which may have the greatest neuroprotective effect with few adverse effects based on studies in human infants and our preliminary feasibility study of 5 term newborns. We will address measures of efficacy and safety, refine the treatment protocol and the target population
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for the full-scale clinical trial. We will show that systemic hypothermia can be safely and uniformly begun at outlying hospitals and during transport of newborns to a tertiary care center. The use of hypothermia in this disease process may be groundbreaking and profoundly change the way asphyxiated newborns are treated even in the most rural areas. Questions regarding measures of safety and efficacy of hypothermia, novel methods for identification of neonates in first few hours after the insult, and outcome predictions for these newborns need to be better defined prior to a definitive clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NERVE DYSFUNCTION POST-REPAIR OF CONGENITAL HEART DEFECT Principal Investigator & Institution: Gaynor, William J.; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 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: NOVEL PRESERVATION FLUID FOR ORGAN TRANSPLANTATION Principal Investigator & Institution: Mabley, Jon G.; Inotek Pharmaceuticals Corporation 100 Cummings Ctr, Ste 419E Beverly, Ma 01915 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2004 Summary: (provided by applicant): Nitric oxide and peroxynitrite are reactive, shortlived species that are important mediators of various forms of hypoxia - reperfusion injury. One of the dow5nstream pathways of peroxynitrite-mediated organ injury is related to activation of the nuclear enzyme poly (ADP-ribose) synthetase (PARS). Based on in vitro and in vivo preliminary data, the applicants propose that the PARS pathway may play a role in the pathogenesis of the reperfusion injury associated with the transplantation of hypoxic organs, and propose studies to directly test the hypothesis that PARP inhibition supplementation in the organ storage fluid is able to improve the function of the transplanted organ. The first aim of the current project is to establish time course of PARS activation and associated organ dysfunction in an experimental kidney transplantation model, and to correlate these alterations with reactive nitrogen species formation in the organ. Reactive nitrogen species formation and PARS activation will be investigated using immunohistochemistry, and organ function will be investigated using conventional techniques. The second aim of the project is to perform direct studies into the role of PARS-related transplantation-induced kidney dysfunction. We will compare traditional organ preservation fluids with ones spiked with a novel potent PARS inhibitor, followed by evaluation of changes in the kidney function associated with transplantation. We will also evaluate the effect of treatment of the recipient with PARS inhibitor. Our studies will provide novel mechanistic information on ischemic storage and transplantation-related renal dysfunction which will be utilized for the future design and commercial development of novel organ preservation fluids. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PROTECTION
OPIOID
HIBERNATION
FACTORS
FOR
MYOCARDIAL
Principal Investigator & Institution: Bolling, Steven F.; Professor; Surgery; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274
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Timing: Fiscal Year 2001; Project Start 08-FEB-1999; Project End 31-JAN-2003 Summary: (Adapted from investigator's abstract) Many patients have advanced cardiac disease, necessitating complicated cardiac surgery or transplantation. During cardiac surgery, including transplantation, the heart is rendered ischemic; and blood flow to the heart is stopped either to undertake the surgery or to transport the organ, which is currently limited to 4-6 hours. In order for the patient to be removed from cardiopulmonary bypass and return to activity, the heart has to function well following cardiac surgery. Any enhancement in myocardial energy preservation will increase the number of positive outcomes for patients and improve the quality of patient care. Interestingly, hibernating animals can preserve up to 90% of the energy required during normal euthermic metabolism. The mechanism of this energy preservation during hibernation is currently unknown; however, many studies point to an opioid "trigger" molecule, which has been termed the hibernation induction trigger or HIT. The opiate nature of HIT is well established, as HIT can be reversed or retarded by opiate antagonists. Evidence indicates that HIT initiates its potential metabolic inhibitory effects through specific membrane opioid receptors, particularly delta receptors. Delta opioids have been shown in many models and the investigators' preliminary results to produce profound behavioral, physiological and metabolic inhibitory effects favoring survival at the whole animal, the organ and the cellular level. The proposed study will investigate the mechanisms of action of delta opioids at both the organ and subcellular levels. These studies could result in extended safe cardiac ischemic time with potential application to cardiac surgery and cardiac transplantation. In these proposed isolated heart studies, the investigators will determine if delta opioids provide enhanced myocardial protection during ischemia. The investigators will also seek to elucidate the intracellular mechanism by which the delta opioids protect the ischemic myocardium. The ability of the delta opioids to effect myocardial protection suggests that the use of these molecules may be valuable in many clinical scenarios resulting in ischemia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERACTION
OPIOIDS,CANNABINOIDS,CHEMOKINES--NEUROIMMUNE
Principal Investigator & Institution: Adler, Martin; Professor; Pharmacology; Temple University 406 Usb, 083-45 Philadelphia, Pa 19122 Timing: Fiscal Year 2001; Project Start 20-MAR-1991; Project End 30-JUN-2006 Summary: Opioids and cannabinoids affect not only the nervous, but also the immune system in humans and rodents. Mu, kappa, and delta opioid receptors and CB1 and CB2 cannabinoid receptors have been demonstrated in the immune system. In addition, in rodents, products of the immune system, such as cytokines, have been shown to alter neural function and to modify the effects of opioids on body temperature and analgesia. Chemokines, a subclass of cytokines, are produced by microglia in the brain. In human peripheral blood mononuclear cells, it has been shown that there is an interaction between opioid receptors and chemokine receptors, both being G-protein coupled, seven transmembrane receptors. Selected ligands for each class of receptor can crossdesensitize the other by cross-phosphorylation. Our preliminary results using transfected cell lines support this conclusion as do our recent novel and very exciting results showing that chemokines injected into rat brain PAG block opioid- induced analgesia. The findings suggest the chemokines may alter opioid function in the brain. We have also found super- and sub- additive effects of opioid receptor-selective ligands (mu and delta2) on immune cell function, as well as similar effects between opioids and cannabinoids. Taken together, these results suggest that the opioid, cannabinoid, and
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chemokine systems interact in the immune system and in the nervous system. It is the purpose of the proposed studies to document the nature of the interactions among these three classes of ligands and their receptors in both the immune and nervous systems. Specifically, we propose to 1) determine the interactions that occur among the classical opioid receptor types and between opioids and cannabinoids in the immune system of mice; 2) determine the cross-regulation of opioid, cannabinoid, and chemokine receptor function in primary human cells and transfected cell lines, and the effect of combinations of these classes of ligands on HIV replication; and 3) examine the effects of Chemokines given supraspinally to rats and mice on morphine- and cannabinoidmediated analgesia and hypothermia. These studies will explore basic interactions between abused drugs and immune function, and between products of the immune system and these drugs on nervous system function, whether the drugs are used therapeutically or non-therapeutically. Common cellular targets and mechanisms will be sought to elucidate drug interaction pathways. As drug abusers usually use more than one drug, the studies also have public health relevance. Because chemokine receptors are co- receptors for HIV, the studies of how opioids and cannabinoids affect levels and function of chemokine receptors have implications for the effects of drugs of abuse, particularly when taken in combination, on HIV progression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OPTIMIZING HEART AND BRAIN COOLING DURING CARDIAC ARREST Principal Investigator & Institution: Becker, Lance B.; Director of Research; Medicine; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 05-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): This revised biomedical partnership proposal from the Univ. of Chicago and Argonne National Lab aims to develop an intra-arrest cooling system for field use by paramedics during cardiac arrest and is directly responsive to the NIH PULSE Workshop calling for new resuscitation methods. Two prototype microparticle slurries have been developed: one saline-based for intravascular use and another perfluorocarbon-based for pulmonary use. These slurries contain high percentages of small (100mum) highly fluid, smooth ice particles with 8 times the cooling capacity of the same liquid (0 degrees C) without ice. In initial swine studies saline slurry resulted in very rapid brain and heart cooling (>1 degree C every 2 minutes) during cardiac arrest with only chest compression to produce circulation, far superior to any external cooling techniques. Moreover, adverse effects of 30 minutes exposure to perfluorocarbon slurry instilled into the lungs of normal animals (not in cardiac arrest) were mild and improved with time. Animals survived unassisted for 48 hours with A-a gradients not significantly different from controls. Thus, creating an optimal cooling method with minimal adverse effects appears a realistic goal. Specific aims and milestones include: (i) bioengineering and developing two microparticulate slurries for pulmonary and intravenous use, (ii) using these slurries to optimize "intraarrest" cooling rates of the heart and brain of animals during cardiac arrest, (iii) describing and minimizing adverse effects of slurries, and finally (iv) testing whether slurry cooling to 2 different levels of intra-arrest low-flow cooling will improve survival in a swine model of cardiac arrest. Unlike any existing method, paramedics could use this cooling method after failed defibrillation in efforts to delay additional heart and brain damage until full reperfusion can occur. An international advisory committee of noted resuscitation experts will advise the project and many wish to test the slurries in
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their home laboratories after completion of these aims, increasing the potential impact of this work. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OUTCOME OF THERAPEUTIC HYPOTHERMIA IN PEDIATRIC ARREST Principal Investigator & Institution: Zaritsky, Arno L.; Health Services Administration; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2005 Summary: (provided by the applicant): There are many important unanswered questions regarding the best methods to improve outcome in infants and children following cardiopulmonary arrest (CPA). There is also a need to identify reliable indicators of poor outcome/vegetative state in CPA survivors to help families make informed decisions and reduce potential life-long burdens on the family and healthcare system. The primary aim of this clinical trial planning grant is to organize an effective research team and develop the elements essential for conducting successful clinical trials of pediatric CPA. This planning grant will develop a clinical trial to assess (1) the effect of early mild therapeutic hypothermia on survival and functional outcome following pediatric CPA; (2) identify early clinical signs and biomarkers associated with survival and various degrees of functional outcome following CPA; and (3) establish the changes in functional outcome over time in children following CPA using more precise outcome measurement tools than previously employed. The latter goal will establish the basis for subsequent trials evaluating the effectiveness of different rehabilitative interventions on ultimate outcome. This planning grant will (1) identify additional collaborators, (2a) develop the experimental design and (2b) intervention protocols including treatment protocols for managing the patient following CPA, (3) select and establish neurological, biomarker, comorbid and functional outcome measurement data elements and tools, (4a) determine the effect size and power needed for clinically meaningful results and (4b) establish an analysis plan including a safety monitoring board, (5) develop a data coordination/management team, (6) assess the feasibility of subject recruitment strategies, (7a) identify the obstacles to conducting a randomized intervention trial waiving informed consent and (7b) determine the requirements that sites need to meet, (8) select study exclusion and inclusion criteria, (9) develop a training program to assure that the treatment intervention and overall patient care is replicated across sites, (10) select sites for the hypothermia randomized controlled trial (RCT) and obtain Institutional Review Board approval, and (11) develop administrative operations to manage the RCT. The long-term objective is to utilize the clinical trial network to conduct additional trials so as to advance the science of pediatric resuscitation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OXIDATION CHEMISTRY OF INDOLES Principal Investigator & Institution: Dryhurst, Glenn; Professor and Chairman; Chemistry and Biochemistry; University of Oklahoma Norman Office of Research Services Norman, Ok 73019 Timing: Fiscal Year 2001; Project Start 15-SEP-1983; Project End 31-AUG-2003 Summary: (Adapted From The Applicant's Abstract): The goal of this project is to contribute to an understanding of the chemical and biochemical mechanisms that underlie the dopaminergic and/or serotonergic neurotoxicity of methamphetamine (MA) and 3,4-methylenedioxymethampetamine (MDMA). The project is based on the
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hypothesis that glutathione (GSH), released from both neurons and glia, and extracellular conditions that influence the activity of gamma-glutamyl transpeptidase (g-GT), are key factors in MA- and MDMA-induced neurotoxicity. It is proposed that extracellular conditions evoked by a MA-induced neuronal energy impairment, notably excessive HO* generation, cause upregulation of g-GT and hydrolysis of GSH to glutamate (Glu), glycine (Gly) and cysteine (CySH). Dopaminergic neuronal damage evoked by MA in the rat is proposed to be dependent on the intraneuronal oxidation of DA by O2-*, generated by NMDA receptor activation by elevated extracellular Glu, in the presence of translocated CySH forming dihydrobenzothiazine (DHBT) and benzothiazine (BT) mitochondrial (mt) toxicants. Similarly, serotonergic neuronal damage may be caused by intraneuronal oxidation of 5-HT by O-2-* in the presence of translocated CySH to give endotoxic metabolites. Mechanisms are proposed by which MDMA, because of its HO* scavenging properties, inhibits g-GT and hence hydrolysis of released GSH. Thus, not only is Glu-mediated NMDA receptor activation and intraneuronal O-2-* generation attenuated, CySH, essential for DHBT/BT formation, is not available and DA neurons are spared. In contrast, the O-2-* mediated oxidation of 5HT generates tryptamine-4,5-dione that in the absence of CySH inhibits mt enzymes and, hence, MDMA evokes selective serotonergic neurotoxicity. Specific aims are to: (1) monitor extracellular changes of DA, 5-HT and their metabolites, thiols/disulfides, and Glu, Asp and Gly in rat brain in response to MA and MDMA using microdialysis; (2) search for unusual products of oxidation of extracellular DA/5-HT/metabolites by HO* that might contribute to MA/MDMA toxicity, also using microdialysis; (3) study the influence of hypothermia, astroglial ablation, and the glucose metabolism inhibitor 2deoxy-D-glucose, on MA/MDMA-induced extracellular neurochemical changes; (4) investigate the effects of MA/MDMA on brain thiol/disulfide concentrations and g-GT activity; (5) study the effects of g-GT inhibition, manipulations of brain GSH, 5-Scysteinyldopamine (DHBT/BT precursor), and glial ablation on MA/MDMA-induced neurotoxicity; (6) analyze brain tissue for evidence of putative endotoxic metabolites and covalently modified proteins; (7) study interactions of putative endotoxins with mt and other enzymes; (8) assay rat brain for activities of mt and other enzymes, following MA/MDMA administration. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHASE II TRIAL OF HYPOTHERMIA FLUOROURACIL/DOXORUBICIN IN MALIGNANCY
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Principal Investigator & Institution: Bull, Joan M.; Director of the Division of Oncology; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROTON MAGNETIC RESONANCE SPECTROSCOPY OF ACUTE TBI Principal Investigator & Institution: Hillary, Frank G.; Kessler Medical Rehab Res & Educ Corp Research & Education Corp. West Orange, Nj 07052 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2004 Summary: (provided by applicant): Each year 230,000 people are hospitalized and survive moderate and severe traumatic brain injury (TBI). As a result, a large number of individuals with TBI endure life-long impairment and disability. Acute rating scales
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such as the Glasgow Coma Scale (GCS) have shown limited predictive validity regarding patient outcome and traditional neuroimaging techniques such as CT and MRI maintain limited correlations with brain injury severity and cognitive functioning. Continued advances in neuroimaging, however, have provided researchers with an important opportunity to study the pathophysiology of brain dysfunction following TBI. According to the NCMRR, "the neurobiology of TBI in humans should be studied with modern imaging techniques". The purpose of this study is to correlate proton magnetic resonance spectroscopy (MRS), an advanced neuroimaging technique, with behavioral measures of TBI severity and cognitive outcome. MRS measures the concentration of cerebral metabolites such as N-acetylaspartate (NAA), choline (Cho), and glutamate (Glu). While MRS has shown promise in predicting brain injury severity and patient outcome, the exact protocols for using MRS with TBI remain undetermined and the purpose of the proposed study is to examine three critical areas: (1) the post-injury time period when the MRS data should be acquired (e.g., within one week or within one month of injury); (2) how metabolites should be measured (i.e., absolute concentrations or changes in concentration over time); and (3) the brain locations best suited for MRS data acquisition (i.e., acquisition near lesion sites or acquisition at sites remote from probable brain lesion). The proposed study will make determinations in these three areas through the use of two acute MRS scans following TBI to measure concentrations of NAA, Cho and Glu and their correlation with injury severity and cognitive variables. In addition, correlation of acute MRS data with behavioral data (e.g., duration of loss of consciousness, duration of post-traumatic amnesia) will elucidate the relationship between changes in brain metabolism and changes in patient behavior during acute recovery from TBI. The present proposal will employ a promising, noninvasive neuroimaging technique, MRS, to determine the most appropriate protocols (i.e., timing, metabolic measurement, brain location for data acquisition) for application of MRS to acute TBI. With an established protocol for using MRS, this instrument should prove useful for determining the effectiveness of acute interventions (e.g. hypothermia, pharmacologic intervention) and for predicting the acute course of patient recovery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: QTL MAPPING FOR ETOH HYPOTHERMIA AND LOCOMOTER ACTIVITY Principal Investigator & Institution: Belknap, John K.; Professor; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 20-DEC-1995; Project End 31-DEC-2005 Summary: This Component 4 presents the continuation of the QTL mapping efforts of the QTL mapping efforts of Component 7 of our present Center grant. In the renewal, we propose to use populations derived from two presently existing long-term selectively-bred-lines the FAST and SLOW lines bred for increased and reduced sensitivity to ethanol-induced locomotor activation, respectively, and the HOT and COLD lines bred for minimal or severe ethanol-induced hypothermia (body temperature loss). Both projects were developed beginning with an HS foundation population, which in turn was derived from an eight-way cross of inbred strains. [Continued studies of the third long-term selection project, WSP/WSR, are now part of an RO1 application in preparation (PI: K.Buck)]. Because of the markedly different gene pools in our HS-compared to our B6-, D2- derived populations, we expect most unique QTLs to emerged in this Component for these traits. In the first four years of Center support, a full genome scan was carried out as part of present Component 7 in the search for QTLs influencing both acute ethanol-induced hypothermia (HOTxCOLD F2)
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and chronic ethanol withdrawal severity (WSPxWSR F2). The third mapping project involving locomotor activation (FASTxSLOW F2) will be finished in the final year of our present support. Thus far, 8 suggestive (P<.0015) and one significant (p<.00005) QTLs influencing either hypothermia or withdrawal have been detected and mapped to broad chromosomal regions. We propose an additional F2 population for hypothermia, and another for locomotor activation, to be tested to increase the number of significant QTLs, and to test for modifier loci of known QTLs, a form of epistasis. For the three most important QTLs per trait, congenic strains will be developed to isolate individual QTLs, and the interval specific strain (ISCS) used to attain high resolution (1 cM) mapping for each QTLs. In addition, a systemic genome-wide search will be carried out to find modifier loci of all apparent QTLs attaining a nominal p,.05. Because the risk of falsepositive modifiers (an epistatic interaction) is substantial, each modifier locus will be specifically tested in new F2 intercross to confirm their existence. This component will be active in all years of requested Center support. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REDOX SIGNALING BY NITRIC OXIDE IN SKELETAL MUSCLE Principal Investigator & Institution: Stamler, Jonathan S.; Professor; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 01-MAR-1997; Project End 28-FEB-2006 Summary: (Applicant's abstract): The long-term goal of this project is to unravel the complex redox regulation of calcium flux and homeostasis, and thus of excitationcontraction (E-C) coupling, in muscle. Our recent findings have concentrated our focus on the intracellular calcium release channel of the sarcoplasmic reticulum (SR) of skeletal muscle, the type 1 ryanodine receptor (RyR1), and its regulation by nitric oxide (NO). RyR1 is essential for E-C coupling. We have discovered that 6-8 of 101 cysteines in this channel protein comprise an "oxygen sensor": the redox state of these residues is modulated reversibly by O2 tension, almost certainly via a redox enzyme system in the SR. Additionally, we have found that at physiological O2 tension (about 10 mm Hg), nanomolar concentrations of NO activate this channel by S-nitrosylation of a single cysteine thiol, and that this effect is dependent on another endogenous modulator, calmodulin. In other words, O2 tunes the response to NO, which in turn is transduced by calmodulin. The specific aims of this proposal are to: 1a. Characterize the behavior of the RyR1 oxygen sensor and the activation of RyR1 by NO over the physiologically relevant range of tissue oxygen tension. 1b. Identify the reversible oxidative modification of cysteines that comprise the oxygen sensor and localize within RyR1 those residues and the critical cysteine that is dynamically S-nitrosylated. 2 Characterize in vitro the functional consequences of replacing identified RyR1 cysteines by sitedirected-mutagenesis. 3. Characterize the enzyme system in the SR that dynamically controls the redox state of RyR1. 4a. Determine the effects of exogenous and endogenously generated NO on depolarization-induced cytosolic Ca2+ flux in intact skeletal muscle fibers over the physiologically relevant range of PO2. 4b. Re-examine the effects of endogenously produced NO and reactive oxygen species on whole muscle contractility under physiologically relevant O2 tensions. The completion of these aims will provide new insights into the regulation of Ca2+ homeostasis in muscle and may allow a better understanding of disease states such as diaphragmatic dysfunction, malignant hypothermia and heat stroke in which the ryanodine receptor plays a central role. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REDUCTION OF CEREBRAL EDEMA USING VENTRICULAR THERAPIES Principal Investigator & Institution: Fowler, William V.; Director; Twin Star Medical 914 S 8Th St, Mc 860C Roseville, Mn 55415 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 30-JUN-2004 Summary: (provided by applicant): Cerebral edema after traumatic brain injury and severe stroke is a life-threatening condition that is refractory to conventional treatments in a significant population of patients. Current treatments (i.e. hyperventilation, osmotic diuretic(s) or hypothermia) are associated with serious side effects that increase with prolonged use. Intracranial hypertension is caused by elevated tissue water content, primarily due to hyperosmosis of ischemic tissue. Thus, removal of water may be an effective treatment. The research plan details feasibility tests of a novel, safe, and effective method of removing water that can be placed within a standard ventriculostomy catheter. Pilot studies have shown a 50% reduction in water uptake by brain tissue in an ex vivo model. In vitro studies will be completed to optimize catheter material and design. Further ex vivo tissue studies will be completed, as well as studies of human post-traumatic CSF. Tissue water removal in a scale model of the human cerebroventricular system will be tested. The goal is to reduce edema in tissue samples without an increase in CSF osmolarity. Successful development and marketing of this proprietary methodology could significantly reduce morbidity and mortality after human TBI, stroke, and other neurological disorders associated with cerebral edema. In Phase II, further efficacy testing of catheter systems is planned in experimental models of cerebral edema and human studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REGULATION OF APP AND A-BETA IN TBI Principal Investigator & Institution: Dekosky, Steven T.; Professor; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001 Summary: Traumatic brain injury (TBI) and Alzheimer's disease (AD) can exhibit similar clinical and pathological features that suggest common neurodegenerative mechanisms. There is increasing evidence linking AD and TBI, including up-regulation of amyloid precursor protein (APP), and its toxic metabolite Abeta peptide, in head injured patients. The current proposal will determine 1) in controlled cortical impact (CCI) injury produces up-regulation of APP and Abeta protein levels; 2) the roles of the inflammatory cytokine IL1beta, NfkappaB, and caspases in this up- regulation; 3) how manipulations which alter IL1beta response, NfkappaB, or caspase activity affect metabolic processing of APP and the production of Abeta; and 4) the effects of these manipulations on apoptosis and behavioral outcomes. A novel approach will utilize 'humanized Abeta mice' that produce only human rather than rodent Abeta. This will enable use of available and extensively characterized antibodies specific for human APP and Abeta, and allow assessment of the toxicity of human Abeta in the in vivo rodent model. We will measure IL1beta, NfkappaB, caspases, APP mRNA and protein, and APP metabolites at various times after TBI in wild type and mutant mice. Experiments will dissect the mechanisms controlling APP metabolism and Abeta synthesis and toxicity, by examining the effects of IL1beta receptor antagonist, NfkappaB inhibitors, and both treatments together, as well as caspase inhibitors, on APP expression and metabolism after TBI. The humanized Abeta mouse will allow us to assess the toxicity of human Abeta in the animal model, assessing cognitive and motor performance outcome
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and apoptosis. Several techniques will be used, including ELISA, and northern and western blot, in situ hybridization, immunocytochemistry, and immunoprecipitation. We will parallel these studies clinically by examining the levels of APP and Abeta in CSF from human head injured patients, and in brain tissue from human patients whose injury required emergency surgical resections. Since TBI at the University of Pittsburgh is treated with 48 hours of hypothermia, we will also be able to assess hypothermia effects on CSF APP and Abeta, comparing them to normothermic samples previously collected. Preliminary evidence demonstrates that APP and Abeta are increased after TBI. The comprehensive studies proposed will provide valuable information regarding APP as a modulator in the post- injury recovery cascade and may suggest new therapeutic targets for both TBI and AD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SEVERE DIFFUSE TRAUMATIC BRAIN INJURY Principal Investigator & Institution: Adelson, P David.; Neurosurgery; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 12-DEC-1996; Project End 31-MAR-2002 Summary: The candidate's overall objective is to obtain sufficient independence and accomplishment as a clinical and basic science investigator and develop an academic career in pediatric neurosurgery with a research focus on brain injury and neuroplasticity in the immature. The MCSDA will provide the opportunity to devote the majority of time to research to develop a strong foundation in basic science, clinical research and teaching in the area of traumatic brain injury in children in the early stages of career development. This application proposes a basic science project with clearly accomplishable aims important for the understanding of the pathologic response of the immature brain to traumatic injury and combines this project with an active clinical program of head injury in children. This proposal is unique since the study of TBI in immatures has been hampered by the lack of a model producing a diffuse cerebral injury. We modified the recently described, diffuse closed-head injury model of Marmarou et al. (53) and have begun to characterize this model of diffuse TBI in immature (17 d) rats (3,4). In this application, we propose to further characterize this diffuse TBI model in the immature rat using two clinically available outcome parameters, namely function (motor and cognitive) and cerebral blood flow (CBF) and we will then use hypothermia to determine its effect on these parameters after diffuse TBI. The specific aims of the proposal are: l) to characterize the motor and cognitive (spatial memory acquisition and retention) deficits produced in the acute and chronic phases after diffuse TBI (closed head injury weight-drop) in immature (17 d) rats; 2) to describe the acute and chronic changes in CBF (hyperemia vs ischemia) and CO2 vasoresponsivity after this injury; and 3) to determine if moderate hypothermia (32 +/0.5 degrees C) applied in the acute period after diffuse TBI will reduce the functional, CBF, and histologic disturbances acutely and chronically in immature rats. The aims will be accomplished by performing serial assessments of functional outcome (cognition and motor) and determining CBF using iodo[14C] antipyrine (14C-IAP) autoradiography. Perfusion magnetic resonance imaging, (pMRI), a noninvasive serial assessment of regional CBF will be validated to autoradiography and then CO2 vasoresponsivity will be tested using pMRl following hyperventilation. Lastly, we will utilize moderate hypothermia after injury in this experimental model of TBI in the immature rat to determine its effect on function, CBF, and histology. Characterization of the functional, cerebrovascular and histologic disturbances in this unique model of diffuse brain injury should yield the first clues as to the mechanism(s) of diffuse swelling in the immature.
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Also this proposal should facilitate the development and testing of targeted therapies for eventual use after severe TBI in infants and children and provide important preclinical data for the multi-center trial of hypothermia in children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SMOKING AND ETHANOL-INDUCED DEFECTS IN PNEUMONIA DEFENSE Principal Investigator & Institution: Gentry-Nielsen, Martha J.; Medicine; Creighton University 2500 California St Omaha, Ne 68178 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2004 Summary: (provided by applicant): The goal of this application is to use a novel rat model to study the compounding effects of cigarette smoke and alcohol abuse on susceptibility to severe pneumococcal pneumonia. Pneumonia is a major cause of morbidity and mortality in alcoholics, and the pneumococcus is the most common bacterial cause. Alcoholics have a higher incidence of pneumococcal pneumonia and they have a greater likelihood of developing bacteremia, which increases their mortality rate. Although scientists have studied the deleterious effects of ethanol ingestion on resistance to infectious diseases for years, the concurrent effects of smoking have been ignored. Because 80-90% of alcoholics smoke and >50% of multi-pack/day smokers are alcohol dependent, it is imperative to consider the additional effects of smoking when studying alcohol-induced defects in host defense against respiratory infections. Our hypothesis is that smoking exacerbates the detrimental effects of ethanol ingestion on host defense mechanisms critical for protection against lethal pneumococcal pneumonia. To test this hypothesis, rats will be exposed twice daily to cigarette smoke or room air in whole body chambers. Half of the rats also will be fed ethanol in a liquid diet. In Specific Aim 1, the rats will be infected intranasally, and the numbers of pneumococci reaching their lungs will be quantified by plate-counts. Movement of the organisms into the lungs will be correlated with alterations in the ciliary beat frequency of the rats' tracheal epithelial cells. In Specific Aim 2, novel in vitro assays will be used to determine the effects of ethanol ingestion, with and without smoke exposure, on the ability of the rats' pulmonary neutrophils to phagocytose and kill pneumococci. In Specific Aim 3, quantitative blood cultures will be used to determine the separate and combined effects of smoke exposure and ethanol ingestion on bacteremia development after establishment of pneumonia. Bacteremia will be correlated with mortality for 10-days post-infection with the use of a hypothermia model to predict death and determine the appropriate time for euthanasia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SPINAL NEURAL ACTIVITY--ROLE IN POST ISCHEMIC INJURY Principal Investigator & Institution: Marsala, Martin; Anesthesiology; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2001; Project Start 01-SEP-1994; Project End 31-MAR-2003 Summary: (Adapted from the applicant's abstract) This revised renewal proposal is to investigate the mechanisms by which certain interventions protect against the cascade of deleterious events that follow a period of spinal ischemia. There are two specific aims. The first is to define the optimal thermal and temporal characteristics of perischemic cooling. Measures of ischemic consequences or correlative changes with protection include spinal extracellular potassium, dorsal horn neuronal activity, amino acid and PGE2 release, neurological outcome at 2-5 days and spinal histopathology. The second
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aim is to define the factors governing spinal expression of HSP72 and immediate early genes, and the correlation of such expression with post-ischemia functional recovery. hsp72, c-fos and c-jun expression will be measured following transient cooling or heating to two different temperatures, intrathecal delivery of substance P; NMDA, AMPA, or kainic acid; high potassium; or either of two transient non-injurious intervals of spinal ischemia. The protective effects of these manipulations will be measured on damage observed with a fixed injurious duration of ischemia delivered at 3 different intervals after the conditioning treatments which induce hsp72 and/or fos/jun expression; measures of damage include neurologic outcome, spinal amino acid and PGE2 release and histopathology. The role of HSP72 expression in protection will be tested by examining the effects of antisense pretreatment on HSP72 expression and the same three measures of ischemic damage. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRAIN DIFFERENCES IN RESPONSE TO OPIOIDS Principal Investigator & Institution: Wenger, Galen R.; Professor; Pharmacology and Toxicology; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2005 Summary: (provided by applicant): Recent advances in genomics have brought to the forefront the fact that the mouse has been drastically underutilized in the behavioral aspects of drug abuse research. The use of operant schedules of reinforcement has played a significant role in our understanding of drugs of abuse and the addictive process in both humans and laboratory species. However, until recently there have been only a small number of laboratories that have attempted to utilize the mouse in experiments involving operant schedules of reinforcement. Many years of research on the genetics of the mouse has supplied the scientific community with a tremendous number of inbred strains. Many of these strains have well defined genetic differences that result in significant differences in drug effects. For example, it has been shown that marked differences exist between C57Bl/6 and DBA/2 mice in response to many effects of morphine including analgesia, locomotor activity, hypothermia, Straub-tail, and voluntary oral morphine consumption. Similarly, although tolerance to the analgesic and locomotor response to morphine has been observed to be about equal in C57Bl/6 and DBA/2 mice, tolerance to the analgesic effects of morphine has been reported not to occur following chronic administration in 129 mice. Whether strain differences exist in the stimulus or reinforcing properties as measured by drug discrimination or IV selfadministration procedures in response to opioid drugs in these strains is not known. Knowledge of such differences may provide significant insight into the role of genetic differences in opioid addiction and the mechanisms of drug action. The present study will use three inbred strains of mice (C57Bl/6J, DBA/2J and 129P3/J). The study will examine the ability of receptor subtype specific opioid agonists to function as discriminative stimuli, the degree to which the drug stimulus generalizes to agonists specific for other receptor subtypes, and the ability of antagonists to block the stimulus properties. Hopefully, by utilizing these well-defined strains, it will be possible to use the known differences in genetics to provide new insight into the abuse of opioids. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STRESS RESPONSES IN MAMMALIAN CELLS Principal Investigator & Institution: Lee, Yong J.; Pharmacology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260
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Timing: Fiscal Year 2001; Project Start 01-JUL-1988; Project End 30-APR-2003 Summary: Angiogenesis is vital for tumor growth and is widely believed to be a factor in tumor metastasis. Recent work by Folkman and his colleagues has demonstrated that inhibition of angiogenesis can keep dormant micro-metastases from growing. Most work on angiogenesis in tumors has focused on how to preven tumor growth and metastasis and not at what mechanisms, both cellular and environmental, are involved in the process. Stress caused by alteration of the micro- or macroenvironment of a cell (e.g. radiation, high temperature, hypoxia, and starvation) has been known to trigger the highly complex cellular stress management system for many years. Recent evidence from our laboratories has also shown that, in addition to the well-known stress proteins, environmental stress can induce the synthesis of growth factor such as basic fibroblast growth factor (bFGF). The observation of the induction of these angiogenic proteins under these circumstances could have significant implications on the process of tumorigenesis. Once the tumor initiation has occurred, the solid tumor cells must promote the formation of new blood vessel to provide nutrients and oxygen; otherwise, they can not grow beyond a very small size. Thus, preventing the formation of new vessels has been a promising new approach to treat cancer patients. In order to inhibit the growth of new vessels, we need to understand the mechanisms of tumor vascularization. It is known that the growth of new vessels is stimulated by angiogenic factors. We proposed that angiogenic factors, i.e., bFGF can be induced by environmental stresses such as heat shock, radiation, hypoglycemia, and hypoxia. Environmental stresses activate special transcription factors, which are referred to as activating protein-1 (AP-1). The AP-1 factors are composed of dimeric complexes formed between three Jun family members (C-Jun, Jun B, Jun D and four Fos family members (c-Fos, Fos B, Fra-1, and Fra-2). The activated AP-1 factors bind the regulatory region of BFGF gene, which then triggers the gene expression. Moreover, AP-1 factors cooperate with other regulatory factor such as Ets-1 protein for the regulation of bFGF gene expression. We believe that investigating the involvement of AP-1 factors in bFGF gene regulation wil provide insight into understanding the mechanism of stress-induced tumor growt and metastasis at the molecular level as well as enable us to improve the efficacy of clinical therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRUCTURE/FUNCTION RELATIONSHIP OF THE AV NODE Principal Investigator & Institution: Efimov, Igor R.; Associate Professor; Biomedical Engineering; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 28-FEB-2003 Summary: Despite significant recent advances in the treatment of supraventricular arrhythmias, the mechanisms governing conduction through the atrioventricular node (AV) remain poorly understood. These difficulties reflect the profound complexity of the 3D structure of functionally diverse cellular structures that comprise the relatively small AV node. Hypotheses: Functional properties of the AV node are determined by two levels of structural 3D organization of the node: vertical and horizontal. Vertically the node has three major layers: a superficial endocardial layer of Na-dependent transitional AN-cells, a middle Ca- dependent compact node (N-cells) in the shape of a flattened football, and a deep layer (bundle) of NH-type Na-dependent cells. Horizontally the node can be divided into the proximal and distal nodes (PN and DN). PN is anterogradely driven by the driving force from wide atrial approaches. Conduction through the PN is preferentially longitudinal and decremental in amplitude, because of weak side-to-side connections. DN is wrapped in unevenly thin collar of connective
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tissue protruding from the central fibrous body. DN may be driven transversely by the endocardial transitional cells or longitudinally by the proximal midlayer. Due to an electrotonic barrier imposed by the connective tissue, weak side-to- side connections, and post-repolarization refractoriness in DN, the transverse excitation has a lower safety factor. Nevertheless this pathway is preferential at long coupling intervals due to the short conduction path. Functional differences between these two sources of excitation constitute the dual pathway electrophysiology, namely the difference between the slow and fast pathways (SPW and FPW). Methods: Structure-function relationship of the AV node will be revealed by state-of-the-art high temporal and spatial resolution 3D fluorescent imaging with voltage-sensitive dyes combined with micro- and macro electrode recordings. Conduction through the AV node will be modulated spatially (reversible ablation of SPW or FPW by perinodal cooling to 15 C) and temporarily (anterograde and retrograde premature stimulation protocol). Electrophysiological and morphological studies will be summarized in a mathematical model of the AV node. Importance: Knowledge of the structure-function relationship of the AV node will assist the clinical evaluation of AV nodal functional properties. The new concept of the dual pathway electrophysiology will guide electrophysiological procedures of AV nodal modification. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRUCTURE/FUNCTION STUDIES OF FATTY ACID AMIDE HYDROLASE Principal Investigator & Institution: Cravatt, Benjamin F.; Associate Professor; Scripps Research Institute Tpc7 La Jolla, Ca 92037 Timing: Fiscal Year 2001; Project Start 01-FEB-2001; Project End 31-DEC-2004 Summary: The objective of this proposal is to understand the catalytic, structural, and cell biological features of fatty acid amide hydrolase (FAAH), a mammalian membranebound enzyme responsible for the catabolism of the fatty acid amide family of endogenous signaling lipids. Representative fatty acid amides degraded by FAAH include the endocannabinoid anandamide and the sleep-inducing lipid oleamide. Fatty acid amides have been shown to induce a remarkable array of pharmacological effects in mammals, including sleep, analgesia, hypothermia, and learning and memory defects. The impressive bioactivity of fatty acid amides suggests that FAAH might serve as an attractive target for therapeutic efforts aimed at influencing pain, sleep, and memory systems. The elucidation of FAAH's catalytic, structural, and cellular features would provide a foundation for the design of FAAH-specific chemical inhibitors to be employed as agents for both the study of fatty acid amide-based physiological processes and the potential pharmaceutical treatment of pathologies associated with these systems. In this application, the molecular and cellular properties of FAAH will be examined using a multidisciplinary approach, employing biochemistry, molecular biology, immunochemistry, and synthetic chemistry techniques towards the goals of determining: 1) the catalytic mechanism and origins of substrate selectivity for FAAHmediated amide hydrolysis, 2) the x-ray crystal structure of a FAAH-oleyl phosphonate inhibitor complex, 3) the domains of FAAH responsible for self-association and membrane binding, and 4) the cellular and subcellular localization of FAAH in mammalian tissue. These proposed studies should provide molecular tools for the chemical and genetic regulation of FAAH in vivo, allowing for a direct evaluation of the potential costs and benefits of therapeutic strategies that target the endocannabinioid system for the treatment of pain, sleep, and/or mood disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE NEONATAL HEART AND CARDIOPULMONARY BYPASS Principal Investigator & Institution: Anderson, Page a W.; Professor; Pediatrics; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 30-JUN-2004 Summary: (Adapted from Applicant's Abstract):The aims of this proposal are to determine the role of complement activation, which occurs during cardiopulmonary bypass, on heart and lung function after bypass. The PI has utilized a neonatal piglet model with cardiopulmonary bypass and hypothermia to demonstrate that there is significant activation of various complement pathways resulting in direct injury to myocardium and lungs. They will first determine the effects of blocking the various pathways of complement activation on recovery of heart and lung function after bypass, and in the second part of these studies they will perform similar mechanistic analysis using a neonatal cardiac myocyte model. In subsequent studies they will determine the role of complement activation on cardiac myofilament structure and function and the effects of activation of proteolytic activity on the contractile proteins. In the final phase they will utilize a reconstitution strategy to replace defective troponin proteins to determine if they can restore cardiac function by this approach. Ultimately, the goal would be to induce expression of these proteins to improve cardiac recovery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THERMAL WITHDRAWAL
AND
METABOLIC
DYSFUNCTION
DURING
Principal Investigator & Institution: Crawshaw, Larry I.; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 20-DEC-1995; Project End 31-DEC-2005 Summary: Component 7 represents the continuation of 2/3 of Component #3 from the current PARC. (Dr. Gallaher's mapping project for ataxia-related QTLs is not being continued in the PARC). EtOH acutely disrupts thermoregulation, and tolerance develops with chronic administration. A different pattern of changes accompanies withdrawal from chronic EtOH dependence, and these changes appear to reflect significant dysregulation of metabolism (specifically, a state of basal hypermetabolism), and decreased overall metabolic scope). In turn, the sequelae of a hypermetabolic state have radiating adverse consequences for a wide range of behavioral responses. EtOH thermal tolerance and withdrawal severity have been found to be negatively genetically correlated, suggesting that some genes affect both traits (Crabbe et al., 1983, Crabbe & Kosobud, 1986). The goal of this component is to explore the genetic determinants of the neuroadaptations that follow the development of ethanol tolerance and withdrawal. Two phenotypes will be addressed. Tolerance to the hypothermic effect of a third daily ip injection of EtOH in a room temperature environment has been analyzed in BXD RI strains and a B6D2F2 population, and marker gene frequencies will be monitor to detect the presence of nearby QTLs. Second, to elucidate the metabolic consequences of chronic ethanol administration, BXD RI strains will be rendered physically dependent on EtOH via vapor inhalation for 72 hr administration, BXD RI strains will be rendered physically dependent on EtOH via vapor inhalation for 72 hr and withdrawn. During withdrawal, disruptions in thermoregulatory and metabolic state in the BXD RIs will be assessed by analysis of core temperature and respiratory gases. Their ability to thermoregulate accurately will be assessed by manipulating ambient temperatures during withdrawal. Provisional QTLs from the BXD RI analysis of these data will be followed up by similar studies in a B6D2F2 population.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THYROID REGULATION IN THE DEVELOPING HEART Principal Investigator & Institution: Portman, Michael A.; Professor; Pediatrics; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 30-SEP-1998; Project End 31-MAR-2007 Summary: (provided by applicant): Thyroid hormone (TH) deficiency occurs in adults and children after cardiopulmonary bypass (CPB), and can be responsible for acute and persistent decreases in myocardial performance during the critical postoperative period. Post-CPB thyroid hormone deficiency may contribute to diminished myocardial viability associated with low cardiac output syndrome. Experimental/clinical data indicate that triiodothyronine (T3) supplementation effects adult heart performance after CPB. Pilot clinical data suggest that children respond similarly to T3, but T3's operative mechanisms require elucidation. Recent studies indicate that postischemic or reperfusion-related alterations in myocardial oxidative phosphorylation and substrate utilization reduce efficiency of ATP production and use. Postischemic cardiac function can be improved through manipulation of substrate utilization pathways. Our data indicate that T3 modulates regulation of oxidative phosphorylation and substrate utilization in intact heart. Postischemic cardiac dysfunction in vivo, linked to inefficient O2 utilization, may be exacerbated by relative T3 deficiency. The PI has developed strategies to examine regulation of myocardial respiration and substrate utilization in the intact animal. The proposed research will address this regulation at near maximal energy expenditure rates (induced by inotropic stimulation) in juvenile porcine hearts exposed to conditions of hypothermia, ischemia, and reperfusion. The degree and duration of hypothermia will emulate clinical conditions during CPB in children. The PI will perform 31Phosphorous magnetic resonance spectroscopy and 13Carbon isotopomer analyses. The specific aims are: 1a. Determine if conditions of hypothermic CPB and circulatory arrest decrease efficiency of energy use, reduce phosphorylation potential, and alter regulation of myocardial respiration in vivo. b. Determine if changes in substrate delivery ameliorate these bioenergetic alterations. c. Determine if thyroid hormone deficiency caused by CPB exacerbates the defined bioenergetic abnormalities, and T3 repletion improves the efficiency of energy utilization. 2.a. Determine if the acetyI-CoA delivery to the tricarboxylic acid cycle through the pyruvate dehydrogenase and acyI-CoA synthase pathways is altered in vivo after cardiopulmonary bypass and circulatory arrest. b. Determine if TH deficiency caused by CPB alters substrate utilization and triiodothyronine repletion reverses such alterations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TRANSGENIC MOUSE MODELS TO STUDY THE ROLE OF NEUROTENSIN RECEPTOR Principal Investigator & Institution: Harris, Robert A.; Professor of Pharmacology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2002 Summary: The goal of this pilot project is to understand the role of the neurotensin receptor (NTR) gene in alcohol sensitivity. It has become increasingly clear that individual differences in alcohol sensitivity are genetically determined, and may translate into components of a genetic predisposition for alcoholism. Several lines of evidence suggest polygenic control of the behavioral and pharmacologic responses to
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ethanol. Specific candidate genes have been identified for the increased or decreased sensitivity to alcohol. Among these genes is the NTR, known to modulate central dopaminergic function. Pharmacological effects of neurotensin include hypothermia, altered locomotor activity, analgesia, muscle relaxation and neuroendocrine effects. It has been shown that neurotensin potentiates ethanol-induced sleep time and hypothermia implicating the NTR as a mediator in some of the actions of ethanol. Endogenous NTR levels are higher in various areas of the brain of LS than SS mice. Moreover recent studies show a significant positive correlation between NTR density and hypnotic sensitivity to ethanol using LSXSS RI strains. Consistently, HAS rats have higher NTR densities compared to the LAS further indicating the positive genetic correlation between the hypnotic sensitivity to ethanol and the NTR densities. NTR cDNAs have been cloned and sequenced in rat and human. We are in the process of sequencing the mouse NTR cDNA. Here we propose to test the hypothesis that NTR gene plays a critical role in the sensitivity to alcohol, by using an LSXSS RI (with low levels of NTR) transgenic mouse line having overexpression of the NTR. LAS further indicating the positive genetic correlation between the hypnotic sensitivity to ethanol and the NTR densities. NTR cDNAs have been cloned and sequenced in rat and human. We are in the process of sequencing the mouse NTR cDNA. For the 2-year period of this grant application, we therefore propose to: 1. Complete the sequence of the mouse NTR cDNA. 2. Use the mouse NTR cDNA to develop a NTR(u/u) (ultra-expression) transgenic mouse line. 3. Use the RI LSXSS and the NTR(u/u) mouse lines to investigate the role of NTR in ethanol sensitivity by means of initial sensitivity, hypnotic sensitivity and locomotor activity. These studies will greatly enhance our understanding about the role of NTR as a genetic factor associated with alcohol sensitivity. Because of high conservation between human and mouse genome studies with these intact mice should help to elucidate the mechanisms surrounding genetic differences in alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRANSMITTER REPLETION: KEY TO PHRENIC-DIAPHRAGM FUNCTION Principal Investigator & Institution: Van Lunteren, Erik; None; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 08-JUL-2002; Project End 31-MAY-2006 Summary: (provided by applicant): Failure of phrenic nerve-diaphragm neuromuscular transmission leads to hypercapnic respiratory failure. This occurs not only in overtly diseased neuromuscular junctions (eg. myasthenia gravis, botulism), but also in normal junctions subjected to high intensity activation during mechanical loading by lung disease (eg. COPD) or during exposure to systemic factors such as hypoxia and hypothermia. Neurotransmission requires sufficient prejunctional release of acetylcholine (ACh) to ensure muscle contraction. During repetitive activation, ACh release diminishes, which when severe leads to transmission failure. Restoration of ACh available for release depends on two separate but interrelated processes: recycling of transmitter from the synaptic cleft, and repletion of the immediately releaseable vesicle pool from one or more reserve pools. Respiratory muscles are active continuously, so that transmitter replenishment needs to be sufficiently robust to ensure that a constant supply of ACh is available for release. The overall objective of this proposal is to further examine the role of transmitter replenishment, and the factors which regulate replenishment, in determining the integrity of transmission in respiratory neuromuscular junctions. The specific hypotheses to be tested are as follows. 1) The rapidity of, and time available for, ACh replenishment are critical determinants of
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transmission at the phrenic-diaphragm neuromuscular junction, especially in diseased neuromuscular junctions. 2) ACh replenishment is hastened by high frequency stimulation, an accommodation to the adverse effects of high frequency activation on release and depletion. Furthermore, the acceleration of replenishment is mediated by elevated presynaptic [Ca+ +]. 3) Hypoxia and hypothermia impair neurotransmission to a large extent by slowing transmitter replenishment, rather than primarily by a direct inhibition of transmitter release. 4) Presynaptic K+ channels regulate not only Ach release but also transmitter replenishment, providing two mechanisms of improving neurotransmission by pharmacologic manipulation of K- channel conductances. Neuromuscular transmission will be assessed using a combination of force measurements to quantify the neuromuscular component of fatigue, electrophysiological recording to determine ACh release and recovery from transmitter rundown, and optical approaches using fluorescent styry1 dyes ( FM1-43, FM2-10) to assess vesicle pool dynamics. These studies may lead to novel therapeutic approaches to respiratory muscle impairment and resulting hypercapnic respiratory failure for conditions which produce neuromuscular junction dysfunction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT OF ACUTE STROKE ETHANOL AND CAFFEINE Principal Investigator & Institution: Grotta, James C.; Professor; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2007 Summary: (provided by the applicant): Neuroprotection refers to the concept of administering a drug that ameliorates at the cellular level those biochemical perturbations leading to brain damage after an acute stroke. Many neuroprotective drugs have been shown to reduce damage in animal models of stroke. For instance, drugs that block glutamate receptors or downstream effects of glutamatergic activity reduce infarct volume by about 50% in rats. However, Clinical trials of these same drugs have failed to demonstrate efficacy. There are probably many reasons for these failures, but in summary, we have failed to design our clinical studies to match the circumstances under which these drugs are effective in the laboratory. For instance: 1. We have started drugs 6-24 hours after stroke onset in humans when they have only been effective in the lab if started within 2-3 hours. 2. We have standardized stroke severity and location in the lab, but have not done so when selecting patients for Clinical trials. 3. We have not routinely coupled neuroprotective therapy to attempts at reperfusion (i.e. giving them along with thrombolytic drugs), even though they are most effective in laboratory models of temporary arterial occlusion. 4. Because of side effects that limit doses we are able to give medically unstable stroke patients, we have not been able to achieve blood levels that are effective in animal models. Another important reason for our clinical failures may be that the drugs we have tested have not been sufficiently potent at protecting cells and reversing the biological abnormalities that occur after stroke. Stronger drugs or combinations of drugs affecting multiple pathways may be needed. This is a proposal for a pilot study that will address all these deficiencies. In work carried out in our laboratory over the past 2 years, we have found that the combination of various doses of ethanol and caffeine can reduce infarct volume by up to 80% after reversible middle cerebral artery occlusion, while the same doses given alone of ethanol are harmful and of caffeine are only slightly protective. This combination is effective if started up to 3 hours after the onset of stroke, and produces blood levels which are within the range that are very well tolerated in humans (i.e. below the legal intoxicating blood alcohol level and roughly 3 cups of coffee). Finally, this treatment is even more
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effective if coupled with mild hypothermia (body temperature reduced to 35 C). See Preliminary Results and Appendix #7 for details. A number of questions remain. The mechanism(s) of action of this combination are unclear. Caffeine blocks adenosine receptors that may lead to changes in glutamate release. Ethanol may affect glutamate and GABA, and also enhances the cellular uptake of a number of substances. These mechanisms need to be explored in future laboratory studies, which have been recently funded in a NIH RO-1, grant to Dr. Aronowski. The combination is less effective in animals that had been previously exposed to ethanol, suggesting a tolerance effect. This may limit its use or require higher doses in a population where alcohol is widely consumed. Finally, the optimal dose of this combination remains to be established in human stroke patients. There are no known reports of the use of the combination of ethanol and caffeine in human stroke patients. One lesson from previous neuroprotective trials is that we should try to achieve doses in humans resulting in blood levels at the high range of efficacy in animals. This may be particularly true in the case of ethanol/caffeine because of previous exposure of our patients to ethanol. In laboratory studies, 5-10% ethanol and 10-mg./kg. caffeine given intravenously in combination over 1 hour are most effective; higher doses provide no additional benefit in naive animals. It is unclear if these doses will be tolerated or effective in human stroke patients. However, the doses to be used in this study are well within the usually consumed amounts of these compounds. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: UNIVERSITY OF PITTSBURGH BRAIN TRAUMA RESEARCH CENTER Principal Investigator & Institution: Dixon, C Edward.; Associate Professor; Neurological Surgery; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 30-SEP-1991; Project End 28-FEB-2005 Summary: The University of Pittsburgh Brain Trauma Research has been investigating the molecular and cellular mechanisms of secondary brain injury (physiologic and neurochemical responses of the injured), and the effects of therapeutic moderate hypothermia since its inception in 1991. Our investigations have identified a subgroup of traumatic brain injured (TBI) patients who appear to benefit from therapeutic moderate hypothermia, and have defined several mechanisms though which this effect is realized. We have begun to characterize the roles of posttraumatic oxidative stress, cytokines, nerve growth factor, inducible nitric oxide synthase, and the bcl-2 family of proteins in secondary brain injury. We also have defined the significance of neutrophil accumulation following experimental TBI. Completion of these studies has lead to an improved understanding of specific molecular mechanisms likely to be responsible for early and delayed neurologic dysfunction following TBI. The investigations of our Center have resulted in more than 100 peer- reviewed journal articles or book chapters during the last four years. It has become to us that laboratory investigations of molecular mechanisms of secondary injury must be coordinated with clinical studies so that we can define the clinical relevance of these molecular mechanisms to functional outcome following human TBI. In this proposal we intend to continue with our investigations of basic molecular mechanisms responsible for secondary injury. These areas of investigations have arisen as logical extension of our previous findings, and include the study of delayed oxidative stress and programmed cell death; the relationship of amyloid precursor protein with interleukin 1 beta and the early development of Alzheimer's disease; the role of inducible systems in causing chronic
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functional and cognitive deficits; and the role of poly(ADP-ribose) polymerase as a mediator of oxidative DNA damage and apoptosis. Special emphases has been placed on the systematic acquisition of human cerebral spinal fluid, dialysate samples of extracellular fluid, and brain tissue for use in our primary investigations. Because of this we will be able to correlate the findings our primary investigations with human TBI and determine their relative importance in effecting neurologic outcome. In this way, the completion of our specific aims can be expected to define critical molecular mechanisms of secondary brain injury and identify treatments most likely to be beneficial to TBI patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: YOUTH, TECHNOLOGY, AND THE PROLIFERATION OF DRUG USE Principal Investigator & Institution: Murguia, Edward E.; Associate Professor; Sociology; Texas A&M University System College Station, Tx 778433578 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2003 Summary: (provided by the applicant): Several drugs, popularly used by adolescents at dance parties, raves, and clubs, have been shown to be a serious health concern to medical researchers. MDMA (ecstasy), Lysergic Acid Diethylamide (LSD), Rohypnol, Methamphetamine, Ketamine, and Gammahydroxybutyrate (GBH) are substances generally labeled "club drugs." Such drugs, while not necessarily new, have gained recent popularity though use at raves. The impact of these drugs on the health of youth has been researched in recent decades. While results are mixed, studies do suggest that ecstasy in particular may be associated with convulsions, cardiac and pulmonary problems, hypothermia, and in rare instances, death. However, ecstasy and other club drugs are most dangerous when used in combination. According to a recent SAMHSA Dawn Report, most medical emergency incidents involving club drugs also involved the use of alcohol, marijuana, cocaine, and other club drugs. Additional work also suggests that the use of polydrugs is common in the rave/club scene. This study proposes to explore the relationship between the Internet and the transmission of information among youth about "club drugs." The Internet has figured prominently in the "rave scene" since the early years of the movement. The Internet has been a primary site of communication about rave parties, DJs, and artists. Moreover, it provides space for youth to connect with others involved in the rave scene through chat rooms and email subscription lists. While raves, house and bush parties change locale often, the setting of web-based interaction remains static and constant. The role of Internet interaction in the use of club drugs has been unexplored. The current research proposes an Internet-based qualitative study of youth involved in Internet chat rooms and discussion boards. The goal of the research is to solicit new and pertinent information related to the context and setting of club drug use (e.g., when, where, and with whom are drugs primarily used; under what circumstances are some drugs chosen over others; etc.). Moreover, it will explore the role of the Internet in transferring and mediating information regarding drug use across settings (e.g., is the Internet a source of new information about drugs among users, how is Internet use related to the local club scene; do drug use trends disseminate through a "virtual community" or through local, geographically tied networks, how can the Internet be used a prevention and education tool among "club drug" users; etc.). For these reasons, the methodology for this project will involve the extension and adaptation of traditional ethnographic methods to the practice of cyberethnography. The project team will combine, as well as adapt field methods for what will at first be a largely unseen group of subjects. We will engage in a two-pronged
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approach to capture both the online and off-line (so-called 'real life') interactions and networks of the subjects. Primarily, field notes will be generated by monitoring online sites and participant observation in site-communications and other Internet-based communications with members of these communities (e.g. email and America Online Instant Messaging). In addition, we will construct an online survey administered to interested members. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “hypothermia” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for hypothermia in the PubMed Central database: •
Delayed minocycline but not delayed mild hypothermia protects against embolic stroke. by Wang CX, Yang T, Noor R, Shuaib A.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=107740
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Experience with prolonged induced hypothermia in severe head injury. by Bernard SA, MacC Jones B, Buist M.; 1999; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=29033
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Experience with prolonged induced hypothermia in severe head injury. by Marion DW.; 1999; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=137243
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Out of the cold: management of hypothermia and frostbite. by Biem J, Koehncke N, Classen D, Dosman J.; 2003 Feb 4; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=140473
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Use of Selective Hypothermia to Protect the Spinal Cord during Resection of Thoracoabdominal Aneurysms. by Cooley DA, Jones BA.; 2000; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=101014
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Water warming garment versus forced air warming system in prevention of intraoperative hypothermia during liver transplantation: a randomized controlled trial [ISRCTN32154832]. by Janicki PK, Stoica C, Chapman WC, Wright JK, Walker G, Pai R, Walia A, Pretorius M, Pinson CW.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=137608
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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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 hypothermia, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “hypothermia” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for hypothermia (hyperlinks lead to article summaries): •
A case of hypothermia combined with systemic lupus erythematosus. Author(s): Yang MH, Park W, Bae SK, Kim SS, Lee YH, Lee KW, Song JS. Source: Korean J Intern Med. 2001 March; 16(1): 44-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11417305&dopt=Abstract
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A case of recurrent and fatal hypothermia in a man with diabetic neuropathy. Author(s): Applebaum GD, Kim B. Source: Diabetes Care. 2002 November; 25(11): 2108-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401770&dopt=Abstract
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A case report of hypothermia in the wilderness. Author(s): Irwin BR. Source: Wilderness Environ Med. 2002 Summer; 13(2): 125-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12092964&dopt=Abstract
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A multicenter prospective randomized controlled trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. Mild Hypothermia Study Group in Japan. Author(s): Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Hashiguchi N, Fujimi S, Nakamori Y, Tanaka H, Shimazu T, Sugimoto H. Source: Journal of Neurosurgery. 2001 January; 94(1): 50-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11147897&dopt=Abstract
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 neonatal hypothermia indicator. Author(s): Morley D, Blumenthal I. Source: Lancet. 2000 February 19; 355(9204): 659-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10697014&dopt=Abstract
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A reusable, custom-made warming blanket prevents core hypothermia during major neonatal surgery. Author(s): Kongsayreepong S, Gunnaleka P, Suraseranivongse S, Pirayavaraporn S, Chowvanayotin S, Montapaneewat T, Manon C. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 JuneJuly; 49(6): 605-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067874&dopt=Abstract
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AANA journal course. Update for nurse anesthetists. A common sense approach to hypothermia. Author(s): Welch TC. Source: Aana Journal. 2002 June; 70(3): 227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12078471&dopt=Abstract
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Accidental deep hypothermia: a rewarming challenge. Author(s): Walpoth B. Source: Wiener Klinische Wochenschrift. 2002 May 15; 114(8-9): 287-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12212361&dopt=Abstract
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Accidental fatal hypothermia in elderly people with Alzheimer's disease. Author(s): Kibayashi K, Shojo H. Source: Med Sci Law. 2003 April; 43(2): 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741656&dopt=Abstract
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Accidental hypothermia and active rewarming: the metabolic and inflammatory changes observed above and below 32 degrees C. Author(s): McInerney JJ, Breakell A, Madira W, Davies TG, Evans PA. Source: Emergency Medicine Journal : Emj. 2002 May; 19(3): 219-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11971831&dopt=Abstract
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Accidental hypothermia in the elderly. Author(s): Ranhoff AH. Source: Int J Circumpolar Health. 2000 October; 59(3-4): 255-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11209677&dopt=Abstract
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Accidental hypothermia in the subtropics. Author(s): Sim MM, Kuo YC. Source: The American Journal of Emergency Medicine. 2000 May; 18(3): 357-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830710&dopt=Abstract
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Accidental hypothermia. An Alaskan problem. Author(s): Gregory RT. Source: Alaska Med. 2001 July-September; 43(3): 73-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11710085&dopt=Abstract
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Active hypothermia in the management of head injuries. Author(s): Martin D, Smith M. Source: Hosp Med. 2003 January; 64(1): 61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12572342&dopt=Abstract
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Acute ischemic stroke: is there a role for hypothermia? Author(s): Hammer MD, Krieger DW. Source: Cleve Clin J Med. 2002 October; 69(10): 770, 773-4, 776-7 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12371800&dopt=Abstract
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Acute respiratory distress syndrome associated with accidental hypothermia. Author(s): Taniguchi T, Okeie K, Mizukoshi Y, Shibata K. Source: Intensive Care Medicine. 2001 April; 27(4): 793-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11398713&dopt=Abstract
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Advanced challenges in resuscitation: special challenges in EEC-hypothermia. Author(s): Durrer B, Brugger H, Syme D. Source: Resuscitation. 2001 August; 50(2): 243-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11724022&dopt=Abstract
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Amrinone can accelerate the cooling rate of core temperature during deliberate mild hypothermia for neurosurgical procedures. Author(s): Inoue S, Kawaguchi M, Sakamoto T, Iwata T, Kawaraguchi Y, Furuya H, Sakaki T. Source: British Journal of Anaesthesia. 2001 May; 86(5): 663-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11575342&dopt=Abstract
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Antegrade cerebral perfusion by axillary artery and left carotid artery inflow at moderate hypothermia. Author(s): Mazzola A, Gregorini R, Villani C, Di Eusanio M. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2002 May; 21(5): 930-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12062294&dopt=Abstract
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Aortic arch and proximal supraaortic arterial repair under continuous antegrade cerebral perfusion and moderate hypothermia. Author(s): Jacobs MJ, de Mol BA, Veldman DJ. Source: Cardiovascular Surgery (London, England). 2001 August; 9(4): 396-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11420166&dopt=Abstract
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Aortic arch surgery using moderate systemic hypothermia and antegrade cerebral perfusion via the right subclavian artery. Author(s): Aebert H, Reber D, Kobuch R, Philipp A, Birnbaum DE. Source: The Thoracic and Cardiovascular Surgeon. 2001 October; 49(5): 283-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11605138&dopt=Abstract
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Application of hypothermia to autologous stem cell purging. Author(s): Miyagi K, Yamazaki T, Tsujino I, Takahashi N, Koya Y, Masutani M, Sawada U, Horie T. Source: Cryobiology. 2001 May; 42(3): 190-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11578118&dopt=Abstract
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Assessment of prognostic factors in severe traumatic brain injury patients treated by mild therapeutic cerebral hypothermia therapy. Author(s): Yamamoto T, Mori K, Maeda M. Source: Neurological Research. 2002 December; 24(8): 789-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500702&dopt=Abstract
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Association between postoperative hypothermia and adverse outcome after coronary artery bypass surgery. Author(s): Insler SR, O'Connor MS, Leventhal MJ, Nelson DR, Starr NJ. Source: The Annals of Thoracic Surgery. 2000 July; 70(1): 175-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10921704&dopt=Abstract
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Atropine prevents midazolam-induced core hypothermia in elderly patients. Author(s): Matsukawa T, Ozaki M, Nishiyama T, Imamura M, Iwamoto R, Iijima T, Kumazawa T. Source: Journal of Clinical Anesthesia. 2001 November; 13(7): 504-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11704448&dopt=Abstract
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Hypothermia
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Attenuation of hypothermia-induced platelet activation and platelet adhesion to artificial surfaces in vitro by modification of hemoglobin to carry S-nitric oxide and polyethylene glycol. Author(s): Fujii H, Fujii S, Togashi H, Yoshioka M, Nakai K, Satoh H, Sakuma I, Kenmotsu O, Kitabatake A. Source: Thrombosis Research. 2000 December 15; 100(6): 519-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152932&dopt=Abstract
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Attenuation of sleep propensity, core hypothermia, and peripheral heat loss after temazepam tolerance. Author(s): Gilbert SS, Burgess HJ, Kennaway DJ, Dawson D. Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2000 December; 279(6): R1980-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11080060&dopt=Abstract
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Atypical antipsychotic induced mild hypothermia. Author(s): Brevik A, Farver D. Source: S D J Med. 2003 February; 56(2): 67-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621956&dopt=Abstract
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Autologous plasma and platelet sequestration at the beginning of cardiopulmonary bypass: a pilot investigation in five patients undergoing extended vascular surgery in deep hypothermia. Author(s): Koster A, Sanger S, Knorig FJ, Kuppe H, Hetzer R, Loebe M. Source: Asaio Journal (American Society for Artificial Internal Organs : 1992). 2002 January-February; 48(1): 106-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11814086&dopt=Abstract
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Avoiding hypothermia in trauma: use of the flameless heater pack, meal ready to eat, as a field-expedient means of warming crystalloid fluid. Author(s): Garcia GD, Modesto VL, Lee KT. Source: Military Medicine. 2000 December; 165(12): 903-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11149058&dopt=Abstract
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Back to basics: monitoring trauma patients for hypothermia induced by treatment in the emergency department. Author(s): Clemence B. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2001 December; 27(6): 610-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11712021&dopt=Abstract
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Baroreflex modulation of peripheral vasoconstriction during progressive hypothermia in anesthetized humans. Author(s): Nakajima Y, Mizobe T, Takamata A, Tanaka Y. Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2000 October; 279(4): R1430-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11004013&dopt=Abstract
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Basal forebrain malformation with hyperhidrosis and hypothermia: variant of Shapiro's syndrome. Author(s): Wright AT. Source: Neurology. 2002 February 12; 58(3): 508-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11839874&dopt=Abstract
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Basal forebrain malformation with hyperhidrosis and hypothermia: variant of Shapiro's syndrome. Author(s): Klein CJ, Silber MH, Halliwill JR, Schreiner SA, Suarez GA, Low PA. Source: Neurology. 2001 January 23; 56(2): 254-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11160966&dopt=Abstract
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Benefits of endovascular hypothermia on myocardial preservation in the setting of cardiogenic shock. Author(s): Rizik DG, Villegas BJ, Bouhasin A. Source: J Invasive Cardiol. 2003 September; 15(9): 525-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12947214&dopt=Abstract
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Bilateral diaphragmatic paralysis after aortic surgery with topical hypothermia: Ventilatory assistance by means of nasal mask bilevel positive pressure. Author(s): Tokuda Y, Matsumoto M, Sugita T, Nishizawa J, Matsuyama K, Yoshida K, Matsuo T. Source: The Journal of Thoracic and Cardiovascular Surgery. 2003 May; 125(5): 1158-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771892&dopt=Abstract
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Bilobed splitting of median nerve somatosensory evoked p14 potential under deep hypothermia. Author(s): Wagner W. Source: Journal of Clinical Monitoring and Computing. 2002 April-May; 17(3-4): 221-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455740&dopt=Abstract
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Bispectral analysis during cardiopulmonary bypass: the effect of hypothermia on the hypnotic state. Author(s): Mathew JP, Weatherwax KJ, East CJ, White WD, Reves JG. Source: Journal of Clinical Anesthesia. 2001 June; 13(4): 301-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11435056&dopt=Abstract
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Hypothermia
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Blood pressure and plasma catecholamines in acute and prolonged hypoxia: effects of local hypothermia. Author(s): Kanstrup IL, Poulsen TD, Hansen JM, Andersen LJ, Bestle MH, Christensen NJ, Olsen NV. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1999 December; 87(6): 2053-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10601149&dopt=Abstract
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Brain hypothermia relieves severe brain swelling following acute major cerebral artery occlusion. Author(s): Kurokawa Y, Kano H, Yonemasu Y, Sasaki T, Inaba K, Uede T. Source: Neurol Med Chir (Tokyo). 2001 February; 41(2): 53-61; Discussion 61-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255629&dopt=Abstract
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Cardiac surgery under perfusionless hypothermia: Siberian experience. Author(s): Karaskov AM, Kitchlu CS, Lomivorotov VN. Source: Asian Cardiovascular & Thoracic Annals. 2002 March; 10(1): 3-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12079961&dopt=Abstract
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Cardiopulmonary cerebral resuscitation using emergency cardiopulmonary bypass, coronary reperfusion therapy and mild hypothermia in patients with cardiac arrest outside the hospital. Author(s): Nagao K, Hayashi N, Kanmatsuse K, Arima K, Ohtsuki J, Kikushima K, Watanabe I. Source: Journal of the American College of Cardiology. 2000 September; 36(3): 776-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987599&dopt=Abstract
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Cardiopulmonary resuscitation after near drowning and hypothermia: restoration of spontaneous circulation after vasopressin. Author(s): Sumann G, Krismer AC, Wenzel V, Adelsmayr E, Schwarz B, Lindner KH, Mair P. Source: Acta Anaesthesiologica Scandinavica. 2003 March; 47(3): 363-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648206&dopt=Abstract
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Cardiovascular baroreceptors mediate susceptibility to hypothermia. Author(s): Fox WC, Hall C, Hall E, Kolkhorst F, Lockette W. Source: Aviation, Space, and Environmental Medicine. 2003 February; 74(2): 132-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602444&dopt=Abstract
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Cardiovascular changes during mild therapeutic hypothermia and rewarming in infants with hypoxic-ischemic encephalopathy. Author(s): Thoresen M, Whitelaw A. Source: Pediatrics. 2000 July; 106(1 Pt 1): 92-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10878155&dopt=Abstract
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Cavoatrial tumor thrombus: single-stage surgical approach with profound hypothermia and circulatory arrest, including a review of the literature. Author(s): Chiappini B, Savini C, Marinelli G, Suarez SM, Di Eusanio M, Fiorani V, Pierangeli A. Source: The Journal of Thoracic and Cardiovascular Surgery. 2002 October; 124(4): 684-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12324725&dopt=Abstract
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Cerebral autoregulation under moderate hypothermia in patients with acute stroke. Author(s): Georgiadis D, Schwarz S, Evans DH, Schwab S, Baumgartner RW. Source: Stroke; a Journal of Cerebral Circulation. 2002 December; 33(12): 3026-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468807&dopt=Abstract
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Cerebral blood flow and oxygen metabolism during mild hypothermia in patients with subarachnoid haemorrhage. Author(s): Kawamura S, Suzuki A, Hadeishi H, Yasui N, Hatazawa J. Source: Acta Neurochirurgica. 2000; 142(10): 1117-21; Discussion 1121-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11129533&dopt=Abstract
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Cerebral hypothermia for prevention of brain injury following perinatal asphyxia. Author(s): Gunn AJ. Source: Current Opinion in Pediatrics. 2000 April; 12(2): 111-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10763759&dopt=Abstract
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Cerebral oxygen metabolism monitoring under hypothermia for severe subarachnoid hemorrhage: report of eight cases. Author(s): Nakamura T, Tatara N, Morisaki K, Kawakita K, Nagao S. Source: Acta Neurologica Scandinavica. 2002 November; 106(5): 314-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12371927&dopt=Abstract
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Cerebral oxygen monitoring during cardiopulmonary bypass and deep hypothermia circulatory arrest by H. Abdul-Khalig et al. Thoracic cardiovascular surg 2002; 50: 77. Author(s): Nollert G, Reichart B. Source: The Thoracic and Cardiovascular Surgeon. 2002 August; 50(4): 254. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165879&dopt=Abstract
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Hypothermia
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Changes of evoked potentials and evaluation of mild hypothermia for treatment of severe brain injury. Author(s): Yan Y, Tang W. Source: Chinese Journal of Traumatology = Chung-Hua Ch'uang Shang Tsa Chih / Chinese Medical Association. 2001 February; 4(1): 8-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835701&dopt=Abstract
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Characteristics of infection and leukocyte count in severely head-injured patients treated with mild hypothermia. Author(s): Ishikawa K, Tanaka H, Shiozaki T, Takaoka M, Ogura H, Kishi M, Shimazu T, Sugimoto H. Source: The Journal of Trauma. 2000 November; 49(5): 912-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11086785&dopt=Abstract
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Charles Drew's profound hypothermia apparatus. Author(s): Hilson A. Source: Lancet. 2001 November 10; 358(9293): 1650. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11716933&dopt=Abstract
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Chill out: therapeutic hypothermia improves survival. Author(s): Morcom F. Source: Emergency Nurse : the Journal of the Rcn Accident and Emergency Nursing Association. 2003 July-August; 11(4): 24-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12889405&dopt=Abstract
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Chronic treatment with antidepressants decreases intraoperative core hypothermia. Author(s): Kudoh A, Takase H, Takazawa T. Source: Anesthesia and Analgesia. 2003 July; 97(1): 275-9, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12818981&dopt=Abstract
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Circadian and hypothermia-induced effects on visual and auditory evoked potentials in multiple sclerosis. Author(s): Romani A, Bergamaschi R, Versino M, Zilioli A, Callieco R, Cosi V. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2000 September; 111(9): 1602-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10964071&dopt=Abstract
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Clinical experience with therapeutic hypothermia in asphyxiated infants. Author(s): Whitelaw A, Thoresen M. Source: Dev Med Child Neurol Suppl. 2001 March; 86: 30-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268724&dopt=Abstract
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Coagulopathy, hypothermia and acidosis in trauma patients: the rationale for damage control surgery. Author(s): De Waele JJ, Vermassen FE. Source: Acta Chir Belg. 2002 October; 102(5): 313-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12471762&dopt=Abstract
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Cold stress, near drowning and accidental hypothermia: a review. Author(s): Giesbrecht GG. Source: Aviation, Space, and Environmental Medicine. 2000 July; 71(7): 733-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10902937&dopt=Abstract
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Cold water submersion and cardiac arrest in treatment of severe hypothermia with cardiopulmonary bypass. Author(s): Wollenek G, Honarwar N, Golej J, Marx M. Source: Resuscitation. 2002 March; 52(3): 255-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886730&dopt=Abstract
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Combined effect of hypothermia and crystalloid hemodilution on the solubility of volatile anesthetics in human blood. Author(s): Zhou J, Liu Y, Liu J. Source: Chinese Medical Journal. 2002 July; 115(7): 1014-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150733&dopt=Abstract
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Combined therapy with hypothermia and anticytokine agents in influenza A encephalopathy. Author(s): Munakata M, Kato R, Yokoyama H, Haginoya K, Tanaka Y, Kayaba J, Kato T, Takayanagi R, Endo H, Hasegawa R, Ejima Y, Hoshi K, Iinuma K. Source: Brain & Development. 2000 September; 22(6): 373-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11042419&dopt=Abstract
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Comparison between hypothermia and glutamate antagonism treatments on the immediate outcome of perinatal asphyxia. Author(s): Engidawork E, Loidl F, Chen Y, Kohlhauser C, Stoeckler S, Dell'Anna E, Lubec B, Lubec G, Goiny M, Gross J, Andersson K, Herrera-Marschitz M. Source: Experimental Brain Research. Experimentelle Hirnforschung. Experimentation Cerebrale. 2001 June; 138(3): 375-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11460776&dopt=Abstract
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Comparison of the effects of sevoflurane and propofol on cooling and rewarming during deliberate mild hypothermia for neurosurgery. Author(s): Iwata T, Inoue S, Kawaguchi M, Takahashi M, Sakamoto T, Kitaguchi K, Furuya H, Sakaki T. Source: British Journal of Anaesthesia. 2003 January; 90(1): 32-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488375&dopt=Abstract
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Complications and treatment of mild hypothermia. Author(s): Sessler DI. Source: Anesthesiology. 2001 August; 95(2): 531-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11506130&dopt=Abstract
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Continuous systemic perfusion via collaterals at moderate hypothermia in aortic arch repairs in neonates. Author(s): Kiraly L, Prodan Z. Source: Croatian Medical Journal. 2002 December; 43(6): 656-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476472&dopt=Abstract
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Cooling for acute ischemic brain damage (cool aid): an open pilot study of induced hypothermia in acute ischemic stroke. Author(s): Krieger DW, De Georgia MA, Abou-Chebl A, Andrefsky JC, Sila CA, Katzan IL, Mayberg MR, Furlan AJ. Source: Stroke; a Journal of Cerebral Circulation. 2001 August; 32(8): 1847-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11486115&dopt=Abstract
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Coronary and sympathetic responses to core hypothermia: answers and questions. Author(s): Grassi G. Source: Clinical Science (London, England : 1979). 2003 May; 104(5): 491-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570868&dopt=Abstract
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Cytokines and therapeutic hypothermia. Author(s): Marion DW. Source: Critical Care Medicine. 2002 July; 30(7): 1666-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131004&dopt=Abstract
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Detrimental effects of hypothermia: a systems analysis. Author(s): Connor EL, Wren KR. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2000 June; 15(3): 151-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249335&dopt=Abstract
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Direct influence of mild hypothermia on cytokine expression and release in cultures of human peripheral blood mononuclear cells. Author(s): Russwurm S, Stonans I, Schwerter K, Stonane E, Meissner W, Reinhart K. Source: Journal of Interferon & Cytokine Research : the Official Journal of the International Society for Interferon and Cytokine Research. 2002 February; 22(2): 215-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11911804&dopt=Abstract
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Do we need hypothermia in myocardial protection? Author(s): Yamamoto F. Source: Ann Thorac Cardiovasc Surg. 2000 August; 6(4): 216-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11042476&dopt=Abstract
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ECG of the month. The big chill. Hypothermia. Author(s): Martinez-Lopez JI. Source: J La State Med Soc. 2001 May; 153(5): 225-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433927&dopt=Abstract
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Effect and feasibility of controlled rewarming after moderate hypothermia in stroke patients with malignant infarction of the middle cerebral artery. Author(s): Steiner T, Friede T, Aschoff A, Schellinger PD, Schwab S, Hacke W. Source: Stroke; a Journal of Cerebral Circulation. 2001 December 1; 32(12): 2833-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11739982&dopt=Abstract
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Effect of amino acid solutions on intraoperative hypothermia and postoperative shivering. Comparison of two anesthetic regimens. Author(s): Sahin A, Aypar U. Source: Acta Anaesthesiologica Scandinavica. 2002 January; 46(1): 64-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11903074&dopt=Abstract
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Effect of early induction of hypothermia on severe head injury. Author(s): Hayashi S, Inao S, Takayasu M, Kajita Y, Ishiyama J, Harada T, Yoshida J. Source: Acta Neurochir Suppl. 2002; 81: 83-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12168365&dopt=Abstract
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Effect of hypothermia on brain tissue oxygenation in patients with severe head injury. Author(s): Andrews P. Source: British Journal of Anaesthesia. 2003 February; 90(2): 251; Author Reply 251-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12538387&dopt=Abstract
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Effect of hypothermia on brain tissue oxygenation in patients with severe head injury. Author(s): Gupta AK, Al-Rawi PG, Hutchinson PJ, Kirkpatrick PJ. Source: British Journal of Anaesthesia. 2002 February; 88(2): 188-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11878653&dopt=Abstract
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Effect of mild hypothermia on focal cerebral ischemia. Review of experimental studies. Author(s): Miyazawa T, Tamura A, Fukui S, Hossmann KA. Source: Neurological Research. 2003 July; 25(5): 457-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866192&dopt=Abstract
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Effect of mild hypothermia on partial pressure of oxygen in brain tissue and brain temperature in patients with severe head injury. Author(s): Zhang S, Zhi D, Lin X, Shang Y, Niu Y. Source: Chinese Journal of Traumatology = Chung-Hua Ch'uang Shang Tsa Chih / Chinese Medical Association. 2002 February; 5(1): 43-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835757&dopt=Abstract
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Effect of mild therapeutic hypothermia on phenytoin pharmacokinetics. Author(s): Iida Y, Nishi S, Asada A. Source: Therapeutic Drug Monitoring. 2001 June; 23(3): 192-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360024&dopt=Abstract
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Effectiveness of resistive heating compared with passive warming in treating hypothermia associated with minor trauma: a randomized trial. Author(s): Kober A, Scheck T, Fulesdi B, Lieba F, Vlach W, Friedman A, Sessler DI. Source: Mayo Clinic Proceedings. 2001 April; 76(4): 369-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11322352&dopt=Abstract
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Effects of acute hypoxemia/ischemia on EEG and evoked responses at normothermia and hypothermia in humans. Author(s): Stecker MM, Escherich A, Patterson T, Bavaria JE, Cheung AT. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 April; 8(4): Cr223-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11951061&dopt=Abstract
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Effects of hypothermia on energy metabolism in Mammalian central nervous system. Author(s): Erecinska M, Thoresen M, Silver IA. Source: Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism. 2003 May; 23(5): 513-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771566&dopt=Abstract
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Effects of hypothermia on excitatory amino acids and metabolism in stroke patients: a microdialysis study. Author(s): Berger C, Schabitz WR, Georgiadis D, Steiner T, Aschoff A, Schwab S. Source: Stroke; a Journal of Cerebral Circulation. 2002 February; 33(2): 519-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11823663&dopt=Abstract
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Effects of hypothermia on median nerve somatosensory evoked potentials during spontaneous circulation. Author(s): Lang M, Welte M, Syben R, Hansen D. Source: Journal of Neurosurgical Anesthesiology. 2002 April; 14(2): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907395&dopt=Abstract
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Effects of hypothermia on neonatal hypoxic-ischemic brain injury in the rat: phosphorylation of Akt, activation of caspase-3-like protease. Author(s): Tomimatsu T, Fukuda H, Endo M, Watanabe N, Mu J, Kohzuki M, Fujii E, Kanzaki T, Murata Y. Source: Neuroscience Letters. 2001 October 12; 312(1): 21-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11578836&dopt=Abstract
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Effects of moderate hypothermia on IL-1 beta-induced leukocyte rolling and adhesion in pial microcirculation of mice and on proinflammatory gene expression in human cerebral endothelial cells. Author(s): Sutcliffe IT, Smith HA, Stanimirovic D, Hutchison JS. Source: Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism. 2001 November; 21(11): 1310-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702046&dopt=Abstract
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Effects of normothermia versus hypothermia on extravascular lung water and serum cytokines during cardiopulmonary bypass: a randomized, controlled trial. Author(s): Honore PM, Jacquet LM, Beale RJ, Renauld JC, Valadi D, Noirhomme P, Goenen M. Source: Critical Care Medicine. 2001 October; 29(10): 1903-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11588449&dopt=Abstract
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Effects of therapeutic hypothermia on intracranial pressure and outcome in patients with severe head injury. Author(s): Polderman KH, Tjong Tjin Joe R, Peerdeman SM, Vandertop WP, Girbes AR. Source: Intensive Care Medicine. 2002 November; 28(11): 1563-73. Epub 2002 October 04. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415442&dopt=Abstract
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Efficacy of moderate hypothermia in patients with severe head injury and intracranial hypertension refractory to mild hypothermia. Author(s): Shiozaki T, Nakajima Y, Taneda M, Tasaki O, Inoue Y, Ikegawa H, Matsushima A, Tanaka H, Shimazu T, Sugimoto H. Source: Journal of Neurosurgery. 2003 July; 99(1): 47-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854743&dopt=Abstract
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Electrocardiographic changes in hypothermia. Author(s): Alsafwah S. Source: Heart & Lung : the Journal of Critical Care. 2001 March-April; 30(2): 161-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11248720&dopt=Abstract
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Electrocardiographic manifestations of hypothermia. Author(s): Mattu A, Brady WJ, Perron AD. Source: The American Journal of Emergency Medicine. 2002 July; 20(4): 314-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12098179&dopt=Abstract
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Electroencephalographic changes and their regional differences during pediatric cardiovascular surgery with hypothermia. Author(s): Akiyama T, Kobayashi K, Nakahori T, Yoshinaga H, Ogino T, Ohtsuka Y, Takeuchi M, Morita K, Sano S, Oka E. Source: Brain & Development. 2001 March; 23(2): 115-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11248460&dopt=Abstract
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Emergency treatment of hypothermia. Author(s): Giesbrecht GG. Source: Emergency Medicine (Fremantle, W.A.). 2001 March; 13(1): 9-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476420&dopt=Abstract
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Emergency treatment of neonatal hyperammonaemic coma with mild systemic hypothermia. Author(s): Whitelaw A, Bridges S, Leaf A, Evans D. Source: Lancet. 2001 July 7; 358(9275): 36-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11454378&dopt=Abstract
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Endovascular cooling for moderate hypothermia in patients with acute stroke: first results of a novel approach. Author(s): Georgiadis D, Schwarz S, Kollmar R, Schwab S. Source: Stroke; a Journal of Cerebral Circulation. 2001 November; 32(11): 2550-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11692015&dopt=Abstract
Studies
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Endovascular cooling with heat exchange catheters: a new method to induce and maintain hypothermia. Author(s): Keller E, Imhof HG, Gasser S, Terzic A, Yonekawa Y. Source: Intensive Care Medicine. 2003 June; 29(6): 939-43. Epub 2003 May 01. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728304&dopt=Abstract
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Epidural cooling for regional spinal cord hypothermia during most or all of descending thoracic or thoracoabdominal aneurysm repair. Author(s): Tabayashi K, Motoyoshi N, Akimoto H, Tsuru Y, Sakurai M, Itoh T, Fukuju T, Iguchi A. Source: Acta Chir Belg. 2002 August; 102(4): 224-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12244900&dopt=Abstract
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Episodic hypothermia and hyperhidrosis after subarachnoid hemorrhage. Case illustration. Author(s): Tuettenberg J, Woitzik J, Siegel L, Thome C. Source: Journal of Neurosurgery. 2003 September; 99(3): 610. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959455&dopt=Abstract
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Episodic hypothermia with hyperhidrosis in a pregnant woman. Author(s): DeRoche ME, Steinfeld JD. Source: Obstetrics and Gynecology. 2002 May; 99(5 Pt 2): 880-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975943&dopt=Abstract
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Extensive subcutaneous soft tissue calcification in a neonate following hypothermia: case report. Author(s): Yimesel M, Assefa G. Source: East Afr Med J. 2000 April; 77(4): 231-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858910&dopt=Abstract
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Factors associated with mortality among elderly patients with hypothermia. Author(s): Muszkat M, Durst RM, Ben-Yehuda A. Source: The American Journal of Medicine. 2002 August 15; 113(3): 234-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208384&dopt=Abstract
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Fatal severe vasospasm due to rewarming following hypothermia--case report. Author(s): Jimbo H, Dohi K, Nakamura Y, Izumiyama H, Ikeda Y, Matsumoto K, Kushima M, Takaki A. Source: Neurol Med Chir (Tokyo). 2000 September; 40(9): 463-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11021078&dopt=Abstract
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Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: A case-control study: the Copenhagen Stroke Study. Author(s): Kammersgaard LP, Rasmussen BH, Jorgensen HS, Reith J, Weber U, Olsen TS. Source: Stroke; a Journal of Cerebral Circulation. 2000 September; 31(9): 2251-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10978060&dopt=Abstract
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Feasibility and safety of moderate hypothermia after acute ischemic stroke. Author(s): Jian S, Yongming Q, Zhihua C, Yan C. Source: International Journal of Developmental Neuroscience : the Official Journal of the International Society for Developmental Neuroscience. 2003 October; 21(6): 353-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927584&dopt=Abstract
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Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Author(s): Schwab S, Georgiadis D, Berrouschot J, Schellinger PD, Graffagnino C, Mayer SA. Source: Stroke; a Journal of Cerebral Circulation. 2001 September; 32(9): 2033-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11546893&dopt=Abstract
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Finger cold-induced vasodilation during mild hypothermia, hyperthermia and at thermoneutrality. Author(s): Daanen HA, Ducharme MB. Source: Aviation, Space, and Environmental Medicine. 1999 December; 70(12): 1206-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10596776&dopt=Abstract
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Forced air surface rewarming in patients with severe accidental hypothermia. Author(s): Deakin CD. Source: Resuscitation. 2000 February; 43(3): 223. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10711494&dopt=Abstract
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Gabapentin's effects on hot flashes and hypothermia. Author(s): Guttuso TJ Jr. Source: Neurology. 2000 June 13; 54(11): 2161-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10851385&dopt=Abstract
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Gene therapy and hypothermia for stroke treatment. Author(s): Yenari MA, Zhao H, Giffard RG, Sobel RA, Sapolsky RM, Steinberg GK. Source: Annals of the New York Academy of Sciences. 2003 May; 993: 54-68; Discussion 79-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12853295&dopt=Abstract
Studies
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Glycine and neuroprotective effect of hypothermia in hypoxic-ischemic brain damage. Author(s): Kvrivishvili G. Source: Neuroreport. 2002 November 15; 13(16): 1995-2000. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12438913&dopt=Abstract
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Harbingers of poor outcome the day after severe brain injury: hypothermia, hypoxia, and hypoperfusion. Author(s): Jeremitsky E, Omert L, Dunham CM, Protetch J, Rodriguez A. Source: The Journal of Trauma. 2003 February; 54(2): 312-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12579057&dopt=Abstract
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Hemicraniectomy and moderate hypothermia in patients with severe ischemic stroke. Author(s): Georgiadis D, Schwarz S, Aschoff A, Schwab S. Source: Stroke; a Journal of Cerebral Circulation. 2002 June; 33(6): 1584-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12052995&dopt=Abstract
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High-dose amrinone is required to accelerate rewarming from deliberate mild intraoperative hypothermia for neurosurgical procedures. Author(s): Inoue S, Kawaguchi M, Sakamoto T, Kitaguchi K, Furuya H, Sakaki T. Source: Anesthesiology. 2002 July; 97(1): 116-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131112&dopt=Abstract
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Hyperemia prior to acute brain swelling during rewarming of patients who have been treated with moderate hypothermia for severe head injuries. Author(s): Iida K, Kurisu K, Arita K, Ohtani M. Source: Journal of Neurosurgery. 2003 April; 98(4): 793-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691404&dopt=Abstract
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Hypothermia after cardiac arrest: a treatment that works. Author(s): Sterz F, Holzer M, Roine R, Zeiner A, Losert H, Eisenburger P, Uray T, Behringer W. Source: Current Opinion in Critical Care. 2003 June; 9(3): 205-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771671&dopt=Abstract
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Hypothermia and acute pancreatitis: myth or reality? Author(s): Stiff RE, Morris-Stiff GJ, Torkington J. Source: Journal of the Royal Society of Medicine. 2003 May; 96(5): 228-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724432&dopt=Abstract
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Hypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery. Author(s): Sayyid SS, Jabbour DG, Baraka AS. Source: Regional Anesthesia and Pain Medicine. 2003 March-April; 28(2): 140-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677625&dopt=Abstract
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Hypothermia and local cold injuries in combat and non-combat situations--the Israeli experience. Author(s): Moran DS, Heled Y, Shani Y, Epstein Y. Source: Aviation, Space, and Environmental Medicine. 2003 March; 74(3): 281-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650278&dopt=Abstract
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Hypothermia and neurologic outcome in patients following cardiac arrest: should we be hot to cool off our patients? Author(s): Smith TL, Bleck TP. Source: Critical Care (London, England). 2002 October; 6(5): 377-80. Epub 2002 August 16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12398769&dopt=Abstract
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Hypothermia and phenytoin toxicity. Author(s): Newberger DS, Blyth SA. Source: Clinical Neuropharmacology. 2003 July-August; 26(4): 172-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897633&dopt=Abstract
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Hypothermia and the approximate entropy of the electroencephalogram. Author(s): Levy WJ, Pantin E, Mehta S, McGarvey M. Source: Anesthesiology. 2003 January; 98(1): 53-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12502979&dopt=Abstract
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Hypothermia and total body exsanguination: a cornerstone for the treatment of renal cell carcinoma with grade IV vascular extension. Author(s): Arap S, Arap MA, Fernandes PM. Source: Curr Urol Rep. 2002 August; 3(4): 259-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12149152&dopt=Abstract
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Hypothermia augments polymorphonuclear leukocyte degranulation and interleukin-8 production from human umbilical vein endothelial cells and increases lipopolysaccharide-induced polymorphonuclear leukocyte-endothelial cell interaction when followed by normothermia. Author(s): Sakao Y, Nakahara Y, Carr FK, Miller EJ. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2002 October; 16(5): 561-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407606&dopt=Abstract
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Hypothermia does not alter somatosensory evoked potential amplitude and global cerebral oxygen extraction during marked sodium nitroprusside-induced arterial hypotension. Author(s): Kottenberg-Assenmacher E, Armbruster W, Bornfeld N, Peters J. Source: Anesthesiology. 2003 May; 98(5): 1112-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12717132&dopt=Abstract
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Hypothermia during head and neck surgery. Author(s): Agrawal N, Sewell DA, Griswold ME, Frank SM, Hessel TW, Eisele DW. Source: The Laryngoscope. 2003 August; 113(8): 1278-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897545&dopt=Abstract
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Hypothermia for neuroprotection after cardiac arrest. Author(s): Mayer SA. Source: Curr Neurol Neurosci Rep. 2002 November; 2(6): 525-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359107&dopt=Abstract
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Hypothermia for the management of intracranial hypertension in acute liver failure. Author(s): Jalan R, Davies NA, Damink SW. Source: Metabolic Brain Disease. 2002 December; 17(4): 437-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602519&dopt=Abstract
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Hypothermia from prolonged immersion: biophysical parameters of a survivor. Author(s): Nuckton TJ, Goldreich D, Rogaski KD, Lessani TM, Higgins PJ, Claman DM. Source: The Journal of Emergency Medicine. 2002 May; 22(4): 371-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113847&dopt=Abstract
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Hypothermia in 2 patients treated with atypical antipsychotic medication. Author(s): Parris C, Mack JM, Cochiolo JA, Steinmann AF, Tietjen J. Source: The Journal of Clinical Psychiatry. 2001 January; 62(1): 61-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11235936&dopt=Abstract
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Hypothermia in a child secondary to ibuprofen. Author(s): Desai PR, Sriskandan S. Source: Archives of Disease in Childhood. 2003 January; 88(1): 87-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495977&dopt=Abstract
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Hypothermia in a hemodialysis patient treated with olanzapine monotherapy. Author(s): Fukunishi I, Sato Y, Kino K, Shirai T, Kitaoka T. Source: Journal of Clinical Psychopharmacology. 2003 June; 23(3): 314. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826994&dopt=Abstract
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Hypothermia in a homeless man. Author(s): Silverman D. Source: Cleve Clin J Med. 2002 May; 69(5): 362; Author Reply 362. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12022378&dopt=Abstract
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Hypothermia in mice tested in Morris water maze. Author(s): Iivonen H, Nurminen L, Harri M, Tanila H, Puolivali J. Source: Behavioural Brain Research. 2003 May 15; 141(2): 207-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742257&dopt=Abstract
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Hypothermia in the elderly. Author(s): Levine MD, Rachmiel AJ. Source: Emerg Med Serv. 2003 September; 32(9): 121-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14503163&dopt=Abstract
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Hypothermia on admission: a risk factor for death in newborns referred to the Pernambuco Institute of Mother and Child Health. Author(s): da Mota Silveira SM, Goncalves de Mello MJ, de Arruda Vidal S, de Frias PG, Cattaneo A. Source: Journal of Tropical Pediatrics. 2003 April; 49(2): 115-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729295&dopt=Abstract
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Hypothermia reduces neurological damage in asphyxiated newborn infants. Author(s): Compagnoni G, Pogliani L, Lista G, Castoldi F, Fontana P, Mosca F. Source: Biology of the Neonate. 2002; 82(4): 222-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381928&dopt=Abstract
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Hypothermia to protect the brain. Author(s): Curfman GD. Source: The New England Journal of Medicine. 2002 February 21; 346(8): 546. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856792&dopt=Abstract
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Hypothermia with heparin-coated circuits and low dose systemic heparinization in neurosurgery. Author(s): Hachiro Y, Morishita K, Koshima R, Nakashima S, Takagi N, Tsukamoto M, Abe T, Hashi K. Source: Artificial Organs. 2002 June; 26(6): 551-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072114&dopt=Abstract
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Hypothermia with indoor occurrence is associated with a worse outcome. Author(s): Megarbane B, Axler O, Chary I, Pompier R, Brivet FG. Source: Intensive Care Medicine. 2000 December; 26(12): 1843-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11271094&dopt=Abstract
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Hypothermia-induced platelet aggregation in human blood in an in vitro model: the dominant role of blood-material interactions. Author(s): Hall MW, Solen KA. Source: Journal of Biomedical Materials Research. 2002 March 5; 59(3): 528-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11774311&dopt=Abstract
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IM droperidol as premedication attenuates intraoperative hypothermia. Author(s): Toyota K, Sakura S, Saito Y, Shido A, Matsukawa T. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2001 October; 48(9): 854-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11606340&dopt=Abstract
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Images in cardiovascular medicine. Giant J waves in hypothermia. Author(s): Anguera I, Valls V. Source: Circulation. 2000 April 4; 101(13): 1627-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10747359&dopt=Abstract
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Inadvertent hypothermia causes pulseless electrical activity in a patient during cervical spine surgery--a case report. Author(s): Lee HL, Lin CM, Hsu JC, Hwang SJ, Yang CY, Wu CY, Lui PW. Source: Acta Anaesthesiol Sin. 2001 September; 39(3): 145-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11688106&dopt=Abstract
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Inadvertent hypothermia: is it just a perioperative problem? Author(s): Enwright A, Plowes D. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1999 October 13-19; 14(4): 46-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10855177&dopt=Abstract
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Increased myocardial perfusion and sympathoadrenal activation during mild core hypothermia in awake humans. Author(s): Frank SM, Satitpunwaycha P, Bruce SR, Herscovitch P, Goldstein DS. Source: Clinical Science (London, England : 1979). 2003 May; 104(5): 503-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540290&dopt=Abstract
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Induced hypothermia for drug overdose. Author(s): Osterhoudt KC, Perrone J. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2002 September; 9(9): 962. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208689&dopt=Abstract
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Induced hypothermia for head injury. Author(s): Chambers S. Source: Nursing in Critical Care. 1999 May-June; 4(3): 112-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10640107&dopt=Abstract
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Induced hypothermia in critical care medicine: a review. Author(s): Bernard SA, Buist M. Source: Critical Care Medicine. 2003 July; 31(7): 2041-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847402&dopt=Abstract
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Induced hypothermia in experimental traumatic spinal cord injury: an update. Author(s): Inamasu J, Nakamura Y, Ichikizaki K. Source: Journal of the Neurological Sciences. 2003 May 15; 209(1-2): 55-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686402&dopt=Abstract
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Induced hypothermia in the management of cerebral oedema secondary to fulminant liver failure. Author(s): Roberts DR, Manas D. Source: Clinical Transplantation. 1999 December; 13(6): 545-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10617247&dopt=Abstract
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Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Author(s): Bernard S, Buist M, Monteiro O, Smith K. Source: Resuscitation. 2003 January; 56(1): 9-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505732&dopt=Abstract
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Induction of anesthesia with ketamine reduces the magnitude of redistribution hypothermia. Author(s): Ikeda T, Kazama T, Sessler DI, Toriyama S, Niwa K, Shimada C, Sato S. Source: Anesthesia and Analgesia. 2001 October; 93(4): 934-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11574360&dopt=Abstract
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Induction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction. Author(s): Dixon SR, Whitbourn RJ, Dae MW, Grube E, Sherman W, Schaer GL, Jenkins JS, Baim DS, Gibbons RJ, Kuntz RE, Popma JJ, Nguyen TT, O'Neill WW. Source: Journal of the American College of Cardiology. 2002 December 4; 40(11): 192834. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475451&dopt=Abstract
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Influence of hypothermia on cell volume and cytotoxic swelling of glial cells in vitro. Author(s): Mueller E, Wietzorrek J, Ringel F, Guretzki S, Baethmann A, Plesnila N. Source: Acta Neurochir Suppl. 2000; 76: 551-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11450089&dopt=Abstract
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Intercenter variance in clinical trials of head trauma--experience of the National Acute Brain Injury Study: Hypothermia. Author(s): Clifton GL, Choi SC, Miller ER, Levin HS, Smith KR Jr, Muizelaar JP, Wagner FC Jr, Marion DW, Luerssen TG. Source: Journal of Neurosurgery. 2001 November; 95(5): 751-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702863&dopt=Abstract
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Intraoperative mild hypothermia ameliorates postoperative cerebral blood flow impairment in patients with aneurysmal subarachnoid hemorrhage. Author(s): Karibe H, Sato K, Shimizu H, Tominaga T, Koshu K, Yoshimoto T. Source: Neurosurgery. 2000 September; 47(3): 594-9; Discussion 599-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10981746&dopt=Abstract
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Intraoperative mild hypothermia does not increase the plasma concentration of stress hormones during neurosurgery. Author(s): Chi OZ, Choi YK, Lee DI, Kim YS, Lee I. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2001 September; 48(8): 815-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11546725&dopt=Abstract
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Intraoperative mild hypothermia therapy in patients scheduled for neurosurgical procedures. Author(s): Gal R, Cundrle I. Source: Bratisl Lek Listy. 2002; 103(4-5): 169-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413205&dopt=Abstract
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Is it justified to disregard the Bohr effect during alpha-stat hypothermia? Author(s): Miyamoto TA, Miyamoto KJ. Source: The Annals of Thoracic Surgery. 2000 March; 69(3): 973-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10750811&dopt=Abstract
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Is it poly(adenosine 5'-diphosphate-ribose) polymerase or hypothermia? Author(s): Marion DW. Source: Critical Care Medicine. 2002 November; 30(11): 2595-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441778&dopt=Abstract
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Is reduced cerebral perfusion pressure better tolerated during hypothermia? Author(s): Prough DS, Bedell EA. Source: Critical Care Medicine. 2000 April; 28(4): 1243-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10809325&dopt=Abstract
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Knowledge, attitude and practices about neonatal hypothermia among medical and paramedical staff. Author(s): Choudhary SP, Bajaj RK, Gupta RK. Source: Indian J Pediatr. 2000 July; 67(7): 491-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10957833&dopt=Abstract
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Lack of effect of induction of hypothermia after acute brain injury. Author(s): Safar P, Kochanek PM. Source: The New England Journal of Medicine. 2001 July 5; 345(1): 66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11439957&dopt=Abstract
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Lack of effect of induction of hypothermia after acute brain injury. Author(s): Sakas DE, Dimopoulou I. Source: The New England Journal of Medicine. 2001 July 5; 345(1): 66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11439956&dopt=Abstract
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Lack of effect of induction of hypothermia after acute brain injury. Author(s): Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR Jr, Muizelaar JP, Wagner FC Jr, Marion DW, Luerssen TG, Chesnut RM, Schwartz M. Source: The New England Journal of Medicine. 2001 February 22; 344(8): 556-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207351&dopt=Abstract
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Laparoscopic ice slush renal hypothermia for partial nephrectomy: the initial experience. Author(s): Gill IS, Abreu SC, Desai MM, Steinberg AP, Ramani AP, Ng C, Banks K, Novick AC, Kaouk JH. Source: The Journal of Urology. 2003 July; 170(1): 52-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796643&dopt=Abstract
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Left ventricular apex venting during deep hypothermia in a case of difficult re-entry into the mediastinum. Author(s): Ito K, Yaku H, Shimada Y, Kawata M, Kitamura N. Source: The Journal of Cardiovascular Surgery. 2001 August; 42(4): 493-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11455284&dopt=Abstract
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Leland C. Clark and Frank Gollan: bubble oxygenators and perfusion hypothermia. Author(s): Litwak RS. Source: The Annals of Thoracic Surgery. 2002 August; 74(2): 612-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173868&dopt=Abstract
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Locating a home page and journal source; hypothermia and the perioperative patient. Author(s): Drake C. Source: Aorn Journal. 1999 August; 70(2): 313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10577356&dopt=Abstract
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Mammalian cell injury induced by hypothermia- the emerging role for reactive oxygen species. Author(s): Rauen U, de Groot H. Source: Biological Chemistry. 2002 March-April; 383(3-4): 477-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12033437&dopt=Abstract
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Management of profound hypothermia in children without the use of extracorporeal life support therapy. Author(s): de Caen A. Source: Lancet. 2002 November 2; 360(9343): 1394-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12423988&dopt=Abstract
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Mechanisms of cell survival in hypoxia and hypothermia. Author(s): Boutilier RG. Source: The Journal of Experimental Biology. 2001 September; 204(Pt 18): 3171-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11581331&dopt=Abstract
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Mild core hypothermia and anesthetic requirement for loss of responsiveness during propofol anesthesia for craniotomy. Author(s): Leslie K, Bjorksten AR, Ugoni A, Mitchell P. Source: Anesthesia and Analgesia. 2002 May; 94(5): 1298-303, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11973207&dopt=Abstract
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Mild hypothermia for hemispheric cerebral infarction after evacuation of an acute subdural hematoma in an infant. Author(s): Inamasu J, Ichikizaki K, Matsumoto S, Nakamura Y, Saito R, Horiguchi T, Kanai R. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2002 April; 18(3-4): 175-8. Epub 2001 September 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11981630&dopt=Abstract
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Mild hypothermia in neurologic emergency: an update. Author(s): Inamasu J, Ichikizaki K. Source: Annals of Emergency Medicine. 2002 August; 40(2): 220-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140503&dopt=Abstract
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Mild hypothermia in resuscitation: a historical perspective. Author(s): Safar P. Source: Annals of Emergency Medicine. 2003 June; 41(6): 887-8; Author Reply 888. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790123&dopt=Abstract
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Mild hypothermia in the prevention of brain edema in acute liver failure: mechanisms and clinical prospects. Author(s): Chatauret N, Rose C, Butterworth RF. Source: Metabolic Brain Disease. 2002 December; 17(4): 445-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602520&dopt=Abstract
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Mild hypothermia increases survival from severe pressure-controlled hemorrhagic shock in rats. Author(s): Prueckner S, Safar P, Kentner R, Stezoski J, Tisherman SA. Source: The Journal of Trauma. 2001 February; 50(2): 253-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11242289&dopt=Abstract
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Mild hypothermia induced by a helmet device: a clinical feasibility study. Author(s): Hachimi-Idrissi S, Corne L, Ebinger G, Michotte Y, Huyghens L. Source: Resuscitation. 2001 December; 51(3): 275-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11738778&dopt=Abstract
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Mild hypothermia therapy for patients with severe brain injury. Author(s): Gal R, Cundrle I, Zimova I, Smrcka M. Source: Clinical Neurology and Neurosurgery. 2002 September; 104(4): 318-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140097&dopt=Abstract
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Mild perioperative hypothermia and the risk of wound infection. Author(s): Flores-Maldonado A, Medina-Escobedo CE, Rios-Rodriguez HM, FernandezDominguez R. Source: Archives of Medical Research. 2001 May-June; 32(3): 227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11395189&dopt=Abstract
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Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. Author(s): Hypothermia after Cardiac Arrest Study Group. Source: The New England Journal of Medicine. 2002 February 21; 346(8): 549-56. Erratum In: N Engl J Med 2002 May 30; 346(22): 1756. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856793&dopt=Abstract
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Mild to moderate hypothermia: the hope for improving outcome of severe head injured patients. Author(s): Jiang J, Zhu C. Source: Chinese Journal of Traumatology = Chung-Hua Ch'uang Shang Tsa Chih / Chinese Medical Association. 2001 February; 4(1): 6-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835700&dopt=Abstract
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Mitochondrial respiratory chain deficiency revealed by hypothermia. Author(s): Cholley F, Edery P, Ricquier D, Peudenier S, Slama A, Tardieu M. Source: Neuropediatrics. 2001 April; 32(2): 104-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11414641&dopt=Abstract
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Mitral valve surgery under perfused ventricular fibrillation with moderate hypothermia. Author(s): Imanaka K, Kyo S, Ogiwara M, Tanabe H, Ohuchi H, Asano H, Yokote Y, Gojo S, Kato M. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2002 May; 66(5): 450-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12030338&dopt=Abstract
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Moderate hypothermia delays proinflammatory cytokine production of human peripheral blood mononuclear cells. Author(s): Kimura A, Sakurada S, Ohkuni H, Todome Y, Kurata K. Source: Critical Care Medicine. 2002 July; 30(7): 1499-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12130969&dopt=Abstract
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Moderate hypothermia depresses arterial baroreflex control of heart rate during, and delays its recovery after, general anesthesia in humans. Author(s): Tanaka M, Nagasaki G, Nishikawa T. Source: Anesthesiology. 2001 July; 95(1): 51-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11465583&dopt=Abstract
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Moderate hypothermia in severe head injuries: the present and the future. Author(s): Marion DW. Source: Current Opinion in Critical Care. 2002 April; 8(2): 111-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12386510&dopt=Abstract
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Moderate hypothermia prevents cerebral hyperemia and increase in intracranial pressure in patients undergoing liver transplantation for acute liver failure. Author(s): Jalan R, Olde Damink SW, Deutz NE, Davies NA, Garden OJ, Madhavan KK, Hayes PC, Lee A. Source: Transplantation. 2003 June 27; 75(12): 2034-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829907&dopt=Abstract
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Moderate hypothermia therapy for patients with severe head injury. Author(s): Chen L, Piao Y, Zeng F, Lu M, Kuang Y, Ki X. Source: Chinese Journal of Traumatology = Chung-Hua Ch'uang Shang Tsa Chih / Chinese Medical Association. 2001 August; 4(3): 164-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835723&dopt=Abstract
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Moderate systemic hypothermia and cold crystalloid cardioplegia influence on myocardial ischemic and revascularisative injury. Author(s): Blaszczyk J, Kedziora J, Zaslonka J, Szram S, Pawlicki L, Sibinska E, Jaszewski R, Iwaszkiewicz A, Mussur M. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2000 September-October; 6(5): 981-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11208442&dopt=Abstract
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Natural hypothermia immediately after transient global cerebral ischemia induced by spontaneous subarachnoid hemorrhage. Author(s): Takagi K, Tsuchiya Y, Okinaga K, Hirata M, Nakagomi T, Tamura A. Source: Journal of Neurosurgery. 2003 January; 98(1): 50-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546352&dopt=Abstract
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Neonatal transport: a 3-day-old neonate with hypothermia, respiratory distress, lethargy and poor feeding. Author(s): Joseph M, Hageman JR. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 September; 22(6): 506-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12168133&dopt=Abstract
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Neurochemical monitoring in the management of severe head-injured patients with hypothermia. Author(s): Yamaguchi S, Nakahara K, Miyagi T, Tokutomi T, Shigemori M. Source: Neurological Research. 2000 October; 22(7): 657-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11091969&dopt=Abstract
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Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatal asphyxia. Author(s): Battin MR, Dezoete JA, Gunn TR, Gluckman PD, Gunn AJ. Source: Pediatrics. 2001 March; 107(3): 480-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11230586&dopt=Abstract
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Neurometabolic changes during treatment with moderate hypothermia in a patient suffering from severe middle cerebral artery infarction. Author(s): Schabitz WR, Berger C, Schellinger PD, Aschoff A, Steiner T, Schwab S. Source: Cerebrovascular Diseases (Basel, Switzerland). 2001; 12(4): 298-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11721098&dopt=Abstract
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Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass: a randomized trial. Author(s): Nathan HJ, Wells GA, Munson JL, Wozny D. Source: Circulation. 2001 September 18; 104(12 Suppl 1): I85-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11568036&dopt=Abstract
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New research in the field of stroke: therapeutic hypothermia after cardiac arrest. Author(s): Dalton Dietrich W, Kuluz JW. Source: Stroke; a Journal of Cerebral Circulation. 2003 April; 34(4): 1051-3. Epub 2003 March 20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649524&dopt=Abstract
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Newborn infant with lethargy, poor feeding, dehydration, hypothermia, hyperammonemia, neutropenia, and thrombocytopenia. Author(s): Elfenbein DS, Barness EG, Pomerance HH, Barness LA. Source: American Journal of Medical Genetics. 2000 October 2; 94(4): 332-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11038448&dopt=Abstract
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Numerical studies on the effect of lowering temperature on the oxygen transport during brain hypothermia resuscitation. Author(s): Ji Y, Liu J. Source: Computers in Biology and Medicine. 2002 November; 32(6): 495-514. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356498&dopt=Abstract
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Open distal anastomosis in conjunction with partial cardiopulmonary bypass and mild hypothermia for repair of descending thoracic aortic aneurysms. Author(s): Ramo OJ, Luosto RV. Source: Ann Chir Gynaecol. 1999; 88(4): 285-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10661825&dopt=Abstract
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Optimal temperature for the management of severe traumatic brain injury: effect of hypothermia on intracranial pressure, systemic and intracranial hemodynamics, and metabolism. Author(s): Tokutomi T, Morimoto K, Miyagi T, Yamaguchi S, Ishikawa K, Shigemori M. Source: Neurosurgery. 2003 January; 52(1): 102-11; Discussion 111-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12493106&dopt=Abstract
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Osborn waves of hypothermia. Author(s): Alhaddad IA, Khalil M, Brown EJ Jr. Source: Circulation. 2000 June 27; 101(25): E233-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10869275&dopt=Abstract
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Osborn waves of severe hypothermia. Author(s): Fehr T, Straumann EH, Bertel O. Source: Clin Cardiol. 2002 May; 25(5): 241. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018883&dopt=Abstract
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Osborne (J) waves in hypothermia. Author(s): Spodick DH. Source: The American Journal of Geriatric Cardiology. 2002 November-December; 11(6): 412. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417849&dopt=Abstract
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Out of the cold: management of hypothermia and frostbite. Author(s): Biem J, Koehncke N, Classen D, Dosman J. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 February 4; 168(3): 305-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566336&dopt=Abstract
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Outcome of thoracoabdominal aortic operations using deep hypothermia and distal exsanguination. Author(s): Carrel TP, Berdat PA, Robe J, Gysi J, Nguyen T, Kipfer B, Althaus U. Source: The Annals of Thoracic Surgery. 2000 March; 69(3): 692-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10750745&dopt=Abstract
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Pancytopenia induced by hypothermia. Author(s): Lo L, Singer ST, Vichinsky E. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2002 November; 24(8): 681-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439045&dopt=Abstract
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Pathophysiology of accidental hypothermia. Author(s): Mallet ML. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 December; 95(12): 775-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12454320&dopt=Abstract
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Patient temperature: an introduction to the clinical guideline for the prevention of unplanned perioperative hypothermia. Author(s): Jeran L. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2001 October; 16(5): 303-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11586474&dopt=Abstract
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Pediatric nonenvironmental hypothermia presenting to the emergency department: Episodic spontaneous hypothermia with hyperhidrosis. Author(s): Greenberg RA, Rittichier KK. Source: Pediatric Emergency Care. 2003 February; 19(1): 32-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12592112&dopt=Abstract
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Perinatal asphyxia: a clinical review, including research with brain hypothermia. Author(s): Flavin NE. Source: Neonatal Netw. 2001 April; 20(3): 31-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12144213&dopt=Abstract
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Physiological responses and management of hypothermia. Author(s): Keane C. Source: Emergency Nurse : the Journal of the Rcn Accident and Emergency Nursing Association. 2000 December-2001 January; 8(8): 26-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11935732&dopt=Abstract
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Pilot investigation of hypothermia in neonates receiving extracorporeal membrane oxygenation. Author(s): Ichiba S, Killer HM, Firmin RK, Kotecha S, Edwards AD, Field D. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2003 March; 88(2): F128-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598502&dopt=Abstract
100 Hypothermia
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Potential mechanisms of hypothermia-induced electrolyte depletion. Author(s): Polderman KH, Girbes AR. Source: Critical Care Medicine. 2002 August; 30(8): 1932; Author Reply 1932-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12163833&dopt=Abstract
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Predictor of core hypothermia and the surgical intensive care unit. Author(s): Kongsayreepong S, Chaibundit C, Chadpaibool J, Komoltri C, Suraseranivongse S, Suwannanonda P, Raksamanee EO, Noocharoen P, Silapadech A, Parakkamodom S, Pum-In C, Sojeoyya L. Source: Anesthesia and Analgesia. 2003 March; 96(3): 826-33, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598269&dopt=Abstract
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Prehospital management of hypothermia. Author(s): Streger MR. Source: Emerg Med Serv. 2001 March; 30(3): 61-4; Quiz 92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11258305&dopt=Abstract
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Preoperative blood pressure and catecholamines related to hypothermia during general anesthesia. Author(s): Kasai T, Hirose M, Matsukawa T, Takamata A, Yaegashi K, Tanaka Y. Source: Acta Anaesthesiologica Scandinavica. 2003 February; 47(2): 208-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12631051&dopt=Abstract
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Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery. Author(s): Vanni SM, Braz JR, Modolo NS, Amorim RB, Rodrigues GR Jr. Source: Journal of Clinical Anesthesia. 2003 March; 15(2): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719051&dopt=Abstract
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Preoperative risk factors of intraoperative hypothermia in major surgery under general anesthesia. Author(s): Moons KG, van Klei W, Kalkman CJ. Source: Anesthesia and Analgesia. 2003 June; 96(6): 1843-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761031&dopt=Abstract
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Preoperative risk factors of intraoperative hypothermia in major surgery under general anesthesia. Author(s): Kasai T, Hirose M, Yaegashi K, Matsukawa T, Takamata A, Tanaka Y. Source: Anesthesia and Analgesia. 2002 November; 95(5): 1381-3, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401629&dopt=Abstract
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Preventing hypothermia at birth in preterm babies: at a cost of overheating some? Author(s): Newton T, Watkinson M. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2003 May; 88(3): F256. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719405&dopt=Abstract
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Preventing post-injury hypothermia during prolonged prehospital evacuation. Author(s): Husum H, Olsen T, Murad M, Heng YV, Wisborg T, Gilbert M. Source: Prehospital Disaster Med. 2002 January-March; 17(1): 23-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12357560&dopt=Abstract
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Prolonged hypothermia following respiratory syncytial viral infection in infancy. Author(s): Milner D, Wailoo MP, Swift PG, Fraser M. Source: Archives of Disease in Childhood. 2003 January; 88(1): 69-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495968&dopt=Abstract
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Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review. Author(s): McIntyre LA, Fergusson DA, Hebert PC, Moher D, Hutchison JS. Source: Jama : the Journal of the American Medical Association. 2003 June 11; 289(22): 2992-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799408&dopt=Abstract
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Prominent J wave and ST segment elevation: serial electrocardiographic changes in accidental hypothermia. Author(s): Noda T, Shimizu W, Tanaka K, Chayama K. Source: Journal of Cardiovascular Electrophysiology. 2003 February; 14(2): 223. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12693512&dopt=Abstract
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Pupillary abnormality on admission and brain bulging during surgery as unfavourable predictors in patients treated with hypothermia: a retrospective review of 81 patients with severe head injury. Author(s): Matsumae M, Ishizaka H, Shiramizu H, Shibata M, Tsugane R. Source: Acta Neurochirurgica. 2001 December; 143(12): 1229-34; Discussion 1234-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11810387&dopt=Abstract
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Q-T and JT dispersion in the elderly with urban hypothermia. Author(s): Durakovic Z, Misigoj-Durakovic M, Corovic N. Source: International Journal of Cardiology. 2001 September-October; 80(2-3): 221-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11578718&dopt=Abstract
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Quantitative evaluation of hypothermia, hyperthermia, and hemodilution on coagulation. Author(s): Kmiecik SA, Liu JL, Vaadia TS, Nichols JD, Kohtz RJ, Mills NJ, Petterson CM, Stammers AH. Source: J Extra Corpor Technol. 2001 May; 33(2): 100-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11467435&dopt=Abstract
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Randomizing patients to permit the development of perioperative hypothermia is inappropriate. Author(s): Booth MG, Gallagher G, Kinsella J. Source: European Journal of Anaesthesiology. 2002 September; 19(9): 688; Author Reply 688-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243295&dopt=Abstract
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Re: Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Author(s): Leker RR, Ovadia H. Source: Stroke; a Journal of Cerebral Circulation. 2002 March; 33(3): 877-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11872918&dopt=Abstract
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Re: New research in the field of stroke: therapeutic hypothermia after cardiac arrest. Author(s): Holzer M, Sterz F, Behringer W. Source: Stroke; a Journal of Cerebral Circulation. 2003 August; 34(8): E103; Author Reply E103. Epub 2003 July 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12869720&dopt=Abstract
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Re: Omert LA et al. Harbingers of poor outcome the day after severe brain injury: hypothermia, hypoxia, and hypoperfusion. Author(s): Gundersen Y, Vaagenes P. Source: The Journal of Trauma. 2003 August; 55(2): 388-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12913660&dopt=Abstract
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Re: Shaken baby syndrome and hypothermia. Author(s): Allasio D, Fischer H. Source: Child Abuse & Neglect. 2001 November; 25(11): 1413-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766007&dopt=Abstract
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Recovery from pH 6.38: lactic acidosis complicated by hypothermia. Author(s): Ahmad S, Beckett M. Source: Emergency Medicine Journal : Emj. 2002 March; 19(2): 169-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11904273&dopt=Abstract
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Regional hypothermia with epidural cooling for spinal cord protection during thoracoabdominal aneurysm repair. Author(s): Cambria RP, Davison JK. Source: Semin Vasc Surg. 2000 December; 13(4): 315-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11156060&dopt=Abstract
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Relationship between brain temperature, brain chemistry and oxygen delivery after severe human head injury: the effect of mild hypothermia. Author(s): Soukup J, Zauner A, Doppenberg EM, Menzel M, Gilman C, Bullock R, Young HF. Source: Neurological Research. 2002 March; 24(2): 161-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11877900&dopt=Abstract
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Relationship between intracranial pressure, mild hypothermia and temperaturecorrected PaCO2 in patients with traumatic brain injury. Author(s): Vigue B, Ract C, Zlotine N, Leblanc PE, Samii K, Bissonnette B. Source: Intensive Care Medicine. 2000 June; 26(6): 722-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10945389&dopt=Abstract
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Renal hypothermia achieved by retrograde endoscopic cold saline perfusion: technique and initial clinical application. Author(s): Landman J, Venkatesh R, Lee D, Vanlangendonck R, Morissey K, Andriole GL, Clayman RV, Sundaram CP. Source: Urology. 2003 May; 61(5): 1023-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12736030&dopt=Abstract
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Repeated episodes of hypothermia in a subject treated with haloperidol, levomepromazine, olanzapine, and thioridazine. Author(s): Hagg S, Mjorndal T, Lindqvist L. Source: Journal of Clinical Psychopharmacology. 2001 February; 21(1): 113-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11199936&dopt=Abstract
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Resistive heating is more effective than metallic-foil insulation in an experimental model of accidental hypothermia: A randomized controlled trial. Author(s): Greif R, Rajek A, Laciny S, Bastanmehr H, Sessler DI. Source: Annals of Emergency Medicine. 2000 April; 35(4): 337-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10736119&dopt=Abstract
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Restoration of cerebral blood flow autoregulation and reactivity to carbon dioxide in acute liver failure by moderate hypothermia. Author(s): Jalan R, Olde Damink SW, Deutz NE, Hayes PC, Lee A. Source: Hepatology (Baltimore, Md.). 2001 July; 34(1): 50-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11431733&dopt=Abstract
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Resuscitative hypothermia after cardiac arrest in adults. Author(s): Gwinnutt CL, Nolan JP. Source: European Journal of Anaesthesiology. 2003 July; 20(7): 511-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12884983&dopt=Abstract
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Reversible hypophosphatemia during moderate hypothermia therapy for braininjured patients. Author(s): Aibiki M, Kawaguchi S, Maekawa N. Source: Critical Care Medicine. 2001 September; 29(9): 1726-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11546972&dopt=Abstract
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Revisiting hypothermia: a critical concept. Author(s): Burns SM. Source: Critical Care Nurse. 2001 April; 21(2): 83-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858443&dopt=Abstract
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Rewarming from accidental hypothermia by extracorporeal circulation. A retrospective study. Author(s): Farstad M, Andersen KS, Koller ME, Grong K, Segadal L, Husby P. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2001 July; 20(1): 58-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11423275&dopt=Abstract
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Rewarming from hypothermia leads to elevated plasma lipopolysaccharide concentrations. Author(s): Gaffin SL, Dietz FB, Brock-Utne JG, Andrews TC, Jaffe RA, Steinberg GK, Wallace RF. Source: Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc. 2000 Spring; 27(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10813433&dopt=Abstract
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Rewarming from hypothermia. Newer aspects on the pathophysiology of rewarming shock. Author(s): Tveita T. Source: Int J Circumpolar Health. 2000 October; 59(3-4): 260-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11209678&dopt=Abstract
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Role of hypothermia in the management of severe cases of subarachnoid hemorrhage. Author(s): Yasui N, Kawamura S, Suzuki A, Hadeishi H, Hatazawa J. Source: Acta Neurochir Suppl. 2002; 82: 93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378998&dopt=Abstract
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Scalp hypothermia to prevent chemotherapy-induced alopecia is effective and safe: a pilot study of a new digitized scalp-cooling system used in 74 patients. Author(s): Ridderheim M, Bjurberg M, Gustavsson A. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2003 June; 11(6): 371-7. Epub 2003 March 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768403&dopt=Abstract
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Sclerema Neonatorum following hypothermia. Author(s): Battin M, Harding J, Gunn A. Source: Journal of Paediatrics and Child Health. 2002 October; 38(5): 533-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354278&dopt=Abstract
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Selective deep spinal hypothermia with vacuum-assisted cerebral spinal fluid drainage for thoracoabdominal aortic surgery. Author(s): Trowbridge C, Bruhn T, Arends B. Source: J Extra Corpor Technol. 2003 June; 35(2): 152-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939025&dopt=Abstract
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Selective protection of non-cancer cells by hypothermia. Author(s): Matijasevic Z. Source: Anticancer Res. 2002 November-December; 22(6A): 3267-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530074&dopt=Abstract
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Serotonin 1A receptor activation and hypothermia in humans: lack of evidence for a presynaptic mediation. Author(s): Blier P, Seletti B, Gilbert F, Young SN, Benkelfat C. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 August; 27(2): 301-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12093604&dopt=Abstract
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Severe accidental hypothermia treated in an ICU: prognosis and outcome. Author(s): Vassal T, Benoit-Gonin B, Carrat F, Guidet B, Maury E, Offenstadt G. Source: Chest. 2001 December; 120(6): 1998-2003. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11742934&dopt=Abstract
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Severe accidental hypothermia with or without hemodynamic instability: rewarming without the use of extracorporeal circulation. Author(s): Roggla M, Frossard M, Wagner A, Holzer M, Bur A, Roggla G. Source: Wiener Klinische Wochenschrift. 2002 May 15; 114(8-9): 315-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12212366&dopt=Abstract
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Severe hypothermia caused by clonidine. Author(s): Quail MT, Shannon M. Source: The American Journal of Emergency Medicine. 2003 January; 21(1): 86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563590&dopt=Abstract
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Severe hypothermia in a neonate following antenatal exposure to haloperidol. Author(s): Mohan MS, Patole SK, Whitehall JS. Source: Journal of Paediatrics and Child Health. 2000 August; 36(4): 412-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10940186&dopt=Abstract
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Severe hypothermia with cardiac arrest: complete neurologic recovery in a 4-year old child. Author(s): Sheth NP. Source: Journal of Pediatric Surgery. 2003 April; 38(4): 654. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677593&dopt=Abstract
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Severe hypothermia with cardiac arrest: complete neurologic recovery in a 4-year-old child. Author(s): Papenhausen M, Burke L, Antony A, Phillips JD. Source: Journal of Pediatric Surgery. 2001 October; 36(10): 1590-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584417&dopt=Abstract
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Significance of temperature difference between cerebral cortex and axilla in patients under hypothermia management. Author(s): Yoo DS, Kim DS, Park CK, Cho KS, Huh PW, Kang JK. Source: Acta Neurochir Suppl. 2002; 81: 85-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12168366&dopt=Abstract
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Slow rewarming: a cool model of posttraumatic hypothermia. Author(s): Vespa PM. Source: Critical Care Medicine. 2001 November; 29(11): 2224-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11700391&dopt=Abstract
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Staged perfusion with an axillary artery graft and deep hypothermia during descending aortic replacement. Author(s): Takahashi T, Shimazaki Y, Watanabe T, Minowa T, Koshika M, Inui K, Hosaka J, Toyama S. Source: The Journal of Thoracic and Cardiovascular Surgery. 2001 July; 122(1): 188-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11436058&dopt=Abstract
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Stress protein involvement in cardioprotection induced by hypothermia. Author(s): Mestril R. Source: Journal of Molecular and Cellular Cardiology. 2001 December; 33(12): 2075-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11735254&dopt=Abstract
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Study on therapeutic mechanism and clinical effect of mild hypothermia in patients with severe head injury. Author(s): Zhi D, Zhang S, Lin X. Source: Surgical Neurology. 2003 May; 59(5): 381-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765810&dopt=Abstract
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Subcutaneous fat necrosis of the newborn following hypothermia and complicated by pain and hypercalcaemia. Author(s): Wiadrowski TP, Marshman G. Source: The Australasian Journal of Dermatology. 2001 August; 42(3): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11488718&dopt=Abstract
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Successful defibrillation in profound hypothermia (core body temperature 25.6 degrees C). Author(s): Thomas R, Cahill CJ. Source: Resuscitation. 2000 November; 47(3): 317-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11114463&dopt=Abstract
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Systemic and cerebral haemodynamics during craniotomy under mild hypothermia in patients with acute subarachnoid haemorrhage. Author(s): Sato K, Sato K, Yoshimoto T. Source: Acta Neurochirurgica. 2000; 142(9): 1013-9; Discussion 1019-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11086810&dopt=Abstract
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Systemic hypothermia in infants with hypoxic-ischaemic encephalopathy: a French pilot study. Author(s): Zupan V. Source: Dev Med Child Neurol Suppl. 2001 March; 86: 32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268725&dopt=Abstract
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The effect of fluoride and hypothermia on the in vitro metabolism of mivacurium. Author(s): Gruber M, Lindner R, Prasser C, Wiesner G. Source: Anesthesia and Analgesia. 2002 August; 95(2): 397-9, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145059&dopt=Abstract
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The effect of graded hypothermia (36 degrees C-32 degrees C) on hemostasis in anesthetized patients without surgical trauma. Author(s): Kettner SC, Sitzwohl C, Zimpfer M, Kozek SA, Holzer A, Spiss CK, Illievich UM. Source: Anesthesia and Analgesia. 2003 June; 96(6): 1772-6, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761010&dopt=Abstract
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The emerging role of induced hypothermia in the management of acute stroke. Author(s): Feigin VL, Anderson CS, Rodgers A, Anderson NE, Gunn AJ. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2002 September; 9(5): 502-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383404&dopt=Abstract
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The emerging role of therapeutic hypothermia in acute stroke. Author(s): Feigin V, Anderson N, Gunn A, Rodgers A, Anderson C. Source: Lancet. Neurology. 2003 September; 2(9): 529. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12941573&dopt=Abstract
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The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. Author(s): Durrer B, Brugger H, Syme D; International Commission for Mountain Emergency Medicine. Source: High Altitude Medicine & Biology. 2003 Spring; 4(1): 99-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12713717&dopt=Abstract
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The use of hypothermia as a method of neuroprotection during neurosurgical procedures and after traumatic brain injury: a survey of clinical practice in Great Britain and Ireland. Author(s): Pemberton PL, Dinsmore J. Source: Anaesthesia. 2003 April; 58(4): 370-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12688273&dopt=Abstract
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Therapeutic hypothermia after cardiac arrest. Author(s): Safar PJ, Kochanek PM. Source: The New England Journal of Medicine. 2002 February 21; 346(8): 612-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856801&dopt=Abstract
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Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life support Task Force of the International Liaison committee on Resuscitation. Author(s): Nolan JP, Morley PT, Hoek TL, Hickey RW; Advancement Life support Task Force of the International Liaison committee on Resuscitation. Source: Resuscitation. 2003 June; 57(3): 231-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858857&dopt=Abstract
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Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Author(s): Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, Kloeck WG, Billi J, Bottiger BW, Morley PT, Nolan JP, Okada K, Reyes C, Shuster M, Steen PA, Weil MH, Wenzel V, Hickey RW, Carli P, Vanden Hoek TL, Atkins D; International Liaison Committee on Resuscitation. Source: Circulation. 2003 July 8; 108(1): 118-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847056&dopt=Abstract
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Therapeutic hypothermia after prolonged cardiac arrest due to non-coronary causes. Author(s): Silfvast T, Tiainen M, Poutiainen E, Roine RO. Source: Resuscitation. 2003 April; 57(1): 109-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668307&dopt=Abstract
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Therapeutic hypothermia for acute stroke. Author(s): Olsen TS, Weber UJ, Kammersgaard LP. Source: Lancet. Neurology. 2003 July; 2(7): 410-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849119&dopt=Abstract
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Therapeutic hypothermia for head injury. Author(s): Gadkary CS, Alderson P, Signorini DF. Source: Cochrane Database Syst Rev. 2002; (1): Cd001048. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869586&dopt=Abstract
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Therapeutic hypothermia for severe traumatic brain injury. Author(s): Kochanek PM, Safar PJ. Source: Jama : the Journal of the American Medical Association. 2003 June 11; 289(22): 3007-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799411&dopt=Abstract
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ThermoSpot in the detection of neonatal hypothermia. Author(s): Zeal J. Source: Annals of Tropical Paediatrics. 2003 March; 23(1): 87-8; Author Reply. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648332&dopt=Abstract
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ThermoSpot in the detection of neonatal hypothermia. Author(s): Kambarami R, Chidede O, Pereira N. Source: Annals of Tropical Paediatrics. 2002 September; 22(3): 219-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369485&dopt=Abstract
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Thyroid hormone response to moderate hypothermia in severe brain injury. Author(s): Meissner W, Krapp C, Kauf E, Dohrn B, Reinhart K. Source: Intensive Care Medicine. 2003 January; 29(1): 44-8. Epub 2002 November 20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528021&dopt=Abstract
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Treatment of acute traumatic brain injury in children with moderate hypothermia improves intracranial hypertension. Author(s): Biswas AK, Bruce DA, Sklar FH, Bokovoy JL, Sommerauer JF. Source: Critical Care Medicine. 2002 December; 30(12): 2742-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12483067&dopt=Abstract
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Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. Author(s): Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K. Source: The New England Journal of Medicine. 2002 February 21; 346(8): 557-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856794&dopt=Abstract
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Treatment of term infants with head cooling and mild systemic hypothermia (35.0 degrees C and 34.5 degrees C) after perinatal asphyxia. Author(s): Battin MR, Penrice J, Gunn TR, Gunn AJ. Source: Pediatrics. 2003 February; 111(2): 244-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563046&dopt=Abstract
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Two case studies of hypothermia induced by an increased dosage of zotepine in a combination therapy. Author(s): Chen KC, Yang YK, Chen PS, Yeh TL, Yang MJ. Source: Psychiatry and Clinical Neurosciences. 2003 August; 57(4): 369-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839516&dopt=Abstract
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Upright posture reduces thermogenesis and augments core hypothermia. Author(s): Nakajima Y, Takamata A, Ito T, Sessler DI, Kitamura Y, Shimosato G, Taniguchi S, Matsuyama H, Tanaka Y, Mizobe T. Source: Anesthesia and Analgesia. 2002 June; 94(6): 1646-51, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032045&dopt=Abstract
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Urban hypothermia and hyperglycemia in the elderly. Author(s): Durakovic Z, Misigoj-Durakovic M, Corovic N, Cubrilo-Turek M. Source: Coll Antropol. 2000 December; 24(2): 405-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11216409&dopt=Abstract
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Use of a centrifugal vortex blood pump and heparin-bonded circuit for extracorporeal rewarming of severe hypothermia in acutely injured and coagulopathic patients. Author(s): Kirkpatrick AW, Garraway N, Brown DR, Nash D, Ng A, Lawless B, Cunningham J, Chun R, Simons RK. Source: The Journal of Trauma. 2003 September; 55(3): 407-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14501879&dopt=Abstract
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Use of selective hypothermia to protect the spinal cord during resection of thoracoabdominal aneurysms. Author(s): Cooley DA, Jones BA. Source: Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 2000; 27(1): 29-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830625&dopt=Abstract
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Vertebral artery surgery with cardiopulmonary bypass and deep hypothermia. Author(s): Demaria RG, Albat B, Frapier JM, Bodino M, Chaptal PA. Source: The Journal of Cardiovascular Surgery. 2000 April; 41(2): 299-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10901540&dopt=Abstract
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Was the biblical King David affected by hypothermia? Author(s): Ben-Noun LL. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2002 June; 57(6): M364-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12023265&dopt=Abstract
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What are the most important risk factors for a patient's developing intraoperative hypothermia? Author(s): Macario A, Dexter F. Source: Anesthesia and Analgesia. 2002 January; 94(1): 215-20, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772832&dopt=Abstract
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Whole-body hypothermia for neonatal encephalopathy: animal observations as a basis for a randomized, controlled pilot study in term infants. Author(s): Shankaran S, Laptook A, Wright LL, Ehrenkranz RA, Donovan EF, Fanaroff AA, Stark AR, Tyson JE, Poole K, Carlo WA, Lemons JA, Oh W, Stoll BJ, Papile LA, Bauer CR, Stevenson DK, Korones SB, McDonald S. Source: Pediatrics. 2002 August; 110(2 Pt 1): 377-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12165594&dopt=Abstract
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CHAPTER 2. NUTRITION AND HYPOTHERMIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and hypothermia.
Finding Nutrition Studies on Hypothermia 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 “hypothermia” (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 “hypothermia” (or a synonym): •
Effects of diabetes and food deprivation on shivering activity during progressive hypothermia in the rat. Author(s): Department of Exercise Science, Concordia University, Montreal, Quebec H4B 1R6 (Canada) Source: Kilgour, R.D. Williams, P.A. Comparative-Biochemistry-and-Physiology.-A,Physiology (United Kingdom). (1996). volume 114(2) page 159-165.
Additional physician-oriented references include: •
Accidental hypothermia. Source: Wright, J Prof-Nurse. 1991 January; 6(4): 197-9 0266-8130
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Cardiovascular effects of morphine during hypothermia. Author(s): Department of Anesthesiology, NYU Medical Center, NY 10016. Source: Alcaraz, C Bansinath, M Turndorf, H Puig, M M Arch-Int-Pharmacodyn-Ther. 1989 Jan-February; 297133-47 0003-9780
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Characterisation of the calcium paradox in the isolated perfused pigeon heart: protection by hypothermia, acidosis and alkalosis. Author(s): Department of Animal and Human Physiology, School of Biology, Faculty of Sciences, University of Athens, Panepistimioupolis, Athens. Source: Gaitanaki, C Anezaki, M Margieti, M M Papazafiri, P Beis, I Cell-PhysiolBiochem. 2002; 12(2-3): 93-100 1015-8987
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Chlorpromazine-induced hypothermia in tumour-bearing mice, acute cytotoxic drug lethality and long-term survival. Author(s): Department of Histology, University of Gothenburg, Sweden. Source: Hultborn, R Lundgren Eriksson, L Ottosson Lonn, S Ryd, W Weiss, L ActaOncol. 1990; 29(7): 941-4 0284-186X
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Cholecystokinin and morphine-induced hypothermia. Author(s): Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran. Source: Rezayat, M Ravandeh, N Zarrindast, M R Eur-Neuropsychopharmacol. 1999 March; 9(3): 219-25 0924-977X
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Desipramine and nortriptyline antagonize apomorphine and reserpine hypothermia by a different mechanism. Author(s): A. Menarini Farmaceutici s.r.l., Pharmacological Research Division, Florence, Italy. Source: Volterra, G Borsini, F Lecci, A Meli, A J-Pharm-Pharmacol. 1990 August; 42(8): 586-9 0022-3573
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Dopamine agonist-induced hypothermia and disruption of prepulse inhibition: evidence for a role of D3 receptors? Author(s): Glaxo Unit for Behavioural Psychopharmacology, University of Hertfordshire, UK.
[email protected] Source: Varty, G B Higgins, G A Behav-Pharmacol. 1998 September; 9(5-6): 445-55 09558810
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Effect of mild therapeutic hypothermia on phenytoin pharmacokinetics. Author(s): Department of Anesthesiology & Intensive Care Medicine, Osaka City University Medical School, Osaka, Japan.
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Source: Iida, Y Nishi, S Asada, A Ther-Drug-Monit. 2001 June; 23(3): 192-7 0163-4356 •
Effect of reserpine on N-methylthiobenzamide-induced pulmonary edema: role of lung norepinephrine and hypothermia. Author(s): Department of Pharmacology and Toxicology, University of Kansas, School of Pharmacy, Lawrence 66045-2500. Source: Gibbs, L S Traiger, G J Toxicology. 1989 March; 54(3): 311-21 0300-483X
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Effect of vitamin E, topical hypothermia and steroid on ischemic liver in rats. Author(s): Department of Surgery, Kaohsiung Medical College Hospital, Taiwan, Republic of China. Source: Lee, K T Tsai, L Y Sheen, P C Kaohsiung-J-Med-Sci. 1998 January; 14(1): 6-12 1607-551X
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Effects of hypothermia and hyperthermia on the reactivity of rat intracerebral arterioles in vitro. Author(s): Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri. Source: Ogura, K Takayasu, M Dacey, R G J-Neurosurg. 1991 September; 75(3): 433-9 0022-3085
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Effects of mild hypothermia on metabolic disturbances in fetal hippocampal slices after oxygen/glucose deprivation depend on depth and time delay of cooling. Author(s): Department of Obstetrics and Gynecology, Ruhr-Universitat Bochum, D44892 Bochum, Germany. Source: Garnier, Y Pfeiffer, D Jensen, A Berger, R J-Soc-Gynecol-Investig. 2001 JulAugust; 8(4): 198-205 1071-5576
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Effects of moderate and deep hypothermia on Ca2+ signaling in rat ventricular myocytes. Author(s): Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1009, USA.
[email protected] Source: Groban, L Zapata Sudo, G Lin, M Nelson, T E Cell-Physiol-Biochem. 2002; 12(23): 101-10 1015-8987
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Glial cell swelling--effect of hypothermia. Author(s): Institute for Surgical Research, Klinikum Grosshadern, Ludwig-Maximilians University, Munich. Source: Plesnila, N Muller, E Ringel, F Peters, J Baethmann, A Acta-Neurochir-Suppl(Wien). 1999; 7363-6 0065-1419
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Hypothermia elicited by some prodynorphin-derived peptides: opioid and nonopioid actions. Author(s): Institute of Pharmacology, University of Bologna, Italy. Source: Cavicchini, E Candeletti, S Spampinato, S Ferri, S Neuropeptides. 1989 July; 14(1): 45-50 0143-4179
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Hypothermia enhances the biological activity of lipopolysaccharide by altering its fluidity state. Author(s): Institute of Immunology and Transfusion Medicine, University of Lubeck, School of Medicine, Germany. Source: Luhm, J Schromm, A B Seydel, U Brandenburg, K Wellinghausen, N Riedel, E Schumann, R R Rink, L Eur-J-Biochem. 1998 September 1; 256(2): 325-33 0014-2956
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Hypothermia with acute renal failure in a patient suffering from diabetic nephropathy and malnutrition. Author(s): Department of Internal Medicine, Kanazawa National Hospital, Japan.
[email protected] Source: Yokoyama, M Noto, Y Kida, H Diabetes-Metab. 2000 April; 26(2): 145-7 12623636
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Hypothermia: the chiller that may be missed? Source: Green, M Geriatr-Nurs-Home-Care. 1987 December; 7(12): 20-1 0269-9079
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Inhibitory effects of MK-801 on contextual sensitization to climbing behavior and on development of tolerance to hypothermia induced by a single high dose of apomorphine. Author(s): College of Pharmacy, Chungbuk National University, Cheongju, Korea. Source: Yun, J S Kim, H S Lee, M K Oh, K W Jang, C G Park, W K Seong, Y H Lee, S C Oh, S K Pharmacol-Res. 2001 December; 44(6): 473-9 1043-6618
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Intraischemic hypothermia differentially modulates oxidative stress proteins during mesenteric ischemia/reperfusion. Author(s): Department of Surgery, UT-Houston Medical School, 77030, USA. Source: Hassoun, H T Kozar, R A Kone, B C Safi, H J Moore, F A Surgery. 2002 August; 132(2): 369-76 0039-6060
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Intravenous prostaglandin E1, cold crystalloid flush and topical hypothermia for cardiopulmonary graft preservation. Source: Harjula, A L Starkey, T D Hagberg, R C Baldwin, J C Ann-Chir-Gynaecol. 1987; 76(1): 56-60 0355-9521
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Mechanisms of excitatory amino acid release in contused brain tissue: effects of hypothermia and in situ administration of Co2+ on extracellular levels of glutamate. Author(s): Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan. Source: Maeda, T Katayama, Y Kawamata, T Yamamoto, T J-Neurotrauma. 1998 September; 15(9): 655-64 0897-7151
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Neuromodulators and hypoxic hypothermia in the rat. Author(s): Atelier de Physiologie Respiratoire, Faculte de Medecine Saint-Antoine, Paris, France. Source: Gautier, H Murariu, C Respir-Physiol. 1998 June; 112(3): 315-24 0034-5687
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Neuroprotective effect of mild hypothermia cannot be explained in terms of a reduction of glutamate release during ischemia. Author(s): Department of Physiology, School of Medicine, Ehime University, Japan. Source: Yamamoto, H Mitani, A Cui, Y Takechi, S Irita, J Suga, T Arai, T Kataoka, K Neuroscience. 1999; 91(2): 501-9 0306-4522
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N-methyl-D-aspartate antagonists and WIN 55212-2 [4,5-dihydro-2-methyl-4(4morpholinylmethyl)-1-(1-naphthalenyl-carbonyl)-6H-pyrrolo[3,2,1-i,j]quinolin-6-one], a cannabinoid agonist, interact to produce synergistic hypothermia. Author(s): Department of Pharmacology and Center for Substance Abuse Research, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
[email protected] Source: Rawls, S M Cowan, A Tallarida, R J Geller, E B Adler, M W J-Pharmacol-ExpTher. 2002 October; 303(1): 395-402 0022-3565
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Role of the nitric oxide pathway in kappa-opioid-induced hypothermia in rats. Author(s): Center for Substance Abuse Research and Department of Pharmacology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
[email protected] Source: BenaMarch, K Geller, E B Adler, M W J-Pharmacol-Exp-Ther. 2002 October; 303(1): 375-8 0022-3565
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The effect of mild hypothermia, mannitol and insulin-induced hypoglycaemia on ischaemic infarct volume in the early period after permanent middle cerebral artery occlusion in the rat. Author(s): Department of Neurosurgery, Akdeniz University, Faculty of Medicine, Antalya, Turkey. Source: Kazan, S Karasoy, M Baloglu, H Tuncer, R Acta-Neurochir-(Wien). 1999; 141(9): 979-87 0001-6268
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Transient spinal cord ischemia in rat: the time course of spinal FOS protein expression and the effect of intraischemic hypothermia (27 degrees C). Author(s): Department of Anesthesiology, Chang Gung Memorial Hospital, Niao Shung Hsiang, Kaohsiung Hsien, Taiwan, ROC. Source: Yang, L C Orendacova, J Wang, V Ishikawa, T Yaksh, T L Marsala, M Cell-MolNeurobiol. 2000 June; 20(3): 351-65 0272-4340
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND HYPOTHERMIA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to hypothermia. 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 hypothermia 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 “hypothermia” (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 hypothermia: •
A feasibility study of a new approach to clinical radiosensitisation: hypothermia and hyperbaric oxygen in combination with pharmacological vasodilatation. Author(s): Sealy R, Harrison GG, Morrell D, Korrubel J, Gregory A, Barry L, Blekkenhorst G, Hering ER, Fataar AB, Boniaszczuk J. Source: The British Journal of Radiology. 1986 November; 59(707): 1093-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3790896&dopt=Abstract
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Accidental deep hypothermia with cardiopulmonary arrest: extracorporeal blood rewarming in 11 patients. Author(s): Walpoth BH, Locher T, Leupi F, Schupbach P, Muhlemann W, Althaus U. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 1990; 4(7): 390-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2397132&dopt=Abstract
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Accidental hypothermia. Part II: Clinical implications of experimental studies. Author(s): Gregory RT, Doolittle WM. Source: Alaska Med. 1973 March; 15(2): 48-52. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4795843&dopt=Abstract
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Accidental hypothermia: an experimental study of inhalation rewarming. Author(s): Hayward JS, Steinman AM. Source: Aviation, Space, and Environmental Medicine. 1975 October; 46(10): 1236-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1180782&dopt=Abstract
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Accidental hypothermia: an experimental study of practical rewarming methods. Author(s): Collis ML, Steinman AM, Chaney RD. Source: Aviation, Space, and Environmental Medicine. 1977 July; 48(7): 625-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=883932&dopt=Abstract
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Acoustic startle, conditioned startle potentiation and the effects of 8-OH-DPAT and buspirone in rats selectively bred for differences in 8-OH-DPAT-induced hypothermia. Author(s): McQueen DA, Overstreet DH, Ardayfio PA, Commissaris RL. Source: Behavioural Pharmacology. 2001 November; 12(6-7): 509-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11742145&dopt=Abstract
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Age effects on chronic tolerance to ethanol hypnosis and hypothermia. Author(s): York JL, Chan AW. Source: Pharmacology, Biochemistry, and Behavior. 1994 October; 49(2): 371-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7824552&dopt=Abstract
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Apparent death with accidental hypothermia. A case report. Author(s): Edwards HA, Benstead JG, Brown K, Makary AZ, Menon NK. Source: British Journal of Anaesthesia. 1970 October; 42(10): 906-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5475449&dopt=Abstract
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Automatic external cardiac massage. An adjunct to recovery from moderate general hypothermia, profound preferential cerebral hypothermia, and prolonged cardiopulmonary arrest. Author(s): Tyers GF, Wolfson SK Jr. Source: Archives of Surgery (Chicago, Ill. : 1960). 1969 June; 98(6): 771-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4976647&dopt=Abstract
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Bath rewarming from immersion hypothermia. Author(s): Hoskin RW, Melinyshyn MJ, Romet TT, Goode RC.
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Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1986 October; 61(4): 151822. Erratum In: J Appl Physiol 1986 December; 61(6): Following 2314. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3781965&dopt=Abstract •
Benefits of endovascular hypothermia on myocardial preservation in the setting of cardiogenic shock. Author(s): Rizik DG, Villegas BJ, Bouhasin A. Source: J Invasive Cardiol. 2003 September; 15(9): 525-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12947214&dopt=Abstract
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Cannabichromene and delta 9-tetrahydrocannabinol: interactions relative to lethality, hypothermia and hexobarbital hypnosis. Author(s): Hatoum NS, Davis WM, Elsohly MA, Turner CE. Source: General Pharmacology. 1981; 12(5): 357-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6269951&dopt=Abstract
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Cannabis-induced hypothermia: a dose-effect comparison of crude marihuana extract and synthetic 9 -tetrahydrocannabinol in male and female rats. Author(s): Borgen LA, Lott GC, Davis WM. Source: Res Commun Chem Pathol Pharmacol. 1973 May; 5(3): 621-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4701259&dopt=Abstract
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Cardiac preservation utilizing hyperbaric oxygen and hypothermia. Author(s): Almond CH, Anido H, Seaber A, Young R, Mackenzie J. Source: Dis Chest. 1966 January; 49(1): 41-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5325148&dopt=Abstract
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Cardiopulmonary bypass for resuscitation of patients with accidental hypothermia and cardiac arrest. Author(s): Baumgartner FJ, Janusz MT, Jamieson WR, Winkler T, Burr LH, Vestrup JA. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1992 April; 35(2): 184-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1562930&dopt=Abstract
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Cardiopulmonary resuscitation following profound immersion hypothermia. Author(s): Steedman DJ, Rainer T, Campanella C. Source: Journal of Accident & Emergency Medicine. 1997 May; 14(3): 170-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9193984&dopt=Abstract
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Carotid perfusion hypothermia for brain surgery using cardiac arrest without bypass. Author(s): Wolfson SK Jr, Selker RG.
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Source: The Journal of Surgical Research. 1973 May; 14(5): 449-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4196153&dopt=Abstract •
Catecholaminergic mechanisms-mediated hypothermia induced by magnolol in rats. Author(s): Hsieh MT, Chueh FY, Lin SM, Chueh FS, Chen CF, Lin MT. Source: Japanese Journal of Pharmacology. 1998 December; 78(4): 501-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9920208&dopt=Abstract
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Cerebral autoregulation during whole-body hypothermia and hyperthermia stimulus. Author(s): Doering TJ, Aaslid R, Steuernagel B, Brix J, Niederstadt C, Breull A, Schneider B, Fischer GC. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 1999 January-February; 78(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9923427&dopt=Abstract
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Cerebral blood flow and oxygen metabolism during mild hypothermia in patients with subarachnoid haemorrhage. Author(s): Kawamura S, Suzuki A, Hadeishi H, Yasui N, Hatazawa J. Source: Acta Neurochirurgica. 2000; 142(10): 1117-21; Discussion 1121-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11129533&dopt=Abstract
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Chlorpromazine-induced hypothermia in tumour-bearing mice, acute cytotoxic drug lethality and long-term survival. Author(s): Hultborn R, Lundgren-Eriksson L, Ottosson-Lonn S, Ryd W, Weiss L. Source: Acta Oncologica (Stockholm, Sweden). 1990; 29(7): 941-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2261211&dopt=Abstract
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Circadian and hypothermia-induced effects on visual and auditory evoked potentials in multiple sclerosis. Author(s): Romani A, Bergamaschi R, Versino M, Zilioli A, Callieco R, Cosi V. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2000 September; 111(9): 1602-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10964071&dopt=Abstract
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Cold-induced release of reactive oxygen species as a decisive mediator of hypothermia injury to cultured liver cells. Author(s): Rauen U, de Groot H. Source: Free Radical Biology & Medicine. 1998 May; 24(7-8): 1316-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9626589&dopt=Abstract
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Coping with food-limited conditions: feeding behavior, temperature preference, and nocturnal hypothermia in pigeons. Author(s): Ostheim J.
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Source: Physiology & Behavior. 1992 February; 51(2): 353-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1557447&dopt=Abstract •
Coronary perfusion under general and selective cardiac hypothermia. Author(s): Iwaya F, von Recum A, Imamura H, Kantrowitz A. Source: The Journal of Cardiovascular Surgery. 1979 January-February; 20(1): 89-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=429458&dopt=Abstract
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Effect of hyperbaric oxygen and regional hypothermia on blood-flow and metabolism in the acutely ischaemic limb. Author(s): Stalker CG, McEwan AJ, Ledingham IA. Source: The British Journal of Surgery. 1970 May; 57(5): 382-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5427893&dopt=Abstract
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Effects of hypothermia on brainstem auditory evoked potentials in humans. Author(s): Markand ON, Lee BI, Warren C, Stoelting RK, King RD, Brown JW, Mahomed Y. Source: Annals of Neurology. 1987 October; 22(4): 507-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3435069&dopt=Abstract
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Effects of surface-induced hypothermia and circulatoroplasms diagnosis biopsy ilium splenectomy liver hodgkins disease diagnosis sarcoma reticulum cell diagnosis lymphoma giant y occlusion on plasma catecholamines. Author(s): Mohri H, Pitts CL, Sands MP, Manhas DR, Dillard DH, Merendino KA. Source: Surgery. 1972 October; 72(4): 596-603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5057651&dopt=Abstract
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Efficacy of hypothermia and transcutaneous electrical nerve stimulation in podiatric surgery. Author(s): Lanham RH Jr, Powell S, Hendrix BE. Source: J Foot Surg. 1984 March-April; 23(2): 152-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6609950&dopt=Abstract
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Electrocardiographic changes during surface-induced deep hypothermia. The influence of ether, halothane, carbon dioxide, and perfusion rewarming. Author(s): Sands MP, Sato S, Mohri H, Guntheroth WG, Merendino KA. Source: The Annals of Thoracic Surgery. 1975 April; 19(4): 386-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1122162&dopt=Abstract
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Enzyme histochemical studies on kidneys preserved in vitro by hypothermia and hyperbaric oxygen. Author(s): Balogh K Jr, Besznyak I.
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Source: Acta Morphol Acad Sci Hung. 1968; 16(2): 205-11. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4879198&dopt=Abstract •
Ethanol-induced hypothermia. Cross tolerance with morphine. Author(s): Fidecka S, Tamborska E, Langwinski R. Source: Acta Physiol Pol. 1986 July-August; 37(4-5): 168-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3591359&dopt=Abstract
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Factors influencing survival of mammalian cells exposed to hypothermia. IV. Effects of iron chelation. Author(s): Zieger MA, Glofcheski DJ, Lepock JR, Kruuv J. Source: Cryobiology. 1990 August; 27(4): 452-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2394129&dopt=Abstract
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Factors limiting survival after circulatory occlusion under hypothermia and hyperbaric oxygenation. Author(s): Edwards WS, Holdefer WF Jr, Dimick A. Source: The Journal of Thoracic and Cardiovascular Surgery. 1965 December; 50(6): 83941. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5846186&dopt=Abstract
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Failure of scalp hypothermia to prevent hair loss when cyclophosphamide is added to doxorubicin and vincristine. Author(s): Middleton J, Franks D, Buchanan RB, Hall V, Smallwood J, Williams CJ. Source: Cancer Treat Rep. 1985 April; 69(4): 373-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3995509&dopt=Abstract
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Fast and slow rewarming after acute and prolonged hypothermia in rabbits. Author(s): Zingg W. Source: The Journal of Trauma. 1969 March; 9(3): 250-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5766841&dopt=Abstract
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Forward blood flow during cardiopulmonary resuscitation in patients with severe accidental hypothermia. An echocardiographic study. Author(s): Mair P, Kornberger E, Schwarz B, Baubin M, Hoermann C. Source: Acta Anaesthesiologica Scandinavica. 1998 November; 42(10): 1139-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9834794&dopt=Abstract
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Glucose-insulin interactions during cardiopulmonary bypass. Hypothermia versus normothermia. Author(s): Kuntschen FR, Galletti PM, Hahn C.
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Source: The Journal of Thoracic and Cardiovascular Surgery. 1986 March; 91(3): 451-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3512920&dopt=Abstract •
Heart preservation with metabolic inhibitor, hypothermia, and hyperbaric oxygenation. Author(s): Todo K, Nakae S, Wada J. Source: Jpn J Surg. 1974 March; 4(1): 29-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4617784&dopt=Abstract
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How I would treat hypothermia and exposure. Author(s): Frankland JC. Source: British Medical Journal (Clinical Research Ed.). 1981 January 31; 282(6261): 36970. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6780030&dopt=Abstract
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Hyperbaric oxygen, hypothermia, and cerebral ischemia in the dog. Author(s): Patterson RH Jr, McSherry CK, Schwartz MS. Source: The Journal of Surgical Research. 1968 June; 8(6): 279-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5655932&dopt=Abstract
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Hyperbaric oxygenation and profound hypothermia to preserve canine kidneys. Author(s): Makin GS, Howard JM. Source: Archives of Surgery (Chicago, Ill. : 1960). 1965 October; 91(4): 568-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5319810&dopt=Abstract
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Hypnotic induction of hypothermia: an additional approach to postoperative control of cancer recurrence. Author(s): August RV. Source: Am J Clin Hypn. 1975 July; 18(1): 52-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1163463&dopt=Abstract
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Hypothermia and circulatory assistance in dogs with acute myocardial infarction. Author(s): Bussemaker JB, Dutka MF, Skinner DB. Source: The Journal of Thoracic and Cardiovascular Surgery. 1972 July; 64(1): 61-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4506233&dopt=Abstract
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Hypothermia and electromagnetic rewarming in the rhesus monkey. Author(s): Olsen RG, David TD. Source: Aviation, Space, and Environmental Medicine. 1984 December; 55(12): 1111-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6517817&dopt=Abstract
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Hypothermia and hemodilution with autologous transfusion. Author(s): Levine AH, Imai PK. Source: Aorn Journal. 1983 May; 37(6): 1060-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6307141&dopt=Abstract
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Hypothermia and high pressure oxygen in whole organ storage. Author(s): Rudolf LE. Source: Transplantation Proceedings. 1969 September; 1(3): 795-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4939676&dopt=Abstract
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Hypothermia in conjunction with hyperbaric oxygenation in the treatment of massive air embolism during cardiopulmonary bypass. Author(s): Steward D, Williams WG, Freedom R. Source: The Annals of Thoracic Surgery. 1977 December; 24(6): 591-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=596971&dopt=Abstract
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Hypothermia in mountain accidents. Author(s): Freeman J, Pugh LG. Source: International Anesthesiology Clinics. 1969 Winter; 7(4): 997-1007. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4922183&dopt=Abstract
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Hypothermia induced by hyperbaric oxygen is not blocked by serotonin antagonists. Author(s): Fenton LH, Beck G, Djali S, Robinson MB. Source: Pharmacology, Biochemistry, and Behavior. 1993 February; 44(2): 357-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8446668&dopt=Abstract
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Hypothermia-induced platelet aggregation in heparinized flowing human blood: identification of a high responder subpopulation. Author(s): Hall MW, Goodman PD, Alston SM, Solen KA. Source: American Journal of Hematology. 2002 January; 69(1): 45-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835331&dopt=Abstract
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In vitro and in vivo assessment of the preserved liver under hypothermia and hyperbaria without perfusion. Author(s): Uchida H, Ruiz JO, Alho AV, Schultz LS, Loken MK, Lillehei RC. Source: Trans Am Soc Artif Intern Organs. 1970; 16: 300-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4916736&dopt=Abstract
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In vitro kidney storage. I. Hypothermia and hyperbaric oxygen. Author(s): Ackermann JR, Barnard CN.
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Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1966 July 2; 40(24): 560-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5338801&dopt=Abstract •
In vitro preservation of whole organs by hypothermia and hyperbaric oxygenation. Author(s): Lillehei RC, Manax WG, Bloch JH, Eyal Z, Hidalgo F, Longerbeam JK. Source: Cryobiology. 1964 November-December; 1(2): 181-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5333442&dopt=Abstract
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Induction of hypercontractility in human cerebral arteries by rewarming following hypothermia: a possible role for tyrosine kinase. Author(s): Sagher O, Huang DL, Webb RC. Source: Journal of Neurosurgery. 1997 September; 87(3): 431-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9285610&dopt=Abstract
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Influence of decompression procedure on heart viability after long-term storage using hyperbaric oxygen and hypothermia. Author(s): Bui-Mong-Hung, Vigano M, Leandri J, Laurent D. Source: Nature. 1968 September 14; 219(159): 1175-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4877536&dopt=Abstract
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Infrared fibers for radiometer thermometry in hypothermia and hyperthermia treatment. Author(s): Katzir A, Bowman HF, Asfour Y, Zur A, Valeri CR. Source: Ieee Transactions on Bio-Medical Engineering. 1989 June; 36(6): 634-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2731950&dopt=Abstract
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Intestinal absorption of ileum preserved by hypothermia and hyperbaric oxygen. Author(s): Lyons GW, Manax WG, Largiader F, Lillehei RC. Source: Surg Forum. 1965; 16: 357-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5835190&dopt=Abstract
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Intestinal preservation by hypothermia and hyperbaric oxygen. Author(s): Momose K, Salerno RA. Source: Annals of Surgery. 1968 July; 168(1): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5673194&dopt=Abstract
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Intraoperative mild hypothermia ameliorates postoperative cerebral blood flow impairment in patients with aneurysmal subarachnoid hemorrhage. Author(s): Karibe H, Sato K, Shimizu H, Tominaga T, Koshu K, Yoshimoto T.
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Kidney preservation with hypothermia and hyperbaric oxygen. I. The diffusion of oxygen into the kidney. Author(s): Likkegaard H. Source: Acta Med Scand. 1970 March 3; 187(3): 189-94. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5444976&dopt=Abstract
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Kidney preservation with hypothermia and hyperbaric oxygen. II. Renal clearances in pigs with autotranlanted 24-hour preserved kidneys. Author(s): Lokkegaard H, Fernandes A, Gyrd-Hansen N, Hansen RI, Hasselager E, Kemp E, Lund F, Rasmussen F. Source: Acta Med Scand. 1970 March 3; 187(3): 195-202. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4910695&dopt=Abstract
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Leter: Treatment of hypothermia. Author(s): Davies L. Source: Lancet. 1975 October 4; 2(7936): 656. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=52019&dopt=Abstract
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Long term changes in NADPH-diaphorase reactivity in striatal and cortical neurons following experimental perinatal asphyxia: neuroprotective effects of hypothermia. Author(s): Fabian Loidl C, Capani F, Lopez-Costa JJ, Selvin-Testa A, Lopez EM, PecciSaavedra J. Source: The International Journal of Neuroscience. 1997 January; 89(1-2): 1-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9134444&dopt=Abstract
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Mechanism of increased tolerance to hypothermia after composite Indian herbal preparation II administration. Author(s): Kumar R, Shyam R, Divekar HM, Pahwa ML, Srivastava KK. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2000 December; 6(6): 509-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152055&dopt=Abstract
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Mild hypothermia: therapeutic window after experimental cerebral ischemia. Author(s): Markarian GZ, Lee JH, Stein DJ, Hong SC. Source: Neurosurgery. 1996 March; 38(3): 542-50; Discussion 551. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8837807&dopt=Abstract
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Modulating the oxygen tension in tumours by hypothermia and hyperbaric oxygen. Author(s): Nias AH, Perry PM, Photiou AR.
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Source: Journal of the Royal Society of Medicine. 1988 November; 81(11): 633-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3210193&dopt=Abstract •
Muscle surface pH monitoring during surface-induced hypothermia with circulatory arrest in puppies. Author(s): Rangarathnam CS, Pizak LF Jr, Slim MS, Dmochowski JR, Gross RE. Source: Journal of Pediatric Surgery. 1972 April; 7(2): 181-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5023194&dopt=Abstract
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Needle stimulation of acupuncture loci Chu-Chih (LI-11) and Ho-Ku (LI-4) induces hypothermia effects and analgesia in normal adults. Author(s): Lin MT, Chandra A, Chen-Yen SM, Chern YF. Source: The American Journal of Chinese Medicine. 1981 Spring; 9(1): 74-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7304501&dopt=Abstract
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Neuroprotection in hypothermia linked to redistribution of oxygen in brain. Author(s): Sakoh M, Gjedde A. Source: American Journal of Physiology. Heart and Circulatory Physiology. 2003 July; 285(1): H17-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12793975&dopt=Abstract
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On the mechanism of preservation with hypothermia and hyperbaric oxygen. Author(s): Lyons GW, Dietzman RH, Lillehei RC. Source: Trans Am Soc Artif Intern Organs. 1966; 12: 236-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5335609&dopt=Abstract
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Partial cardiopulmonary bypass for core rewarming in profound accidental hypothermia. Author(s): Splittgerber FH, Talbert JG, Sweezer WP, Wilson RF. Source: The American Surgeon. 1986 August; 52(8): 407-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3729178&dopt=Abstract
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Pathogenesis and treatment of metabolic acidosis in open heart surgery under surface induced deep hypothermia. Author(s): Shida H. Source: Jpn J Surg. 1974 December; 4(4): 198-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4465470&dopt=Abstract
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Pharmacological characteristics of bombesin receptor mediating hypothermia in the central nervous system of rats. Author(s): Tsushima H, Mori M, Fujiwara N, Moriyama A.
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Phenitrone and marihuana induced hypothermia. Author(s): Lomax P, Campbell C. Source: Experientia. 1971 October 15; 27(10): 1191-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5127877&dopt=Abstract
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Post-ischemic hypothermia ameliorates ischemic brain damage but not post-ischemic audiogenic seizures in rats. Author(s): Siemkowicz E, Haider A. Source: Resuscitation. 1995 August; 30(1): 61-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7481104&dopt=Abstract
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Prehospital treatment of hypothermia. Author(s): Giesbrecht GG. Source: Wilderness Environ Med. 2001 Spring; 12(1): 24-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11294552&dopt=Abstract
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Preservation of canine kidneys by hypothermia and hyperbaric oxygen: long-term survival of autografts following 24-hour storage. Author(s): Ladaga LG, Nabseth DC, Besznyak I, Hendry WF, McLeod G, Deterling RA Jr. Source: Annals of Surgery. 1966 April; 163(4): 553-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5327272&dopt=Abstract
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Preservation of canine lung for re-implantation using hypothermia and hyperbaric oxygen. Survival following contralateral pneumonectomy. Author(s): Ross CA, Alves RF. Source: Thorax. 1969 May; 24(3): 336-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5810375&dopt=Abstract
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Preservation of pig liver using hypothermia, hyperbaric oxygenation and perfusion. Author(s): Gorin JP, Clot JP, Nizza M, Perie G, Auriol M, Chomette G, Garnier H. Source: Rev Eur Etud Clin Biol. 1971 October; 16(8): 760-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4942803&dopt=Abstract
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Preservation of the canine lung in vitro for 24 hours with the use of hypothermia and hyperbaric oxygen. Author(s): Blumenstock DA, Lempert N, Morgado F.
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Source: The Journal of Thoracic and Cardiovascular Surgery. 1965 December; 50(6): 76974. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5321162&dopt=Abstract •
Prevention of docetaxel-induced erythrodysesthesia with local hypothermia. Author(s): Zimmerman GC, Keeling JH, Lowry M, Medina J, Von Hoff DD, Burris HA. Source: Journal of the National Cancer Institute. 1994 April 6; 86(7): 557-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7907667&dopt=Abstract
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Prevention of neonatal hypothermia in Himalayan villages. Role of the domiciliary caretaker. Author(s): Iyengar SD, Bhakoo ON. Source: Trop Geogr Med. 1991 July; 43(3): 293-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1816665&dopt=Abstract
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Prolonged resuscitation in acute deep hypothermia. Author(s): Stoneham MD, Squires SJ. Source: Anaesthesia. 1992 September; 47(9): 784-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1306059&dopt=Abstract
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Prolonged visual failure following cardiac arrest due to accidental hypothermia. Author(s): MCAULEY FD. Source: The British Journal of Ophthalmology. 1964 November; 48: 628-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14224936&dopt=Abstract
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Protective effect of mild hypothermia on symptomatic vasospasm: a preliminary report. Author(s): Nagao S, Irie K, Kawai N, Kunishio K, Ogawa T, Nakamura T, Okauchi M. Source: Acta Neurochir Suppl. 2000; 76: 547-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11450087&dopt=Abstract
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Renal preservation with hyperbaric oxygenation and hypothermia. Author(s): Basso A, Calne RY, Hopkinson WI. Source: British Journal of Urology. 1967 June; 39(3): 276-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5338912&dopt=Abstract
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Resection of a large, high-flow arteriovenous malformation during hypotension and hypothermia induced by a percutaneous cardiopulmonary support system. Case report. Author(s): Iwama T, Hashimoto N, Todaka T, Sasako Y, Inamori S, Kuro M.
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Risk factors associated with neonatal hypothermia during cleaning of newborn infants in labour rooms. Author(s): Cheah FC, Boo NY. Source: Journal of Tropical Pediatrics. 2000 February; 46(1): 46-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10730042&dopt=Abstract
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Ro15-4513 differentially affects ethanol-induced hypnosis and hypothermia. Author(s): Syapin PJ, Gee KW, Alkana RL. Source: Brain Research Bulletin. 1987 November; 19(5): 603-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3690369&dopt=Abstract
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Role of hypothermia in the management of severe cases of subarachnoid hemorrhage. Author(s): Yasui N, Kawamura S, Suzuki A, Hadeishi H, Hatazawa J. Source: Acta Neurochir Suppl. 2002; 82: 93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378998&dopt=Abstract
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Serotoninergic mechanisms of the hypothermia induced by clerodenron fragrans (Ventenaceae) in the rat. Author(s): Lin MT, Ho ML, Chandra A, Hsu HK. Source: The American Journal of Chinese Medicine. 1981 Summer; 9(2): 144-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7345919&dopt=Abstract
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Severe hypothermia as a result of barbiturate overdose complicated by cardiac arrest. Author(s): Fell RH, Gunning AJ, Bardhan KD, Triger DR. Source: Lancet. 1968 February 24; 1(7539): 392-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4169977&dopt=Abstract
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Severe hypothermia with barbiturate intoxication. Author(s): Linton AL, Ledingham IM. Source: Lancet. 1966 January 1; 1(7427): 24-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4159158&dopt=Abstract
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Sex differences in ethanol-induced hypnosis and hypothermia in young Long-Evans rats. Author(s): Webb B, Burnett PW, Walker DW. Source: Alcoholism, Clinical and Experimental Research. 2002 May; 26(5): 695-704. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12045479&dopt=Abstract
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Single-dose relative biological effectiveness and toxicity studies under conditions of hypothermia and hyperbaric oxygen. Author(s): Hering ER, Blekkenhorst G, Harrison GG, Morrell D, Korrubel J, Gregory A, Phillips J, Manca V, Sealy R. Source: The British Journal of Radiology. 1986 November; 59(707): 1099-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3790897&dopt=Abstract
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Spontaneous periodic hypothermia. Author(s): Kloos RT. Source: Medicine; Analytical Reviews of General Medicine, Neurology, Psychiatry, Dermatology, and Pediatrics. 1995 September; 74(5): 268-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7565067&dopt=Abstract
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Spontaneous periodic hypothermia: diencephalic epilepsy. Author(s): Fox RH, Wilkins DC, Bell JA, Bradley RD, Browse NL, Cranston WI, Foley TH, Gilby ED, Hebden A, Jenkins BS, Rawlins MD. Source: British Medical Journal. 1973 June 23; 2(5868): 693-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4733249&dopt=Abstract
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Successful treatment of severe hypothermia and prolonged cardiac arrest with closed thoracic cavity lavage. Author(s): Winegard C. Source: The Journal of Emergency Medicine. 1997 September-October; 15(5): 629-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9348049&dopt=Abstract
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Survival of dogs subjected to profound hypothermia with circulatory support. Author(s): Zarins CK, Moossa AR, Skinner DB. Source: Archives of Surgery (Chicago, Ill. : 1960). 1976 February; 111(2): 186-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1062190&dopt=Abstract
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The effect of mild hypothermia and induced hypertension on long term survival rate and neurological outcome after asphyxial cardiac arrest in rats. Author(s): Hachimi-Idrissi S, Corne L, Huyghens L. Source: Resuscitation. 2001 April; 49(1): 73-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11334694&dopt=Abstract
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The effect of oxygen at elevated atmospheric pressure and hypothermia on tissue metabolism. Author(s): Norman JN, Smith G, Douglas TA. Source: Surg Gynecol Obstet. 1966 April; 122(4): 778-84. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5934188&dopt=Abstract
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The effects of hemodilution, hypothermia, and hyperbaric oxygenation on intact dogs. Author(s): Osteen RT, Klebanoff G. Source: Cryobiology. 1970 November-December; 7(4): 263-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5510618&dopt=Abstract
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The influence of hypothermia on outer hair cells of the cochlea and its efferents. Author(s): Seifert E, Brand K, van de Flierdt K, Hahn M, Riebandt M, LamprechtDinnesen A. Source: British Journal of Audiology. 2001 February; 35(1): 87-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11314915&dopt=Abstract
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The use of hypothermia, hyperbaria, and metabolic inhibition in organ preservation. Author(s): Feemster JA, Idezuki Y, Dietzman RH, Lillehei RC, Manax WG. Source: Vascular Surgery. 1970 June; 4(2): 141-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5420444&dopt=Abstract
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Thermal and cardiovascular changes during three methods of resuscitation from mild hypothermia. Author(s): Hayward JS, Eckerson JD, Kemna D. Source: Resuscitation. 1984 February; 11(1-2): 21-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6322264&dopt=Abstract
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Twelve-hour liver preservation in the pig using hypothermia and hyperbaric oxygen. Author(s): Spilg H, Uys CJ, Hickman R, Saunders SJ, Terblanche J. Source: The British Journal of Surgery. 1972 April; 59(4): 273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4553587&dopt=Abstract
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Visual short-term memory deficit from hypothermia of frontal cortex. Author(s): Fuster JM, Bauer RH. Source: Brain Research. 1974 December 13; 81(3): 393-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4434203&dopt=Abstract
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Whole canine organ preservation. Prolongation in vitro by hypothermia and hyperbaria. Author(s): Manax WG, Largiader F, Lillehei RC. Source: Jama : the Journal of the American Medical Association. 1966 June 27; 196(13): 1121-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5952512&dopt=Abstract
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to hypothermia; 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 Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Frostbite Source: Integrative Medicine Communications; www.drkoop.com Heat Exhaustion Source: Integrative Medicine Communications; www.drkoop.com TIAs Source: Integrative Medicine Communications; www.drkoop.com Transient Ischemic Attacks Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements Illicium Alternative names: Star Anise; Illicium verum (Hook, F.) Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Lobelia Alternative names: Lobelia inflata L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Lobelia Alternative names: Lobelia inflata, Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Lobelia Inflata Source: Integrative Medicine Communications; www.drkoop.com Zingiber Alternative names: Ginger; Zingiber officinale Roscoe 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. DISSERTATIONS ON HYPOTHERMIA Overview In this chapter, we will give you a bibliography on recent dissertations relating to hypothermia. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “hypothermia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hypothermia, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Hypothermia ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to hypothermia. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
Acetaminophen-induced Hepatotoxicity, Hepatic Congestion and Hypothermia in Mice by Walker, Robin M; Phd from Queen's University at Kingston (canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK61558
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Hypothermia and the Cold Exposure Syndrome during Prolonged Exercise in a Wet Cold Environment by Thompson, Robert Lawrence; Phd from University of Victoria (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL53748
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Implications of Aquatic Hypothermia for Dive Performance in the Semi-aquatic Muskrat, Ondatra Zibethicus by Hindle, Allyson Gayle; Msc from The University of Manitoba (canada), 2002, 80 pages http://wwwlib.umi.com/dissertations/fullcit/MQ76770
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The Effects of Moderate Hypothermia on Il-1beta and Ischemia-induced Cerebral Inflammation in C57/bl6 Mice by Sutcliffe, Ian; Msc from University of Ottawa (canada), 2002, 122 pages http://wwwlib.umi.com/dissertations/fullcit/MQ76639
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The Role of Polyamines in the Hypothermia of the Elderly (spermine, Thermoregulation, Hplc) by Restivo, Kathleen Mary, Edd from Columbia University Teachers College, 1985, 87 pages http://wwwlib.umi.com/dissertations/fullcit/8602068
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The Use of Hypothermia and Hyperbaric Oxygen in the Preservation of Kidneys in Dogs by Ladaga, Luciano Galbizo; Advdeg from Mcgill University (canada), 1967 http://wwwlib.umi.com/dissertations/fullcit/NK01349
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND HYPOTHERMIA Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning hypothermia.
Recent Trials on Hypothermia The following is a list of recent trials dedicated to hypothermia.8 Further information on a trial is available at the Web site indicated. •
Hypothermia to Treat Severe Brain Injury Condition(s): Brain Injuries; Hypothermia Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: The purpose of this trial is to determine if hypothermia (body cooling), administered very soon after a severe brain injury in patients who are hypothermic on admission, improves functional outcome. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00040339
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.
8
These are listed at www.ClinicalTrials.gov.
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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 “hypothermia” (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 6. PATENTS ON HYPOTHERMIA 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 “hypothermia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hypothermia, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Hypothermia By performing a patent search focusing on hypothermia, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on hypothermia: •
Catheter system for controlling a patient's body temperature by in situ blood temperature modification Inventor(s): Ginsburg; Robert (Greenwood Village, CO) Assignee(s): Radiant Medical, Inc. (Redwood City, CA) Patent Number: 6,306,161 Date filed: August 7, 1998 Abstract: The present invention provides a method and apparatus for controlling the internal body temperature of a patient. According to the present invention, a catheter is inserted through an incision into a large blood vessel of a patient. By selectively heating or cooling a portion of the catheter lying within the blood vessel, heat may be transferred to or from blood flowing within the vessel and the patient's body temperature may thereby be increased or decreased as desired. The invention will find use in treating undesirable conditions of hypothermia and hyperthermia, or for inducing a condition of artificial hypothermia when desired. Excerpt(s): The present invention relates generally to the selective modification and control of a patient's body temperature. More particularly, the present invention provides methods and apparatus for treating hypothermia or hyperthermia by inserting a catheter into a blood vessel of the patient and selectively controlling the temperature of a portion of the catheter within the blood vessel. Heat is transferred to or from blood flowing through the vessel and the patient's body temperature may thereby be increased or decreased as desired. Under ordinary circumstances the thermoregulatory system of the human body maintains a near constant temperature of about 37.degree. C. (98.6.degree. F.). Heat lost to the environment is precisely balanced by heat produced within the body. Hypothermia is a condition of abnormally low body temperature. Hypothermia can be clinically defined as a core body temperature of 35.degree. C. or less. Hypothermia is sometimes characterized further according to its severity. A body core temperature in the range from 32.degree. C. to 35.degree. C. is described as "mild" hypothermia, 30.degree. C. to 32.degree. C. is called "moderate," 24.degree. C. to 30.degree. C. is described as "severe," and a body temperature less than 24.degree. C. constitutes "profound" hypothermia. Although the above ranges provide a useful basis for discussion, they are not absolutes and definitions vary widely in the medical literature. Web site: http://www.delphion.com/details?pn=US06306161__
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Extracorporeal circulation apparatus for selective cooling method Inventor(s): Kobayashi; Takuichi (Shiga-ken, JP), Ohta; Tomio (Osaka, JP) Assignee(s): Tomio Ohta (Osaka-fu, JP) Patent Number: 6,336,910 Date filed: November 9, 1998 Abstract: An extracorporeal circulation apparatus capable of maintaining hypothermia for a prolonged period when used in the selective cooling method.The extracorporeal circulation apparatus used in the selective cooling method includes (1) a diluent supply
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unit for cooling a diluent and metering the diluent into a blood vessel; (2) a blood concentration unit for metering a diluted blood out from a blood vessel and concentrating the diluted blood thus drawn out by filtering the diluted blood; and (3) a blood supply unit for heating the concentrated blood and metering the concentrated blood into a blood vessel, wherein a flow rate of the injected diluent flow rate, Vd and a flow rate of a filtrate, Vb are so controlled that a relationship 0.1 Vd.ltoreq.Vb.ltoreq.Vd is maintained. Excerpt(s): The present invention relates to a novel extracorporeal circulation apparatus used when conducting a selective (or exclusive) cooling method employed in various medical treatments in mammals, especially in humans. Since Woodhall introduced in 1960 a systemic profound hypothermia under a cardiac arrest for the purpose of protecting a brain against a hemorrhage or an ischemia upon a craniotomy, the systemic profound hypothermia has been employed in many types of operations. However, a pump-oxygenator employed in this method makes the procedure complicated and the blood perfusion to various organs insufficient and the method requires a large amount of heparin as an anticoagulant, resulting in problems such as a secondary cerebral hemorrhage. One of the inventors had made an effort to overcome the problems mentioned above and had developed a method for cooling a brain selectively (which is substantially similar in its meanings to the abovementioned "selective cooling method") while using a pump-oxygenator, and applied the method to a craniotomy (J. Neurosurg; Vol 24, pages 994 to 1001, 1966)). This selective cooling method did provide a cerebral hypotension safely but still involved problems with regard to the intra- and postoperative hemorrhages due to the use of a large amount of heparin still associated therewith. Web site: http://www.delphion.com/details?pn=US06336910__ •
Inflatable cooling apparatus for selective organ hypothermia Inventor(s): Werneth; Randell (Poway, CA) Assignee(s): Innercool Therapies, Inc. (San Diego, CA) Patent Number: 6,325,818 Date filed: October 7, 1999 Abstract: A cooling apparatus having an inflatable balloon near a distal end of a multilumen catheter, with a plurality of blood flow passageways formed through the interior of the balloon from a proximal face of the inflated balloon to a distal face of the inflated balloon. Chilled saline solution is introduced through a supply lumen of the catheter to inflate the balloon in a feeding artery of the selected organ; this allows blood to flow through the blood flow passageways of the balloon, from one exterior face of the balloon to another exterior face. The saline solution continues to circulate around the blood flow passageways inside the balloon, to cool the blood, eventually exiting the balloon through a return lumen of the catheter. Excerpt(s): The current invention relates to selective cooling, or hypothermia, of an organ, such as the brain, by cooling the blood flowing into the organ. This cooling can protect the tissue from injury caused by anoxia or trauma. Organs of the human body, such as the brain, kidney, and heart, are maintained at a constant temperature of approximately 37.degree. C. Cooling of organs below 35.degree. C. is known to provide cellular protection from anoxic damage caused by a disruption of blood supply, or by trauma. Cooling can also reduce swelling associated with these injuries. Hypothermia is
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currently utilized in medicine and is sometimes performed to protect the brain from injury. Cooling of the brain is generally accomplished through whole body cooling to create a condition of total body hypothermia in the range of 20.degree. to 30.degree. C. This cooling is accomplished by immersing the patient in ice, by using cooling blankets, or by cooling the blood flowing externally through a cardiopulmonary bypass machine. Web site: http://www.delphion.com/details?pn=US06325818__ •
Inhibition of platelet activation, aggregation and/or adhesion by hypothermia Inventor(s): Dae; Michael W. (Belmont, CA), Keller; Wade A. (San Jose, CA), Machold; Timothy R. (Moss Beach, CA) Assignee(s): Radiant Medical, Inc. (Redwood City, CA) Patent Number: 6,544,282 Date filed: February 21, 2001 Abstract: A method for treating acute coronary syndromes (i.e., unstable angina or nonQ-wave MI) or transient ischemic attacks in a human or animal patient by placing a heat exchange apparatus in the patient's vasculature and using that heat exchange apparatus to cool the patient to a temperature (e.g. 30-36.degree. C.) at which platelet inhibition (i.e., inhibition of platelet activation and/or aggregation and/or adhesion) occurs. Antishivering drugs or anesthesia may be administered to patients whose body temperature is cooled below that patient's shivering threshold (typically approximately 35.5 C.). If it is determined that platelet inhibition is no longer desirable, such as when the patient is about to undergo a surgical or interventional procedure wherein bleeding could be problematic, the hypothermia-induced platelet inhibition may be rapidly reversed by using the intravascular heat exchange apparatus to re-warm the patient's body to normothermia or near normothermia. Excerpt(s): This invention relates generally to methods for medical treatment and more particularly to the intravascular application of hypothermia to treat acute coronary syndromes or other disorders that are treatable by inhibiting platelet activation and/or platelet aggregation and/or platelet adhesion. As used in this patent application the terms "anti-platelet" and "platelet inhibiting" shall mean any inhibition of platelet activation and/or platelet aggregation and/or platelet adhesion. Platelet activation, aggregation and/or adhesion are believed to play significant rolls in the pathogenesis of many vaso-occlusive disorders such as unstable angina, acute myocardial infarction, reocclusion of vessels following balloon angioplasty, transient ischemic attacks and strokes. Generally speaking, when a blood vessel becomes damaged, chemical agonists bind with certain binding sites on circulating platelets, causing the platelets to become activated. The types of blood vessel wall damage that can trigger platelet activation include perforation or injury to the vessel wall, progression of atherosclerotic plaque, the performance of some interventional procedure (e.g., angioplasty, atherectomy or stenting) which stretches the vessel wall or causes intimal tearing, or other causes. When activated, platelets interact with fibrinogen, fibronectin and other clotting factors causing them to adhere to the affected blood vessel wall and to aggregate with one another and with other blood cells (e.g., leukocytes). This activation, adherence and aggregation of platelets leads to the formation of a thrombus or blood clot. Web site: http://www.delphion.com/details?pn=US06544282__
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•
Medicament for hypothermia treatment Inventor(s): Hayashi; Nariyuki (Tokyo, JP) Assignee(s): Sumitomo Pharmaceuticals Company, Limited (Osaka, JP) Patent Number: 6,210,697 Date filed: April 16, 1999 Abstract: A medicament containing human growth hormone (hGH), which can prevent or decrease the immunosuppression and the onset of infectious diseases such as pneumonia in a hypothermia treatment that has been recognized to show remarkable effects on the lifesaving and/or the improvement of recovery of a patient with serious cerebral injury, and thereby contributing to the expansion of the range of application and the improvement of lifesaving effect of hypothermia treatment. Excerpt(s): The present invention relates to a supportive use of a medicament for carrying out a hypothermia treatment safely, and a pharmaceutical composition to be used in the treatment. More specifically, it relates to a medicament which is used supportively to inhibit the suppression of immune functions or the onset of infectious complications in a mild hypothermia treatment aimed at the prevention of the cerebral perfusion disorder of a patient with serious cerebral injury. The hypothermia treatment is a therapeutic method carried out to prevent an irreversible cranial nerve injury in the cases of accident or angiopathy, which is characterized in that a subject in anesthetized condition is cooled with a blanket having circulating cold water so that the temperature of the spinal cord and central nervous system is kept slightly low (cerebral temperature=ca., 33.degree. C.) for a certain period of time. Clinical application of the treatment was started from about 1994, after the effectiveness was confirmed in the field of animal experimental pharmacology around the latter half of 1980's. Since then, remarkable successes have been reported in cases of severe head injury and subarachnoid hemorrhage (Hayashi, N et al.: J. Cereb. Blood Frow Metab. 15 (Suppl.1): S724, 1995, Maekawa, T et al.: Minerva-Anesthesiol. 60(10): 537-540, 1994). The hypothermia treatment herein referred to is entirely different from a primitive one that had been employed in the field of thoracic surgery, in which the brain temperature was simply lowered to below 30.degree. C. By contrast, the hypothermia treatment herein described came to afford satisfactory results only after the detailed procedures for controlling the cerebral temperature, blood pressure, respiration, intracranial pressure or the like; preventing stress diseases or infectious diseases; and matters to be regarded while rewarming were established (Hayashi, N., Hirayama, A: Medical Postgraduates 31:59-71,1993). Web site: http://www.delphion.com/details?pn=US06210697__
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Method and apparatus for establishing and maintaining therapeutic hypothermia Inventor(s): Evans; Scott M. (Santa Ana, CA), Worthen; William J. (Coto de Caza, CA) Assignee(s): Alsius Corporation (Irvine, CA) Patent Number: 6,454,793 Date filed: November 2, 2000 Abstract: A kit for establishing and maintaining hypothermia in a patient for neurotherapeutic purposes includes a high cooling capacity catheter that is advanced into the patient's central venous system to quickly cool the patient to, e.g., 32.degree. C.
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or so. Once hypothermia has been established, the high capacity catheter is removed and replaced with a lower cooling capacity catheter which maintains a desired reduced temperature. The lower capacity catheter advantageously can be configured as a central venous catheter for permitting the catheter to be used for multiple functions. Alternatively, the high cooling capacity catheter can be used to attenuate a fever and lower the patient's body temperature to normal, with the lower capacity catheter being used to maintain normal body temperature. Excerpt(s): The present invention relates generally to methods and apparatus for cooling patients for therapeutic purposes, and more particularly to systems for treating brain trauma and brain ischemia by inducing hypothermia in a patient. It has been discovered that the medical outcome for a patient suffering from severe brain trauma or from ischemia caused by stroke or heart attack is degraded if the patient's body temperature rises above normal (38.degree. C.). It is further believed that the medical outcome for many such patients might be significantly improved if the patients were to be cooled relatively quickly to around 32.degree. C. for a short period, e.g., 24-72 hours. The affected organ, in any case, is the brain. Accordingly, systems and methods have been disclosed that propose cooling blood flowing to the brain through the carotid artery. An example of such systems and methods is disclosed in co-pending U.S. patent application Ser. No. 09/063,984, filed Apr. 21, 1998, owned by the present assignee and incorporated herein by reference. In the referenced application, various catheters are disclosed which can be advanced into a patient's carotid artery and through which coolant can be pumped in a closed circuit, to remove heat from the blood in the carotid artery and thereby cool the brain. The referenced devices have the advantage over other methods of cooling (e.g., wrapping patients in cold blankets) of being controllable, relatively easy to use, and of being capable of rapidly cooling and maintaining blood temperature at a desired set point. Web site: http://www.delphion.com/details?pn=US06454793__ •
Method and apparatus for heating bodies Inventor(s): Pompei; Francesco (Boston, MA) Assignee(s): Exergen Corporation (Watertown, MA) Patent Number: 6,245,094 Date filed: June 18, 1999 Abstract: A patient's body temperature is regulated by using an enclosure to enclose a portion of the patient's body in an isolated environment. In accordance with one embodiment, the patient's entire body below his head is enclosed. Once enclosed, the patient is surrounded by heated vapor that is injected into the enclosure. The heated vapor condenses on the patient's skin to warm the patient quickly, efficiently and safely. This embodiment is well suited for the treatment of hypothermia patients. In accordance with alternative embodiments, only a portion of the patient's head is enclosed. In these embodiments, an enclosure is placed on the patient's head, and heated vapor is fed into the enclosure. Excess air and vapor are preferably dissipated by vents in the cap, whereas excess condensate is preferably absorbed by an absorbent layer provided in the cap. These embodiments are well suited for regulating a patient's body temperature in a surgical setting. Tympanic temperature is monitored and thus vapor dew point temperature is controlled to less than 47.degree. C. but greater than tympanic temperature. Heated vapor may heat other articles such as intravenous supply bags. The
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heated vapor for many locations in a building may be supplied from a central steam generator. Excerpt(s): Adjusting and maintaining a person's body temperature using external means has proven to be a difficult task in many instances. One means of adjusting and maintaining body temperatures is to submerge the patient into a bath of water. The water temperature in the bath is chosen to properly adjust the patient's temperature. Although this technique has proven to be quite useful in many applications it is not particularly appropriate in many instances. For example, this approach often does not fare well with hypothermia patients. In such cases, the patient is typically submerged in a very warm bath to raise the body temperature of the patient. The use of a water bath is, however, frequently impractical, for it requires the use of a bath tub of sufficient size to completely submerge a patient, and it also requires close regulation of water temperature. Furthermore, this approach is time consuming because time must be spent preparing the warm bath. In cases such as at sea when a person has fallen overboard, these impracticalities can prove to be quite costly. Another situation where the use of a water bath is impractical for regulating body temperature is in a clinical environment, including a surgical environment. Operating rooms are most often maintained at fairly cold temperatures to aid in the comfort of the surgical personnel. Unfortunately, it is not typically desirable for the patient to be exposed to such cool temperatures. In colder temperatures, patients tend to bleed more profusely and many patients may become uncomfortably chilled by the cold. Web site: http://www.delphion.com/details?pn=US06245094__ •
Method and apparatus for predicting mortality in congestive heart failure patients Inventor(s): Casscells, III; Samuel W. (3656 Wickersham La., Houston, TX 77027), Naghavi; Monteza (Houston, TX), Siadaty; M. Said (Houston, TX) Assignee(s): Casscells, III; Samuel W. (Houston, TX) Patent Number: 6,454,707 Date filed: March 6, 2000 Abstract: Methods of predicting mortality or imminent death in patients with congestive heart failure include detecting changes in the patient's temperature and/or the detection of hypothermia. The invention also relates to devices and kits for implementation of these methods. Excerpt(s): The present invention generally relates to methods of predicting mortality in patients with congestive heart failure, and more particularly to such methods including detection of hypothermia in a congestive heart failure patient. The invention also relates to apparatus, devices and kits for carrying out the methods. Congestive heart failure (CHF) is a leading, and increasing, cause of morbidity and mortality. Numerous predictors of mortality in patients with CHF have been described in the literature. For example, Myers et al.sup.1 reports that in predicting outcome in severe chronic heart failure, peak oxygen uptake (VO.sub.2) surpassed clinical variables, right-heart catheterization data, exercise time, and other exercise test variables. Other prognostic variables have also been identified, including left ventricular ejection function (LVEF), age, creatinine, right ventricular ejection fraction (RVEF), hyponatremia, bilirubin and recently, lymphocyte count. Nevertheless, these variables together account for only a portion of the variance, with the strong predictors usually applying to only a few patients, leaving prognosis uncertain for the individual patient. The ability to accurately
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predict which patients are likely to have the shortest survival times is particularly needed in the selection of patients for heart transplantation or left ventricular assist device (LVAD) implantation.sup.2-19. An accurate prognosis helps physicians optimize therapies for their patients. Even if in the circumstances a more accurate prognosis would not improve therapy (e.g., when the therapy has already been optimized), most patients and their families want as accurate a prognosis as possible. The invention contemplates a method, apparatus and kit devices for detecting a drop in a patient's body temperature as a means of predicting imminent death in congestive heart failure patients. Web site: http://www.delphion.com/details?pn=US06454707__ •
Method and system for control of a patient's body temperature by way of a transluminally insertable heat exchange catheter Inventor(s): Bloom; Nicole Denise (San Francisco, CA), Keller; Wade A. (San Jose, CA), Machold; Timothy R. (Moss Beach, CA), Roth; Alex T. (Redwood City, CA) Assignee(s): Radiant Medical, Inc. (Redwood City, CA) Patent Number: 6,620,189 Date filed: November 6, 2000 Abstract: Methods and apparatuses for temperature modification of a patient, or selected regions thereof, including an induced state of hypothermia. The temperature modification is accomplished using an in-dwelling heat exchange catheter within which a fluid heat exchange medium circulates. A heat exchange cassette of any one of several disclosed variations is attached to the circulatory conduits of the catheter, the heat exchange cassette being sized to engage a cavity within one of various described reusable control units. The control units include a heater/cooler device, a user input device, and a processor connected to receive input from various sensors around the body and the system. The heater/cooler device may be thermoelectric to enable both heating and cooling based on polarity. A temperature control scheme for ramping the body temperature up or down without overshoot is provided. The disposable heat exchange cassettes may include an integral pump head that engages with a pump drive mechanism within the re-usable control unit. More than one control unit may be provided to receive the same heat exchange cassette so that, for example, a large capacity control unit can be used initially, and a smaller, battery-powered unit can be substituted once the patient reaches the desired target temperature. Excerpt(s): The present invention relates generally to medical devices and methods and, more particularly, to a programmable, microprocessor based controller and method for controlling the temperature and flow of a thermal exchange fluid that is circulated through a heat exchange catheter inserted into a patient's body for the purpose or cooling or warming at least a portion of the patient's body. Under ordinary circumstances, the thermoregulatory mechanisms of a healthy human body serve to maintain the body at a constant temperature of about 37.degree. C. (98.6.degree. F.), a condition sometimes referred to as normothermia. To maintain normothermia, the thermoregulatory mechanisms act so that heat lost from the person's body is replaced by the same amount of heat generated by metabolic activity within the body. For various reasons such as extreme environmental exposure to a cold environment or loss of thermoregulatory ability as a result of disease or anesthesia, a person may develop a body temperature that is below normal, a condition known as hypothermia. A person may develop a condition that is above normothermia, a condition known as
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hyperthermia, as a result of extreme exposure to a hot environment, or malfunctioning thermoregulatory mechanisms, the latter being a condition sometimes called malignant hyperthermia. The body may also establish a set point temperature (that is, the temperature which the body's thermoregulatory mechanisms function to maintain) that is above normothermia, a condition usually referred to as fever. The present invention addresses all of these situations. Accidental hypothermia is generally a dangerous condition that may even be life threatening, and requires treatment. If severe, for example where the body temperature drops below 30.degree. C., hypothermia may have serious consequences such as cardiac arrhythmias, inability of the blood to clot normally, or interference with normal metabolism. If the period of hypothermia is extensive, the patient may even experience impaired immune response and increased incidence of infection. Web site: http://www.delphion.com/details?pn=US06620189__ •
Method and system treating heart malady such as cardiac arrest and heart attack using hypothermia Inventor(s): Balding; David (Mission Viejo, CA), Evans; Scott M. (Santa Ana, CA), Winter; Suzanne C. (Coto de Caza, CA), Worthen; William J. (Coto de Caza, CA) Assignee(s): Alsius Corporation (Irvine, CA) Patent Number: 6,432,124 Date filed: May 3, 2000 Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient using one or more cooling catheter positioned in the central venous system of the patient. Excerpt(s): The present invention relates to methods and systems for treating cardiac arrest. It has been discovered that the medical outcome for a patient suffering from severe brain trauma or from ischemia caused by stroke or heart attack is improved if the patient is cooled below normal body temperature (38.degree. C.). As understood by the present invention, the medical outcome for many such patients might be significantly improved if the patients were to be moderately cooled to 32.degree. C.-34.degree. C. relatively quickly after an ischemic insult for a short period, e.g., 12-72 hours. It is believed that such cooling improves cardiac arrest patient outcomes by improving the mortality rate, in that many organs can benefit from the cooling, and by improving the neurological outcome for those patients that survive. Systems and methods have been disclosed that propose cooling blood flowing to the brain through the carotid artery. An example of such systems and methods is disclosed in co-pending U.S. patent application Ser. No. 09/063,984, filed Apr. 21, 1998, owned by the present assignee and incorporated herein by reference. In the referenced application, various catheters are disclosed which can be advanced into a patient's carotid artery and through which coolant can be pumped in a closed circuit, to remove heat from the blood in the carotid artery and thereby cool the brain. The referenced devices have the advantage over other methods of cooling (e.g., wrapping patients in cold blankets) of being controllable, relatively easy to use, and of being capable of rapidly cooling and maintaining blood temperature at a desired set point. Web site: http://www.delphion.com/details?pn=US06432124__
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Method for determining the effective thermal mass of a body or organ using cooling catheter Inventor(s): Magers; Michael (Encinitas, CA), Yon; Steven A. (San Diego, CA) Assignee(s): Innercool Therapies, Inc. (San Diego, CA) Patent Number: 6,383,210 Date filed: June 2, 2000 Abstract: A method and apparatus is provided for determining an effective thermal mass of a patient. The effective thermal mass is employed to determine a gain factor used in a feedback control system controlling patient temperature. The method begins by inducing hypothermia or hyperthermia in at least a selected portion of the patient with a device having a heat transfer surface. Next, power is transferred between the device and the patient. A change in temperature over time, which arises in the selected portion of the patient, is measured while performing the step of inducing hypothermia or hyperthermia. Finally, an effective thermal mass is calculated based on the measured power and the measured temperature change over time. Excerpt(s): The present invention relates generally to the modification and control of the temperature of the whole body or a selected body organ. More particularly, the invention relates to a method for controlling whole body or organ temperature by selecting an appropriate gain based on the mass of the body or organ. Organs in the human body, such as the brain, kidney and heart, are maintained at a constant temperature of approximately 37.degree. C. Hypothermia can be clinically defined as a core body temperature of 35.degree. C. or less. Hypothermia is sometimes characterized further according to its severity. A body core temperature in the range of 33.degree. C. to 35.degree. C. is described as mild hypothermia. A body temperature of 28.degree. C. to 32.degree. C. is described as moderate hypothermia. A body core temperature in the range of 24.degree. C. to 28.degree. C. is described as severe hypothermia. Hypothermia is uniquely effective in reducing brain injury caused by a variety of neurological insults and may eventually play an important role in emergency brain resuscitation. Experimental evidence has demonstrated that cerebral cooling improves outcome after global ischemia, focal ischemia, or traumatic brain injury. For this reason, hypothermia may be induced in order to reduce the effect of certain bodily injuries to the brain as well as other organs. Web site: http://www.delphion.com/details?pn=US06383210__
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Method of inotropic treatment of heart disease using hypothermia Inventor(s): Dae; Michael W. (Belmont, CA), Stull; Paul M. (San Mateo, CA) Assignee(s): Radiant Medical, Inc. (Redwood City, CA) Patent Number: 6,607,517 Date filed: August 24, 2001 Abstract: A method for treating cardiac failure such as congestive heart failure by application of hypothermia. Hypothermia may be applied by endovascular cooling using a heat exchange catheter circulating heat exchange fluid between an external heat exchanger controlled using temperature feedback from a temperature probe on or in the patient to cool the heart to a sufficiently low temperature for a sufficient length of time to increase cardiac output and improve the vascular condition of the patient. The patient
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may be maintained in the hypothermic condition for a period of time and is then rewarmed slowly and controllably. The endovascular temperature management may be controlled automatically in response to a temperature probe on the patient, and shivering while the patient is cool may be combated using surface warming and antishivering drugs. The method is applicable to treat congestive heart failure and may be used repeatedly on the same patient to restore that patient to adequate heart function when the vascular condition of that patient has become unacceptable. The method may be used to maintain a patient until a heart transplant becomes available. The method may be used to stabilize a patient's condition to allow needed surgery or intervention. The method may be used in conjunction with other treatments including drugs, balloon pumps, pacing devices and ventricular assist devices. Excerpt(s): This invention relates generally to methods for medical treatment and more particularly to the application of hypothermia by various means including by endovascular heat exchange to treat chronic heart disease. These methods find particular usefulness in treating congestive heart failure. The condition of heart failure is complex and may be diagnosed by any one or a number of different criteria: the cardiac output may be low, generally consideredbelow 2.5 liters per minute; the stroke volume of the heart may be low, for example below 25 cc; the ejection fraction of the sick heart may be below 40%; there may be echocardiographic findings of enlarged or improperly pumping hear; physical examinations including x-rays and stress testing may indicate cardiac failure; there may be cardiomegally; there may be increased left ventricular wall thickness and chamber dilation indicative of cardiac failure; there may be pulmonary edema, which with other sympotoms and findings may indicate cardiac failure; there may be angiographic findings indicative of heart failure; and a diagnostic test of blood components, such as electrolytes or proteins may indicate heart failure. This lis is not exhaustive of the symptoms and findings that may help diagnose heart failure, but is offered to show the extent to which heart failure impacts the entire patient and may radically deteriorate the patient's life quality. One common condition is congestive heart failure (CHF). CHF is one of the most serious health problems in the world. An estimated 4.8 million Americans alone have CHF. It is often the end stage of serious heart disease; half of those diagnosed with CHF will be dead within 5 years. An estimated 400,000 new case are diagnosed each year. It is the most common diagnosis in hospital patients age 65 years and older, with the disease affecting 10% of all those over the age of 70. The financial cost of treatment of CHF patients is over $17 billion a year. The human cost is beyond measure. Web site: http://www.delphion.com/details?pn=US06607517__ •
Mutant mouse containing a knockout mutation in DNA encoding an endogenous alpha 4 subunit of nicotinic acetylcholine receptor Inventor(s): Changeux; Jean-Pierre (Paris, FR), Marubio; Lisa (Paris, FR) Assignee(s): Institut Pasteur (FR) Patent Number: 6,252,132 Date filed: October 27, 1999 Abstract: A mutant mouse has germ cells and somatic cells containing a mutation comprising a disruption of the endogenous.alpha.4 subunit of the nicotinic acetylcholine receptor (nAChR) gene, wherein the disrupted.alpha.4 subunit of the nAChR gene results in the mouse lacking detectable levels of the endogenous.alpha.4 subunit of nAChR without a change in level of expression of other nAChR subunits as compared to
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a wild type mouse. The mutant mouse is useful for studying the roles of the various subunits of the nAChR. The results are useful in studying the antinociceptive, hypothermia, and locomotor effects of nicotine in other mammals. Excerpt(s): This invention relates to a mutant mouse having a defect in an endogenous.alpha.4 subunit of the nicotinic acetylcholine receptor and to a transgenic animal based on the mutant mouse. In addition, this invention relates to isolated cells derived from these animals and to the use of the animals in assays for assessing the effects of nicotine and nicotinic agonists and antagonists in these animals and cells. Finally, this invention provides a nucleotide construct for use in generating these animals and cells. The nicotinic acetylcholine receptor (nAChR) is a pentameric protein that forms a non-selective cation channel at the neuro-muscular junction and in the central nervous system (CNS). The genes encoding the neuronal nicotinic receptor subunits represent a large multigene family consisting of at least eight alpha subunits (.alpha.2-9) and three beta subunits (.beta.2-4). Each subunit has four putative transmembrane-spanning domains (M1-4) and a similar topological structure. Neuronal receptors form either heteropentamers comprised of a total of 5 subunits: Two alpha subunits (.alpha.2,.alpha.3,.alpha.4, or.alpha.6) and three beta subunits (.beta.2 or.beta.4) or they are capable of forming homopentamers (.alpha.7,.alpha.8 or.alpha.9) (Refs. 1 and 2). The binding site for acetylcholine (ACh) is found at the interface between.alpha. and.beta. subunits indicating that both types of subunits contribute to the various pharmacological profiles of neuronal nAChRs (Ref. 3). Web site: http://www.delphion.com/details?pn=US06252132__ •
Noninvasive method for increasing or decreasing the body temperature of a patient Inventor(s): Ferrigno; Massimo (Brookline, MA) Assignee(s): The Brigham and Women's Hospital Inc. (Boston, MA) Patent Number: 6,303,156 Date filed: June 22, 1999 Abstract: The present invention is directed to a method for changing the body temperature of a patient by having them hyperventilate a gas mixture containing sulfur hexafluoride and oxygen. The method may be applied to cool patients in any clinical situation where induced hypothermia is desirable or to rapidly rewarm hypothermic patients. The invention also includes the gas mixtures used in the method. Excerpt(s): The present invention is directed to noninvasive methods for rapidly changing the body temperature of a patient. This is accomplished by having the patient hyperventilate a gaseous mixture containing sulfur hexafluoride and oxygen. The invention also includes the compositions used in these methods. Patients undergoing operations that require low blood flow or circulatory arrest often must have their body temperature lowered prior to surgery in order to help protect the heart and brain. In particular, hypothermia has been induced in patients undergoing cardiac surgery and operations for cerebral aneurysms. More recently, the lowering of body temperature has been used as a technique for protecting the brain in head trauma patients and there are indications that this procedure may be useful in treating patients for hemorrhagic shock. Unfortunately, there is, at present, no reliable noninvasive method for rapidly lowering a patient's body temperature. The present invention addresses this problem and discloses a method that can be used for rapidly inducing hypothermia or, alternatively, for rapidly warming a hypothermic patient. The present invention is based upon the
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concept that respiratory heat exchange can be used to rapidly change a patient's body temperature. The method requires nothing more than standard hospital equipment such as a ventilator and a means for heating or cooling gases prior to administration to a patient. Web site: http://www.delphion.com/details?pn=US06303156__ •
Phase change thermal control materials, method and apparatus Inventor(s): Buckley; Theresa M. (P.O. Box 1239, Ashton, MD 20861) Assignee(s): none reported Patent Number: 6,319,599 Date filed: March 2, 1998 Abstract: An apparatus and method for metabolic cooling and insulation of a user in a cold environment. In its preferred embodiment the apparatus is a highly flexible composite material having a flexible matrix containing a phase change thermal storage material. The apparatus can be made to heat or cool the body or to act as a thermal buffer to protect the wearer from changing environmental conditions. The apparatus may also include an external thermal insulation layer and/or an internal thermal control layer to regulate the rate of heat exchange between the composite and the skin of the wearer. Other embodiments of the apparatus also provide 1) a path for evaporation or direct absorption of perspiration from the skin of the wearer for improved comfort and thermal control, 2) heat conductive pathways within the material for thermal equalization, 3) surface treatments for improved absorption or rejection of heat by the material, and 4) means for quickly regenerating the thermal storage capacity for reuse of the material. Applications of the composite materials are also described which take advantage of the composite's thermal characteristics. The examples described include a diver's wet suit, ski boot liners, thermal socks, gloves and a face mask for cold weather activities, and a metabolic heating or cooling blanket useful for treating hypothermia or fever patients in a medical setting and therapeutic heating or cooling orthopedic joint supports. Excerpt(s): This invention relates to a flexible composite material containing a phase change material for thermal storage and to garments and other articles made from the composite material. The use of phase change materials or PCM's for thermal storage has long been known. In many materials much more heat can be stored as latent heat of phase change than as sensible heat. One of the earliest known applications of this principle is the use of ice as a thermal storage medium for perishable foods. Some of the phase transitions that involve significant amounts of latent heat are solid-to-liquid or liquid-to-gas phase changes or, in certain materials, solid-to-solid phase changes. Another subgroup of PCM's uses reversible exothermic reactions, such as hydrationdehydration or solution-precipitation reactions, for heat storage. The latent heat of phase change can be used for heating or cooling depending on whether the phase change is exothermic or endothermic. In most materials, the phase changes are reversible so that the latent heat storage can be used for either heating or cooling depending on the temperature conditions. U.S. Pat. No. 4,894,931 to Senee et al. describes a Heating Device for warming body parts, such as the soles of the feet. The device uses a battery powered electric heater and a PCM salt. The PCM salt serves as a heat storage medium and as a temperature regulator for the resistance heater since it can absorb a lot of heat without rising above its melt temperature. This device is described as having a rigid base, which
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along with the inherent rigidity of the solid PCM salt, would make it unusable for applications where flexibility is important. Web site: http://www.delphion.com/details?pn=US06319599__ •
Starting dialysate composition for use as an initial dialysate in hemo dialysis Inventor(s): Ash; Stephen R. (Lafayette, IN) Assignee(s): ViaCirq, Inc. (Pittsburgh, PA) Patent Number: 6,348,162 Date filed: April 3, 2000 Abstract: An apparatus for use in whole body hypothermia includes a dialyzer having a blood side and a dialysate side separated by one or more dialysis membranes. A blood pump associated with the a blood circuit established on the blood side circulates blood through the dialyzer at high rates advantageous for hyperthermia treatments. A bypass is included whereby circulated blood can bypass the dialyzer. The bypass aids in preventing blood-side tensioning of dialyzer membranes thereby allowing proper membrane movement to assist in mixing a sorbent suspension circulated on the dialysate side of the dialyzer. A sorbent suspension composition for use as a dialysate in hemodialysis, especially when performed in conjunction with whole body hyperthermia, includes water, a surface adsorptive agent such as charcoal, a cation exchanger, and precipitated calcium phosphate. The precipitated calcium phosphate serves as a reservoir for calcium and phosphate ions to assist in controlling patient blood chemistries. Excerpt(s): The present invention relates to a specialized device for whole-body hyperthermia, including extracorporeal blood heating and dialysis, as an antiviral protocol. Whole body hyperthermia (WBHT) as a treatment for neoplasms has been carefully studied and applied since the 1960s (3,4,27). Prior to that period there were multiple reports of tumor regression coincident with induced fever. Biochemical studies of the effects of hyperthermia have indicated that temperatures greater than 41.degree. C. induce necrosis of some types of tumor (3,5). In the body, there are additional physiologic effects by which hyperthermia induces tumor necrosis. In both normal and tumorous tissue, hyperthermia causes an initial vasodilation of blood vessels with a resulting increase in blood flow. Then, there is a decrease in blood flow due to autoregulation and vasoconstriction (6). Tumor tissues have less vascular reactivity to autoregulate blood flow, and are therefore more prone than normal tissues to the effects of high temperature during either local hyperthermia or WBHT (7). It is now generally accepted that hyperthermia is a useful therapy in treatment of cancers, and regional hyperthermia for accessible tumors is used in every major cancer therapy center in the U.S. Regional hyperthermia is a valuable adjunct to radiation and chemotherapy, because it carries low risk, has few side effects, and often exerts its best effects in patients whose lesions are unresponsive to radiation or chemotherapy (3). In metastatic solid tissue tumors, WBHT is used more than regional hyperthermia, since it is difficult to apply regional therapy to lesions in the abdomen or chest. Even in patients who have failed radiation or chemotherapy, there is a partial remission of the tumors in about half of the patients, and complete remission in a few patients. These results are similar to those obtained with many drugs; however, with drug therapy of cancer, the incidence of side-effects is approximately 100%. Though there are some side-effects of WBHT, most of them are short-lived and not serious.
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Web site: http://www.delphion.com/details?pn=US06348162__ •
System and method for warming a person to prevent or treat hypothermia Inventor(s): Arnold; Randall C. (Maplewood, MN), Augustine; Scott D. (Bloomington, MN) Assignee(s): Augustine Medical, Inc. (Eden Prairie, MN) Patent Number: 6,524,332 Date filed: February 9, 2001 Abstract: Prevention or treatment of hypothermia in a person is afforded by an inflatable cover with a surface for expelling air from the cover. A heater/blower unit is connected to the cover to inflate the cover with warmed air and to maintain the temperature of warmed air expelled through the surface in a range of 85.2.degree. F. to 117.7.degree. F. The heater/blower unit may also maintain the temperature of warmed air provided to inflate the cover in a range of 113.3.degree. F. to 121.3.degree. F. The heater/blower unit may also maintain the temperature of warmed air under the surface in a range of 103.8.degree. F. to 112.5.degree. F. A pattern of apertures in the surface or vents in sides of the inflatable cover may be provided in order to circulate the warmed air to edges of the inflatable cover. Excerpt(s): This invention relates to thermal blankets used in a medical setting to deliver a bath of a thermally-controlled medium to a patient. The thermal blanket prior art is best expressed in our prior U.S. Pat. No. 4,572,188 entitled "AIRFLOW COVER FOR CONTROLLING BODY TEMPERATURE." In our prior patent, a self-erecting, inflatable airflow cover is inflated by the introduction into the cover of a thermally-controlled inflating medium, such as warmed air. When inflated, the cover self-erects about a patient, thereby creating an ambient environment about the patient, the thermal characteristics of which are determined by the temperature of the inflating medium. Holes on the underside of our prior art airflow cover exhaust the thermally-controlled, inflating medium from inside the cover to the interior of the erected structure. Our airflow cover is intended for the treatment of hypothermia, as might occur postoperatively. Evaluation of our airflow cover by skilled practitioners has resulted in general approbation: the opinion is that the airflow cover efficiently and effectively accomplishes its purpose of giving a thermally-controlled bath. We have realized, however, that, while our prior art airflow cover achieves its objective, certain improvements to it are necessary in order to realize additional clinical objectives and to enjoy further advantages in its use. Web site: http://www.delphion.com/details?pn=US06524332__
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Technique for using heat flow management to treat brain disorders Inventor(s): Lesser; Ronald P. (Towson, MD), Webber; W. Robert S. (Ellicott City, MD) Assignee(s): The Johns Hopkins University (Baltimore, MD) Patent Number: 6,248,126 Date filed: January 12, 1999 Abstract: A method of treating a brain disorder by heat transfer from brain tissue comprising the steps of surgically cutting a heat transfer aperture into a patient's skull,
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thereby exposing a predetermined portion of patient's brain; surgically implanting into said heat transfer aperture a heat pump having one or more electrical sensor elements and one or more temperature sensor elements; surgically implanting a heat transfer management unit in a body cavity of said patient such that a micro controller of the heat transfer management unit is connected to one or more activity sensor elements and one or more temperature sensor elements contacting brain tissue and connecting the heat transfer management unit to said heat pump via a lead bundle. Optionally, the heat transfer unit may be located external to the patient's body. Responsive to signals from one or more activity or temperature sensor elements, mathematical algorithms of the heat transfer management unit determine abnormal brain activity, causing the heat pump to remove heat from the brain tissue into a heat sink, thereby cooling the predetermined portion of the patient's brain. This technique utilizes acute hypothermia by means of a Peltier cooler or similar device to cool the brain temperature to reduce or prevent seizure initiation and/or propagation. The method may be used in association with brain stimulation and/or drug application to acutely avoid the occurrence of a seizure episode. Excerpt(s): The invention pertains to acute methods of treating a brain disorder using heat transfer to improve brain function. Heat transfer may be combined with electrical stimulation of the brain or direct infusion of therapeutic agents into the brain to reduce or prevent the occurrence of, for example, an epileptic seizure. The method may also be used for brain disorders other than epilepsy, for spinal disorders, and for disorders of other body organs and tissues. Epileptic seizures occur because of an abnormal intensity and synchronized firing of brain cells. Generalized seizures can begin over essentially the entire brain at one time, while others, known as focal or partial seizures, begin in a localized area of the brain and then spread. Thus, both widespread and localized mechanisms appear to be involved in the occurrence of seizures. As an example, seizures manifest themselves as seizure discharges affecting the cerebral cortex, the outer most layer of the brain, though paradoxically, stimulation of the thalamus and other subcortical regions, located deeper within the brain, have been shown to not only initiate but also control or even prevent seizures. Evidence suggests that the thalamus and the substantial nigra are involved in the development of certain kinds of seizures.sup.15, 9, 41, 39, 13. Even more widespread mechanisms might be involved, as evidenced by the successful use of vagal nerve stimulation for treatment of some seizures. The vagus nerve is located in the neck and extends to the brain stem from which it has widespread connections within the brain, including branches to the thalamus.sup.32; 22. Studies have shown that chronic vagal nerve stimulation can reduce seizures by 50% or more in a third of treated patients.sup.14; 4. A vagal nerve simulator has recently been released as a commercial product. Information thus far indicates that it is moderately effective, but only rarely controls seizures completely. In some patients, seizures are sufficiently localized such that removal of a particular area of the brain may result in complete seizure control.sup.11. Electrical stimulation provides a non-surgical means for impairing generation of localized seizures.sup.38, 32, 34, 27. In experimental animal models, drug application to a seizure focus can suppress or eliminate seizure activity.sup.10, 28, 16, 24, 33. Web site: http://www.delphion.com/details?pn=US06248126__
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Thermal conditioning apparatus Inventor(s): Beran; Anthony V. (Santa Ana, CA), Shigezawa; Gordon (Irvine, CA), Tomic-Edgar; Kerry (Santa Ana, CA) Assignee(s): Respiratory Support Products, Inc. (Irvine, CA) Patent Number: 6,277,144 Date filed: October 7, 1998 Abstract: The present invention relates to an improved thermal conditioning apparatus for thermally treating a patient. More specifically, the present invention relates to an inflatable apparatus for bathing a patient with a thermally conditioned medium. Such a treatment apparatus is useful for medically treating a patient suffering from hypothermia or hyperthermia, or for maintaining the body temperature of a patient undergoing a surgical procedure. A thermal conditioning apparatus according to the present invention includes first and second pluralities of orifices, the first plurality of orifices being smaller than the second plurality. An inlet portion which receives the thermal conditioning medium is located closer to the first plurality of orifices than the second plurality of orifices. The combined use of smaller orifices in close proximity to the inlet portion with larger orifices distal from the inlet portion tends to minimize the thermal gradients that may occur. Furthermore, a thermal conditioning apparatus according to the present invention includes a cover portion formed from the first and second material layers which make up the thermal conditioning apparatus. Excerpt(s): Conventional patient thermal treatment systems suffer from several disadvantages. First, conventional patient thermal treatment systems fail to deliver the thermal medium to the patient without encumbering access to the patient's body. Next, conventional patient thermal treatment systems are difficult to manufacture, consisting of numerous parts requiring a time-consuming, labor-intensive, and costly manufacturing process to assemble into a completed system. Finally, conventional patient thermal treatment systems are thermally inefficient in treating patients. With conventional patient thermal treatment systems, patients are subjected to large thermal gradients within the thermal treatment apparatus, causing undesirable hot-spots or cool zones. Accordingly, there is a need for an improved thermal conditioning apparatus for treating a patient which is inexpensive, easy to manufacture, flexible in its operation, and provides a more uniform thermal treatment. Web site: http://www.delphion.com/details?pn=US06277144__
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Use of adenosine compounds to alleviate or normalize pathologically hyperexcited sensory nerve function in a human patient Inventor(s): Fukunaga; Atsuo F. (5411 Littlebow Rd., Rancho Palos Verdes, CA 90275) Assignee(s): none reported Patent Number: 6,642,209 Date filed: May 4, 1998 Abstract: A method of inducing anesthesia, sedation, analgesia, hypothermia, and reduced stress by administering an effective amount of an adenosine compound to a mammal. It also provides a method for preserving donor organs in vivo by contacting them with an adenosine compound, as well as a method for preparing organ recipients for transplant.
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Excerpt(s): This invention relates to a method of using adenosine compounds to induce anesthesia, sedation, analgesia, hypothermia, and to ameliorate stress. A patient is protected from the pain and stress of surgery and similar procedures by anesthesia which allows the maintenance of physiological homeostasis. Adenosine has a variety of extracellular effects. It is known to have potent vasodilating, blood pressure lowering (hypotensive) and shock-inducing effects, but has never been demonstrated to have anesthetic activity when used clinically. Furthermore, the conventional wisdom is that neither adenosine nor adenosine triphosphate (hereinafter ATP), an adenine nuclectide, circulating in the blood, will cross the blood brain barrier. Therefore, despite analgesic and sedative effects suggested by previous studies in laboratory experiments, neither adenosine nor ATP had ever been thought to be suitable as anesthetics. A major problem with prior studies is that they were performed under such poorly controlled conditions that the vital signs: circulatory, such as blood pressure, heart rate and respiratory functions were not measured. Because data on the behavior of these parameters are essential in determining therapeutic efficacy, these studies failed to teach whether such potential analgesic and sedative effects were caused by the profound effects of these compounds on cardiovascular function, namely: hypotension, coma, bradycardia, or shock. Failure to determine the vital signs, and to isolate the analgesic properties from the coma or shock, which may be produced by potent hypotensive effects of adenosine, render these reports fatally flawed as teaching analgesia or sedation caused by adenosine. Consequently, previous studies do not evaluate usage for treatment purposes of these agents. Based on previous reports, such effects (analgesia, sedation) could not possibly have been translated to clinical applicability. Web site: http://www.delphion.com/details?pn=US06642209__ •
Warming blanket for pediatric use Inventor(s): Chivetta; Dennis S. (Ballwin, MO), Dikerhoff; Scott D. (Ballwin, MO), Kappel; Thomas F. (St. Louis, MO), Metzler; Philip M. (St. Charles, MO) Assignee(s): Mallinckrodt Inc. (St. Louis, MO) Patent Number: 6,156,058 Date filed: September 20, 1999 Abstract: The present invention relates to a blanket for use with forced air convection systems, wherein the blanket is sized to accommodate pediatric patients. The blankets according to the present invention may be used both over or under the patient, thereby facilitating use in the operating room or outside the operating room. The present invention also relates to a blanket for use with forced air convection systems which is nonflammable and laser resistant. In addition, the present invention relates to methods of prevention hypothermia and hyperthermia and to a method of making a blanket for use with forced air convection systems. Excerpt(s): Hypothermia is a condition of subnormal body temperature and presents serious consequences to the patient suffering therefrom. It has been shown that nearly seventy five percent of all patients who undergo surgical procedures develop hypothermia. This equates to approximately fourteen million patients a year in the United States alone. In the operating room, the hypothermic condition may be brought on by many factors including anesthesia, the air conditioning of the operating room, and the infusion of cold blood, I-V solutions, or irrigating fluids. Hypothermia is also a problem in the recovery room or PACU, as well as other areas in a hospital where room temperatures are kept cool and infusions of blood or other fluids may continue. The
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prevention of hypothermia is especially important for pediatric care, because pediatric patients may be adversely effected by small changes in temperature. In particular, pediatric patients lose heat faster than adult patients because of their relatively low skin surface area to body mass ratio. Conversely, pediatric patients can also gain heat faster than adult patients. Therefore, pediatric patients are more susceptible to surgical complications, such as catching colds, from slight changes in temperature. Several methods and products have been developed to help prevent hypothermia from occurring; such as the use of infrared lamps, cotton blankets, and warm water mattresses. However, none of these methods and products have proven completely successful. In fact, it has been shown that these methods and products can not even prevent the patients from losing their endogenous heat. (See Journal of Post Anesthesia Nursing, Vol. 5, No. 4, August 1990, pp 254-263). Web site: http://www.delphion.com/details?pn=US06156058__
Patent Applications on Hypothermia 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 hypothermia: •
"Thermangel" external body temperature regulator Inventor(s): Vester, Mary Frances; (Nashville, TN) Correspondence: Mary Frances Vester; 1205 Plymouth Avenue; Nashville; TN; 37216; US Patent Application Number: 20030088300 Date filed: November 6, 2001 Abstract: The Thermangel thermoregulating device is a unique approach to treating hyperthermia/hypothermia and other serious conditions. By the process of regulating the temperature around the hypothalamus, the regulatory center of the body, we can effect the ability of the body to regulate itself. This process allows the human body to return to normal or homeostatic conditions. The process of hypothermia and hyperthermia is currently being studied as a treatment for conditions such as alopecia, hair loss due to chemotherapy. As well as improving the survival of cardiac arrest resuscitations. It is essentially non-invasive and will decrease medical costs for everyone. It decreases the amount of time spent in the critical-care setting, decreases the need for medications and intravenous fluids and provides comfort to the patient. This is also a new and effective way to treat Malignant Hyperthermia, which is a deadly condition found the surgical environment. It will provide a cost-effective solution to improve heath care for the patient, hospital and related entities. In the future, this product could be furthered improved by placing an electrical heating/cooling unit to set the exact temperature desired. Excerpt(s): This invention was designed on Oct. 3, 2001. Its conception began over 5 years ago, while working as a nurse in a community hospital. I was taking care of a patient whose temperature began to climb above 104 degrees. In trying to bring down
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This has been a common practice outside the United States prior to December 2000.
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the patient's temperature, I had a moment of serendipity. If the cooling center of the body is in the hypothalamus, located at the base of the brain, why not put some ice in a bag and put it under the head? So I got some ice bags and put them their. Well, as you may have already assumed, it worked, and it worked beautifully. The patient's temperature decreased to 99.0 F in approximately 4 hours. And that is where it began. After taking care of many critically-ill patients, especially those with sepsis, this idea became my mainstay. It was so much easier than previously used methods and did not make near as much mess. Much expense both financial and otherwise can be attributed to thermoregulation difficulties. To describe the prior art of thermoregulation intervention is two part. I will describe how hyperthermia/hypothermia was previously treated as well as the closest cousin to this design. Hyperthermia is a condition where the temperature is too high. This is commonly found in sepsis, a massive infection state where the body begins to shut down from the illness. Hyperthermia is also found in drug reactions, heatstroke, thyroid disorders, alcohol withdrawal and many other illnesses. It is commonly treated with ice baths, cooling blankets and ice packs to the groin and axilla (underarms). These approaches are both problematic, time-consuming and less than effective at times. Usually when someone is hyperthermic, they are critically ill and near death. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
ANTI-OSTEOARTHRITIS AND ANTI-HYPOTHERMIA GARMENT Inventor(s): Donaldson, Archie R.; (Nassau, BS) Correspondence: Phouphanmketh Ditthavong; Ditthavong & Carlson, P.C.; 10507 Braddock RD Ste A; Fairfax; VA; 22032; US Patent Application Number: 20030074709 Date filed: August 23, 2001 Abstract: A garment made from three layers of flexible material dimensioned to surround respective joints, body parts or the complete body, except for the entire face, of a wearer. The garment alleviates or reduces pain from certain forms of arthritis, especially osteoarthritis and can delay the onset of such conditions. The garment also can prevent hypothermia and reduce adverse effects from exposure to reduced temperatures. Excerpt(s): This invention relates to garments for delaying the onset of osteoarthritis and to provide relief for people having osteoarthritis by reducing the pain and swelling of the joints. This invention also relates to garments which can prevent or alleviate conditions caused by hypothermia of body parts. Osteoarthritis is an inflammation of the joints due to infectious, metabolic, or constitutional causes which results in painful stiffness and swelling of the joints. Osteoarthritis is mainly a disease of "wear and tear". It is for this reason that a "cure" is very difficult to achieve because of the constant injury, however slight, which exceeds the normal repair process. Healthy cartilage, the slippery tissue that covers the ends of the bones of a joint, allows bones to glide over one another and absorb the shock of physical movements. Over time, the cartilage deteriorates, allowing the bones to rub together, which can cause pain, swelling and loss of motion. Osteoarthritis may become even more widespread as the growing popularity of certain sports and stress exercises take place. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Anti-osteoarthritis and anti-hypothermia garment and device Inventor(s): Donaldson, Archie R.; (Nassau, BS) Correspondence: Ditthavong & Carlson, P.C.; Suite A; 10507 Braddock Road; Fairfax; VA; 22032; US Patent Application Number: 20030041364 Date filed: August 6, 2002 Abstract: A multilayered material is provided that exhibits therapeutic effects for relieving the pain and swelling of various forms of arthritis (particularly osteoarthritis), delaying the onset of osteoarthritis, or preventing hypothermia or alleviating conditions caused by hypothermia. The flexible, breathable multilayered material includes a first layer of soft and hypoallergenic material (e.g., cotton, silk, linen), a second layer of soft, heat retentive material (e.g., wool, cashmere) contacting the first layer, and a third layer of water repellent material contacting the second layer. Additionally, the multilayered material provides a thin, flexible, breathable fabric that can be used to construct various garments, devices, and gears to combat harsh weather conditions. Excerpt(s): The present application is a Continuation-In-Part of U.S. patent application Ser. No. 09/934,755 entitled "Anti-osteoarthritis and Anti-hypothermia Garment" filed on Aug. 23, 2001, the contents of which are hereby incorporated by reference. The present invention relates to textile fabrics, and more particularly to a multilayered material used to construct garments, gears, or devices capable of providing therapeutic effects relating to various forms of arthritis (particularly osteoarthritis) and conditions associated with hypothermia. Usability of a material in the construction of garments, gears, and devices depends largely on whether the material can be readily manipulated and that the material can effectively exhibit certain desired characteristics. For instance, clothing and gear manufacturers are continually seeking out materials to satisfy the demands of its customers for comfortable, lightweight garments and gears to provide protection against the elements (i.e., harsh weather conditions stemming from extreme temperatures and/or rain, sleet, and snow). Conventionally, to achieve the desired protection against the weather, manufacturers have utilized fabrics that are difficult to handle because of their inflexibility and bulkiness. Fabric material characteristics are also critical in the product of medical garments and devices. Manufacturers of therapeutic garments and devices are likewise tasked with developing new products to address various medical conditions. Because of the limitations of the materials used to construct such products, aesthetics and comfort are sacrificed. Therefore, the material characteristics sought after by clothing and gear manufacturers and that of medical garments and devices manufacturers are traditionally divergent, with respect to comfort, aesthetics, and functionality. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Combined cryotherapy and hypothermia method for the treatment of airway obstruction or prostate enlargement Inventor(s): Beyar, Motti; (Herzliya B., IL), DeRowe, Ari; (Mosahav Salit, IL) Correspondence: Oppenheimer Wolff & Donnelly Llp; 840 Newport Center Drive; Suite 700; Newport Beach; CA; 92660; US Patent Application Number: 20020062831 Date filed: January 14, 2002
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Abstract: A method of reducing tissue volume for treatment of airway obstruction, obstructive sleep apnea, snoring, prostate tumor, and other pathologies comprising: applying a cryoprobe with a diameter preferably less than about 2 mm and with a sharp tip to first freeze the affected interstitial tissue of the soft palate, base of the tongue, tonsils or adenoids, singularly or in combination, or to the prostate, or other tissue, and then applying the same cryoprobe to heat the treated tissue. Excerpt(s): The present invention relates to a method of reducing tissue volume by applying a unique cryoprobe. The invention is especially useful in reducing pharyngeal tissues, including tonsils and soft palate, in treating upper airway obstruction, such as exists in obstructive sleep apnea, and or snoring, or in treating an enlarged prostate, and is described below with respect to such applications, but it will be appreciated that the invention could advantageously be used in other applications as well, such as, in treating abundant vascular tissue in the uterus, as found in menometrorrhagia, or in treating hypertrophic inferior turbinates in nasal obstruction. Obstructive Sleep Apnea is of unknown etiology, but it is generally accepted that it results from the combination of a structurally small upper airway and a normal or abnormal loss of physiologic muscle tone during sleep. Patterns of pharyngeal narrowing and collapse suggest that 30-50% of patients with obstructive sleep apnea have obstruction at the level of the upper pharynx or in the retropalatal segment. This can be due to abundant tissue of the palate or tonsillar hypertrophy. An even higher percentage of snorers have the soft palate as the source of the vibrations of snoring. Obstructive Sleep Apnea is a potentially life threatening disorder, which affects up to 2 to 4% of the adult population. Even when not life threatening, it is annoying to a bed mate. Obstructive Sleep Apnea is associated with snoring, which is believed to affect 20% of adults. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Cooling body wrap with phase change material Inventor(s): Barnett, Richard I.; (Georgetown, SC), Lachenbruch, Charles A.; (Summerville, SC) Correspondence: Kathleen M Harleston; The Harleston Law Firm; 909 Tall Pine Road; MT Pleasant; SC; 29464 Patent Application Number: 20030109911 Date filed: December 8, 2001 Abstract: A cooling body wrap for rapidly inducing hypothermia, includes: (a) a fluidimpermeable, flexible, conformable envelope; (b) a mixture of from about 20 to about 90 weight % of alkanes having a carbon chain length of between 10 and 14, and from about 10 to about 80 weight % of a gel or viscous fluid carrier in which the alkanes are relatively evenly distributed, the mixture being sealed within the envelope; (c) at least one layer of insulation adjacent to a first side of the envelope; and (d) fastening means for fastening the body wrap around a body part. Excerpt(s): The present device is an unpowered body wrap containing phase change material with a melting point of between about -10 and 6 degrees Centigrade, the phase change material being distributed in a gel or viscous fluid carrier, for quick, thorough cooling of a portion of the body in the event of a stroke, heart attack, or other emergency medical condition. Rapid response is vital in the emergency treatment of strokes and heart attacks. Medical experts are finding that immediately inducing a state of hypothermia in stroke victims, for example, along with administering certain
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intravenous medications, ameliorates damage from a stroke. Many of the adverse effects of a stroke occur within the first few hours of the actual stroke, which is caused by blockage of a blood vessel by a blood clot. In the hypothermic state, the stroke victim's metabolic rate is reduced, which in turn reduces the adverse after-effects of the stroke, and even cheats death in some cases. To be effective, hypothermia should be induced as rapidly as possible. Quick treatment is imperative. The adverse effects of stroke include impaired motion on one side of the body, short-term memory loss, slurred speech, confusion, etc. Strokes occur spontaneously in teens and adults of any age, although they occur more frequently in older people. It is a leading cause of long-term disability and death in Americans over age 45. Rapidly reducing body temperature is also known to be helpful in treating heart attacks, head injuries, and limb amputations, and may prove to be helpful for treating other types of injuries. Cardiovascular disease is the most significant health problem in the United States today, afflicting roughly one quarter of adult Americans. If rapid body temperature reduction can be done safely by emergency personnel in the field, more patients can be saved and/or have an improved prognosis. There is a need for an inexpensive, easy to use, portable device which can be used in the field and elsewhere to quickly drop body temperature. Ice packs rapidly lower body temperature, but they are difficult to keep in place on a patient, particularly one who is being jostled in a moving ambulance. One ice pack only covers a small area of the body. Also, most frozen ice packs do not conform easily to the shape of the body part. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
FIELD-DEPLOYABLE FORCED AIR WARMING SYSTEM Inventor(s): Ducharme, Michel B.; (Kettleby, CA), Frim, John; (Bramalea, CA) Correspondence: George A. Seaby; Seaby & Associates; 603 - 880 Wellington Street; Ottawa; ON; K1r 6k7; CA Patent Application Number: 20020077681 Date filed: December 14, 2000 Abstract: A portable, forced air apparatus for warming a hypothermia victim in the field includes a stretcher, strips of material extending across the stretcher for supporting the torso of the victim above the stretcher bottom, a canopy for covering the victim's torso, a blower operated heater in a compartment in the stretcher beneath the victim's legs for delivering hot air to the canopy in the area of the torso for warming the victim's body while the legs and arms are covered to prevent heat loss, a heated head and neck support for controlled warming of the victim's head and neck, and sleeves for covering the victim's arms and legs to prevent heat loss therefrom during torso warming. The heating system is complemented by warm IV infusion and warm oxygen delivery to the victim. Excerpt(s): This invention relates to a portable forced air warming apparatus for warming victims of hypothermia. Severe hypothermia is a surprisingly common occurrence in cold areas of the world. Hypothermia is considered to be severe when there is a significant risk of spontaneous ventricular fibrillation, which can result in death of the victim. The risk of ventricular fibrillation increases significantly when the victim's core or deep body temperature is below 28.degree. C. At such low core temperatures, the victim should be handled carefully because of his/her unstable condition. A severe hypothermia victim who has been cooled rapidly, e.g. during immersion in water, is preferably rewarmed rapidly. A severe hypothermia victim who
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has been cooled slowly, e.g. by exposure to cold air, is preferably rewarmed slowly. In any event, it is imperative to stop heat loss and to initiate rewarming of victims of hypothermia as soon as possible to optimize the chances of survival. During rescue operations in remote areas, it may take several hours to transport casualties from the rescue site to a hospital for treatment. Warming apparatuses, some of which are portable, are disclosed by U.S. Pat. Nos. 5,300,101, which issued to S. D. Augustine et al on Apr. 5, 1994; 5,304,213, which issued to L. D. Berke et al on Apr. 19, 1994; 5,336,249, which issued to I. Mahawili on Aug. 9, 1994; 5,350,417, which issued to S. D. Augustine on Sep. 27, 1994 and 6,001,057, which issued to R. A. Bongiovanni et al on Dec. 14, 1999. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Heat pipe nerve cooler Inventor(s): Dobak, John D. III; (La Jolla, CA) Correspondence: Mark Wieczorek; Innercool Therapies, INC.; 3931 Sorrento Valley Boulevard; San Diego; CA; 92121; US Patent Application Number: 20020068964 Date filed: January 22, 2002 Abstract: The invention provides a method and apparatus for producing reversible focal hypothermia of the nervous system to control chronic pain. Nerve conduction is blocked by mild cooling (0 to 25.degree. C.), or hypothermia. At these temperatures, nerve tissue is not destroyed and recovers completely when cooling is terminated, such that the treatment is reversible. By blocking conduction in pain nerves, pain sensation is eliminated in a manner analogous to drugs such as lidocaine that also block nerve conduction to provide anesthesia. The invention can be applied to a variety of conditions such as urge incontinence, muscle spasticity, and epilepsy. Many of these disorders are mediated by nerve and nervous tissue that could be interrupted by cooling. In addition, neurologic dysfunction found in multiple sclerosis may improve by cooling of the nerves. The method and apparatus may be used to cool areas of the nervous system affected by multiple sclerosis to allow more normal functions. Excerpt(s): This application is a continuation of co-pending U.S. patent application Ser. No. 09/328,854, filed Jun. 9, 1999, entitled "Heat Pipe Nerve Cooler", which is a continuation-in-part of the following U.S. patent applications: U.S. patent application Ser. No. 09/012,287, filed Jan. 23, 1998, entitled "Selective Organ Hypothermia Method and Apparatus"; U.S. patent application Ser. No. 09/047,012, filed Mar. 24, 1998, entitled "Improved Selective Organ Hypothermia Method and Apparatus"; U.S. patent application Ser. No. 09/052,545, filed Mar. 31, 1998, entitled "Circulating Fluid Hypothermia Method and Apparatus"; U.S. patent application Ser. No. 09/103,342, filed Jun. 23, 1998, entitled "A Selective Organ Cooling Catheter and Method of Using the Same"; U.S. patent application Ser. No. 09/215,038, filed Dec. 16, 1998, entitled "An Inflatable Catheter for Selective Organ Heating and Cooling Catheter and Method of Using the Same"; U.S. patent application Ser. No. 09/215,040, filed Dec. 16, 1998, entitled "Method and Device for Applications of Selective Organ Cooling"; and U.S. patent application Ser. No. 09/262,805, filed Mar. 4, 1999, entitled "A Selective Organ Cooling Catheter with Guide Wire Apparatus", all of which are incorporated herein. Not Applicable. A number of types of nerves are disposed within the posterior gray horn 16. Two types of pain sensing nerves have been identified: A.sub.delta. and C. Referring to FIGS. 2 and 3, A.sub.delta. fibers 18 are disposed within regions I and V and the same produce a rapid initial and intense response to painful stimuli. C fibers 20 are disposed
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within region II and produce a more blunted but prolonged response. C fibers 20 are believed to be responsible for many chronic pain syndromes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
High efficiency cardiac gene transfer Inventor(s): Chien, Kenneth R.; (La Jolla, CA), Hoshijma, Masahiko; (San Diego, CA), Ikeda, Yasuhiro; (Yamaguchi, JP), Ross, John JR.; (La Jolla, CA) Correspondence: Brown Martin Haller & Mcclain; 1660 Union Street; San Diego; CA; 92101; US Patent Application Number: 20020032167 Date filed: September 11, 2001 Abstract: Methods for the delivery of genes to improve cardiac function including the use of viral vectors, isolation of the heart from systemic circulation, and induction of hypothermia/cardiac arrest are described. The method results in high-level, long-term expression of reporter genes and enhanced cardiac function in hamster models of heart disease. Excerpt(s): This application claims the benefit of priority of U.S. provisional application Ser. No. 60/231,821 filed Sep. 11, 2000, which is incorporated herein by reference in its entirety. Somatic gene transfer offers a myriad of possibilities for therapeutic usage in a number of diseases including congenital defects, as well as acquired forms of pathological abnormalities. There have been several critical limitations that have hindered the practical application of gene transfer in vivo. These include the duration of expression of transferred genes, the trade-off between tissue specificity and the efficiency of gene expression, and the adverse side effects of local inflammation provoked by vectors. In the field of cardiovascular medicine, gene therapy has been focused on vascular gene transfer, mainly aimed at ischemic coronary disease. Many research groups have attempted cardiac gene transfer using adenovirus (Ad) vectors with strong, non-tissue specific gene expression cassettes driven by cytomegalovirus (CMV) or Rous sarcoma virus (RSV) promoters. Clinical trials of several angiogenic factors including vascular endothelial cell growth factor (VEGF), fibroblast growth factor (FGF) and hepatocyte growth factor (HGF) have been ongoing. The expectation is that transduction of cardiac cells with viral vectors will result in the secretion of these growth factors from cardiac cells, inducing the growth of new blood vessels and improving the blood supply to the heart to decrease ischemia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Inducing hypothermia and rewarming using a helium-oxygen mixture Inventor(s): Johnson, Larry D.; (Hastings, MN), Kumar, Matthew M.; (Oronoco, MN) Correspondence: Intellectual Property Group; Fredrikson & Byron, P.A.; 4000 Pillsbury Center; 200 South Sixth Street; Minneapolis; MN; 55402; US Patent Application Number: 20030131844 Date filed: December 4, 2002 Abstract: Devices and methods to heat and cool human beings, including inducing and maintaining hypothermia in human patients. Methods include inducing hypothermia
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to treat ischemic events, including heart attack and stroke, to limit damage caused by the ischemic event. Methods can include: using the lungs for heat exchange; using cooled gases for ventilation; using helium in the ventilation gas mixture, using medications to control reflex heat production; and injecting a perfluorocarbon mist into the gas stream to increase the cooling rate. The high thermal conductivity and diffusivity of helium results in greater inspired gas temperature equalization toward body temperature. Due to the latent heat of vaporization, addition of even small quantity of phase-change perfluorocarbon dramatically increases the heat carrying capacity of the respiratory gases. Hypothermia may be terminated by discontinuing the medications and warming the patient using a warmed helium-oxygen mixture. Excerpt(s): The present application claims priority to U.S. Provisional Patent Application Ser. No. 60/336,668, titled A NOVEL METHOD TO INDUCE AND MAINTAIN HYPOTHERMIA, filed Dec. 4, 2001; U.S. Provisional Patent Application Ser. No. 60/377,335, titled A NOVEL METHOD TO INDUCE HYPOTHERMIA AND REWARMING, filed Apr. 30,2002; and U.S. Provisional Patent Application Ser. No. 60/405,137, titled INDUCING HYPOTHERMIA AND REWARMING USING A HELIUM-OXYGEN MIXTURE, filed Aug. 22, 2002, all herein incorporated by reference in their entireties. The present invention relates generally to medical devices and methods. More specifically, the present invention includes methods and devices for cooling and/or heating a human being body by providing cold and warm gases for respiration. The present invention includes methods and devices for rapidly and intentionally inducing hypothermia in a human being, from ambulance through operating room, for purposes including decreasing tissue oxygen consumption in order to increase the likelihood of survival and decrease cell damage following ischemic events, including heart attack or stroke. Deliberate lowering of the body temperature, or "induced hypothermia", as a therapeutic modality was first described by Talbot in 1941. (Talbot J H: The Physiologic and Therapeutic Effects of Hypothermia. N Engl J Med 224:281, 1941). The National Academy of Sciences published the investigational report on the physiological effects of hypothermia in 1955. (Dripps, R D, Ed: The Physiology of Induced Hypothermia. Washington, D.C., National Academy of Science Publication 451, 1956). These studies established that when cooled, the body's metabolism decreases at about 8% per degree Celsius and drops to one-half the normal at 28.degree. C. Such a reduction in metabolism renders metabolically active organs such as the brain and heart less susceptible to periods of ischemia and hypoxia. As a result of this protective effect, hypothermia is used in heart surgery, brain surgery, spine surgery, aortic surgery, organ transplantation surgery, prevention of cerebral palsy, and treatment of strokes and heart attacks. Despite the expanding role of hypothermia in clinical settings, the methods to induce and maintain hypothermia remain primitive, cumbersome, unpredictable and dangerous. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Indwelling heat exchange catheter and method of using saMen Inventor(s): Evans, Scott M.; (Santa Ana, CA), Gobin, Yves Pierre; (Los Angeles, CA), Jones, Mike L.; (Capistrano Beach, CA), Noda, Wayne A.; (Mission Viejo, CA), Walker, Blair D.; (Mission Viejo, CA), Worthen, William J.; (Cote de Caza, CA) Correspondence: Arlyn L. Alonzo, ESQ.; Alsius Corporation; Suite 150; 15770 Laguna Canyon Road; Irvine; CA; 92618; US Patent Application Number: 20020049409 Date filed: September 4, 2001 Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system. Excerpt(s): This invention relates generally to apparatus and methods for producing heat exchange with body tissue, and more specifically to methods and apparatus for the hypothermic treatment of a body fluid in a body conduit. Many of the advantages of hypothermia are well known. By way of example, it has been found particularly desirable to lower the temperature of body tissue in order to reduce the metabolism of the body. In stroke, trauma and several other pathological conditions, hypothermia also reduces the permeability of the blood/brain barrier. It inhibits release of damaging neurotransmitters and also inhibits calcium-mediated effects. Hypothermia inhibits brain edema and lowers intracranial pressure. In the past, hypothermic treatment has been typically addressed systemically, meaning that the overall temperature of the entire body has been lowered to achieve the advantages noted above. This has been particularly desirable in surgical applications where the reduced metabolism has made it possible to more easily accommodate lengthy operative procedures. An example of this systemic approach includes catheters for transferring heat to or from blood flowing within a patient's vessel, as disclosed by Ginsburg in U.S. Pat. No. 5,486,208. A closed loop heat exchange catheter is also disclosed by Saab in U.S. Pat. No. 5,624,392. A cooling device for whole-body hyperthermia that utilizes the circulatory system of the body is known to be more efficient since the entire volume of the body is constantly perfused with the cold fluid at a capillary level. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Indwelling heat exchange catheter and method of using saMen Inventor(s): Evans, Scott M.; (Santa Ana, CA), Gobin, Yves Pierre; (Harrison, NY), Jones, Mike; (Capistrano Beach, CA), Noda, Wayne A.; (Mission Viejo, CA) Correspondence: Alsius Corporation; 15770 Laguna Canyon Road, Suite 150; Irvine; CA; 92618; US Patent Application Number: 20020151945 Date filed: April 22, 2002
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Abstract: A catheter is adapt to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include at least one balloon which is adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. Embodiments including multiple balloons enhance the surface area of contact, and the mixing of both the heat exchange and the body fluid. The catheter car be positioned to produce hypothermia in a selective area of the body without cooling the entire body system. It is of particular advantage in brain surgeries where stroke, trauma or cryogenic tumors can best be addressed under hypothermic conditions. Excerpt(s): This invention relates generally to apparatus and methods for producing heat exchange with body tissue, and more specifically to methods and apparatus for the hypothermic treatment of a body fluid in a body conduit. Many of the advantages of hypothermia are well known. By way of example, it has been found particularly desirable to lower the temperature of body tissue in order to reduce the metabolism of the body. In stroke and several other pathological conditions, hypothermia also reduces the permeability of the blood/brain barrier. It inhibits release of damaging neurotransmitters and also inhibits calcium-mediated effects. Hypothermia inhibits brain edema and lowers intracranial pressure. Some of the disadvantages of systemic hypothermia include cardiac arrhythmia, pulmonary edema and coagulopathies. Systemic hypothermia also results in hypotension and various immunodeficiencies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Material having magnetic permeability at R.F. frequency Inventor(s): Gilderdale, David John; (South Devon, GB), Hajnal, Joseph Vilmos; (London, GB), Larkman, David James; (London, GB), Pendry, John Brian; (Cobham, Surrey, GB), Wiltshire, Michael Charles Keogh; (Bucks, GB), Young, Ian Robert; (Wiltshire, GB) Correspondence: Venable, Baetjer, Howard And Civiletti, Llp; P.O. Box 34385; Washington; DC; 20043-9998; US Patent Application Number: 20030155919 Date filed: April 1, 2003 Abstract: A material having magnetic permeability at r.f. frequency, for example a microstructured magnetic material has a magnetic permeability of negative value but unity magnitude over a particular r.f. frequency range. The singularity in the flux pattern has the result that magnetic resonant disturbances in a plane C,E normal to the line C,D are focussed into a plane D,F also normal to the line C,D and vice versa. This is particularly applicable to magnetic resonance apparatus, since the material can be used to transfer the r.f. magnetic flux distribution in a target region in a patient, for example at C,E to D,F where the flux may be directly measured by receive coils. Equally, transmit coils may generate flux to be focussed into the target region by the material. Magnetic resonance apparatus may be constructed which does not require gradient coils, and r.f. hypothermia may be carried out in a focussed way, minimising damage to surrounding tissue. Excerpt(s): This invention relates to materials having magnetic permeability at r.f. frequencies. Materials comprising an array of non-magnetic elements having capacitance and inductance and spaced by distance much smaller than the wavelength
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at which the magnetic permeability is exhibited, which may be termed microstructured magnetic materials, have been proposed (Magnetism from Conductors and Enhanced Nonlinear Phenomena by J B Pendry, A J Holden, D J Robbins and W J Stewart, IEEE Transactions on Microwave Theory and Techniques, Volume 47, No. 11, November 1999, pages 2075 to 2084, and International Patent Application WO 00/41270). International Patent Application No. PCT/GB01/00968 proposes a screen made of such microstructured magnetic material, in which the real part of the magnetic permeability is zero or negative over the band of r.f. frequencies over which the screen is effective. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Medical procedure Inventor(s): Dobak, John D. III; (La Jolla, CA) Correspondence: Mayer, Fortkort & Williams, PC; 251 North Avenue West; 2nd Floor; Westfield; NJ; 07090; US Patent Application Number: 20020040717 Date filed: December 7, 2001 Abstract: The use of an intravascular cooling element to induce hypothermia in connection with a medical procedure. According to a first aspect of the present, invention, a coronary bypass procedure is conducted in which a patient's blood is oxygenated with the patient's lungs and in which blood is circulated using the patient's heart or using an intracorporeal pump. The procedure preferably comprises: (a) positioning a heat transfer element in a blood vessel of a patient; (b) cooling the body of the patient to less than 35.degree. C., more preferably 32.+-.2.degree. C., using the heat transfer element; and (c) forming a fluid communicating graft between an arterial blood supply and the coronary artery. The body of the patient is preferably heated to about 37.degree. C. using the heat transfer element subsequent to the step of forming the fluid communicating graft. According to a further aspect of the invention, a hypothermic medical procedure is provided while a patient is in a conscious or semiconscious state, comprising (a) administering a beta-blocking drug to the patient; (b) delivering a heat transfer element to a blood vessel of the patient; and (c) cooling a region of the patient or the body of the patient to less than 35.degree. C. using the heat transfer element. Excerpt(s): This application is a continuation-in-part of Ser. No. 09/373,112 filed Aug. 11, 1999 and a continuation-in-part of Ser. No. 09/103,342 filed Jun. 23, 1998, which is a continuation-in-part of Ser. No. 09/047,012 filed Mar. 24, 1998. Each of these disclosures is hereby incorporated by reference in its entirety. The present invention relates to the use of an intravascular cooling element to induce hypothermia in connection with medical procedures. A number of approaches have been developed for treating coronary artery disease. In less severe cases, it is often sufficient to merely treat the symptoms with pharmaceuticals or to treat the underlying causes of the disease with lifestyle modification. In more severe cases, the coronary blockage can be treated endovascularly or percutaneously using techniques such as balloon angioplasty, atherectomy, laser ablation, stents, and the like. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method and apparatus for treating acute myocardial infarction with selective hypothermic perfusion Inventor(s): Esch, Brady; (San Jose, CA), Macoviak, John A.; (La Jolla, CA), Robinson, Janine; (Half Moon Bay, CA), Samson, Wilfred J.; (Saratoga, CA) Correspondence: Gunther Hanke; Fulwider Patton Lee & Utecht; P.O. Box 22615; Long Beach; CA; 90801-5615; US Patent Application Number: 20020161351 Date filed: March 19, 2002 Abstract: An apparatus and method are described for therapeutic hypothermia of the heart by selective hypothermic perfusion of the myocardium through the patient's coronary arteries. The apparatus and method provide rapid cooling of the affected myocardium to achieve optimal myocardial salvage in a patient experiencing acute myocardial infarction. The therapeutic hypothermia system includes one or more selective coronary perfusion catheters and a fluid source for delivering a hypothermically-cooled physiologically-acceptable fluid, such as saline solution, oxygenated venous blood, autologously-oxygenated arterial blood and/or an oxygenated blood substitute. The system may also include one or more guidewires, subselective catheters and/or interventional catheters introduced through a lumen in the selective coronary perfusion catheter. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/384,467, filed on Aug. 30, 1999, which claims the benefit of U.S. provisional application serial No. 60/098,727, filed on Sep. 1, 1998, the specifications of which are hereby incorporated in their entirety. The present invention relates generally to methods and devices for treatment of heart disease. More particularly, it relates to methods and devices for treating acute myocardial infarction with selective hypothermic perfusion. Heart disease is the most common cause of death in the United States and in most countries of the western world. Coronary artery disease accounts for a large proportion of the deaths due to heart disease. Coronary artery disease is a form of atherosclerosis in which lipids, cholesterol and other materials deposit in the arterial walls gradually narrowing the arterial lumen, thereby depriving the myocardial tissue downstream from the narrowing of blood flow that supplies oxygen and other critical nutrients and electrolytes. These conditions can be further exacerbated by a blockage due to thrombosis, embolization or arterial dissection at the site of the stenosis. A severe reduction or blockage of blood flow can lead to ischemia, myocardial infarction and necrosis of the myocardial tissue. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method and system for control of a patient's body temperature by way of transluminally insertable heat exchange catheter Inventor(s): Keller, Wade A.; (San Jose, CA), MacHold, Timothy R.; (Moss Beach, CA), Roth, Alex T.; (Redwood City, CA) Correspondence: Fulwider Patton Lee & Utecht, Llp; Howard Hughes Center; 6060 Center Drive; Tenth Floor; Los Angeles; CA; 90045; US Patent Application Number: 20030135252 Date filed: February 1, 2002
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Abstract: Methods and apparatuses for temperature modification of a patient, or selected regions thereof, including inducing hypothermia. The temperature modification is accomplished using an in-dwelling heat exchange catheter within which a fluid heat exchange medium circulates. A heat exchange cassette of any one of several disclosed variations is attached to the circulatory flow lines of the catheter, the heat exchange cassette being sized to engage a cavity within one of various described reusable control units. A temperature control scheme for ramping the body temperature up or down without overshoot is provided. The disposable heat exchange cassettes may include an integral pump head that engages with a pump drive mechanism within the re-usable control unit. More than one control unit may be provided to receive the same heat exchange cassette allowing substitution of a smaller, battery-powered unit for a large capacity control once the patient reaches the desired target temperature. Excerpt(s): This application is a Continuation-In-Part of U.S. patent application Ser. No. 09/138,830, filed on Aug. 24, 1998 and also claims benefit of priority to U.S. application Ser. No., 09/563,946, filed on May 2, 2000, U.S. Provisional Application Serial No. 60/185,561, filed Feb. 28, 2000, and U.S. application Ser. No. 60/219,922, filed Jul. 21, 2000, the entireties of which are expressly incorporated herein by reference. The present invention relates generally to medical devices and methods and, more particularly, to a programmable, microprocessor based controller and method for controlling the temperature and flow of a thermal exchange fluid that is circulated through a heat exchange catheter inserted into a patient's body for the purpose or cooling or warming at least a portion of the patient's body. Under ordinary circumstances, the thermoregulatory mechanisms of a healthy human body serve to maintain the body at a constant temperature of about 37.degree. C. (98.6.degree. F.), a condition sometimes referred to as normothermia. To maintain normothermia, the thermoregulatory mechanisms act so that heat lost from the person's body is replaced by the same amount of heat generated by metabolic activity within the body. For various reasons such as extreme environmental exposure to a cold environment or loss of thermoregulatory ability as a result of disease or anesthesia, a person may develop a body temperature that is below normal, a condition known as hypothermia. A person may develop a condition that is above normothermia, a condition known as hyperthermia, as a result of extreme exposure to a hot environment, or malfunctioning thermoregulatory mechanisms, the latter being a condition sometimes called malignant hyperthermia. The body may also establish a set point temperature (that is, the temperature which the body's thermoregulatory mechanisms function to maintain) that is above normothermia, a condition usually referred to as fever. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and system for treating stroke using hypothermia Inventor(s): Evans, Scott M.; (Santa Ana, CA), Luo, Xia; (Los Angeles, CA), Worthen, William J.; (Coto de Caza, CA) Correspondence: Alsius Corporation; Suite 150; 15770 Laguna Canyon Road; Irvine; CA; 92618; US Patent Application Number: 20020032430 Date filed: July 6, 2001 Abstract: A method for treating stroke patients includes inducing mild or moderate hypothermia in a patient using one or more closed loop heat exchange catheters positioned either in the patient's central venous system, carotid artery or both when the
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patient's body temperature and/or brain temperature are above predetermined thresholds. Additional steps for treating and managing a stroke patient can also be undertaken, e.g., infusing paralytics, infusing neuro-protectants, infusing anti-clot and/or clot lysis medications, performing neuro-protection procedures, performing non-catheter-based hypothermia, performing angioplasty, deploying stent, removing clot(s), maintaining a predetermined ICP level such as draining CSF, and/or ventilating the patient. Excerpt(s): The present invention relates to methods and systems for managing stroke conditions. Every year, approximately 700,000 Americans suffer a stroke. It is estimated that about 30% of stroke victims die within 3 months, and a significant number of those who survive need assistance in their daily routine. Stroke is considered the third leading killer in the United States, following cancer and heart disease. There are two types of strokes: ischemic and hemorrhagic. Ischemic stroke is caused by a blockage in the artery, thereby cutting off the oxygen supply to the brain cells. Hemorrhagic stroke is caused by an intracerebral hemorrhage or a subarachnoid hemorrhage. Studies have shown that an association exists between body temperature and initial stroke severity, infarct size, mortality and outcome in survivors. For example, it was reported that a difference in body temperature of 1 degree C was equivalent to a 4-point difference in Scandinavian Stroke Scale ("SSS") on hospital admission, a 15 mm difference in infarct size, an 80% difference in mortality, and a 4-point difference in SSS score at discharge (Reith et al., Body Temperature in Acute Stroke; Relation to Stroke Severity, Infarct size, Mortality, and Outcome, The Lancet, Vol. 347, pp. 422-425, Feb. 17, 1996). Thus, if body temperature can be reduced quickly in a stroke patient, significant improvements may be achieved in reducing mortality and outcome in the survivors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for determining the effective thermal mass of a body or organ using a cooling catheter Inventor(s): Magers, Michael; (Encinitas, CA), Yon, Steven A.; (San Diego, CA) Correspondence: Mayer, Fortkort & Williams, PC; 251 North Avenue West; 2nd Floor; Westfield; NJ; 07090; US Patent Application Number: 20020082671 Date filed: February 25, 2002 Abstract: A method and apparatus is provided for determining an effective thermal mass of a patient. The effective thermal mass is employed to determine a gain factor used in a feedback control system controlling patient temperature. The method begins by inducing hypothermia or hyperthermia in at least a selected portion of the patient with a device having a heat transfer surface. Next, power is transferred between the device and the patient. A change in temperature over time, which arises in the selected portion of the patient, is measured while performing the step of inducing hypothermia or hyperthermia. Finally, an effective thermal mass is calculated based on the measured power and the measured temperature change over time. Excerpt(s): The present invention relates generally to the modification and control of the temperature of the whole body or a selected body organ. More particularly, the invention relates to a method for controlling whole body or organ temperature by selecting an appropriate gain based on the mass of the body or organ. Organs in the human body, such as the brain, kidney and heart, are maintained at a constant
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temperature of approximately 37.degree. C. Hypothermia can be clinically defined as a core body temperature of 35.degree. C. or less. Hypothermia is sometimes characterized further according to its severity. A body core temperature in the range of 33.degree. C. to 35.degree. C. is described as mild hypothermia. A body temperature of 28.degree. C. to 32.degree. C. is described as moderate hypothermia. A body core temperature in the range of 24.degree. C. to 28.degree. C. is described as severe hypothermia. Hypothermia is uniquely effective in reducing brain injury caused by a variety of neurological insults and may eventually play an important role in emergency brain resuscitation. Experimental evidence has demonstrated that cerebral cooling improves outcome after global ischemia, focal ischemia, or traumatic brain injury. For this reason, hypothermia may be induced in order to reduce the effect of certain bodily injuries to the brain as well as other organs. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for inducing hypothermia Inventor(s): Becker, Lance B.; (Chicago, IL), Hoek, Terry Vanden; (Chicago, IL), Kasza, Kenneth E.; (Palos Park, IL) Correspondence: Brinks Hofer Gilson & Lione; P.O. Box 10395; Chicago; IL; 60610; US Patent Application Number: 20030066304 Date filed: June 3, 2002 Abstract: Systems for phase-change particulate slurry cooling equipment and methods to induce hypothermia in a patient through internal and external cooling are provided. Subcutaneous, intravascular, intraperitoneal, gastrointestinal, and lung methods of cooling are carried out using saline ice slurries or other phase-change slurries compatible with human tissue. Perfluorocarbon slurries or other slurry types compatible with human tissue are used for pulmonary cooling. And traditional external cooling methods are improved by utilizing phase-change slurry materials in cooling caps and torso blankets. Excerpt(s): The present invention relates to the production and use of engineered phasechange particulate slurries, such as ice slurries, with high cooling capacity, fluidity, and stability to induce protective hypothermia through internal and external cooling. It is well known that hypothermia can postpone damage to tissues caused by inadequate blood flow and oxygen deprivation. One important example of the potential protective properties of hypothermia is in the area of cardiac arrest. Sudden cardiac arrest is one of the leading causes of death in the United States, affecting about 1,000 people every day, most of them outside of a hospital setting. Despite widespread use of basic life support and advanced cardiac life support by paramedics, survival of cardiac arrest patients is usually less than 2-4%, in large part because cells of the brain and the heart begin to die within minutes following global ischemia, or inadequate blood flow. The ability of these cells to survive severe ischemia can be significantly enhanced by transient hypothermia. However, rapid and significant cooling (within 10 minutes, and to a temperature of 34.degree. C. or less) of a patient without blood flow in a pre-hospital setting has been unachievable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method for inducing hypothermia for treating cancer Inventor(s): Fox, James Allan; (Palo Alto, CA) Correspondence: Roberta L. Robins; Robins & Pasternak Llp; 90 Middlefield Road, Suite 200; Menlo Park; CA; 94025; US Patent Application Number: 20020091426 Date filed: January 28, 2002 Abstract: In the present invention heat is directed to the hypothalamus of a warmblooded animal, utilizing the physiological mechanisms that regulate body temperature to effect a compensatory cooling response, thereby lowering body temperature. The invention relates generally to methods of treating cancer comprising inducing hypothermia by directing heat to the hypothalamus, optionally maintaining cancerous tissue at or near to normal body temperature, and optionally applying another cancer treatment. This other cancer treatment may be radiation therapy, chemotherapy, a combination of radiation and chemotherapy, or some other cancer treatment. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 08/909,752 filed Aug. 12, 1997, from which priority is claimed under 35 U.S.C.sctn.120 and which application is incorporated herein by reference in its entirety. The invention relates generally to methods for treating cancer. More particularly, it relates to methods for treating cancer by inducing hypothermia comprising warming the hypothalamus of an animal with cancerous tissue, inducing hypothermia, and optionally maintaining the cancerous tissue at near to, or above, normal body temperature. Cancer is progressive disease characterized by malignant cells that grow without control, forming tumors, and often metastasize, spreading new tumors to multiple locations in the body. Treatments for cancer are often aimed at slowing cancerous growth, or reducing metastasis, or rendering cancerous tissue more susceptible to cytotoxic agents. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method for reducing myocardial infarct by application of intravascular hypothermia Inventor(s): Dea, Michael W.; (Belmont, CA), Keller, Wade A.; (San Jose, CA), Machold, Timothy R.; (Moss Beach, CA) Correspondence: Robert D. Buyan; Stout, Uxa, Buyan & Mullins, Llp; Suite 300; 4 Venture; Irvine; CA; 92618; US Patent Application Number: 20020111616 Date filed: December 12, 2000 Abstract: Methods and apparatus for preventing myocardial infarction, or lessening the size/severity of an evolving myocardial infarction, by cooling at least the affected area of the myocardium using an intravascular heat exchange catheter. The heat exchange catheter may be inserted into the vasculature (e.g., a vein) and advanced to a position wherein a heat exchanger on the catheter is located in or near the heart (e.g., within the vena cava near the patient's heart). Thereafter, the heat exchange catheter is used to cool the myocardium (or the entire body of the patient) to a temperature that effectively lessens the metabolic rate and/or oxygen consumption of the ischemic myocardial cells or otherwise protects the ischemic myocardium from undergoing irreversible damage or infarction.
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Excerpt(s): This application claims priority to U.S. Provisional Patent Application Ser. No. 60/170,831 entitled Method for Reducing Myocardial Infarct by Application of Intravascular Hypothermia, the entire disclosure of such provisional application being expressly incorporated herein by reference. This invention relates generally to the field of cardiac therapy, and more particularly to the intravascular application of hypothermia to prevent or reduce myocardial infarct resulting from myocardial ischemia. When the normal blood supply a person's heart muscle is disrupted, the person may suffer what is commonly termed a heart attack. Heart attacks are one of the major health problems in the world. In the United States alone there are over 1.1 million heart attacks a year. Of those 1.1 million victims, about 250,000 die within 1 hour. However, those that survive the initial heart attack generally subsequently receive treatment. In fact, about 375,000 of those heart attack victims will make it to a hospital for treatment within 1 hour; about 637,000 will make it to a hospital for treatment within 4 hours. Unfortunately, when treated using current methods, heart attacks often result in serious and permanent damage to the heart muscle. In fact, it is estimated that about 66% of the MI patients do not make a complete recovery, but rather suffer permanent injury to cardiac muscle cells. An effective treatment that minimizes permanent damage to the heart as a result of the heart attack would be of great value to these patents. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for supporting medical practitioners in managing patient temperature Inventor(s): Worthen, William J.; (Irvine, CA) Correspondence: John L. Rogitz; Suite 3120; 750 "b" Street; San Diego; CA; 92101; US Patent Application Number: 20030055472 Date filed: September 19, 2001 Abstract: A method for supporting medical practitioners in managing patient temperature includes obtaining regulatory approval to use a heat exchange catheter having a circulating working fluid in a neuro intensive care unit (NICU) to manage patient temperature. Moreover, regulatory approval is obtained to use the catheter outside the NICU for patient temperature management. The catheter can be used outside the NICU to induce therapeutic hypothermia to treat cardiac arrest, stroke, and acute myocardial infarction. Also, the catheter can be used to treat hypothermia after coronary artery bypass graft (CABG) surgery. Excerpt(s): The present invention relates generally to methods and apparatus for exchanging heat with the body of a patient. It has been discovered that the medical outcome for a patient suffering from severe brain trauma or from ischemia caused by stroke or heart attack is improved if the patient is cooled below normal body temperature (37.degree. C.). Furthermore, it is also accepted that for such patients, it is important to prevent hyperthermia (fever) even if it is decided not to induce hypothermia. Moreover, in certain applications such as post-CABG surgery, it might be desirable to rewarm a hypothermic patient. Having recognized the importance of temperature management, the present invention seeks to support medical practitioners in their endeavors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method of using cryotreatment to treat brain tissue Inventor(s): Chauvet, Patrick; (St-Laurent, CA), Nahon, Daniel; (Ottawa, CA) Correspondence: Christopher, Weisberg & Crush, P.A.; 200 East Las Olas Boulevard; Suite 2040; Fort Lauderdale; FL; 33301; US Patent Application Number: 20020128638 Date filed: February 15, 2002 Abstract: A method is disclosed for treating brain tissue with cryotreatment. A surgical tool, such as a catheter is disposed proximate to a target region of brain tissue. The tool or catheter provided includes a cryotreatment element. The cryotreatment element may be a cryochamber for enclosing the flow of a fluid refrigerant therein. The cryotreatment element is disposed at the situs of brain tissue to be treated, either through endovascular insertion, or via an opening in the cranium. A refrigerant flow within the cryochamber creates endothermic cooling with respect to the surrounding brain tissue, inducing hypothermia and forming iceballs proximate said tissue. The cooling may be reversible and non-permanent, or may be permanent leading to cell death, necrosis, apoptosis and/or surgical excision or ablation of tissue. Mapping using conventional techniques may be used to measure and assess brain function before and after cryotreatment, and cryotreatment itself may be integrally and progressively used to map brain function and treat tissue. Excerpt(s): This application is related to and claims priority to U.S. Provisional Application Serial No. 60/269,566, filed Feb. 16, 2001, entitled DEVICE AND METHOD FOR USING CRYOGENIC ENERGY TO TREAT BRAIN TISSUE, the entirety of which is incorporated herein by reference. The present invention relates to a method for treatment of brain tissue, and, in particular, a method for treating brain tissue using cryotreatment. Disorders of the brain, such as epilepsy, tumors, cysts, or Parkinson's disease, are conventionally treated by drug therapy. Yet drug therapy carries a significant risk of complications and side effects, and must be carefully monitored over a period of time to find the precise dosage required. Additionally, drug therapy can cause potentially life-threatening low blood pressure conditions and side effects. Further, brain disorders such as stroke (hemorrhagic or embolic), vasospasm, and ischemia pose additional difficulties. Another option, angioplasties, while providing some relief, are not always useful and are difficult to position inside the complex structure of the brain. Moreover, many patients do not respond to such treatment and thus surgical excision of a target region of brain tissue, or "focus", becomes necessary. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Methods for enhancing a plant stress response Inventor(s): Gupta, Rajeev; (Berkeley, CA), Kim, Kyung-Nam; (Seoul, KR), Luan, Sheng; (Kensington, CA), Pandey, Girdhar K.; (El Cerrito, CA) Correspondence: Townsend And Townsend And Crew, Llp; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20020166139 Date filed: March 15, 2002 Abstract: The invention provides novel methods useful for enhancing a stress response in plants. Specifically, the methods of the present invention are useful for increasing the
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tolerance of a plant to stresses such as hyperthermia, hypothermia, hyperosmolarity, hypoosmolarity, and wounds. Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application Serial No. 60/282,118, filed Apr. 6, 2001, which is herein incorporated by reference in its entirety. The present invention is directed to plant genetic engineering. In particular, it relates to methods for controlling a stress response in plants. Drought, cold, and salinity are critical environmental factors that limit crop productivity worldwide. In response to these stress signals, plants mount a number of defense reactions that increase the tolerance to the stressful conditions. The best-known molecular response is the activation of gene expression that leads to changes in protein profiles and physiological processes. The products of these so called "stress genes" are categorized in at least two functional groups. The first group includes metabolic enzymes required for biosynthesis of various osmo-protectants, chaperons, detoxifying enzymes, and other effector proteins that are directly involved in stress protection processes. The second category of gene products includes sensor/receptor proteins, protein kinases and phosphatases, enzymes involved in second messenger metabolism, and other components that constitute the signal transduction pathways connecting the stress signal to the cellular responses (Shinozaki et al., Plant Physiol. 115:327-334 (1997); Ingram et al., Ann. Rev. Plant Physiol. Plant Mol. Biol. 47:377-403 (1996); Bray, Trends Plant Sci. 2:48-54 (1997)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Multipurpose catheter assembly Inventor(s): Werneth, Randell; (Poway, CA) Correspondence: Gerald W Spinks; P. O. Box 2330; Port Orchard; WA; 98366; US Patent Application Number: 20020068901 Date filed: December 6, 2000 Abstract: An apparatus for performing hypothermia of the body of a patient, or of a selected organ, while delivering a medicament to a selected blood vessel. A flexible coaxial catheter is inserted through the vascular system of a patient to place the distal tip of the catheter in a selected artery. A chilled fluid is pumped through an inner supply conduit of the catheter to cool a flexible heat transfer element in the distal tip of the catheter. The heat transfer element cools the blood flowing through the artery distal to the tip of the catheter. The medicament, such as a vaso-dilator, is delivered either separately or mixed with the chilled fluid, through a very small exit port in or near the heat transfer element. Excerpt(s): The current invention relates to cooling or warming of the body of a patient, or selective cooling or warming of a selected organ, by cooling or warming the blood in a major artery, or cooling or warming the blood flowing into the selected organ. This thermal treatment can protect the tissue from injury caused by anoxia or trauma, or it can achieve other purposes. Organs of the human body, such as the brain, kidney, and heart, are maintained at a constant temperature of approximately 37.degree. C. Cooling of organs below 35.degree. C. is known to provide cellular protection from anoxic damage caused by a disruption of blood supply, or by trauma. Cooling can also reduce swelling associated with these injuries. Hypothermia is currently utilized in medicine and is sometimes performed to protect the brain from injury. Cooling of the brain is generally accomplished through whole body cooling to create a condition of total body hypothermia in the range of 20.degree. to 30.degree. C. This cooling is accomplished by
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immersing the patient in ice, by using cooling blankets, or by cooling the blood flowing externally through a cardiopulmonary bypass machine. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Novel hypothermic modalities and direct application of protective agents to neural structures or into CSF Inventor(s): Levin, Bruce H.; (Merion Station, PA) Correspondence: Bruce H. Levin MD; 125 Broome Lane; Merion Station; PA; 19066; US Patent Application Number: 20030028137 Date filed: May 17, 2002 Abstract: Novel use of CNS hypothermia and csf drug delivery to minimize CNS insult in a variety of disease states is disclosed. Specifically, cooling of CSF, epidural or subdural spaces are discussed and the direct delivery of pharmacologically active agents directly into the CSF to improve delivery to damaged or vulnerable CNS tissues if disclosed. Excerpt(s): This application claims the filing benefit under 35 U.S.C.sctn.119(e) of U.S. Provisional Application No. 60/292,027, filed May 18, 2001, which is included herein by reference. The present invention pertains generally to neuroprotection, and more particularly to novel methods of cooling CNS structures in a more effective manner or delivering neuroprotective agents into areas of Cerebrospinal fluid circulation to affect improved neuroprotection. Hypothermia has been proven to decrease the metabolic demands of tissues and organs and in a variety of settings. CNS structures are particularly vulnerable to hypoperfusion, hypoxia and other insults. Intellectually, hypothermia is an extremely attractive methodology for increasing brain or spinal cord tissue survival in many clinical scenarios. However, many obstacles have prevented its use in this regard. Notably, generalized hypothermia has significant affects on many organ systems and these may create significant problems. For example, cardiac conduction and contractility are adversely affected below certain thresholds, as are blood viscosity and coaguabilty. Respiration may cease and mechanical ventilation maybe required. Furthermore, techniques used to cool the brain or spinal cord have not been particularly effective. For example, applying external cooling devices to the head is not optimally effective because the vascularity of the scalp and the insulation provided by the structures therein limit direct cooling. Cooling the arterial inflow can be effective, but the rapid flow of blood through a relatively small cross sectional area located within a larger section of tissues presents many limitations. CNS hypothermia has been attempted by cooling blood entering the CNS but this introduces the many problems associated with the resulting cardiac and systemic hypothermia. Thus there is no effective way to cool the CNS to a much greater relative degree than than the rest of the body. This limits the effectiveness of current attempts to provide clinically useful CNS hypothermia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Phase change material thermal capacitor clothing Inventor(s): Buckley, Theresa M.; (Ashton, MD) Correspondence: Leary & Associates; 3900 Newpark Mall RD.; Third Floor, Suite 317; Newark; CA; 94560; US Patent Application Number: 20020164473 Date filed: November 20, 2001 Abstract: An apparatus and method for metabolic cooling and insulation of a user in a cold environment. In its preferred embodiment the apparatus is a highly flexible composite material having a flexible matrix containing a phase change thermal storage material. The apparatus can be made to heat or cool the body or to act as a thermal buffer to protect the wearer from changing environmental conditions. The apparatus may also include an external thermal insulation layer and/or an internal thermal control layer to regulate the rate of heat exchange between the composite and the skin of the wearer. Other embodiments of the apparatus also provide 1) a path for evaporation or direct absorption of perspiration from the skin of the wearer for improved comfort and thermal control, 2) heat conductive pathways within the material for thermal equalization, 3) surface treatments for improved absorption or rejection of heat by the material, and 4) means for quickly regenerating the thermal storage capacity for reuse of the material. Applications of the composite materials are also described which take advantage of the composite's thermal characteristics. The examples described include a diver's wet suit, ski boot liners, thermal socks, gloves and a face mask for cold weather activities, and a metabolic heating or cooling blanket useful for treating hypothermia or fever patients in a medical setting and therapeutic heating or cooling orthopedic joint supports. Excerpt(s): This patent application is a continuation of patent application Ser. No. 09/033,439 filed Mar. 2, 1998, now U.S. Pat. No. 6,319,599, which is a continuation-inpart of patent application Ser. No. 08/404,419 filed Mar. 15, 1995, now U.S. Pat. No. 5,722,482, which is a continuation-in-part of patent application Ser. No. 07/913,246 filed Jul. 14, 1992 now U.S. Pat. No. 6,004,662, the specifications of which are hereby incorporated by reference in their entirety. This invention relates to a flexible composite material containing a phase change material for thermal storage and to garments and other articles made from the composite material. The use of phase change materials or PCM's for thermal storage has long been known. In many materials much more heat can be stored as latent heat of phase change than as sensible heat. One of the earliest known applications of this principle is the use of ice as a thermal storage medium for perishable foods. Some of the phase transitions that involve significant amounts of latent heat are solid-to-liquid or liquid-to-gas phase changes or, in certain materials, solid-to-solid phase changes. Another subgroup of PCM's uses reversible exothermic reactions, such as hydration-dehydration or solution-precipitation reactions, for heat storage. The latent heat of phase change can be used for heating or cooling depending on whether the phase change is exothermic or endothermic. In most materials, the phase changes are reversible so that the latent heat storage can be used for either heating or cooling depending on the temperature conditions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Retrograde venous perfusion with isolation of cerebral circulation Inventor(s): Barbut, Denise R.; (New York, NY) Correspondence: Lyon & Lyon Llp; 633 West Fifth Street; Suite 4700; Los Angeles; CA; 90071; US Patent Application Number: 20020128586 Date filed: May 7, 2002 Abstract: A medical device for providing retrograde venous perfusion to the cerebral vasculature for treatment of global or focal cerebral ischemia is disclosed. The device includes a catheter having an infusion port at its distal end, venous drainage port(s), and an expandable occluder disposed between the infusion port and drainage port(s). The catheter is adapted for insertion in the superior vena cava or the internal jugular vein. The catheter is attached proximally to a pump and an oxygenator with or without a cooling system. Alternatively, the device comprises two catheters, each having a lumen communicating with a distal infusion port and an occluder mounted proximal to the port. The catheters are adapted for insertion in the internal jugular veins distal to jugular venous valves. Methods of using the devices to provide retrograde venous perfusion and isolated cerebral hypothermia are disclosed. Excerpt(s): This is a continuation of U.S. application Ser. No. 09/285,939, filed Apr. 2, 1999, the contents of which are expressly incorporated herein by reference. The present invention generally relates to devices and methods useful in maintaining cerebral perfusion during global or focal cerebral ischemia. More specifically, the devices and methods provide effective retrograde perfusion to the cerebral circulation through the superior vena cava or the internal jugular veins. Retrograde venous perfusion may be used with hypothermia to provide isolated cerebral cooling. The devices and methods are also useful in improving perfusion to other peripheral organs besides the brain. Cerebral ischemia refers to cessation or reduction of blood flow to the cerebral tissues. Cerebral ischmia can be characterized as either global or hemispherical. Hemispherical or focal ischemia refers to cessation or reduction of blood flow within the cerebral vasculature resulting from a partial or complete occlusion in the intracranial or extracranial cerebral arteries. Global ischemia refers to cessation or reduction of blood flow within the cerebral vasculature resulting from systemic circulatory failure from various causes, including aortic surgery, cardiac arrest, shock, and trauma. Circulatory arrest is often required in performing surgeries on the aorta, e.g., aneurysm repair, aortic dissection, endarterectomy of aortic atheroma, and aortic stenting. Blood flow through the aorta is often interrupted due to opening of the aorta for these surgical procedures. Cessation of systemic circulation therefore places a patient at great risk, particularly in the cerebral vasculature where ischemia can rapidly lead to irreversible neurologic damage. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Selective delivery of cryogenic energy to intervertebral disc tissue and related methods of intradiscal hypothermia therapy Inventor(s): Carl, Allen; (Slingerlands, NY) Correspondence: Knobbe Martens Olson & Bear Llp; 620 Newport Center Drive; Sixteenth Floor; Newport Beach; CA; 92660; US Patent Application Number: 20020095144 Date filed: October 30, 2001 Abstract: The present invention relates to devices and methods for altering the tissue in and around an intervertebral disc through localized hypothermia therapy to restore function of the disc and reduce pain. Hypothermia therapy is defined as the reduction of tissue temperature to below that of the equilibrium temperature. Target therapeutic temperatures and times are varied according to the desired treatment effect. Intended effects of hypothermia of the intervertebral disc include cellular disruption leading to cell death and or structural and chemical denaturation within the anulus fibrosus, nucleus pulposus, or nerve fibers, temporary or permanent deadening of the nerves within or surrounding the disc, induction of a healing response, angiogenesis, or accelerated degeneration and/or drying of the nucleus pulposus and/or anulus fibrosus. Various effects can be achieved by reaching different temperatures for differing periods of time or by the proximity of the hypothermia therapy device to the treatment target. Accordingly, it is an object of one or more the embodiments of the invention to provide hypothermic therapy to selected locations within an intervertebral disc utilizing a flexible and guidable cryogenic device. Excerpt(s): This application claims benefit to U.S. Provisional Application No. 60/243,702 filed Oct. 30, 2000, the entire teachings of this application being incorporated herein by reference. The present invention relates generally to intervertebral discs and vertebrae and methods of hypothermia therapy applied thereto to relieve pain and restore function. Low back pain afflicts more than 10 million people in the United States annually. It impacts the individual sufferer's life physically, emotionally and financially, restricting his or her activities and often leading to depression and absenteeism from work. As a nation, the United States spends more than $50 billion dollars in direct and indirect medical expenses related to back pain, making it one of the leading healthcare expenditures overall. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Selective organ hypothermia method and apparatus Inventor(s): Dobak, John D. III; (La Jolla, CA) Correspondence: Gerald W Spinks; P. O. Box 2330; Port Orchard; WA; 98366; US Patent Application Number: 20020198578 Date filed: May 29, 2002 Abstract: A method and apparatus for performing hypothermia of a selected organ without significant effect on surrounding organs or other tissues. A flexible catheter is inserted through the vascular system of a patient to place the distal tip of the catheter in an artery feeding the selected organ. A compressed refrigerant is pumped through the catheter to an expansion element near the distal tip of the catheter, where the refrigerant vaporizes and expands to cool a flexible heat transfer element in the distal tip of the
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catheter. The heat transfer element cools the blood flowing through the artery, to cool the selected organ, distal to the tip of the catheter. Excerpt(s): This application is a continuation application of co-pending U.S. Ser. No. 09/650,940, filed Aug. 30, 2000, titled "Selective Organ Hypothermia Method and Apparatus", which is a continuation application of U.S. Ser. No. 09/306,866, filed May 7, 1999, titled "Selective Organ Hypothermia Method and Apparatus", now U.S. Pat. No. 6,235,048, which is a divisional application of U.S. Ser. No. 09/012,287, filed Jan. 23, 1998, titled "Selective Organ Hypothermia Method and Apparatus", now U.S. Pat. No. 6,051,019. The current invention relates to selective cooling, or hypothermia, of an organ, such as the brain, by cooling the blood flowing into the organ. This cooling can protect the tissue from injury caused by anoxia or trauma. Organs of the human body, such as the brain, kidney, and heart, are maintained at a constant temperature of approximately 37.degree. C. Cooling of organs below 35.degree. C. is known to provide cellular protection from anoxic damage caused by a disruption of blood supply, or by trauma. Cooling can also reduce swelling associated with these injuries. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Supported hypo/hyperthermia pad Inventor(s): Flick, Roland E.; (Elma, NY), Jusiak, Joel T.; (Holland, NY) Correspondence: Kevin D. Mccarthy; Roach Brown Mccarthy & Gruber, P.C.; 1620 Liberty Building; 420 Main Street; Buffalo; NY; 14202; US Patent Application Number: 20030196267 Date filed: May 14, 2003 Abstract: The present invention relates to a first conformable material having a threedimensional shape and a first hypothermia and/or hyperthermia device. This invention is used as a pad for sleeping, lying down, or sitting, to maintain a desired temperature to the contacting surface of a body to the pad. Excerpt(s): The present invention claims priority to U.S. Provisional patent application No. 60/128,433, filed on Apr. 6, 1999. The present invention relates to a pad that provides hypo/hyperthermia properties to a person using the pad. In U.S. Pat. No. 5,336,708, Chen discloses a gelatinous elastomer composite article. These articles, as disclosed by Chen, "include: GMG, MGM, MG.sub.1G.sub.2M, M.sub.1M.sub.2G.sub.1G.sub.2, M.sub.2M.sub.1G.sub.1G.sub.2, G.sub.1MG.sub.1G.sub.2, MG.sub.1G.sub.2, G.sub.1G.sub.2M, G.sub.2G.sub.1M, GM.sub.1M.sub.2G, G.sub.1M.sub.1G.sub.2M.sub.2M.sub.1, M.sub.1GM.sub.2GM.sub.3GM.sub.4, [sic] ect, where G=gel and M=material. The subscript 1, 2, 3, and 4 are different and are represented by n which is a positive number. The material (M) suitable for forming composite articles with the gelatinous elastomer compositions can include foam, plastic fabric, metal, concrete, wood, wire screen, refractory material, glass, synthetic resin, synthetic fibers, and the like. Sandwiches of gel/material. are ideal for use as shock absorbers, acoustical isolators, vibration dampers, vibration isolators and wrappers. For example the vibration isolators can be [sic] use under research microscopes, office equipment, tables, and the like to remove background vibrations." U.S. Pat. No. 5,336,708, col. 3, lines 35-51. Chen further discloses, "generally the molten gelatinous elastomer composition will adhere sufficiently to certain plastics (e.g., acrylic, ethylene copolymers, nylon, polybutylene, polycarbonate, polystyrene, polyester, polyethylene, polypropylene, styrene
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copolymers, and the like) provided the temperature of the molten gelatinous elastomer composition is [sic] sufficient high to fuse or nearly fuse with the plastic. In order to obtain sufficient adhesion to glass, ceramics, or certain metals, sufficient temperature is also required (e.g., above 250.degree. F. [121.degree. C.])." U.S. Pat. No. 5,336,708, col. 9, lines 8-18 (brackets added for consistency of temperature comparison). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Therapeutic modulation of body temperature Inventor(s): Fox, James A.; (Palo Alto, CA) Correspondence: Robins & Pasternak Llp; 545 Middlefield Road; Suite 180; Menlo Park; CA; 94025; US Patent Application Number: 20020045924 Date filed: December 12, 2001 Abstract: The invention relates generally to methods of treating cancer and other diseases by modulating body temperature. Heat may directed to the hypothalamus of a warm-blooded animal to cool the animal, utilizing the physiological mechanisms that regulate body temperature to effect a compensatory cooling response, thereby lowering body temperature (hypothermia), and rendering other methods of lowering body temperature more effective. Heat may be withdrawn from the hypothalamus of an animal, cooling the hypothalamus, inducing a compensatory increase in body temperature (hyperthermia), and rendering other methods of raising body temperature more effective. Body temperature may be directly modulated by heat-exchange catheter positioned within a blood vessel of a patient. The invention relates generally to methods of treating cancer by inducing hypothermia by directing heat to the hypothalamus, optionally maintaining cancerous tissue at or near to normal body temperature, and optionally applying another cancer treatment. This other cancer treatment may be radiation therapy, chemotherapy, a combination of radiation and chemotherapy, or some other cancer treatment. The invention relates generally to methods of treating diseases including cancer, viral infections, and other diseases, comprising inducing hyperthermia by cooling the hypothalamus, and optionally applying another treatment, for example radiation, chemotherapy, antiviral therapy, or a combination of therapies. Excerpt(s): This application is a continuation-in-part of patent application Ser. No. 09/523,829 filed Mar. 13, 2000, entitled "Method for Inducing Hypothermia for Treating Cancer," which is a continuation-in-part of patent application Ser. No. 08/909,752 filed Aug. 12, 1997, now U.S. Pat. No. 6,090,132, from which applications priority is claimed under 35 U.S.C.sctn. 120. This application is also a continuation-in-part of patent application Ser. No. 09/675,810, filed Sep. 29, 2000, entitled "Method and Apparatus for Inducing Hyperthermia" from which priority is claimed under 35 U.S.C.sctn. 120. This application also claims priority under 35 U.S.C.sctn. 119(e) from Provisional Application Serial No. 60/256,271, filed Dec. 15, 2000, entitled "Methods for using heat exchange catheters to induce hypothermia for treating cancer." All the above-named patents and patent applications are incorporated herein by reference in their entirety. The invention relates generally to methods and apparatus for modulating body temperature to induce hypothermia or hyperthermia in an animal. In addition, it relates to methods and apparatus for treating diseases or aiding in the treatment of diseases by modulating body temperature. Body temperature is regulated by warm-blooded animals; the main brain center responsible for the regulation of body temperature is the hypothalamus. The progress and the treatment of many diseases may be affected by body temperature.
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For example, temperature affects cancer treatment. Cancer is progressive disease characterized by malignant cells that grow without control, forming tumors, and often metastasize, spreading new tumors to multiple locations in the body. Treatments for cancer are often aimed at slowing cancerous growth, or reducing metastasis, or rendering cancerous tissue more susceptible to cytotoxic agents. Altered body temperature can affect the growth and proliferation of cancerous cells, metastasis of cancer cells, the efficacy of cytotoxic agents, and the expression and properties of markers expressed by cancerous cells. Hyperthermia (increased body temperature) has been used by research and clinical workers to enhance cancer treatments, to treat viral diseases, and for other medical purposes. Hypothermia (reduced body temperature) has been used by researchers and clinical workers to reduce neurological damage from stroke and trauma, to treat cancer, to enhance cancer treatments, and for other medical purposes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Uniform selective cerebral hypothermia Inventor(s): Lennox, Charles D.; (Hudson, NH) Correspondence: Charles D. Lennox; 17 Williams DR.; Hudson; NH; 03051; US Patent Application Number: 20030130651 Date filed: December 27, 2002 Abstract: Disclosed is an apparatus and method for uniform selective cerebral hypothermia. The apparatus includes a brain-cooling probe, a head-cooling cap, a bodyheating device and a control console. The brain-cooling probe cools the cerebrospinal fluid within one or more brain ventricles. The brain-cooling probe withdraws a small amount of cerebrospinal fluid from a ventricle into a cooling chamber located ex-vivo in close proximity to the head. After the cerebrospinal fluid is cooled it is then reintroduced back into the ventricle. This process is repeated in a cyclical or continuous manner. The head-cooling cap cools the cranium and therefore cools surface of the brain. The combination of ventricle cooling and cranium cooling provides for whole brain cooling while minimizing temperature gradients within the brain. The bodyheating device replaces heat removed from the body by the brain-cooling probe and the head-cooling cap and provides for a temperature difference between the brain and the body where the brain is maintained a temperature lower than the temperature of the body. Excerpt(s): This application is entitled to the benefit of Provisional Patent Application Ser. No. 60/344,986 filed Dec. 31, 2001. This invention relates to a method, device and system for inducing global cerebral hypothermia while maintaining normal body core temperature for the prevention of secondary brain injury from stroke, trauma, or surgery. Patients suffering from stroke or head trauma, or have undergone invasive brain or vascular surgery are at risk from secondary brain injury. Secondary brain injury is a result of the innate healing response of the brain to the original insult caused by several not completely understood mechanisms. Regardless of the specific mechanisms involved, the end result is swelling of the brain caused by edema, which can lead to a critical or terminal rise in intra-cranial pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Keeping Current In order to stay informed about patents and patent applications dealing with hypothermia, 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 “hypothermia” (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 hypothermia. You can also use this procedure to view pending patent applications concerning hypothermia. 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 7. BOOKS ON HYPOTHERMIA Overview This chapter provides bibliographic book references relating to hypothermia. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on hypothermia 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 “hypothermia” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “hypothermia” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “hypothermia” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Accidental hypothermia by Derek Maclean; ISBN: 0632008318; http://www.amazon.com/exec/obidos/ASIN/0632008318/icongroupinterna
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Accidental hypothermia : the cold can be trouble for older people (SuDoc HE 20.3852:H 99/993) by U.S. Dept of Health and Human Services; ISBN: B00010H5HK; http://www.amazon.com/exec/obidos/ASIN/B00010H5HK/icongroupinterna
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Accidental Hypothermia and Near Drowning: Proceedings by R. C. G. Gallandat Huet (Editor) (1988); ISBN: 9023223845; http://www.amazon.com/exec/obidos/ASIN/9023223845/icongroupinterna
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Basic Essentials Hypothermia, 2nd by William Forgey (Author); ISBN: 0762704918; http://www.amazon.com/exec/obidos/ASIN/0762704918/icongroupinterna
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Bioheat Transfer: Applications in Hypothermia; Emerging Horizons in Instrumentation and Modeling (H t D, Vol 126) by R.B. Roemer, et al; ISBN:
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0791803945; http://www.amazon.com/exec/obidos/ASIN/0791803945/icongroupinterna •
Biological Physical and Clinical Aspects of Hypothermia Monagraph #16 (Medical Physics Monograph, No. 16) by Aapm, et al (1988); ISBN: 088318558X; http://www.amazon.com/exec/obidos/ASIN/088318558X/icongroupinterna
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Brain Hypothermia Treatment by Nariyuki Hayashi, Dalton W. Dietrich (2003); ISBN: 4431404465; http://www.amazon.com/exec/obidos/ASIN/4431404465/icongroupinterna
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Brain Hypothermia: Pathology, Pharmacology and Treatment of Severe Brain Injury by N. Hayashi (Editor) (2000); ISBN: 4431702776; http://www.amazon.com/exec/obidos/ASIN/4431702776/icongroupinterna
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Cold Can Kill: Hypothermia by Christine B. Hall (1994); ISBN: 1566120268; http://www.amazon.com/exec/obidos/ASIN/1566120268/icongroupinterna
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Cold Hearts: The Story of Hypothermia and the Pacemaker in Heart Surgery by Wilfred G. Bigelow; ISBN: 0771014147; http://www.amazon.com/exec/obidos/ASIN/0771014147/icongroupinterna
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EMED: Cold and Hypothermia by Primedia; ISBN: 1401875505; http://www.amazon.com/exec/obidos/ASIN/1401875505/icongroupinterna
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Experimental Malignant Hypothermia by Charles H. Williams; ISBN: 0387965548; http://www.amazon.com/exec/obidos/ASIN/0387965548/icongroupinterna
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Hibernation and hypothermia, perspectives and challenges Symposium held at Snow-mass-at-Aspen, Colorado, January 3-8, 1971; ISBN: 0444410074; http://www.amazon.com/exec/obidos/ASIN/0444410074/icongroupinterna
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Hypothermia by Robert S. and Born, David O. Pozoz; ISBN: 083290127X; http://www.amazon.com/exec/obidos/ASIN/083290127X/icongroupinterna
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Hypothermia (Education Publication Series: No 15) by Alaska Sea Grant Program (1992); ISBN: 1566120063; http://www.amazon.com/exec/obidos/ASIN/1566120063/icongroupinterna
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Hypothermia and Cold Stress by Evan L. Lloyd; ISBN: 0871893010; http://www.amazon.com/exec/obidos/ASIN/0871893010/icongroupinterna
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Hypothermia for Cardiovascular Surgery by Hitoshi Mohri; ISBN: 0896400603; http://www.amazon.com/exec/obidos/ASIN/0896400603/icongroupinterna
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Hypothermia for the Neurosurgical Patient by Antonio Boba; ISBN: 0398001820; http://www.amazon.com/exec/obidos/ASIN/0398001820/icongroupinterna
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Hypothermia in Biology and in Medicine by Popovic; ISBN: 0808908537; http://www.amazon.com/exec/obidos/ASIN/0808908537/icongroupinterna
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Hypothermia, a cold weather hazard (SuDoc HE 20.3861:H 99/2) by U.S. Dept of Health and Human Services; ISBN: B000115K08; http://www.amazon.com/exec/obidos/ASIN/B000115K08/icongroupinterna
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Hypothermia, Frostbite, and Other Cold Injuries: Prevention, Recognition and PreHospital Treatment by James A. Wilkerson (Editor), et al (1986); ISBN: 0898860245; http://www.amazon.com/exec/obidos/ASIN/0898860245/icongroupinterna
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Hypothermia: Ashore and Afloat by James Adam (1981); ISBN: 008025750X; http://www.amazon.com/exec/obidos/ASIN/008025750X/icongroupinterna
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Hypothermia: Death by Exposure by William W. Forgey, et al; ISBN: 0934802106; http://www.amazon.com/exec/obidos/ASIN/0934802106/icongroupinterna
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Hypothermia: Medical and Social Aspects by Dharam P. Maudgal (Editor); ISBN: 0080341888; http://www.amazon.com/exec/obidos/ASIN/0080341888/icongroupinterna
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Hypothermia: The Facts by Kenneth John Collins; ISBN: 019261360X; http://www.amazon.com/exec/obidos/ASIN/019261360X/icongroupinterna
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Interstitial Hypothermia by L. Handl-Zeller (Editor); ISBN: 0387822801; http://www.amazon.com/exec/obidos/ASIN/0387822801/icongroupinterna
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Interstitial, Endocavity, and Perfusional Hypothermia: Methods and Clinical Trials (Clinical Thermology Subseries Thermotherapy, Vol 5) by M. Gautheria, J. M. Cosset; ISBN: 0387509836; http://www.amazon.com/exec/obidos/ASIN/0387509836/icongroupinterna
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Locoregional High-Frequency Hypothermia and Temperature Measurement (Recent Results in Cancer Research, Vol 101) by G. Bruggmoser; ISBN: 0387155015; http://www.amazon.com/exec/obidos/ASIN/0387155015/icongroupinterna
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Nature & Treatment Hypothermia by Pozoz Et Al; ISBN: 0709920458; http://www.amazon.com/exec/obidos/ASIN/0709920458/icongroupinterna
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Old and Cold: Hypothermia and Social Policy (Studies in Social Policy and Welfare) by Malcom Wick; ISBN: 0435829394; http://www.amazon.com/exec/obidos/ASIN/0435829394/icongroupinterna
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Preventing Hyperthermia, Hypothermia and Drowning (Injury Prevention for the Elderly) by Bonnie L. Walker; ISBN: 0834208334; http://www.amazon.com/exec/obidos/ASIN/0834208334/icongroupinterna
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Survival in Cold Water: the Physiology and Treatment of Immersion Hypothermia and Drowning; ISBN: 0632052805; http://www.amazon.com/exec/obidos/ASIN/0632052805/icongroupinterna
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Systemic Hypothermia After Spinal Cord Injury: An Experimental Study in the Rat (Comprehensive Summaries of Uppsala Dissertations, 831) by Hans Westergren (1999); ISBN: 9155444326; http://www.amazon.com/exec/obidos/ASIN/9155444326/icongroupinterna
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The Nature and Treatment of Hypothermia by Robert S. Pozos, Lorentz E., Jr. Wittmers (Editor); ISBN: 0816611548; http://www.amazon.com/exec/obidos/ASIN/0816611548/icongroupinterna
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 “hypothermia” (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 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
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Basic quantitative studies of severe hypothermia; final report, 1951-61. Responsible investigator: E. F. Adolph. Author: Rochester, N. Y. University. School of Medicine and Dentistry. Dept. of Physiology.; Year: 2001; Rochester, 1961
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Clinical hypothermia. Author: Blair, Emil.; Year: 1969; New York, McGraw-Hill [c1964]
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Cryonics: solid state human hypothermia Author: Blair-Giles, Brian.; Year: 1971; London: [Blair-Giles], c1977
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Hypothermia and artificial hibernation for space travel; a survey, prepared by Technical Information Center. Author: North American Aviation, inc. Space and Information Systems Division.; Year: 1968; [Downey, Calif.] 1963
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Hypothermia for the neurosurgical patient. Author: Boba, Antonio,; Year: 1969; Springfield, Ill., Thomas [c1960]
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Hypothermia in neurosurgery: symposium Author: Maspes, P. E.; Year: 1966; Wien; New York: Springer-Verlag, 1964
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Hypothermia in surgical practice [ed.] by K. E. Cooper and D. N. Ross. Author: Cooper, K. E. (Keith Edward); Year: 1969; London, Cassell [1960]
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Intravenous anesthesia, ed. by John W. Dundee. Hypothermia, ed. by A. R. Hunter. Author: Dundee, John W. (John Wharry); Year: 1972; Boston, Little, Brown, 1964
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Left heart bypass in normo- and hypothermia; An experimental study on dogs and a clinical report, by L. J. Telivuo [et al.]. Author: Telivuo, Leo Johannes,; Year: 1961; Helsinki, 1965
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Mountain hypothermia. Author: British Subcommittee.; Year: 1969; London [1973]
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Resuscitation and artificial hypothermia. Author: Negovskii, V. A. (Vladimir Aleksandrovich); Year: 1969; New York, Consultants Bureau, 1962
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Survival in cold water; the physiology and treatment of immersion hypothermia and of drowning. Author: Keatinge, W. R.; Year: 1965; Oxford, Blackwell Scientific Publications [1969]; ISBN: 632052805
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The influence of hypothermia on glycaemia in animals with alloxan diabetes. Author: Zakolski, Wojciech.; Year: 1964; Gda´nsk, 1961
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The problem of acute hypothermia. Tr. from the Russian by R. E. Hammond, ed. by E. Neil. Author: Starkov, Pavel Mikhailovich.; Year: 1817; New York, Pergamon, 1960
Mountaineering
Council.
Safety
Chapters on Hypothermia In order to find chapters that specifically relate to hypothermia, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and hypothermia 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 “hypothermia” (or 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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synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on hypothermia: •
Drugs and the Liver Source: in Sherlock, S.; Dooley, J. Diseases of the Liver and Biliary System. Malden, MA: Blackwell Science, Inc. 2002. p.335-363. Contact: Available from Blackwell Science, Inc. 350 Main Street, Commerce Place, Malden, MA 02148. (800) 215-1000 or (617) 388-8250. Fax (617) 388-8270. E-mail:
[email protected]. Website: www.blackwell-science.com. PRICE: $178.95. ISBN: 0632055820. Summary: The liver is particularly concerned with drug metabolism, and especially of drugs given orally. Drugs can cause toxic effects that can mimic almost every naturally occurring liver disease in man. This chapter on drugs and the liver is from a textbook that presents a comprehensive and up-to-date account of diseases of the liver and biliary system. The chapter is organized into specific pathologies and their potential causes: hepato-cellular zone 3 necrosis, due to carbon tetrachloride, Amanita mushrooms, paracetamol (acetaminophen), salicylates, hyperthermia, hypothermia, and burns; hepato-cellular zone 1 necrosis, due to ferrous sulfate or phosphorus; mitochondrial cytopathies, due to sodium valproate, tetracyclines, tacrine, antiviral nucleoside analogues, and Bacillus cereus; steatohepatitis, due to perhexiline maleate, amiodarone, synthetic estrogens, and calcium channel blockers; fibrosis, due to methotrexate, other cytotoxic drugs, arsenic, vinyl chloride, vitamin A, and retinoids; vascular changes, due to sinusoidal dilatation, peliosis hepatitis, and veno-occlusive disease (VOD); acute hepatitis, due to isoniazid, methyl dopa, halothane, hydrofluorocarbons, systemic antifungals, oncology drugs, nervous system modifiers, sustained-release nicotinic acid (niacin), sulfonamides and derivatives, nonsteroidal anti-inflammatory drugs, antithyroid drugs, quinidine and quinine, troglitazone, and anti-convulsants; chronic hepatitis, due to herbal remedies and recreational drugs; canalicular cholestasis, due to cyclosporine A and ciprofloxacin; hepato-canalicular cholestasis, due to chlorpromazine, penicillins, sulfonamides, erythromycin, haloperidol, cimetidine and ranitidine, oral hypoglycemic agents, tamoxifen, other causes, and dextropropoxyphene; ductular cholestasis; biliary sludge; sclerosing cholangitis; hepatic nodules and tumors; and hepatocellular carcinoma (HCC, liver cancer). 28 figures. 5 tables. 170 references.
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Mountain Hiking Source: in Devlin, J.T. and Schneider, S.H., eds. Handbook of Exercise in Diabetes. Alexandria, VA: American Diabetes Association. 2002. p.649-653. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $69.95 plus shipping and handling. ISBN: 1580400191. Summary: This chapter on mountain hiking is from a book that provides a practical, comprehensive guide to diabetes and exercise for health care professionals involved in patient care. The author reviews the hazards of mountain hiking, including dehydration, sun radiation, frostbite and hypothermia, avalanche, lightning, and mountain sickness syndrome; insulin conservation; self monitoring of blood glucose (SMBG) equipment; diabetic complications, including hypoglycemia (low blood glucose), retinopathy (eye disease), and neuropathy (nerve disease); and self management. The author concludes that, if performed during good conditions, mountain hiking is an endurance sport. The
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exercise is aerobic and lasts many hours to several days. Under these circumstances, insulin needs usually decrease substantially, and carbohydrate consumption increases. Therefore, climbers should regularly monitor their blood glucose levels and keep a record of the duration and quality of their exercise in relation to their body's reactions. 1 table. 5 references. •
Chapter 76: Disorders of the Eccrine Sweat Gland Source: in Freedberg, I.M., et al., eds. Fitzpatrick's Dermatology in General Medicine. 5th ed., Vol. 1. New York, NY: McGraw-Hill. 1999. p. 800-809. Contact: Available from McGraw-Hill Customer Services. P.O. Box 548, Blacklick, OH 43004-0548. (800) 262-4729 or (877) 833-5524. Fax (614) 759-3749 or (614) 759-3641. E-mail:
[email protected]. PRICE: $395.00 plus shipping and handling. ISBN: 0070219435. Summary: This chapter provides health professionals with information on disorders of the eccrine sweat gland. These disorders can occur as a result of dysfunction of the sweat centers, preganglionic efferent sympathetic pathways, sympathetic ganglia, postganglionic sympathetic fibers, pharmacologic receptors, the secretory function of the sweat gland, or the sweat duct. Excessive sweating of the palms, soles, and axillae occurs during emotional stress. Some patients with a past history of spinal cord injuries may experience episodes of profuse sweating months or years after their injuries. The episodes include hyperhidrosis associated with autonomic dysreflexia, hyperhidrosis triggered by orthostatic hypotension, and hyperhidrosis resulting from posttraumatic syringomyelia. Hyperhidrosis may be associated with peripheral neuropathies. For example, it has been reported in some patients with Riley-Day syndrome or congenital autonomic dysfunction, as well as in some patients exposed to cold. Various lesions in the brain can cause episodes of profuse sweating. They may be separated into those associated with hypothermia and those not associated with hypothermia. Hyperhidrosis may be associated with intrathoracic neoplasms or lesions. Increased sweating has been reported in various systemic medical problems, including diabetes mellitus, hypoglycemia, congestive heart failure, and the menopausal state. Excessive sweating has been reported as a side effect of various drugs or as a result of poisoning. Night sweats may be associated with various systemic diseases, including Hodgkin's disease. Compensatory hyperhidrosis is the occurrence of hyperhidrosis on the trunk and legs after thoracic sympathectomy and is usually triggered by thermal stimuli or by physical activity. Localized hyperhidrosis includes idiopathic unilateral circumscribed hyperhidrosis; hyperhidrosis associated with cutaneous diseases; and gustatory sweating associated with encephalitis, syringomyelia, diabetic neuropathy, herpes zoster, parotitis, parotid abscesses, thoracic sympathectomy, and Frey's syndrome. Miscellaneous forms of localized hyperhidrosis include lacrimal sweating and Harlequin syndrome. Hypohidrosis of relatively large areas may result from poral occlusion, congenital or acquired absence of sweat glands, damage to sweat gland function by inflammation of the skin, or dysfunction of sympathetic nerves in neuropathies. Localized hypohidrosis can occur as a result of damage to the sweat glands by infection, trauma, tumors, morphea, scars, or inflammatory infiltrate; denervation; and follicular atrophoderma. Sweat retention syndromes include miliaria crystallina, rubra, pustulosa, and profunda; tropical anhidrotic asthenia; transient acantholytic dermatosis; and heat hyperpyrexia and heat stroke. 7 figures, 4 tables, and 88 references.
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Extracorporeal Shock Wave Lithotripsy Source: in O'Donnell, P.D., ed. Geriatric Urology. Boston, MA: Little, Brown and Company. 1994. p. 337-343. Contact: Available from Lippincott-Raven Publishers. 12107 Insurance Way, Hagerstown, MD 21740. (800) 777-2295. Fax (301) 824-7390. E-mail:
[email protected]. Website: http://www.lrpub.com. PRICE: $135.00. ISBN: 0316630039. Summary: This chapter, from a text on geriatric urology, discusses the use of extracorporeal shock wave lithotripsy (ESWL), a technique that enables the majority of renal calculi to be treated safely and effectively without the need for open surgery. The authors stress that treatment approaches to renal calculus disease have not been specifically tailored to the elderly patient, and side effects of treatment programs designed for younger patients have to be considered before their initiation. Topics include the management of renal stones; the management of ureteral stones; the role of anesthesia free, second generation lithotripters; and special considerations in the elderly, including anesthetic risk, drug therapy, cardiac pacemakers, and other practical considerations, such as avoiding hypothermia. 4 tables. 37 references.
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CHAPTER 8. MULTIMEDIA ON HYPOTHERMIA Overview In this chapter, we show you how to keep current on multimedia sources of information on hypothermia. 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.
Video Recordings An excellent source of multimedia information on hypothermia is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “hypothermia” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, 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 “Videorecording (videotape, videocassette, etc.).” Type “hypothermia” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on hypothermia: •
Laparoscopic Partial Nephrectomy Video Source: Houston, TX: American Urological Association (AUA) Office of Education. 2000. (videocassette). Contact: Available from AUA Office of Education. 2425 West Loop South, Suite 333, Houston, Texas 77027. (800) 282-7077. Fax: (713) 622-2898. PRICE: $20.00. Item number HV2246. Summary: This videotape program demonstrates the step by step technique of laparoscopic partial nephrectomy (removal of part of the kidney, done with a laparoscope, an illuminated tube that permits transcutaneous, or through the skin, surgery). The program first reviews the patient preparation and trocar placement (how and where on the abdomen the laparoscopes are placed), then details the operative technique used. Each step of the surgery is shown in 3 dimensional graphics, then the actual surgery is depicted in a 46 year old female patient who has a 7 centimeter left renal (kidney) tumor. Graphics are interspersed and overlaid to help visualize the steps
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of each procedure. The steps depicted include ureteral catheterization, port placement, exposure of the kidney, laparoscopic ultrasonography, renal hilum (where the vessels and nerves enter the kidney) control, preparation of the surgical bolster, kidney hypothermia (reduction in temperature), excision of the kidney tumor, repair of the collecting system (if needed), and parenchymal hemostasis (return of normal blood flow to the kidney). The program concludes by offering statistics and information about complications in a series of 22 patients.
Bibliography: Multimedia on Hypothermia 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 hypothermia (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 hypothermia: •
Accidental hypothermia [slide]. Year: 1985; Format: Slide; Columbus [Ohio]: Center for Continuing Medical Education, the Ohio State University College of Medicine, [1985]
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Emergency management of accidental hypothermia [motion picture] Source: Abbott Laboratories, in cooperation with American College of Emergency Physicians; produced by Scientificom; Year: 1978; Format: Motion picture; North Chicago: The Laboratories: [for loan or sale by its Audio-Visual Services], c1978
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Hemmorhage [i.e. Hemorrhage], hypertension, and hypothermia [videorecording]: the critical hours following cardiac surgery Source: HSN, Hospital Satellite Network program of continuing education; a Mark Massari production; Year: 1983; Format: I.e. Hemorrhage; [Los Angeles, Calif.]: The Network, c1983
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Hypothermia [electronic resource] Source: written by Ray Wright; medical reviewer, Mark S. Holcomb; Year: 1985; Format: Electronic resource; Edwardsville, KS: Medi-Sim, c1985
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Hypothermia [sound recording] Source: College of Nursing, Niagara University; Year: 1976; Format: Sound recording; Buffalo: Communications in Learning, 1976
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Hypothermia [videorecording] Source: produced for the University of Alaska. [et al.]; a production of University of Alaska Instructional Telecommunications Services; Year: 1983; Format: Videorecording; [Fairbanks, Alaska]: The Services, c1983
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Hypothermia in the elderly [slide] Source: William Davison; Year: 1984; Format: Slide; Chelmsford, Essex, UK: Graves Medical Audiovisual Library, [1984]
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Interpretations of microbiology reports [videorecording]; Risk assessment and pressure ulcer prevention; Perioperative hypothermia: coming in from the cold Source: HSTN, Health & Sciences Television Network; Year: 2002; Format: Videorecording; Carrollton, TX: PRIMEDIA Workplace Learning, c2002
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Preventing hyperthermia, hypothermia, and drowning [videorecording]. Year: 2001; Format: Videorecording; Chicago, IL: Terra Nova Films, c2001
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Suprahepatic renal-cell carcinoma tumor thrombus [videorecording]: surgical management utilizing, cardiopulmonary bypass, hypothermia, temporary cardiac arrest Source: produced by the Johns Hopkins University, School of Medicine, Department of Motion Picture &; Year: 1985; Format: Videorecording; [S.l.: s.n.], 1985
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Surgical treatment for intracranial aneurysms with induced hypothermia and circulatory arrest by the open thorax and closed thorax perfusion technic [motion picture] Source: Mayo Clinic and Mayo Foundation; Year: 1965; Format: Motion picture; Rochester, Minn.: The Clinic, 1965
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Use of deep hypothermia and circulatory arrest for correction of congenital cardiac defects in infancy [videorecording] Source: WRAMC TV; Year: 1973; Format: Videorecording; Washington: WRAMC TV, [1973]
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CHAPTER 9. PERIODICALS AND NEWS ON HYPOTHERMIA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover hypothermia.
News Services and Press Releases One of the simplest ways of tracking press releases on hypothermia 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 “hypothermia” (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 hypothermia. 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 “hypothermia” (or synonyms). The following was recently listed in this archive for hypothermia: •
Therapeutic hypothermia recommended for some cardiac arrest patients Source: Reuters Medical News Date: July 07, 2003
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Hypothermia may improve outcome of traumatic brain injury Source: Reuters Industry Breifing Date: June 10, 2003
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Hemicraniectomy superior to moderate hypothermia for severe ischemic stroke Source: Reuters Medical News Date: July 05, 2002
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Hypothermia appears beneficial following cardiac resuscitation Source: Reuters Medical News Date: February 20, 2002
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Neurotensin analog produces cerebral hypothermia in rats after cardiac arrest Source: Reuters Industry Breifing Date: January 17, 2002
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Controlled rewarming improves hypothermia therapy in stroke patients Source: Reuters Medical News Date: December 25, 2001
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Hypothermia safe for revived cardiac patients, but slow Source: Reuters Medical News Date: October 08, 2001
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Moderate hypothermia feasible for patients with acute stroke Source: Reuters Medical News Date: September 14, 2001
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MI patient stable after therapeutic hypothermia Source: Reuters Medical News Date: February 21, 2001
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Induced hypothermia not effective in patients with severe brain injury Source: Reuters Medical News Date: February 21, 2001
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Moderate hypothermia may improve outcome in severe stroke Source: Reuters Medical News Date: February 14, 2001
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Knowledge of neonatal hypothermia lacking among Indian healthcare workers Source: Reuters Medical News Date: August 24, 2000
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Mild hypothermia increases survival of embryonic neural grafts in rats Source: Reuters Medical News Date: July 10, 2000
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Resistive heating recommended for rewarming hypothermia victims in the field Source: Reuters Medical News Date: April 03, 2000
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Nine-hour effort successfully resuscitates victim of deep hypothermia Source: Reuters Medical News Date: January 28, 2000
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Hypothermia victims may be revived Source: Reuters Health eLine Date: January 28, 2000
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Hypothermia reduces intracranial pressure in patients with acute liver failure Source: Reuters Medical News Date: October 04, 1999
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Impaired ability to swim rather than hypothermia is main danger in cold water Source: Reuters Medical News Date: August 20, 1999
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Mild hypothermia delays ammonia-induced brain edema in rats Source: Reuters Medical News Date: April 08, 1999
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Hypothermia a risk in warmer climes, too Source: Reuters Health eLine Date: December 31, 1998
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Mild hypothermia during intracranial surgery deserves full-scale trial Source: Reuters Medical News Date: December 30, 1998
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Device speeds hypothermia recovery Source: Reuters Health eLine Date: December 09, 1998
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Early hypothermia induction could improve outcomes linked to hyperthermia after stroke Source: Reuters Medical News Date: December 04, 1998
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CDC Warns Of Hypothermia Risks Source: Reuters Health eLine Date: January 26, 1998
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Extracorporeal Blood Warming For Deep Hypothermia: Long-Term Outcomes Favorable Source: Reuters Medical News Date: November 20, 1997
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Bypass Treatment Ups Hypothermia Survival Source: Reuters Health eLine Date: November 20, 1997
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Induced Hypothermia Improves Outcome After Out-Of-Hospital Cardiac Arrest Source: Reuters Medical News Date: August 04, 1997
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Use Of Hypothermia Blankets In The ICU Questioned Source: Reuters Medical News Date: June 23, 1997
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Hypothermia After Traumatic Brain Injury Improves OutcoMen Source: Reuters Medical News Date: February 20, 1997
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CDC Warn Against Hypothermia Source: Reuters Health eLine Date: December 19, 1996
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Intraoperative Hypothermia Predisposes Patients To Wound Infections Source: Reuters Medical News Date: May 09, 1996
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Mild Hypothermia In Stroke Patients Associated With Better OutcoMen Source: Reuters Medical News Date: February 19, 1996
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Hypothermia Increases Intraoperative Blood Loss Source: Reuters Medical News Date: February 02, 1996 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “hypothermia” (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 “hypothermia” (or synonyms). If you know the name of a company that is relevant to hypothermia, 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/.
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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 “hypothermia” (or synonyms).
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 “hypothermia” (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 hypothermia: •
Let It Snow, Let It Snow, Let It Snow--But Be Aware of Winter Hazards Source: Fit Society Page. p. 4,6. Winter 2001. Contact: American College of Sports Medicine. P.O. Box 1440, Indianapolis, IN 462061440. www.acsm.org. Summary: Cold weather exercisers can benefit from safety tips, according to this article. Sun damage occurs in the winter as well as in summer. Sunscreen and sunglasses or ski goggles are important winter activity equipment. The authors discuss the prevention of frostbite and hypothermia. They describe the best clothing for wind protection and insulation. Eating nutritious meals before activity and snacks at regular times during the activity increase needed heat production. Whenever possible, persons should perform warm-up exercises indoors before going into the cold for outdoor activity.
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Get Ready for Outdoor Winter Play: Prepare Yourself for the Cold Source: Fit Society Page. p. 1,6. Winter 2001. Contact: American College of Sports Medicine. P.O. Box 1440, Indianapolis, IN 462061440. www.acsm.org. Summary: Enjoying winter activities entails preparing yourself for the cold. The main physiological difference between exercising in the cold rather than in a warmer climate is the loss of body heat. Exercising in the cold also uses more energy as you move over the snow in heavy clothing and boots. Moreover, the drier cold air in winter is responsible for an increased water loss through breathing, which can lead to long-term dehydration unless you increase your water intake. Cold weather health risks include chilblains (a swelling and burning sensation in the hands, ears, face, legs, and toes), 'immersion foot,' frostnip, frostbite, and hypothermia. To minimize the risks of developing cold weather injuries, use proper clothing to protect against cold, wind, and moisture.
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Academic Periodicals covering Hypothermia Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to hypothermia. In addition to these sources, you can search for articles covering hypothermia 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 10. 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 hypothermia. 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 nonprofit 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 hypothermia. 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.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to hypothermia: Benzodiazepines •
Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
Lidocaine •
Topical - U.S. Brands: Lidoderm http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500058.html
Phenothiazines •
Systemic - U.S. Brands: Chlorpromazine Hydrochloride Intensol; Compazine; Compazine Spansule; Mellaril; Mellaril Concentrate; Mellaril-S; Permitil; Permitil Concentrate; Prolixin; Prolixin Concentrate; Prolixin Decanoate; Prolixin Enanthate; Serentil; Serentil Concentrate; Ste http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202457.html
Procainamide •
Systemic - U.S. Brands: Promine; Pronestyl; Pronestyl-SR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202483.html
Sodium Bicarbonate •
Systemic - U.S. Brands: Bell/ans; Citrocarbonate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202525.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
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brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. 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
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant 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.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
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 “hypothermia” (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 25311 282 34 6 1 25634
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 “hypothermia” (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/.
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.
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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 hypothermia 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 hypothermia. 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 hypothermia. 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 “hypothermia”:
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•
Other guides Chemical Weapons http://www.nlm.nih.gov/medlineplus/chemicalweapons.html Diabetes http://www.nlm.nih.gov/medlineplus/diabetes.html Heat Illness http://www.nlm.nih.gov/medlineplus/heatillness.html Juvenile Diabetes http://www.nlm.nih.gov/medlineplus/juvenilediabetes.html Motor Vehicle Safety http://www.nlm.nih.gov/medlineplus/motorvehiclesafety.html Water Safety http://www.nlm.nih.gov/medlineplus/watersafetyrecreational.html
Within the health topic page dedicated to hypothermia, the following was listed: •
General/Overviews Hypothermia Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00333 Hypothermia: What You Should Know Source: American College of Emergency Physicians http://www.acep.org/1%2C205%2C0.html
•
Diagnosis/Symptoms Is it Hypothermia? Look for the “Umbles” -- Stumbles, Mumbles, Fumbles, and Grumbles Source: National Institute on Aging http://www.nih.gov/news/pr/jan2003/nia-23.htm
•
Treatment Hypothermia: First Aid Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=FA00017
•
Specific Conditions/Aspects Frostbite Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=FA00023 Gangrene Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00737
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Outdoor Action Guide to Hypothermia and Cold Weather Injuries Source: Centers for Disease Control and Prevention http://www.cdc.gov/nasd/docs/d001201-d001300/d001216/d001216.html •
Children Cold Weather Cautions For Kids Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00446 Frostbite Source: Nemours Foundation http://kidshealth.org/parent/firstaid_safe/emergencies/frostbite.html
•
Organizations National Institute for Occupational Safety and Health http://www.cdc.gov/niosh/homepage.html National Institute on Aging http://www.nia.nih.gov/
•
Prevention/Screening Extreme Cold: A Prevention Guide to Promote Your Personal Health and Safety Source: Centers for Disease Control and Prevention http://www.cdc.gov/nceh/hsb/extremecold/ Protecting Workers in Cold Environments Source: Occupational Safety and Health Administration http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=FACT_SH EETS&p_id=186&p_text_version=FALSE
•
Statistics Hypothermia-related Deaths --- Utah, 2000, and United States, 1979--1998 Source: Centers for Disease Control and Prevention http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5104a2.htm
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. 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:
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•
Hypothermia: A Cold Weather Hazard Source: National Institute on Aging, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3762 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 hypothermia. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMD®Health: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to hypothermia. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with hypothermia. 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 hypothermia. 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.
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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 “hypothermia” (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 “hypothermia”. 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 “hypothermia” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “hypothermia” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
23
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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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/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
227
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
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
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
228 Hypothermia
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
229
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 hypothermia: •
Basic Guidelines for Hypothermia Hypothermia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000038.htm Myxedema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000353.htm
•
Signs & Symptoms for Hypothermia Apathy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Apnea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003069.htm Ataxia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm
230 Hypothermia
Cardiac arrest Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003078.htm Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Confusion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Cyanosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Dysarthria Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003204.htm Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Gastrointestinal bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003133.htm Hypotension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Lethargy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Loss of coordination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Pale Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003244.htm Shivering Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003091.htm Slurred speech Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003204.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm
Online Glossaries 231
•
Diagnostics and Tests for Hypothermia Blood culture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003744.htm Blood gases Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003855.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Chest X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm ECG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm HCT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003646.htm Partial thromboplastin time Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003653.htm Platelet count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003647.htm Prothrombin time Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003652.htm Thyroid function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003444.htm Toxicology screen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Urinalysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm
•
Background Topics for Hypothermia Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Bleeding control Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Cardiovascular Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002310.htm
232 Hypothermia
CPR Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000010.htm Fluid imbalance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001187.htm Foley catheter Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003981.htm Hypothermia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000038.htm Peripheral Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002273.htm Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm Unconscious Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000022.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
233
HYPOTHERMIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Ablation: The removal of an organ by surgery. [NIH] Absenteeism: Chronic absence from work or other duty. [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] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [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] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Actin: Essential component of the cell skeleton. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH]
234 Hypothermia
Adenocarcinoma: A malignant 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] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate 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] 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] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [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 Agents: Drugs that act on adrenergic receptors or affect the life cycle of adrenergic transmitters. Included here are adrenergic agonists and antagonists and agents that affect the synthesis, storage, uptake, metabolism, or release of adrenergic transmitters. [NIH]
Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Advanced Cardiac Life Support: The use of sophisticated methods and equipment to treat cardiopulmonary arrest. Advanced Cardiac Life Support (ACLS) includes the use of specialized equipment to maintain the airway, early defibrilation and pharmacological therapy. [NIH] Advanced Life Support: The medical care given by medical doctors and nurses trained in critical care medicine with the use of specialized technical equipment, infusion of fluids and drugs aimed to stabilize or restore vital functions. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
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
Dictionary 235
tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Air Embolism: Occurs when the lungs over expand to the point that air bubbles are forced through the air sacs of the lungs into the circulatory system. [NIH] Air Sacs: Thin-walled sacs or spaces which function as a part of the respiratory system in birds, fishes, insects, and mammals. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Alcohol Drinking: Behaviors associated with the ingesting of alcoholic beverages, including social drinking. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkalosis: A pathological condition that removes acid or adds base to the body fluids. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha
236 Hypothermia
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] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [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] 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] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amnesia: Lack or loss of memory; inability to remember past experiences. [EU] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amrinone: A positive inotropic cardiotonic agent with vasodilator properties, phosphodiesterase inhibitory activity, and the ability to stimulate calcium ion influx into the cardiac cell. Its therapeutic use in congestive heart or left ventricular failure is associated with significant increases in the cardiac index, reductions in pulmonary capillary wedge pressure and systemic vascular resistance, and little or no change in mean arterial pressure. One of its more serious side effects is thrombocytopenia in some patients. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [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] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH]
Dictionary 237
Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphase: The third phase of cell division, in which the chromatids separate and migrate to opposite poles of the spindle. [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] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] 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] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [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] Angiopathy: Disease of the blood vessels (arteries, veins, and capillaries) that occurs when someone has diabetes for a long time. There are two types of angiopathy: macroangiopathy and microangiopathy. In macroangiopathy, fat and blood clots build up in the large blood vessels, stick to the vessel walls, and block the flow of blood. In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they bleed, leak protein, and slow the flow of blood through the body. Then the cells, for example, the ones in the center of the eye, do not get enough blood and may be damaged. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [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
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positive pole during electrolysis. [NIH] Anoxia: Clinical manifestation of respiratory distress consisting of a relatively complete absence of oxygen. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery. Branches of the anterior cerebral artery supply the caudate nucleus, internal capsule, putamen, septal nuclei, gyrus cinguli, and surfaces of the frontal lobe and parietal lobe. [NIH] Anterograde: Moving or extending forward; called also antegrade. [EU] Antianginal: Counteracting angina or anginal conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antifungals: Drugs that treat infections caused by fungi. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH]
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Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [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] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH]
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Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [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] 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] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]
Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Articular: Of or pertaining to a joint. [EU] Artificial Eye: Usually made of artificial plastic material or glass to which small quantities of metallic oxides have been added in order to imitate the features and coloring of the various parts of t he human eye; a prosthesis made of glass, plastic, or similar material. [NIH] Artificial Limbs: Prosthetic replacements for arms, legs, and parts therof. [NIH] Artificial Organs: Devices intended to replace non-functioning organs. They may be temporary or permanent. Since they are intended always to function as the natural organs they are replacing, they should be differentiated from prostheses and implants and specific types of prostheses which, though also replacements for body parts, are frequently cosmetic (artificial eye) as well as functional (artificial limbs). [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Aspartate: A synthetic amino acid. [NIH] Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including
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those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called endarterectomy. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [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] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Dysreflexia: That part of the nervous system concerned with the unconscious regulation of the living processes of the body. [NIH] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the
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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] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axilla: The underarm or armpit. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder. [NIH] Axillary Vein: The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Baroreflex: A negative feedback system which buffers short-term changes in blood pressure. Increased pressure stretches blood vessels which activates pressoreceptors (baroreceptors) in the vessel walls. The net response of the central nervous system is a reduction of central
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sympathetic outflow. This reduces blood pressure both by decreasing peripheral vascular resistance and by lowering cardiac output. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure. [NIH]
Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] 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] Baths: The immersion or washing of the body or any of its parts in water or other medium for cleansing or medical treatment. It includes bathing for personal hygiene as well as for medical purposes with the addition of therapeutic agents, such as alkalines, antiseptics, oil, etc. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU]
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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Bioengineering: The application of engineering principles to the solution of biological problems, for example, remote-handling devices, life-support systems, controls, and displays. [NIH] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Bioreactors: Tools or devices for generating products using the synthetic or chemical conversion capacity of a biological system. They can be classical fermentors, cell culture perfusion systems, or enzyme bioreactors. For production of proteins or enzymes, recombinant microorganisms such as bacteria, mammalian cells, or insect or plant cells are usually chosen. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blast phase: The phase of chronic myelogenous leukemia in which the number of immature, abnormal white blood cells in the bone marrow and blood is extremely high. Also called blast crisis. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH]
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Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood 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 transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Viscosity: The internal resistance of the blood to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as sickle cell anemia and polycythemia. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]
Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] 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] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachiocephalic Trunk: The first and largest artery branching from the aortic arch. It distributes blood to the right side of the head and neck and to the right arm. [NIH] Brachiocephalic Veins: Large veins on either side of the root of the neck formed by the junction of the internal jugular and subclavian veins. They drain blood from the head, neck, and upper extremities, and unite to form the superior vena cava. [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] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Hypoxia: Lack of oxygen leading to unconsciousness. [NIH] Brain Infarction: The formation of an area of necrosis in the brain, including the cerebral hemispheres (cerebral infarction), thalami, basal ganglia, brain stem (brain stem infarctions), or cerebellum secondary to an insufficiency of arterial or venous blood flow. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]
Bupivacaine: A widely used local anesthetic agent. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central
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nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcineurin: A calcium- and calmodulin-binding protein present in highest concentrations in the central nervous system. Calcineurin is composed of two subunits. A catalytic subunit, calcineurin A, and a regulatory subunit, calcineurin B, with molecular weights of about 60 kD and 19 kD, respectively. Calcineurin has been shown to dephosphorylate a number of phosphoproteins including histones, myosin light chain, and the regulatory subunit of cAMP-dependent protein kinase. It is involved in the regulation of signal transduction and is the target of an important class of immunophilin-immunosuppressive drug complexes in T-lymphocytes that act by inhibiting T-cell activation. EC 3.1.3.-. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Calmodulin: A heat-stable, low-molecular-weight activator protein found mainly in the brain and heart. The binding of calcium ions to this protein allows this protein to bind to cyclic nucleotide phosphodiesterases and to adenyl cyclase with subsequent activation. Thereby this protein modulates cyclic AMP and cyclic GMP levels. [NIH] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [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]
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Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [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] Cardiac Surgical Procedures: Surgery performed on the heart. [NIH] Cardiogenic: Originating in the heart; caused by abnormal function of the heart. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH]
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Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [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] Causality: The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors. [NIH] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell Fusion: Fusion of somatic cells in vitro or in vivo, which results in somatic cell hybridization. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell motility: The ability of a cell to move. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell 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 Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellular Structures: Components of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrosome: The cell center, consisting of a pair of centrioles surrounded by a cloud of amorphous material called the pericentriolar region. During interphase, the centrosome nucleates microtubule outgrowth. The centrosome duplicates and, during mitosis, separates to form the two poles of the mitotic spindle (mitotic spindle apparatus). [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Hemorrhage: Bleeding into a cerebral hemisphere of the brain, including lobar, subcortical white matter, and basal ganglia hemorrhages. Commonly associated conditions include hypertension; intracranial arteriosclerosis; intracranial aneurysm; craniocerebral trauma; intracranial arteriovenous malformations; cerebral amyloid angiopathy; and cerebral infarction. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] 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]
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Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervical Plexus: A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chilblains: Recurrent localized itching, swelling and painful erythema on the fingers, toes or ears, produced by exposure to cold. It is also called pernio. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]
Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH]
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Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chromosome Segregation: The orderly segregation of chromosomes during meiosis or mitosis. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic phase: Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Cinchona: A genus of rubiaceous South American trees that yields the toxic cinchona alkaloids from their bark; quinine, quinidine, chinconine, cinchonidine and others are used to treat malaria and cardiac arrhythmias. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [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] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [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] Clonic: Pertaining to or of the nature of clonus. [EU] 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
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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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Coenzymes: Substances that are necessary for the action or enhancement of action of an enzyme. Many vitamins are coenzymes. [NIH] 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] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Comatose: Pertaining to or affected with coma. [EU] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [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
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to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complement Activation: The sequential activation of serum components C1 through C9, initiated by an erythrocyte-antibody complex or by microbial polysaccharides and properdin, and producing an inflammatory response. [NIH] 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] Complete response: The disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [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] 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] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU]
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Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [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] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] 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] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contractile Proteins: Proteins which participate in contractile processes. They include muscle proteins as well as those found in other cells and tissues. In the latter, these proteins participate in localized contractile events in the cytoplasm, in motile activity, and in cell aggregation phenomena. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Contusion: A bruise; an injury of a part without a break in the skin. [EU] Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera
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as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Convulsants: Substances that act in the brain stem or spinal cord to produce tonic or clonic convulsions, often by removing normal inhibitory tone. They were formerly used to stimulate respiration or as antidotes to barbiturate overdose. They are now most commonly used as experimental tools. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Corneal Transplantation: Partial or total replacement of the cornea from one human or animal to another. [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 Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Disease: Disorder of cardiac function due to an imbalance between myocardial function and the capacity of the coronary vessels to supply sufficient flow for normal function. It is a form of myocardial ischemia (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. [NIH] 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
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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] Coronary Vessels: The veins and arteries of the heart. [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] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Craniotomy: An operation in which an opening is made in the skull. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Cryotherapy: Any method that uses cold temperature to treat disease. [NIH] CSF: Cerebrospinal fluid. The fluid flowing around the brain and spinal cord. CSF is produced in the ventricles of the brain. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Custom-made: Any active implantable medical device specifically made in accordance with a medical specialist's written prescription which gives, under his responsibility, specific design characteristics and is intended to be used only for an individually named patient. [NIH]
Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclin: Molecule that regulates the cell cycle. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]
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
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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, 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] Cytokinesis: Division of the rest of cell. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] 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] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]
Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] 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] Defibrillation: The act to arrest the fibrillation of (heart muscle) by applying electric shock across the chest, thus depolarizing the heart cells and allowing normal rhythm to return. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU]
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Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Deoxyglucose: 2-Deoxy-D-arabino-hexose. An antimetabolite of glucose with antiviral activity. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple
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mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [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] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [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] 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] Diffusivity: Of a reverberant sound field. The degree to which the directions of propagation of waves are random from point to point. [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] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [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] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH]
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Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Disulfides: Chemical groups containing the covalent disulfide bonds -S-S-. The sulfur atoms can be bound to inorganic or organic moieties. [NIH] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Docetaxel: An anticancer drug that belongs to the family of drugs called mitotic inhibitors. [NIH]
Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] 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] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH]
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Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dynorphins: A class of opioid peptides including dynorphin A, dynorphin B, and smaller fragments of these peptides. Dynorphins prefer kappa-opioid receptors (receptors, opioid, kappa) and have been shown to play a role as central nervous system transmitters. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dystonia: Disordered tonicity of muscle. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [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] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] 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 particles are usually detected only when the atomic nucleus decays and then only
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transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emetic: An agent that causes vomiting. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [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] Endonucleases: Enzymes that catalyze the hydrolysis of the internal bonds and thereby the formation of polynucleotides or oligonucleotides from ribo- or deoxyribonucleotide chains. EC 3.1.-. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]
Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH]
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Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] 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] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] 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] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord.
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An epidural injection is given into this space. [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] Epistasis: The degree of dominance exerted by one gene on the expression of a non-allelic gene. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Equalization: The reduction of frequency and/or phase distortion, or modification of gain and or phase versus frequency characteristics of a transducer, by the use of attenuation circuits whose loss or delay is a function of frequency. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by radioisotope dilution technique. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Etomidate: Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic. [NIH]
Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Euthanasia: The act or practice of putting to death people or animals suffering from incurable conditions or diseases. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by
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stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acid Agonists: Drugs that bind to and activate excitatory amino acid receptors. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Excitotoxicity: Excessive exposure to glutamate or related compounds can kill brain neurons, presumably by overstimulating them. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] 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 in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extracorporeal: Situated or occurring outside the body. [EU] Extracorporeal Circulation: Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation. [NIH] Extracorporeal Membrane Oxygenation: Application of a life support system that circulates the blood through an oxygenating system, which may consist of a pump, a membrane oxygenator, and a heat exchanger. Examples of its use are to assist victims of smoke
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inhalation injury, respiratory failure, and cardiac failure. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extravascular: Situated or occurring outside a vessel or the vessels. [EU] Extravascular Lung Water: Water present within the lungs; its volume is roughly equal to, or a little less than, the intracellular blood volume of the lungs. Accumulations of extravascular lung water result in pulmonary edema. [NIH] 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] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fat Necrosis: A condition in which the death of adipose tissue results in neutral fats being split into fatty acids and glycerol. [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] Febrile: Pertaining to or characterized by fever. [EU] Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] 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]
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Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [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] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Food Deprivation: The withholding of food in a structured experimental situation. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Frostbite: Damage to tissues as the result of low environmental temperatures. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH]
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Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] 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] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [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] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [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 Deletion: A genetic rearrangement through loss of segments of DNA or RNA, bringing sequences which are normally separated into close proximity. This deletion may be detected using cytogenetic techniques and can also be inferred from the phenotype, indicating a deletion at one specific locus. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Pool: The total genetic information possessed by the reproductive members of a population of sexually reproducing organisms. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called
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codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]
Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] 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] Glial Fibrillary Acidic Protein: An intermediate filament protein found only in glial cells or cells of glial origin. MW 51,000. [NIH] Gliosis: The production of a dense fibrous network of neuroglia; includes astrocytosis, which is a proliferation of astrocytes in the area of a degenerative lesion. [NIH] Globus Pallidus: The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to inulin clearance. [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] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9.
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[NIH]
Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycols: A generic grouping for dihydric alcohols with the hydroxy groups (-OH) located on different carbon atoms. They are viscous liquids with high boiling points for their molecular weights. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] Granule: A small pill made from sucrose. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]
Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue,
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due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heart Arrest: Sudden and usually momentary cessation of the heart beat. This sudden cessation may, but not usually, lead to death, sudden, cardiac. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart Catheterization: Procedure which includes placement of catheter, recording of intracardiac and intravascular pressure, obtaining blood samples for chemical analysis, and cardiac output measurement, etc. Specific angiographic injection techniques are also involved. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Transplantation: The transference of a heart from one human or animal to another. [NIH]
Heartbeat: One complete contraction of the heart. [NIH] Heat Stroke: A condition characterized by cessation of sweating, hot dry skin, delirium, collapse, and coma and resulting from prolonged exposure to high environmental temperature. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Hematopoiesis: The development and formation of various types of blood cells. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodilution: Reduction of blood viscosity usually by the addition of cell free solutions. Used clinically l) in states of impaired microcirculation, 2) for replacement of intraoperative blood loss without homologous blood transfusion, and 3) in cardiopulmonary bypass and
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hypothermia. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin C: A commonly occurring abnormal hemoglobin in which lysine replaces a glutamic acid residue at the sixth position of the beta chains. It results in reduced plasticity of erythrocytes. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhagic stroke: A disorder involving bleeding within ischemic brain tissue. Hemorrhagic stroke occurs when blood vessels that are damaged or dead from lack of blood supply (infarcted), located within an area of infarcted brain tissue, rupture and transform an "ischemic" stroke into a hemorrhagic stroke. Ischemia is inadequate tissue oxygenation caused by reduced blood flow; infarction is tissue death resulting from ischemia. Bleeding irritates the brain tissues, causing swelling (cerebral edema). Blood collects into a mass (hematoma). Both swelling and hematoma will compress and displace brain tissue. [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 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] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocyte: A liver cell. [NIH] Hepatocyte Growth Factor: Multifunctional growth factor which regulates both cell growth and cell motility. It exerts a strong mitogenic effect on hepatocytes and primary epithelial cells. Its receptor is proto-oncogene protein C-met. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one
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generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heritability: The proportion of observed variation in a particular trait that can be attributed to inherited genetic factors in contrast to environmental ones. [NIH] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Hexobarbital: A barbiturate that is effective as a hypnotic and sedative. [NIH] Hibernation: The dormant state in which some animal species pass the winter. It is characterized by narcosis and by sharp reduction in body temperature and metabolic activity and by a depression of vital signs. It is a natural physiological process in many warm-blooded animals. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human growth hormone: A protein hormone, secreted by the anterior lobe of the pituitary, which promotes growth of the whole body by stimulating protein synthesis. The human gene has already been cloned and successfully expressed in bacteria. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH]
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Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydration: Combining with water. [NIH] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [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] Hydroxides: Inorganic compounds that contain the OH- group. [NIH] Hydroxyl Radical: The univalent radical OH that is present in hydroxides, alcohols, phenols, glycols. [NIH] Hyperammonemia: Metabolic disorder characterized by elevated level of ammonia in blood. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperhidrosis: Excessive sweating. In the localized type, the most frequent sites are the palms, soles, axillae, inguinal folds, and the perineal area. Its chief cause is thought to be emotional. Generalized hyperhidrosis may be induced by a hot, humid environment, by fever, or by vigorous exercise. [NIH] Hyperpyrexia: Exceptionally high fever either in comparison of the fever usually accompanying a particular disease or absolutely (as in heat stroke). [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH]
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Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [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] Hyperventilate: To breathe abnormally fast and deep; results in the intake of excessive amounts of oxygen into the lung and reduced carbon dioxide levels in the blood. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]
Hypoglycemic Agents: Agents which lower the blood glucose level. [NIH] Hypohidrosis: Abnormally diminished or absent perspiration. Both generalized and segmented (reduced or absent sweating in circumscribed locations) forms of the disease are usually associated with other underlying conditions. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [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] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] 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] Ileum: The lower end of the small intestine. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH]
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Immersion: The placing of a body or a part thereof into a liquid. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and 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] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunology: The study of the body's immune system. [NIH] Immunophilin: A drug for the treatment of Parkinson's disease. [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] 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] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU]
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Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] 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] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] 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]
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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] 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]
Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, Tlymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] 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] Interneurons: Most generally any neurons which are not motor or sensory. Interneurons may also refer to neurons whose axons remain within a particular brain region as contrasted with projection neurons which have axons projecting to other brain regions. [NIH] Interphase: The interval between two successive cell divisions during which the chromosomes are not individually distinguishable and DNA replication occurs. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH]
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Intracranial Aneurysm: A saclike dilatation of the walls of a blood vessel, usually an artery. [NIH]
Intracranial Arteriosclerosis: Vascular diseases characterized by thickening, hardening, and remodeling of the walls of intracranial arteries. There are three subtypes: (1) atherosclerosis, marked by fatty depositions in the innermost layer of the arterial walls, (2) Monckeberg's sclerosis, which features calcium deposition in the media and (3) arteriolosclerosis, which refers to sclerosis of small caliber arteries. Clinically, this process may be associated with transient ischemic attack, brain infarction, intracranial embolism and thrombosis, or intracranial aneurysm. [NIH] Intracranial Hemorrhages: Bleeding within the intracranial cavity, including hemorrhages in the brain and within the cranial epidural, subdural, and subarachnoid spaces. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intraoperative Period: The period during a surgical operation. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for 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] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU]
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Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Isoniazid: Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Jugular Veins: Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins. [NIH] Kainic Acid: (2S-(2 alpha,3 beta,4 beta))-2-Carboxy-4-(1-methylethenyl)-3-pyrrolidineacetic acid. Ascaricide obtained from the red alga Digenea simplex. It is a potent excitatory amino acid agonist at some types of excitatory amino acid receptors and has been used to discriminate among receptor types. Like many excitatory amino acid agonists it can cause neurotoxicity and has been used experimentally for that purpose. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratitis: Inflammation of the cornea. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Kinetochores: Large multiprotein complexes that bind the centromeres of the chromosomes to the microtubules of the mitotic spindle during metaphase in the cell cycle. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lacrimal: Pertaining to the tears. [EU] Lactation: The period of the secretion of milk. [EU] Laparoscopes: Endoscopes for examining the interior of the abdomen. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large
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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] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH] Left ventricular assist device: A mechanical device used to increase the heart's pumping ability. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocyte Count: A count of the number of white blood cells per unit volume in venous blood. A differential leukocyte count measures the relative numbers of the different types of white cells. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukocytosis: A transient increase in the number of leukocytes in a body fluid. [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and
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strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Light microscope: A microscope (device to magnify small objects) in which objects are lit directly by white light. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] 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] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is laser lithotripsy. [NIH] Litter: Appliance consisting of an oblong frame over which is stretched a canvas or other material, used for carrying an injured or disabled person. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]
Liver Neoplasms: Tumors or cancer of the liver. [NIH] Liver Regeneration: Repair or renewal of hepatic tissue. [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] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU]
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Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [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] Lymphopenia: Reduction in the number of lymphocytes. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant Hyperthermia: Rapid and excessive rise of temperature accompanied by muscular rigidity following general anesthesia. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammary: Pertaining to the mamma, or breast. [EU]
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Mammogram: An x-ray of the breast. [NIH] Mandibular Fractures: Fractures of the lower jaw. [NIH] Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannitol: A diuretic and renal diagnostic aid related to sorbitol. It has little significant energy value as it is largely eliminated from the body before any metabolism can take place. It can be used to treat oliguria associated with kidney failure or other manifestations of inadequate renal function and has been used for determination of glomerular filtration rate. Mannitol is also commonly used as a research tool in cell biological studies, usually to control osmolarity. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maternal Behavior: The behavior patterns associated with or characteristic of a mother. [NIH]
Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maximum Tolerated Dose: The highest dose level eliciting signs of toxicity without having major effects on survival relative to the test in which it is used. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediastinum: The area between the lungs. The organs in this area include the heart and its large blood vessels, the trachea, the esophagus, the bronchi, and lymph nodes. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by
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means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [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] Memory Disorders: Disturbances in registering an impression, in the retention of an acquired impression, or in the recall of an impression. Memory impairments are associated with dementia; craniocerebraltrauma; encephalitis; alcoholism (see also alcohol amnestic disorder); schizophrenia; and other conditions. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [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] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metaphase: The second phase of cell division, in which the chromosomes line up across the equatorial plane of the spindle prior to separation. [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] Metastasize: To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the
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body to another. [NIH] Methamphetamine: A central nervous system stimulant and sympathomimetic with actions and uses similar to dextroamphetamine. The smokable form is a drug of abuse and is referred to as crank, crystal, crystal meth, ice, and speed. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microsurgery: Surgical procedures on the cellular level; a light microscope and miniaturized instruments are used. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]
Middle Cerebral Artery: The largest and most complex of the cerebral arteries. Branches of the middle cerebral artery supply the insular region, motor and premotor areas, and large regions of the association cortex. [NIH] Middle Cerebral Artery Infarction: Terminal branch of the internal carotid artery which supplies the lateral portion of the cortex, the optic chiasm, the optic tract, and the optic radiations. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH]
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Minocycline: A semisynthetic staphylococcus infections. [NIH]
antibiotic
effective
against
tetracycline-resistant
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] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mitotic inhibitors: Drugs that kill cancer cells by interfering with cell division (mitostis). [NIH]
Mitotic Spindle Apparatus: An organelle consisting of three components: (1) the astral microtubules, which form around each centrosome and extend to the periphery; (2) the polar microtubules which extend from one spindle pole to the equator; and (3) the kinetochore microtubules, which connect the centromeres of the various chromosomes to either centrosome. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocyte: A type of white blood cell. [NIH] Monocyte Chemoattractant Protein-1: A chemokine that is a chemoattractant for human monocytes and may also cause cellular activation of specific functions related to host defense. It is produced by leukocytes of both monocyte and lymphocyte lineage and by fibroblasts during tissue injury. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic.
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Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Multigene Family: The progeny of a single open-pollinated parent or of a single cross between two individuals. [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] Muscle Proteins: The protein constituents of muscle, the major ones being ACTINS and MYOSIN. More than a dozen accessary proteins exist including troponin, tropomyosin, and dystrophin. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spasticity: Strongly marked hypertonicity of muscles. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelin Sheath: The lipid-rich sheath investing many axons in both the central and peripheral nervous systems. The myelin sheath is an electrical insulator and allows faster and more energetically efficient conduction of impulses. The sheath is formed by the cell membranes of glial cells (Schwann cells in the peripheral and oligodendroglia in the central nervous system). Deterioration of the sheath in demyelinating diseases is a serious clinical
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problem. [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] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]
Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] 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] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH]
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Nasal Obstruction: Any hindrance to the passage of air into and out of the nose. The obstruction may be in the nasal vestibule, fossae, or other areas of the nasal cavity. [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] Near Drowning: Non-fatal immersion or submersion in water. The subject is resuscitable. [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] Neonatology: A subspecialty of pediatrics concerned with the newborn infant. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Neostriatum: The phylogenetically newer part of the corpus striatum consisting of the caudate nucleus and putamen. It is often called simply the striatum. [NIH] Nephrectomy: Surgery to remove a kidney. Radical nephrectomy removes the kidney, the adrenal gland, nearby lymph nodes, and other surrounding tissue. Simple nephrectomy removes only the kidney. Partial nephrectomy removes the tumor but not the entire kidney. [NIH]
Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH]
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Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neuroprotective Agents: Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event, but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Neurosurgical Procedures: Surgery performed on the nervous system or its parts. [NIH] Neurotensin: A biologically active tridecapeptide isolated from the hypothalamus. It has been shown to induce hypotension in the rat, to stimulate contraction of guinea pig ileum and rat uterus, and to cause relaxation of rat duodenum. There is also evidence that it acts as both a peripheral and a central nervous system neurotransmitter. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [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] 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]
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Neutropenia: An abnormal decrease in the number of neutrophils, a type of white blood cell. [NIH] Neutrophil: A type of white blood cell. [NIH] Neutrophil Infiltration: The diffusion or accumulation of neutrophils in tissues or cells in response to a wide variety of substances released at the sites of inflammatory reactions. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nicotinic Agonists: Drugs that bind to and activate nicotinic cholinergic receptors (receptors, nicotinic). Nicotinic agonists act at postganglionic nicotinic receptors, at neuroeffector junctions in the peripheral nervous system, and at nicotinic receptors in the central nervous system. Agents that function as neuromuscular depolarizing blocking agents are included here because they activate nicotinic receptors, although they are used clinically to block nicotinic transmission. [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] Nitroprusside: (OC-6-22)-Pentakis(cyano-C)nitrosoferrate(2-). A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins. [NIH] Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. [NIH]
Nocodazole: Nocodazole is an antineoplastic agent which exerts its effect by depolymerizing microtubules. [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] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [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]
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Nucleates: Bacteria-inducing ice nucleation at warm temperatures (between zero and minus ten degrees C.). [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] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nurse Anesthetists: Professional nurses who have completed postgraduate training in the administration of anesthetics and who function under the responsibility of the operating surgeon. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Oligodendroglia: A class of neuroglial (macroglial) cells in the central nervous system. Oligodendroglia may be called interfascicular, perivascular, or perineuronal satellite cells according to their location. The most important recognized function of these cells is the formation of the insulating myelin sheaths of axons in the central nervous system. [NIH] Oligodendroglial: A cell that lays down myelin. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncology: The study of cancer. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the enkephalins, the dynorphins, and the endorphins. Each of these families derives from different precursors, proenkephalin, prodynorphin, and proopiomelanocortin, respectively. There are also at least three classes of opioid receptors, but the peptide families do not map to the receptors in a simple way. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver
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somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [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]
Orderly: A male hospital attendant. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organ Preservation: The process by which organs are kept viable outside of the organism from which they were removed (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmolarity: The concentration of osmotically active particles expressed in terms of osmoles of solute per litre of solution. [EU] Osmoles: The standard unit of osmotic pressure. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] 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] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overall survival: The percentage of subjects in a study who have survived for a defined period of time. Usually reported as time since diagnosis or treatment. Often called the survival rate. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overexpress: An excess of a particular protein on the surface of a cell. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH]
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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, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] 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] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH]
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Paramedic: An emergency medical technician (EMT) who received further training for the delivery of some aspects of advanced life support (ALS) care. [NIH] Parenchyma: The essential elements of an organ; used in anatomical nomenclature as a general term to designate the functional elements of an organ, as distinguished from its framework, or stroma. [EU] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Parotitis: Inflammation of the parotid gland. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Partial response: A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment. [NIH] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU]
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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] Perhexiline: 2-(2,2-Dicyclohexylethyl)piperidine. Coronary vasodilator used especially for angina of effort. It may cause neuropathy and hepatitis. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perineal: Pertaining to the perineum. [EU] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Perivascular: Situated around a vessel. [EU] Perspiration: Sweating; the functional secretion of sweat. [EU] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] 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] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH]
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Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Phrenic Nerve: The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. [NIH]
Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [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] Piloerection: Involuntary erection or bristling of hairs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH]
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Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelet Factor 4: A high-molecular-weight proteoglycan-platelet factor complex which is released from blood platelets by thrombin. It acts as a mediator in the heparin-neutralizing capacity of the blood and plays a role in platelet aggregation. At high ionic strength (I=0.75), the complex dissociates into the active component (molecular weight 29,000) and the proteoglycan carrier (chondroitin 4-sulfate, molecular weight 350,000). The molecule exists in the form of a dimer consisting of 8 moles of platelet factor 4 and 2 moles of proteoglycan. [NIH]
Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pneumonectomy: An operation to remove an entire lung. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [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] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] 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]
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Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postoperative Period: The period following a surgical operation. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] 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] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Precipitation: The act or process of precipitating. [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] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Pregnancy Maintenance: Physiological mechanisms that sustain the state of pregnancy. [NIH]
Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH]
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Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progeny: The offspring produced in any generation. [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] Progressive disease: Cancer that is increasing in scope or severity. [NIH] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prone: Having the front portion of the body downwards. [NIH] Pro-Opiomelanocortin: A precursor protein, MW 30,000, synthesized mainly in the anterior pituitary gland but also found in the hypothalamus, brain, and several peripheral tissues. It incorporates the amino acid sequences of ACTH and beta-lipotropin. These two hormones, in turn, contain the biologically active peptides MSH, corticotropin-like intermediate lobe peptide, alpha-lipotropin, endorphins, and methionine enkephalin. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propofol: A widely used anesthetic. [NIH] Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in
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the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostheses and Implants: Artificial substitutes for body parts, and materials inserted into tissue for functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the body, tend to be used therapeutically. Experimental implants is available for those used experimentally. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]
Protein 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 Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [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] 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] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH]
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Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudotumor Cerebri: A condition marked by raised intracranial pressure and characterized clinically by headaches; nausea; papilledema, peripheral constriction of the visual fields, transient visual obscurations, and pulsatile tinnitus. Obesity is frequently associated with this condition, which primarily affects women between 20 and 44 years of age. Chronic papilledema may lead to optic nerve injury (optic nerve diseases) and visual loss (blindness). [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] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Public 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 Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH]
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Pulposus: Prolapse of the nucleus pulposus into the body of the vertebra; necrobacillosis of rabbits. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Putamen: The largest and most lateral of the basal ganglia lying between the lateral medullary lamina of the globus pallidus and the external capsule. It is part of the neostriatum and forms part of the lentiform nucleus along with the globus pallidus. [NIH] Pyramidal Cells: Projection neurons in the cerebral cortex and the hippocampus. Pyramidal cells have a pyramid-shaped soma with the apex and an apical dendrite pointed toward the pial surface and other dendrites and an axon emerging from the base. The axons may have local collaterals but also project outside their cortical region. [NIH] 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] Quinidine: An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular action potential, and decreases automaticity. Quinidine also blocks muscarinic and alphaadrenergic neurotransmission. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH]
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Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] 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] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] 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, Nicotinic: One of the two major classes of cholinergic receptors. Nicotinic receptors were originally distinguished by their preference for nicotine over muscarine. They are generally divided into muscle-type and neuronal-type (previously ganglionic) based on pharmacology, molecular biology, and biophysical properties of the channels. [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] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Recovery Room: Hospital unit providing continuous monitoring of the patient following anesthesia. [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] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the
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cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reentry: Reexcitation caused by continuous propagation of the same impulse for one or more cycles. [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] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH] Relative Biological Effectiveness: The ratio of radiation dosages required to produce identical change based on a formula comparing other types of radiation with that of gamma or Roentgen rays. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Reproductive cells: Egg and sperm cells. Each mature reproductive cell carries a single set of 23 chromosomes. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Reserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration
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(= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Reverberant: The sound field prevailing in a large enclosure with moderately reflecting surfaces. [NIH] Rewarming: Application of heat to correct hypothermia, accidental or induced. [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] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Ryanodine: Insecticidal alkaloid isolated from Ryania speciosa; proposed as a myocardial
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depressant. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Salicylic: A tuberculosis drug. [NIH] Salicylic Acids: Derivatives and salts of salicylic acid. [NIH] Saline: A solution of salt and water. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [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] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sarcoplasmic Reticulum: A network of tubules and sacs in the cytoplasm of skeletal muscles that assist with muscle contraction and relaxation by releasing and storing calcium ions. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [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] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH]
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Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [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] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] 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] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septum: A dividing wall or partition; a general term for such a structure. The term is often used alone to refer to the septal area or to the septum pellucidum. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [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,
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and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Agonists: Agents that have an affinity for serotonin receptors and are able to mimic the effects of serotonin by stimulating the physiologic activity at the cell receptors. These compounds are used as antidepressants, anxiolytics, and in the treatment of migraine. [NIH]
Serotonin Antagonists: Drugs that bind to but do not activate serotonin receptors, thereby blocking the actions of serotonin or serotonin agonists. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals. [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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH]
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Sludge: A clump of agglutinated red blood cells. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoke Inhalation Injury: Pulmonary injury following the breathing in of toxic smoke from burning materials such as plastics, synthetics, building materials, etc. This injury is the most frequent cause of death in burn patients. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Snoring: Rough, noisy breathing during sleep, due to vibration of the uvula and soft palate. [NIH]
Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] 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
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the extents of these reactions. [NIH] Sperm: The fecundating fluid of the male. [NIH] Spermatids: Male germ cells derived from spermatocytes and developing into spermatozoa. [NIH]
Spermatocytes: Male germ cells derived from spermatogonia and developing into spermatids. [NIH] Spermatogonia: The spermatocytes. [NIH]
primitive
differentiated
male
gametes
which
give
rise
to
Spermidine: A polyamine formed from putrescine. It is found in almost all tissues in association with nucleic acids. It is found as a cation at all pH values, and is thought to help stabilize some membranes and nucleic acid structures. It is a precursor of spermine. [NIH] Spermine: A biogenic polyamine formed from spermidine. It is found in a wide variety of organisms and tissues and is an essential growth factor in some bacteria. It is found as a polycation at all pH values. Spermine is associated with nucleic acids, particularly in viruses, and is thought to stabilize the helical structure. [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] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Spinal Cord Ischemia: Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with arteriosclerosis, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to infarction of spinal cord tissue. [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] Splenectomy: An operation to remove the spleen. [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]
Stagnation: The slowing down or stoppage of the flowing of any fluid. [NIH] Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this
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group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [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] Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb. [NIH] Subclavian Vein: The continuation of the axillary vein which follows the subclavian artery and then joins the internal jugular vein to form the brachiocephalic vein. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU]
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Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sulfur Hexafluoride: Sulfur hexafluoride. An inert gas used mainly as a test gas in respiratory physiology. Other uses include its injection in vitreoretinal surgery to restore the vitreous chamber and as a tracer in monitoring the dispersion and deposition of air pollutants. [NIH] Superior vena cava: Vein which returns blood from the head and neck, upper limbs, and thorax. It is formed by the union of the two brachiocephalic veins. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathectomy: The removal or interruption of some part of the sympathetic nervous system for therapeutic or research purposes. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH]
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Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Syringomyelia: The presence in the spinal cord of elongated central fluid containing cavities surrounded by gliosis. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systems Analysis: The analysis of an activity, procedure, method, technique, or business to determine what must be accomplished and how the necessary operations may best be accomplished. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tacrine: A cholinesterase inhibitor that crosses the blood-brain barrier. Tacrine has been used to counter the effects of muscle relaxants, as a respiratory stimulant, and in the treatment of Alzheimer's disease and other central nervous system disorders. [NIH]
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Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temazepam: A benzodiazepinone that acts as a GABA modulator and anti-anxiety agent. [NIH]
Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thermogenesis: The generation of heat in order to maintain body temperature. The uncoupled oxidation of fatty acids contained within brown adipose tissue and shivering are examples of thermogenesis in mammals. [NIH] Thermoregulation: Heat regulation. [EU] 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]
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Thoracic Surgery: A surgical specialty concerned with diagnosis and treatment of disorders of the heart, lungs, and esophagus. Two major types of thoracic surgery are classified as pulmonary and cardiovascular. [NIH] Thorax: A part of the trunk between the neck and the abdomen; 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] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway 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] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]
Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tissue Survival: The span of viability of a tissue or an organ. [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] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonsils: Small masses of lymphoid tissue on either side of the throat. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH]
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Topical: On the surface of the body. [NIH] Torpor: State of mental and motor inactivity with partial insensibility, stagnation of function, without losing consciousness. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [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] Traction: The act of pulling. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] 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] Transient Ischemic Attacks: Focal neurologic abnormalities of sudden onset and brief duration that reflect dysfunction in the distribution of the internal carotid-middle cerebral or the vertebrobasilar arterial system. [NIH] Transitional cells: Cells that vary in shape depending on whether the tissue is being stretched. The cells may be stretched without breaking apart. They line hollow organs such as the bladder. [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] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH]
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Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigeminal Ganglion: The semilunar-shaped ganglion containing the cells of origin of most of the sensory fibers of the trigeminal nerve. It is situated within the dural cleft on the cerebral surface of the petrous portion of the temporal bone and gives off the ophthalmic, maxillary, and part of the mandibular nerves. [NIH] Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the trigeminal ganglion and project to the trigeminal nucleus of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Troglitazone: A drug used in diabetes treatment that is being studied for its effect on reducing the risk of cancer cell growth in fat tissue. [NIH] Tropomyosin: A protein found in the thin filaments of muscle fibers. It inhibits contraction of the muscle unless its position is modified by troponin. [NIH] Troponin: One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberculostatic: Inhibiting the growth of Mycobacterium tuberculosis. [EU] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other
Dictionary 321
mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tunica Intima: The innermost coat of blood vessels, consisting of a thin lining of endothelial cells longitudinally oriented and continuous with the endothelium of capillaries on the one hand and the endocardium of the heart on the other. [NIH] Turbinates: The scroll-like bony plates with curved margins on the lateral wall of the nasal cavity. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in dialysis separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as hemofiltration or hemodiafiltration (if combined with hemodialysis). [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] Univalent: Pertaining to an unpaired chromosome during the zygotene stage of prophase to first metaphase in meiosis. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [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] Urinary tract: The organs of the body that produce and discharge urine. These include the
322 Hypothermia
kidneys, ureters, bladder, and urethra. [NIH] Urinate: To release urine from the bladder to the outside. [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] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [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] Uvula: Uvula palatinae; specifically, the tongue-like process which projects from the middle of the posterior edge of the soft palate. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular 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] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs
Dictionary 323
and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [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] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Ventricular Pressure: The pressure within a cardiac ventricle. Ventricular pressure waveforms can be measured in the beating heart by catheterization or estimated using imaging techniques (e.g., Doppler echocardiography). The information is useful in evaluating the function of the myocardium, cardiac valves, and pericardium, particularly with simultaneous measurement of other (e.g., aortic or atrial) pressures. [NIH] Ventriculostomy: Surgical creation of an opening in a cerebral ventricle. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] 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] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Vinyl Chloride: A gas that has been used as an aerosol propellant and is the starting material for polyvinyl resins. Toxicity studies have shown various adverse effects, particularly the occurrence of liver neoplasms. [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]
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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 kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Vitreoretinal: A rare familial condition characterized by a clear vitreous, except for preretinal filaments and veils which have been loosened from the retina, a dense hyaloid membrane which is perforated and detached, and masses of peripheral retinal pigmentation inters. [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] Void: To urinate, empty the bladder. [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] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] Wounds, Gunshot: Disruption of structural continuity of the body as a result of the discharge of firearms. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zygote: The fertilized ovum. [NIH]
Dictionary 325
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]
327
INDEX A Abdomen, 154, 195, 233, 245, 271, 281, 283, 298, 313, 314, 318, 322, 324 Abdominal, 233, 234, 260, 280, 286, 296, 298 Ablation, 52, 60, 169, 176, 233 Absenteeism, 181, 233 Acceptor, 233, 283, 296 Accommodation, 64, 233 Acetaminophen, 137, 191, 233 Acetylcholine, 63, 151, 152, 233, 251, 293 Acetylcysteine, 5, 233 Acidosis, 77, 102, 114, 129, 233 Acne, 233, 308 Actin, 233, 289, 290, 320 Action Potentials, 12, 233 Acute renal, 116, 233 Adaptability, 233, 249, 250 Adaptation, 13, 66, 233, 251, 300 Adenine, 21, 158, 233, 234 Adenocarcinoma, 234, 273 Adenosine, 65, 92, 157, 158, 234, 236, 247, 299 Adenosine Triphosphate, 158, 234, 299 Adenovirus, 165, 234 Adipocytes, 234, 255, 282 Adipose Tissue, 10, 234, 267, 317 Adjustment, 233, 234 Adolescence, 7, 8, 20, 234, 297 Adrenal Medulla, 234, 249, 264, 265, 293 Adrenergic, 9, 10, 234, 238, 239, 261, 265, 305, 316 Adrenergic Agents, 9, 234 Adsorptive, 154, 234 Advanced Cardiac Life Support, 173, 234 Advanced Life Support, 109, 234, 297 Adverse Effect, 47, 50, 64, 160, 163, 234, 239, 307, 311, 323 Aerobic, 192, 234, 266, 288 Aerosol, 234, 293, 323 Afferent, 234, 267, 282 Affinity, 234, 235, 241, 259, 311, 312 Agar, 235, 299 Age Groups, 10, 235 Aged, 80 and Over, 235 Agonist, 9, 13, 16, 114, 116, 235, 239, 246, 261, 281, 293, 317 Air Embolism, 126, 235
Air Sacs, 235, 236 Airway, 161, 162, 234, 235, 311 Airway Obstruction, 161, 162, 235 Akathisia, 235, 239 Alcohol Drinking, 7, 235 Alertness, 235, 247 Algorithms, 46, 156, 235, 244 Alkaline, 233, 235, 236, 247 Alkaloid, 235, 253, 288, 293, 305, 307, 308 Alkalosis, 45, 114, 235 Allergen, 235, 259, 310 Alopecia, 105, 159, 235, 257 Alpha Particles, 235, 305 Alternative medicine, 202, 236 Alveoli, 236, 323 Amino Acid Sequence, 236, 238, 269, 302 Amino Acids, 236, 265, 266, 269, 292, 297, 300, 303, 315, 319, 321 Amiodarone, 191, 236 Ammonia, 201, 236, 275, 315, 321 Amnesia, 53, 236 Amnestic, 236, 268, 286, 287 Amphetamines, 236, 253 Ampulla, 236, 251, 264 Amrinone, 70, 85, 236 Amygdala, 236, 243, 317 Amyloid, 55, 65, 236, 250 Anabolic, 236 Anaesthesia, 69, 70, 78, 79, 80, 89, 91, 108, 120, 131, 236, 278 Anal, 236, 264, 268 Analgesic, 58, 158, 233, 237, 263, 276, 282, 288, 293, 295, 305 Analog, 200, 237 Analogous, 164, 237, 319 Anaphase, 25, 237 Anaphylatoxins, 237, 254 Anaplasia, 237 Anastomosis, 98, 237 Anatomical, 17, 237, 241, 255, 260, 277, 297, 309 Anemia, 237, 245 Anesthetics, 77, 158, 237, 242, 265, 294 Aneurysm, 17, 31, 83, 103, 180, 237, 239, 322 Angina, 144, 237, 238, 298 Angiogenesis, 59, 181, 237 Angiopathy, 145, 237, 250
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Angioplasty, 144, 169, 172, 237, 241, 290 Animal model, 5, 7, 8, 12, 33, 34, 39, 42, 46, 55, 64, 156, 237 Anions, 237, 280, 315 Anoxia, 143, 177, 182, 238 Antagonism, 6, 77, 238, 247 Anterior Cerebral Artery, 238, 250 Anterograde, 11, 60, 238 Antianginal, 236, 238 Anti-Anxiety Agents, 238, 301 Antiarrhythmic, 236, 238 Antibiotic, 238, 258, 261, 265, 288, 297, 301, 317 Antibiotic Prophylaxis, 238, 301 Antibodies, 30, 55, 238, 275, 277, 284, 299 Antibody, 25, 235, 238, 253, 254, 274, 278, 285, 288, 305, 306, 310, 312 Anticoagulant, 143, 238, 303 Antiemetic, 238, 239, 251 Antifungals, 191, 238 Antigen, 235, 238, 254, 274, 275, 277, 278, 285, 310 Antigen-Antibody Complex, 238, 254 Antihypertensive, 238, 307 Anti-inflammatory, 24, 36, 37, 191, 233, 238, 276, 309 Antimetabolite, 239, 259 Antimicrobial, 239, 252 Antineoplastic, 239, 257, 261, 293, 323 Antioxidant, 41, 239, 296 Antipsychotic, 72, 87, 239, 251, 292, 307 Antipyretic, 233, 239, 305 Antiviral, 154, 183, 191, 233, 239, 259 Anxiety, 22, 235, 238, 239, 268, 296, 317 Anxiolytic, 239, 246, 287 Aorta, 180, 239, 248, 256, 302, 313, 314, 323 Aortic Aneurysm, 98, 239 Aperture, 155, 239, 305 Apnea, 29, 32, 162, 229, 239 Apomorphine, 114, 116, 239 Aponeurosis, 239, 269 Apoptosis, 6, 14, 17, 23, 26, 55, 66, 176, 239, 248 Applicability, 158, 240 Approximate, 86, 240 Aqueous, 240, 243, 258, 263, 275 Arachidonic Acid, 240, 302 Arginine, 237, 240, 293 Aromatic, 240, 298, 314 Arrhythmia, 168, 238, 240 Arterial, 64, 71, 87, 95, 169, 170, 178, 236, 240, 246, 250, 256, 276, 280, 303, 316, 319
Arteries, 17, 35, 170, 237, 239, 240, 245, 250, 256, 257, 280, 281, 287, 290, 304, 313 Arterioles, 115, 240, 245, 247, 287, 290, 322 Arteriosclerosis, 240, 313 Arteriosus, 240, 304 Arteriovenous, 131, 240, 250, 287 Articular, 240, 295 Artificial Eye, 240, 303 Artificial Limbs, 240 Artificial Organs, 27, 88, 240 Ascites, 240, 294 Aspartate, 38, 116, 240, 281 Asphyxia, 14, 46, 75, 77, 97, 99, 110, 128, 240, 293 Assay, 52, 240 Asthenia, 192, 240 Astrocytes, 14, 240, 270 Asymptomatic, 241, 296 Ataxia, 8, 22, 61, 229, 241, 275, 317 Atherectomy, 144, 169, 241, 263 Atmospheric Pressure, 133, 241, 275 Atrial, 59, 236, 241, 256, 320, 323 Atrioventricular, 59, 241, 256, 315 Atrioventricular Node, 59, 241, 315 Atrium, 241, 248, 256, 315, 320, 323 Atrophy, 3, 241 Attenuated, 10, 52, 241 Attenuation, 41, 72, 241, 265 Atypical, 72, 87, 241, 293 Auditory, 18, 27, 76, 122, 123, 241, 266, 272, 285, 322 Autodigestion, 241, 296 Autoimmune disease, 241, 289 Autologous, 40, 71, 72, 126, 241 Autonomic, 192, 233, 239, 241, 293, 298, 315 Autonomic Dysreflexia, 192, 241 Autonomic Nervous System, 241, 298, 315 Autoradiography, 9, 13, 56, 242 Axilla, 106, 160, 242, 245 Axillary, 71, 106, 242, 314 Axillary Artery, 71, 106, 242 Axillary Vein, 242, 314 Axonal, 11, 242 Axons, 11, 242, 259, 279, 289, 291, 294, 305 B Babesiosis, 242, 305 Back Pain, 181, 242 Bacteremia, 4, 57, 242 Bacteria, 238, 242, 244, 263, 264, 267, 271, 274, 287, 294, 306, 310, 313, 319, 322 Bacterial Physiology, 233, 242
Index 329
Bactericidal, 242, 265 Bacteriophage, 242, 299, 319 Bacteriostatic, 242, 265 Barbiturate, 132, 242, 256, 274 Baroreflex, 73, 95, 242 Basal Ganglia, 14, 239, 241, 243, 246, 250, 251, 269, 305 Basal Ganglia Diseases, 241, 243, 251 Base, 28, 42, 153, 160, 162, 233, 235, 243, 259, 269, 281, 305, 317, 321 Basophils, 243, 271, 282 Baths, 160, 243 Benign, 19, 243, 246, 269, 272, 291, 306 Benzodiazepines, 206, 243, 246 Beta-pleated, 236, 243 Beta-Thromboglobulin, 243, 279 Bewilderment, 243, 255 Bile, 243, 251, 269, 283, 314 Bile Ducts, 243 Biliary, 191, 243, 247, 251, 296 Biliary Tract, 243, 247, 296 Bilirubin, 147, 243 Binding Sites, 12, 144, 243 Bioavailability, 12, 243 Biochemical, 10, 12, 14, 21, 22, 28, 36, 51, 64, 154, 239, 244, 295, 298, 310 Bioengineering, 50, 212, 244 Biological Markers, 15, 244 Biological therapy, 244, 271 Biological Transport, 244, 260 Biomarkers, 51, 244 Biopsy, 123, 244, 297 Bioreactors, 42, 244 Biosynthesis, 177, 240, 244 Biotechnology, 67, 68, 189, 202, 213, 244 Bipolar Disorder, 16, 244 Bladder, 244, 277, 283, 289, 303, 319, 321, 322, 324 Blast phase, 244, 252 Blastocyst, 244, 254 Blood Coagulation, 244, 245, 247, 318 Blood Glucose, 4, 191, 245, 273, 276, 279 Blood Platelets, 245, 300, 310, 318 Blood pressure, 27, 74, 100, 145, 158, 176, 238, 242, 245, 251, 276, 288, 293, 304, 312 Blood transfusion, 245, 272 Blood Viscosity, 178, 245, 272 Blood Volume, 46, 245, 267 Blood-Brain Barrier, 245, 282, 316 Blot, 28, 56, 245 Body Fluids, 235, 244, 245, 246, 261, 312, 320
Bone Marrow, 244, 245, 252, 257, 277, 284, 312, 314 Bone scan, 245, 309 Bowel, 236, 245, 260, 314 Bowel Movement, 245, 260, 314 Brachial, 242, 245, 285 Brachial Plexus, 245, 285 Brachiocephalic Trunk, 245, 314 Brachiocephalic Veins, 245, 315 Brachytherapy, 245, 279, 305 Bradycardia, 158, 246 Bradykinin, 246, 293 Brain Hypoxia, 46, 246, 317 Brain Infarction, 246, 280 Brain Ischemia, 37, 146, 246 Brain Neoplasms, 246, 275, 317 Brain Stem, 156, 246, 250, 256, 320 Branch, 227, 246, 262, 284, 285, 287, 297, 304, 312, 317 Breakdown, 246, 260, 269 Breeding, 26, 246 Bronchi, 246, 265, 285, 319 Buffers, 242, 246 Bupivacaine, 246, 282 Burns, 104, 191, 246 Burns, Electric, 246 Buspirone, 120, 246 Bypass, 21, 35, 46, 49, 61, 62, 72, 73, 74, 75, 77, 81, 97, 98, 111, 121, 124, 126, 129, 144, 154, 169, 178, 190, 196, 201, 246, 248, 272, 290 C Caffeine, 64, 246 Calcification, 83, 240, 247 Calcineurin, 12, 247 Calcium, 15, 22, 54, 114, 154, 167, 168, 191, 236, 247, 253, 280, 287, 290, 309, 311, 320 Calcium channel blocker, 191, 247 Calcium Channel Blockers, 191, 247 Calculi, 193, 247 Calmodulin, 54, 247 Cannabidiol, 247 Cannabinoids, 49, 247 Cannabinol, 247 Capillary, 167, 236, 246, 247, 270, 322, 323 Carbohydrate, 192, 248, 271 Carbon Dioxide, 103, 123, 248, 268, 269, 276, 307, 322 Carcinogenic, 248, 278, 314 Carcinoma, 86, 196, 248 Cardiac Output, 62, 150, 151, 243, 248, 272, 314
330 Hypothermia
Cardiac Surgical Procedures, 15, 248 Cardiogenic, 73, 121, 248 Cardiopulmonary Resuscitation, 27, 33, 34, 124, 248 Cardiorespiratory, 248, 287 Cardiotonic, 236, 248 Cardiovascular System, 248, 265 Case report, 68, 83, 89, 120, 131, 248, 252 Case series, 248, 252 Caspase, 41, 55, 81, 248 Catabolism, 60, 249 Catecholamine, 9, 249, 261 Catheterization, 196, 237, 249, 280, 290, 323 Catheters, 83, 146, 149, 167, 170, 171, 180, 183, 249, 277, 279 Cathode, 249, 262 Cations, 44, 249, 280 Caudal, 249, 260, 276, 301 Causal, 28, 249, 264 Causality, 20, 249 Cause of Death, 170, 249, 312 Cell Cycle, 249, 257, 281, 322 Cell Death, 14, 17, 41, 65, 176, 181, 239, 249, 291 Cell Differentiation, 249, 311 Cell Division, 237, 242, 249, 271, 279, 285, 286, 288, 299, 302, 310 Cell Fusion, 25, 249 Cell membrane, 21, 244, 247, 249, 259, 289, 299, 301 Cell motility, 249, 273 Cell proliferation, 25, 240, 249, 311 Cell Respiration, 249, 288, 307 Cell Survival, 93, 250, 271 Cellular Structures, 59, 250 Cellulose, 250, 299 Central Nervous System Infections, 250, 272, 275 Centrosome, 25, 250, 288 Cerebellar, 7, 241, 250, 307 Cerebellum, 246, 250, 301, 307 Cerebral Arteries, 127, 180, 250, 287 Cerebral hemispheres, 243, 246, 250, 317 Cerebral Hemorrhage, 143, 250 Cerebral Infarction, 19, 94, 246, 250, 275 Cerebral Palsy, 14, 166, 250 Cerebrospinal, 178, 184, 250, 257, 275 Cerebrospinal fluid, 178, 184, 250, 257, 275 Cerebrovascular, 56, 97, 243, 247, 250, 317 Cerebrum, 250, 317 Cervical, 89, 245, 251, 285, 299
Cervical Plexus, 251, 299 Cervix, 251 Chelation, 124, 251 Chemokines, 36, 49, 251 Chemoreceptor, 239, 251 Chemotactic Factors, 251, 254 Chemotherapy, 105, 154, 159, 174, 183, 251 Chilblains, 203, 251 Chlorpromazine, 114, 122, 191, 206, 251 Cholangitis, 191, 251 Cholestasis, 191, 251 Cholesterol, 170, 243, 251, 257, 314, 317 Choline, 53, 251 Cholinergic, 16, 239, 251, 293, 306 Chorea, 239, 251 Chromatin, 239, 251, 264 Chromosomal, 54, 251, 252, 309 Chromosome, 25, 252, 272, 283, 309, 310, 321 Chromosome Segregation, 25, 252 Chronic lymphocytic leukemia, 252 Chronic myelogenous leukemia, 244, 252 Chronic phase, 56, 252 Ciliary, 57, 240, 252 Cimetidine, 191, 252 Cinchona, 252, 305 Ciprofloxacin, 191, 252 Circulatory system, 167, 235, 252, 263, 280 Clamp, 11, 29, 38, 252 Clinical Medicine, 252, 301 Clinical study, 17, 30, 252 Clinical trial, 6, 29, 32, 41, 45, 47, 51, 64, 91, 139, 140, 165, 213, 252, 255, 257, 303, 306 Clonic, 252, 256 Cloning, 244, 252 Coagulation, 102, 244, 252, 273, 318 Coca, 253 Cocaine, 66, 253 Cochlea, 134, 253 Coenzymes, 253, 293 Cofactor, 253, 303, 318 Cognition, 56, 253, 292 Cognitive restructuring, 253, 314 Collagen, 253, 268, 269, 300 Collapse, 28, 30, 34, 162, 246, 253, 272, 311 Comatose, 90, 110, 253 Combination Therapy, 110, 253 Complement, 19, 36, 37, 61, 237, 253, 254, 270, 310 Complement Activation, 61, 237, 254
Index 331
Complementary and alternative medicine, 119, 136, 254 Complementary medicine, 119, 254 Complete remission, 154, 254, 307 Complete response, 254 Compress, 254, 273 Computational Biology, 213, 254 Computed tomography, 254, 309 Computerized axial tomography, 254, 309 Conception, 159, 254, 267, 313 Concretion, 247, 254 Conduction, 59, 164, 178, 241, 254, 289 Confounding, 45, 255 Confusion, 163, 230, 255, 260, 276, 292, 321 Congenita, 255, 305 Congestion, 137, 239, 255, 265 Congestive heart failure, 147, 150, 151, 192, 255 Conjugated, 255, 258 Conjunctiva, 34, 254, 255, 278, 320 Connective Tissue, 60, 245, 253, 255, 268, 269, 284, 308, 309, 316 Connective Tissue Cells, 255 Consciousness, 53, 237, 238, 255, 259, 308, 319 Constipation, 239, 255 Constitutional, 160, 255, 289 Constriction, 255, 280, 304, 309, 322 Constriction, Pathologic, 255, 322 Consumption, 7, 21, 26, 33, 44, 45, 58, 192, 255, 296 Continuum, 32, 255 Contractile Proteins, 61, 255 Contractility, 44, 54, 178, 255, 262 Contracture, 44, 255 Contraindications, ii, 255 Contralateral, 130, 255, 295, 306 Control group, 5, 255 Contusion, 19, 255 Conus, 255, 304 Conventional therapy, 256 Conventional treatment, 55, 256 Convulsants, 191, 256 Convulsions, 7, 38, 66, 242, 256, 276, 292 Coordination, 51, 230, 250, 256, 289 Cor, 34, 256, 302 Cornea, 34, 256, 281, 309, 314 Corneal Transplantation, 34, 256 Coronary Arteriosclerosis, 256, 290 Coronary Artery Bypass, 71, 175, 256 Coronary Disease, 165, 256 Coronary heart disease, 22, 256
Coronary Thrombosis, 257, 287, 290 Coronary Vessels, 256, 257 Cortex, 14, 18, 106, 134, 156, 241, 250, 257, 264, 265, 266, 268, 287, 302, 305, 307 Cortical, 6, 18, 33, 55, 128, 257, 266, 305, 310, 317 Cranial, 145, 184, 250, 257, 267, 272, 280, 285, 298, 320, 322 Craniocerebral Trauma, 243, 250, 257, 272, 275, 317 Craniotomy, 17, 31, 93, 107, 143, 257 Creatinine, 147, 257, 321 Critical Care, 32, 78, 81, 82, 85, 86, 90, 92, 95, 96, 100, 104, 106, 110, 234, 257 Cryotherapy, 161, 257 CSF, 55, 56, 172, 178, 250, 257, 280 Curative, 257, 293, 317 Custom-made, 69, 257 Cutaneous, 9, 192, 251, 257, 284 Cyclic, 6, 9, 247, 257, 271, 293, 298, 303, 310 Cyclin, 25, 257 Cyclophosphamide, 124, 257 Cyclosporine, 191, 257 Cysteine, 52, 54, 233, 251, 257, 315 Cystine, 257 Cytochrome, 33, 41, 252, 257, 296 Cytokine, 24, 34, 36, 40, 55, 79, 95, 258, 279 Cytokinesis, 25, 258 Cytomegalovirus, 165, 258 Cytoplasm, 28, 239, 243, 249, 255, 258, 264, 271, 309 Cytoskeleton, 28, 258, 287 Cytotoxic, 40, 91, 114, 122, 174, 184, 191, 258, 306, 311 D Databases, Bibliographic, 213, 258 Daunorubicin, 258, 261 Decompression, 127, 258 Decompression Sickness, 258 Defense Mechanisms, 57, 258 Defibrillation, 50, 107, 258 Degenerative, 256, 258, 270, 273, 289, 295, 308 Dehydration, 4, 97, 153, 179, 191, 203, 259 Deletion, 239, 259, 269 Delirium, 239, 259, 272 Dementia, 239, 259, 286 Denaturation, 181, 259 Dendrites, 259, 292, 305 Density, 9, 33, 42, 63, 259, 294, 300, 312 Dentate Gyrus, 39, 259, 274
332 Hypothermia
Deoxyglucose, 11, 259 Depolarization, 54, 259, 311 Deprivation, 14, 115, 173, 259 Dermatosis, 192, 259 Desensitization, 13, 259 Desipramine, 9, 114, 259 Deuterium, 259, 275 Dextroamphetamine, 259, 287 Diabetes Mellitus, 192, 260, 270, 273 Diagnostic procedure, 141, 202, 260 Dialysate, 66, 154, 260 Dialyzer, 154, 260, 272 Diaphragm, 63, 251, 260, 274, 299, 300 Diastole, 260 Diastolic, 44, 260, 276 Diencephalon, 260, 276, 317 Diffusion, 41, 46, 128, 244, 260, 278, 293, 321 Diffusivity, 166, 260 Digestion, 243, 245, 260, 283, 314 Digestive system, 140, 260 Dilatation, 191, 237, 260, 280, 302, 322 Dilatation, Pathologic, 260, 322 Dilation, 151, 241, 246, 260, 275, 322 Dilator, 177, 260 Diploid, 260, 299 Discrimination, 58, 260 Disinfectant, 260, 265 Disorientation, 255, 258, 259, 260 Disparity, 6, 260 Dissection, 170, 180, 261 Distal, 59, 98, 143, 157, 167, 168, 177, 180, 181, 242, 256, 261, 262, 304 Disulfides, 52, 261 Diuresis, 247, 261 Diuretic, 55, 261, 285, 312 Docetaxel, 131, 261 Dominance, 261, 265 Dopa, 191, 261, 282 Dopamine, 38, 114, 239, 251, 253, 260, 261, 282, 298 Dorsal, 57, 261, 301 Dorsum, 261, 269 Dose-dependent, 21, 261 Doxorubicin, 124, 261 Drive, ii, vi, 24, 39, 42, 113, 148, 171, 261 Drug Interactions, 206, 207, 261 Drug Resistance, 261 Drug Tolerance, 20, 261, 318 Duct, 192, 236, 249, 251, 261, 309, 315 Duodenum, 243, 261, 264, 292, 314 Dyes, 60, 64, 236, 243, 262
Dynorphins, 262, 294 Dyskinesia, 239, 262 Dystonia, 239, 262 E Echocardiography, 262, 323 Edema, 5, 37, 39, 55, 94, 167, 168, 184, 201, 230, 262, 273, 280, 290, 294, 321 Effector, 40, 177, 233, 253, 262, 291, 292, 298 Effector cell, 40, 262, 291, 292 Efficacy, 31, 32, 39, 47, 55, 59, 64, 68, 82, 123, 158, 184, 246, 262 Ejection fraction, 147, 151, 262 Elective, 105, 262 Electric shock, 248, 258, 262 Electrocoagulation, 253, 262 Electrode, 60, 249, 262 Electrolysis, 238, 249, 262 Electrolyte, 100, 259, 262, 273, 301, 312, 321 Electromyography, 262 Electrons, 239, 243, 249, 262, 280, 284, 296, 305, 306 Electrophysiological, 7, 12, 17, 39, 60, 64, 262 Elementary Particles, 262, 284, 292, 304 Emboli, 170, 263, 313 Embolization, 170, 263 Embolus, 263, 278 Embryo, 244, 249, 263, 278 Emergency Treatment, 162, 263 Emetic, 239, 263 Emulsion, 242, 263, 268 Encephalitis, 192, 263, 286 Encephalitis, Viral, 263 Encephalopathy, 33, 42, 43, 47, 75, 77, 107, 111, 263 Endarterectomy, 180, 237, 241, 263 Endocrine System, 263, 292 Endonucleases, 17, 263 Endorphin, 22, 263 Endoscope, 263, 264 Endoscopic, 103, 264, 287 Endothelial cell, 40, 81, 86, 165, 245, 264, 268, 279, 318, 321 Endothelium, 37, 264, 293, 321 Endothelium, Lymphatic, 264 Endothelium, Vascular, 264 Endothelium-derived, 264, 293 Endotoxic, 52, 264, 283 Endotoxin, 264, 321 End-stage renal, 4, 264
Index 333
Energy balance, 11, 264, 282 Enkephalins, 264, 294 Entorhinal Cortex, 264, 274 Environmental Exposure, 148, 171, 244, 264, 294 Environmental Health, 212, 214, 264 Enzymatic, 6, 247, 254, 264, 274, 308 Eosinophils, 264, 271, 282 Epidemiologic Studies, 244, 264 Epidural, 83, 103, 178, 264, 280 Epinephrine, 149, 234, 261, 265, 293, 321 Epistasis, 54, 265 Epithelial, 57, 234, 244, 265, 273 Epithelial Cells, 57, 265, 273 Epithelium, 264, 265, 280 Equalization, 153, 166, 179, 265 Erythema, 251, 265 Erythrocyte Volume, 245, 265 Erythrocytes, 237, 242, 245, 265, 273, 306, 310 Erythromycin, 191, 265 Esophagus, 260, 265, 285, 298, 314, 318 Estrogen, 265, 310, 317 Ethanol, 6, 7, 8, 20, 22, 26, 39, 53, 57, 61, 63, 64, 120, 124, 132, 265 Ether, 123, 265 Etomidate, 31, 265 Eukaryotic Cells, 265, 277, 295 Euthanasia, 57, 265 Evacuation, 94, 101, 255, 265 Evoke, 265, 314 Evoked Potentials, 76, 81, 122, 123, 265 Excitability, 15, 38, 266, 290, 305 Excitation, 54, 60, 236, 251, 266 Excitatory, 37, 39, 47, 81, 116, 266, 270, 281, 292 Excitatory Amino Acid Agonists, 266, 281 Excitatory Amino Acids, 37, 47, 81, 266, 292 Excitotoxicity, 33, 266 Exercise Test, 147, 266 Exhaustion, 135, 238, 266 Exogenous, 30, 54, 266 Expiration, 266, 307 External-beam radiation, 266, 305 Extracellular, 14, 28, 30, 33, 52, 57, 66, 116, 158, 236, 241, 255, 266, 268, 287, 312 Extracellular Matrix, 255, 266, 268 Extracellular Space, 14, 266, 287 Extracorporeal, 93, 99, 104, 105, 111, 119, 142, 143, 154, 193, 201, 266, 273
Extracorporeal Circulation, 104, 105, 142, 143, 266 Extracorporeal Membrane Oxygenation, 99, 266 Extraction, 46, 87, 267 Extrapyramidal, 235, 239, 261, 267 Extravasation, 267, 272 Extravascular, 81, 267 Extravascular Lung Water, 81, 267 Extremity, 245, 267, 285 Eye Infections, 234, 267 F Facial, 267, 285, 297 Facial Nerve, 267, 297 Family Planning, 213, 267 Fat, 11, 107, 234, 237, 240, 245, 256, 257, 263, 267, 282, 283, 289, 308, 312, 320 Fat Necrosis, 107, 267 Fatigue, 64, 230, 267, 272 Fatty acids, 267, 302, 317 Febrile, 4, 24, 38, 267 Feeding Behavior, 122, 267 Femoral, 248, 267 Femoral Artery, 248, 267 Fetus, 267, 302, 322 Fibrillation, 163, 258, 267 Fibrin, 244, 267, 318 Fibrinogen, 144, 267, 318 Fibroblast Growth Factor, 59, 165, 268 Fibroblasts, 255, 268, 279, 288 Fibronectin, 144, 268 Fibrosis, 191, 255, 268, 309 Fissure, 259, 268 Fixation, 3, 28, 268, 310 Flatus, 268, 269 Fluorescence, 45, 268 Flush, 116, 268 Fluvoxamine, 9, 268 Fold, 268, 286 Food Deprivation, 114, 268 Forearm, 245, 268, 285 Fovea, 268 Frontal Lobe, 238, 250, 268 Frostbite, 67, 98, 135, 188, 191, 203, 218, 219, 268 Fructose, 21, 268 Fungi, 238, 267, 269, 287, 324 G Gallbladder, 233, 243, 260, 269, 283 Gamma Rays, 269, 305, 306 Ganglia, 192, 233, 243, 269, 291, 298, 315 Ganglion, 34, 269, 320
334 Hypothermia
Gas, 20, 152, 153, 166, 179, 236, 248, 258, 260, 268, 269, 275, 293, 304, 308, 315, 322, 323 Gas exchange, 269, 308, 322, 323 Gastric, 241, 252, 269, 274, 297, 306 Gastric Acid, 252, 269 Gastrin, 252, 269, 274 Gastrointestinal, 173, 230, 246, 252, 265, 269, 306, 310, 313, 315, 320 Gastrointestinal tract, 265, 269, 310, 313, 320 Gelatin, 269, 271 Gene Deletion, 15, 269 Gene Expression, 6, 9, 26, 30, 59, 81, 165, 177, 269 Gene Pool, 53, 269 Generator, 147, 269 Genetic Code, 269, 294 Genetic Engineering, 177, 244, 252, 270 Genetics, 22, 28, 58, 97, 261, 270 Genital, 252, 270, 322 Genomics, 58, 270 Genotype, 28, 270, 298 Geriatric, 5, 98, 193, 270 Germ Cells, 151, 270, 285, 312, 313 Gestation, 21, 270, 298 Gland, 192, 234, 270, 284, 291, 296, 297, 299, 303, 310, 314, 315, 318 Glial Fibrillary Acidic Protein, 6, 270 Gliosis, 270, 316 Globus Pallidus, 243, 270, 305 Glomerular, 270, 285 Glomerular Filtration Rate, 270, 285 Glucose, 4, 6, 33, 52, 115, 124, 191, 245, 250, 259, 260, 270, 271, 273, 276, 279, 309, 312 Glucose Intolerance, 260, 270 Glucuronic Acid, 270, 273 Glutamate, 14, 16, 23, 33, 38, 52, 53, 64, 77, 116, 266, 270 Glutamic Acid, 270, 273 Glutathione Peroxidase, 41, 270 Glycerol, 267, 271, 299 Glycine, 52, 85, 271 Glycols, 271, 275 Glycolysis, 21, 271 Glycoprotein, 267, 268, 271, 289, 318, 320 Gonadal, 271, 314 Governing Board, 271, 301 Grade, 4, 86, 271 Graft, 106, 116, 169, 175, 271, 274, 277, 290 Graft Rejection, 271, 277
Grafting, 256, 271, 277 Gram-negative, 264, 271 Gram-Negative Bacteria, 264, 271 Granule, 259, 271 Granulocytes, 271, 311, 324 Gravis, 63, 271 Groin, 160, 271, 278 Growth factors, 165, 271 Guanylate Cyclase, 271, 293 H Haematoma, 271, 272 Haemorrhage, 75, 107, 122, 272 Hair Cells, 134, 272 Haloperidol, 103, 106, 191, 272 Haploid, 272, 299 Headache, 247, 272, 275, 276, 278 Heart Arrest, 248, 272 Heart attack, 146, 149, 162, 166, 175, 272 Heart Catheterization, 147, 272 Heart failure, 147, 151, 272, 294 Heart Transplantation, 21, 148, 272 Heartbeat, 272, 323 Heat Stroke, 54, 192, 272, 275 Hematoma, 94, 272, 273 Hematopoiesis, 43, 272 Heme, 243, 258, 272 Hemodiafiltration, 272, 321 Hemodialysis, 87, 154, 260, 272, 273, 281, 321 Hemodilution, 77, 102, 126, 134, 272 Hemodynamics, 6, 98, 273 Hemofiltration, 272, 273, 321 Hemoglobin, 46, 72, 237, 265, 272, 273 Hemoglobin C, 46, 273 Hemorrhagic stroke, 39, 172, 273 Hemostasis, 108, 196, 273, 310 Heparin, 88, 111, 143, 273, 300 Hepatic, 137, 191, 259, 273, 283 Hepatitis, 5, 191, 273, 298 Hepatocellular, 191, 273 Hepatocellular carcinoma, 191, 273 Hepatocyte, 165, 251, 273 Hepatocyte Growth Factor, 165, 273 Hepatotoxicity, 5, 137, 273 Hereditary, 273, 289 Heredity, 269, 270, 274 Heritability, 39, 274 Herpes, 34, 192, 274 Herpes Zoster, 192, 274 Heterogeneity, 42, 235, 274 Hexobarbital, 121, 274 Hibernation, 49, 188, 190, 274
Index 335
Hiccup, 251, 274 Hippocampus, 38, 39, 46, 259, 274, 305, 315 Histamine, 237, 239, 252, 274, 306 Histidine, 3, 274 Histology, 56, 114, 274 Homeostasis, 10, 28, 44, 54, 158, 274 Homogeneous, 42, 255, 274 Homologous, 272, 274, 310, 316 Hormonal, 11, 241, 274 Hormone, 11, 62, 110, 244, 265, 269, 274, 279, 282, 286, 302, 310, 311, 318 Host, 57, 242, 274, 277, 288, 322, 324 Human growth hormone, 145, 274 Hybrid, 40, 46, 274, 275 Hybridization, 26, 249, 275 Hybridomas, 275, 279 Hydration, 153, 179, 275 Hydrocephalus, 46, 275, 280 Hydrogen, 45, 233, 243, 246, 248, 259, 270, 275, 283, 288, 292, 294, 296, 304, 315 Hydrogen Peroxide, 270, 275, 283, 315 Hydrolysis, 52, 60, 263, 275, 299, 300, 303 Hydroxides, 275 Hydroxyl Radical, 47, 275 Hyperammonemia, 97, 275 Hyperbaric, 104, 119, 121, 123, 124, 125, 126, 127, 128, 129, 130, 131, 133, 134, 138, 275 Hyperbaric oxygen, 119, 121, 123, 124, 125, 126, 127, 128, 129, 130, 131, 133, 134, 275 Hyperglycemia, 42, 110, 275 Hyperhidrosis, 73, 83, 99, 192, 275 Hyperpyrexia, 192, 275 Hypersensitivity, 235, 259, 275, 310 Hypertension, 55, 133, 196, 247, 250, 276, 280, 321 Hypertrophy, 162, 256, 276, 320 Hyperventilate, 152, 276 Hyperventilation, 55, 56, 276 Hypnotic, 7, 22, 63, 73, 125, 242, 265, 274, 276, 287 Hypoglycaemia, 117, 259, 276 Hypoglycemia, 59, 191, 192, 276 Hypoglycemic, 191, 276 Hypoglycemic Agents, 191, 276 Hypohidrosis, 192, 276 Hypotension, 87, 131, 143, 158, 168, 192, 230, 239, 256, 276, 292 Hypotensive, 158, 276 Hypothalamic, 4, 24, 276
Hypothalamus, 24, 159, 160, 174, 183, 242, 246, 260, 276, 292, 299, 302, 317 Hypoxemia, 80, 276 Hypoxia, 14, 21, 23, 32, 33, 36, 46, 47, 48, 59, 63, 74, 85, 93, 102, 166, 178, 259, 276 I Ibuprofen, 87, 276 Id, 118, 135, 218, 219, 220, 226, 228, 276 Idiopathic, 5, 192, 276 Ileum, 127, 276, 292 Imidazole, 265, 274, 276, 306 Immersion, 87, 120, 121, 163, 189, 190, 203, 243, 277, 291 Immune function, 50, 145, 277 Immune response, 149, 238, 241, 271, 277, 310, 315, 322, 323, 324 Immune system, 24, 49, 244, 262, 277, 284, 289, 290, 322, 324 Immunity, 40, 277 Immunization, 277, 310 Immunochemistry, 60, 277 Immunogenic, 277, 283 Immunohistochemistry, 6, 48, 277 Immunology, 43, 115, 235, 277 Immunophilin, 247, 277 Immunosuppressive, 247, 257, 277 Immunosuppressive therapy, 277 Immunotherapy, 40, 244, 259, 277 Impairment, 13, 46, 52, 64, 91, 127, 241, 243, 251, 259, 262, 267, 277, 286, 304 Implant radiation, 277, 279, 305 Implantation, 130, 148, 254, 277 In situ, 6, 36, 56, 116, 142, 277 In Situ Hybridization, 6, 36, 56, 277 In vitro, 11, 39, 48, 54, 55, 57, 72, 89, 91, 107, 115, 123, 126, 127, 130, 134, 245, 249, 277, 318 In vivo, 9, 11, 42, 48, 55, 60, 62, 126, 157, 165, 249, 273, 277, 287 Incision, 142, 277, 280 Incontinence, 164, 275, 277 Indicative, 151, 187, 277, 297, 322 Induction, 15, 16, 23, 30, 35, 46, 49, 59, 79, 90, 91, 92, 125, 127, 165, 181, 201, 239, 265, 278, 281 Infancy, 38, 101, 197, 278 Infant, Newborn, 235, 278 Infarction, 79, 84, 102, 170, 174, 250, 273, 278, 307, 313 Infertility, 278, 322 Infiltration, 37, 278, 302 Influenza, 77, 278
336 Hypothermia
Informed Consent, 33, 51, 278 Infusion, 156, 158, 163, 180, 234, 278, 290, 319 Ingestion, 20, 57, 268, 278, 300 Inguinal, 275, 278 Inhalation, 61, 120, 234, 274, 278, 300 Initiation, 11, 59, 156, 193, 278, 319 Inlay, 278, 308 Innervation, 245, 267, 278, 285 Inorganic, 261, 275, 278 Inotropic, 62, 150, 236, 261, 278 Insight, 11, 12, 37, 58, 59, 278 Insulator, 279, 289 Insulin, 4, 11, 21, 117, 124, 191, 279 Insulin-dependent diabetes mellitus, 279 Intensive Care, 32, 70, 81, 83, 89, 100, 103, 110, 114, 175, 279 Intensive Care Units, 32, 279 Interleukin-1, 24, 36, 37, 279 Interleukin-2, 279 Interleukin-6, 34, 40, 279 Interleukin-8, 86, 279 Intermittent, 8, 279, 298 Internal radiation, 279, 305 Interneurons, 39, 279 Interphase, 250, 279 Interstitial, 162, 189, 245, 266, 279 Intervertebral, 181, 279 Intestines, 233, 269, 279 Intoxication, 7, 8, 132, 259, 279, 324 Intracellular, 15, 16, 28, 30, 44, 49, 54, 247, 267, 278, 279, 286, 293, 301, 303, 306, 310, 311 Intracranial Aneurysm, 17, 31, 197, 250, 280 Intracranial Arteriosclerosis, 250, 280 Intracranial Hemorrhages, 275, 280, 317 Intracranial Hypertension, 82, 87, 110, 272, 275, 280 Intracranial Pressure, 17, 68, 81, 96, 98, 103, 145, 167, 168, 200, 280, 304 Intraoperative Period, 31, 280 Intraperitoneal, 12, 173, 280 Intrathecal, 58, 86, 280 Intravascular, 14, 29, 50, 144, 169, 173, 174, 175, 272, 280 Intravenous, 12, 50, 90, 116, 146, 159, 163, 190, 278, 280 Intubation, 249, 280 Invasive, 19, 30, 73, 121, 159, 184, 277, 280, 284
Involuntary, 243, 251, 267, 280, 290, 299, 307, 311 Ion Channels, 241, 280, 292, 316 Ionizing, 236, 264, 280, 306 Ions, 154, 243, 246, 247, 262, 275, 280, 301, 309 Iris, 240, 256, 280, 305 Ischemic stroke, 41, 47, 70, 78, 84, 85, 172, 200, 281 Isoniazid, 191, 281 J Joint, 153, 160, 179, 240, 252, 258, 281, 295, 316 Jugular Veins, 180, 281 K Kainic Acid, 58, 281 Kb, 212, 281 Keratinocytes, 279, 281 Keratitis, 34, 281 Ketamine, 66, 90, 281 Kidney Failure, 264, 281, 285 Kidney Transplantation, 48, 281 Kinetics, 12, 281 Kinetochores, 25, 281 L Labile, 253, 281 Labyrinth, 253, 281, 323 Lacrimal, 192, 267, 281 Lactation, 21, 281 Laparoscopes, 195, 281 Large Intestine, 260, 279, 281, 306, 312 Larynx, 282, 319, 322 Latency, 20, 282 Latent, 34, 153, 166, 179, 282, 301 Lavage, 133, 282 Left ventricular assist device, 148, 282 Leptin, 11, 282 Lesion, 53, 256, 270, 282, 283, 317, 321 Lethal, 11, 35, 57, 242, 282 Lethargy, 96, 97, 230, 275, 282 Leukemia, 252, 261, 282 Leukocyte Count, 76, 282 Leukocytes, 35, 37, 144, 243, 245, 251, 264, 271, 282, 288, 321 Leukocytosis, 4, 282 Leukopenia, 5, 282 Levo, 261, 282 Levodopa, 261, 282 Library Services, 226, 282 Lidocaine, 164, 206, 282 Life cycle, 234, 269, 282 Ligament, 282, 303
Index 337
Ligands, 40, 49, 283 Ligation, 36, 283 Light microscope, 283, 287 Limbic, 38, 236, 283 Linkages, 273, 283, 297 Lipid, 22, 60, 240, 251, 271, 279, 283, 287, 289, 296 Lipid A, 22, 283 Lipid Peroxidation, 283, 296 Lipopolysaccharide, 24, 86, 104, 115, 271, 283 Lithium, 239, 283 Lithotripsy, 193, 283 Litter, 21, 283 Liver cancer, 191, 283 Liver Neoplasms, 283, 323 Liver Regeneration, 5, 283 Liver scan, 283, 309 Liver Transplantation, 5, 67, 96, 283 Lobe, 38, 250, 274, 283, 302 Localization, 13, 15, 30, 60, 277, 283 Localized, 6, 156, 181, 192, 246, 251, 255, 268, 271, 272, 275, 278, 283, 294, 299, 321 Locomotion, 283, 299 Locomotor, 26, 40, 53, 58, 63, 152, 283 Loop, 167, 171, 195, 284 Lumbar, 242, 284 Lumen, 143, 170, 180, 264, 284 Lupus, 284, 316 Lymph, 242, 251, 252, 264, 284, 285, 291 Lymph node, 242, 251, 284, 285, 291 Lymphatic, 264, 278, 284, 294, 312, 313 Lymphatic system, 284, 312, 313 Lymphocyte, 40, 147, 238, 284, 285, 288 Lymphocyte Count, 147, 284 Lymphoid, 238, 284, 318 Lymphoma, 123, 284 Lymphopenia, 5, 284 Lysine, 273, 284 M Macrophage, 279, 284 Magnetic Resonance Imaging, 19, 56, 284, 309 Magnetic Resonance Spectroscopy, 42, 53, 62, 284 Malformation, 73, 131, 284 Malignant, 40, 54, 79, 149, 159, 171, 174, 184, 188, 234, 239, 246, 283, 284, 291, 306, 309 Malignant Hyperthermia, 149, 159, 171, 284 Malnutrition, 116, 241, 284
Mammary, 256, 284, 317 Mammogram, 247, 285, 287 Mandibular Fractures, 3, 285 Mandibular Nerve, 285, 320 Manic, 239, 244, 283, 285, 304 Manifest, 156, 242, 285 Mannitol, 31, 117, 285 Mastication, 285, 320 Maternal Behavior, 39, 285 Maxillary, 285, 320 Maximum Tolerated Dose, 261, 285 Meatus, 285, 322 Mechanical ventilation, 178, 285 Median Nerve, 73, 81, 285 Mediastinum, 93, 285 Mediate, 13, 37, 74, 261, 285, 306 Mediator, 23, 63, 66, 122, 261, 279, 285, 300, 311 Medical Records, 32, 285, 308 Medicament, 145, 177, 285 MEDLINE, 213, 285 Medullary, 285, 305 Meiosis, 25, 252, 285, 316, 321 Melanin, 280, 286, 298, 321 Melanocytes, 286 Melanoma, 28, 286 Membrane Glycoproteins, 286 Membrane Proteins, 286, 303 Memory, 13, 15, 18, 38, 56, 60, 134, 163, 236, 259, 286 Memory Disorders, 18, 286 Meninges, 250, 257, 286, 314 Mental Disorders, 18, 140, 286, 304 Mental Health, iv, 5, 140, 212, 214, 286, 304 Mental Retardation, 14, 286 Mesenteric, 116, 286 Mesentery, 286 Mesolimbic, 239, 286 Metabolite, 12, 55, 286, 293 Metaphase, 281, 286, 321 Metastasis, 25, 59, 174, 184, 286 Metastasize, 174, 184, 286, 310 Metastatic, 154, 246, 286, 310 Methamphetamine, 51, 66, 287 Methionine, 287, 302, 315 MI, 144, 175, 200, 232, 287 Microbe, 287, 319 Microbiology, 196, 233, 241, 287 Microcalcifications, 247, 287 Microcirculation, 81, 272, 287 Microdialysis, 6, 14, 52, 81, 287
338 Hypothermia
Microorganism, 253, 287, 324 Microscopy, 25, 287 Microsurgery, 25, 287 Microtubules, 25, 281, 287, 288, 293 Midazolam, 71, 287 Middle Cerebral Artery, 64, 79, 97, 117, 287 Middle Cerebral Artery Infarction, 97, 287 Migration, 37, 287 Minocycline, 67, 288 Mitochondria, 45, 288, 290, 295 Mitochondrial Swelling, 288, 291 Mitosis, 25, 239, 250, 252, 288 Mitotic, 25, 250, 261, 281, 288 Mitotic inhibitors, 261, 288 Mitotic Spindle Apparatus, 250, 288 Mobilization, 11, 288 Modification, 7, 26, 54, 60, 72, 142, 148, 150, 169, 171, 172, 265, 270, 288, 305 Modulator, 54, 56, 288, 317 Molecule, 49, 238, 243, 254, 257, 262, 264, 266, 275, 288, 294, 296, 300, 306, 311, 322 Monitor, 46, 52, 61, 80, 96, 192, 257, 288, 293 Monoclonal, 275, 288, 305 Monocyte, 36, 288 Monocyte Chemoattractant Protein-1, 36, 288 Mononuclear, 49, 79, 95, 288, 321 Monotherapy, 87, 288 Mood Disorders, 60, 288 Morphine, 12, 50, 58, 86, 114, 124, 239, 288, 290, 295 Morphological, 14, 60, 263, 286, 289 Motility, 289, 310 Motor Activity, 256, 289 Motor nerve, 289, 299 Movement Disorders, 33, 239, 289, 317 Mucinous, 269, 289 Mucolytic, 233, 289 Multigene Family, 152, 289 Multiple sclerosis, 76, 122, 164, 289 Muscle Contraction, 63, 289, 309 Muscle Fibers, 54, 241, 289, 290, 320 Muscle Proteins, 255, 289 Muscle Relaxation, 63, 289, 290 Muscle Spasticity, 164, 289 Mutagenesis, 54, 289 Mutagens, 289 Myalgia, 278, 289 Myasthenia, 63, 289 Mydriatic, 260, 289
Myelin, 289, 294 Myelin Sheath, 289, 294 Myocardial infarction, 91, 125, 144, 170, 174, 175, 243, 257, 287, 290 Myocardial Ischemia, 15, 175, 256, 290 Myocardial Reperfusion, 290, 307 Myocardial Reperfusion Injury, 290, 307 Myocardium, 49, 61, 170, 174, 287, 290, 323 Myosin, 247, 289, 290, 320 Myotonia, 290, 305 N Naive, 65, 290 Narcolepsy, 16, 259, 290 Narcosis, 274, 290 Narcotic, 288, 290, 293 Nasal Cavity, 290, 291, 321 Nasal Mucosa, 278, 290 Nasal Obstruction, 162, 291 Nausea, 238, 239, 291, 296, 304, 321 NCI, 1, 140, 211, 291 Near Drowning, 74, 77, 187, 291 Necrosis, 23, 39, 154, 170, 176, 191, 239, 246, 250, 278, 287, 290, 291, 307 Neonatal, 15, 32, 36, 42, 43, 47, 61, 69, 81, 82, 92, 96, 99, 101, 109, 111, 131, 132, 200, 291 Neonatology, 42, 291 Neoplasm, 291, 309, 321 Neoplastic, 237, 275, 284, 291 Neostriatum, 291, 305 Nephrectomy, 92, 195, 291 Nephropathy, 116, 291 Nerve, 10, 65, 123, 145, 156, 157, 164, 181, 191, 233, 234, 237, 241, 242, 245, 251, 259, 267, 269, 278, 285, 289, 291, 299, 301, 302, 304, 308, 309, 314, 319, 320, 322 Nerve Fibers, 181, 245, 251, 291, 299 Nerve Growth Factor, 65, 291 Networks, 18, 29, 32, 66, 291 Neural, 7, 8, 11, 18, 19, 29, 42, 49, 178, 200, 234, 236, 259, 291 Neuroeffector Junction, 291, 293 Neuroendocrine, 11, 63, 292 Neuroleptic, 235, 239, 292 Neurologic, 23, 31, 32, 35, 58, 65, 86, 94, 95, 106, 164, 180, 238, 275, 292, 319 Neuromuscular, 63, 233, 292, 293, 321 Neuromuscular Junction, 63, 233, 292 Neuronal, 11, 14, 18, 23, 31, 33, 36, 38, 41, 47, 52, 57, 152, 290, 292, 306
Index 339
Neurons, 7, 14, 22, 29, 52, 128, 253, 259, 266, 269, 279, 282, 291, 292, 293, 305, 315, 316 Neuropathy, 68, 191, 192, 292, 298 Neuropeptide, 10, 292 Neurophysiology, 76, 122, 259, 292 Neuroprotective Agents, 178, 292 Neurosurgery, 19, 41, 45, 56, 68, 78, 82, 83, 85, 88, 91, 94, 96, 98, 117, 127, 128, 132, 190, 292 Neurosurgical Procedures, 47, 70, 85, 91, 108, 292 Neurotensin, 12, 62, 200, 292 Neurotoxicity, 51, 281, 292 Neurotransmitters, 167, 168, 266, 292 Neutrons, 235, 292, 305 Neutropenia, 97, 293 Neutrophil, 37, 65, 293 Neutrophil Infiltration, 37, 293 Niacin, 191, 293, 320 Nicotine, 152, 293, 306 Nicotinic Agonists, 152, 293 Nitric Oxide, 6, 15, 23, 35, 37, 42, 43, 54, 65, 72, 117, 293 Nitrogen, 48, 235, 257, 258, 268, 293, 320 Nitroprusside, 87, 293 Nitrous Oxide, 20, 293 Nocodazole, 25, 293 Norepinephrine, 10, 115, 234, 259, 261, 293, 307 Nortriptyline, 114, 293 Nuclear, 28, 48, 243, 262, 265, 269, 291, 293, 317 Nucleates, 250, 294 Nuclei, 14, 235, 236, 238, 262, 270, 284, 288, 292, 294, 304 Nucleic acid, 12, 269, 275, 277, 289, 293, 294, 313 Nucleic Acid Hybridization, 275, 294 Nurse Anesthetists, 69, 294 O Ocular, 34, 294 Oedema, 90, 294 Oligodendroglia, 37, 289, 294 Oligodendroglial, 36, 294 Oliguria, 281, 285, 294 Oncogene, 273, 294 Oncology, 52, 99, 191, 294 On-line, 45, 229, 294 Opacity, 259, 294 Ophthalmic, 294, 320 Ophthalmology, 131, 268, 294
Opioid Peptides, 22, 262, 264, 294 Opium, 288, 294 Optic Chiasm, 276, 287, 295 Orderly, 252, 295 Organ Culture, 295, 318 Organ Preservation, 21, 35, 48, 134, 295 Organ Transplantation, 166, 295 Organelles, 258, 286, 295 Orthostatic, 192, 239, 295 Osmolarity, 55, 285, 295 Osmoles, 295 Osmosis, 295 Osmotic, 55, 288, 295 Osteoarthritis, 160, 161, 295 Osteoporosis, 3, 295 Outpatient, 32, 295 Overall survival, 27, 34, 295 Overdose, 90, 132, 256, 295 Overexpress, 7, 295 Ovum, 270, 282, 295, 302, 324 Oxidation, 52, 233, 239, 257, 258, 270, 283, 296, 317 Oxidative Phosphorylation, 62, 296 Oxidative Stress, 65, 116, 296 Oxygen Consumption, 166, 174, 266, 296, 307 Oxygenation, 46, 79, 80, 258, 273, 276, 296 Oxygenator, 143, 180, 248, 266, 296 P Pacemaker, 29, 39, 188, 296 Palate, 162, 296, 312, 322 Palliative, 296, 317 Pancreas, 233, 244, 260, 279, 296, 320 Pancreatic, 296 Pancreatitis, 85, 296 Panic, 16, 268, 296 Panic Disorder, 268, 296 Paralysis, 73, 296 Paramedic, 24, 50, 173, 297 Parenchyma, 19, 297 Parietal, 18, 238, 297, 300 Parietal Lobe, 238, 297 Parkinsonism, 239, 282, 297 Parotid, 192, 297 Parotitis, 192, 297 Partial remission, 154, 297, 307 Partial response, 297 Particle, 297, 312, 319 Patch, 29, 255, 297 Pathogenesis, 12, 18, 34, 36, 48, 129, 144, 297
340 Hypothermia
Pathologic, 56, 233, 239, 244, 256, 275, 297, 304, 307 Pathologic Processes, 239, 297 Pathologies, 46, 60, 162, 191, 297 Pathophysiology, 4, 41, 53, 99, 104, 297 Pediatrics, 31, 32, 36, 42, 43, 47, 61, 62, 75, 88, 97, 110, 111, 132, 133, 291, 297 Pelvic, 297, 303 Penicillin, 238, 297 Pepsin, 252, 297 Pepsin A, 252, 297 Peptide, 12, 22, 55, 268, 282, 294, 297, 300, 302, 303 Percutaneous, 91, 131, 283, 297 Perforation, 144, 239, 297 Perhexiline, 191, 298 Pericardium, 298, 316, 323 Perinatal, 33, 42, 43, 47, 75, 77, 96, 97, 99, 110, 128, 298 Perineal, 275, 298 Perioperative, 89, 93, 95, 99, 102, 196, 298 Peripheral blood, 49, 79, 95, 298 Peripheral Nervous System, 264, 289, 293, 298, 315 Peritoneal, 240, 260, 280, 294, 298 Peritoneal Cavity, 240, 280, 294, 298 Peritoneal Dialysis, 260, 298 Perivascular, 294, 298 Perspiration, 153, 179, 276, 298 Petechiae, 272, 298 Phallic, 268, 298 Pharmacodynamics, 12, 298 Pharmacokinetic, 12, 298 Pharmacologic, 6, 23, 33, 53, 62, 64, 192, 237, 298, 319 Pharynx, 162, 278, 290, 298, 322 Phenotype, 7, 40, 244, 269, 298 Phenylalanine, 297, 298, 321 Phosphodiesterase, 236, 298 Phospholipases, 299, 311 Phospholipids, 267, 299 Phosphorus, 191, 247, 299 Phosphorylation, 22, 28, 49, 62, 81, 299 Photocoagulation, 253, 299 Phrenic Nerve, 63, 299 Physical Examination, 151, 299 Physical Fitness, 4, 299 Physiologic, 27, 41, 65, 154, 162, 166, 235, 244, 261, 299, 302, 306, 307, 311 Physiology, 9, 72, 73, 74, 114, 116, 121, 123, 129, 166, 189, 190, 244, 262, 292, 299 Pigment, 243, 286, 299
Piloerection, 276, 299 Pilot study, 47, 64, 78, 105, 107, 111, 299 Pituitary Gland, 268, 299, 302 Plants, 176, 177, 235, 246, 248, 251, 253, 270, 293, 299, 309, 319, 322 Plaque, 144, 237, 241, 299 Plasma cells, 238, 299 Plasma Volume, 245, 299 Plasticity, 38, 273, 300 Platelet Activation, 72, 144, 300, 311 Platelet Aggregation, 89, 126, 144, 237, 293, 300 Platelet Factor 4, 279, 300 Platelets, 16, 144, 243, 293, 300, 318 Platinum, 284, 300 Pleural, 294, 300 Pleural cavity, 294, 300 Pneumonectomy, 130, 300 Poisoning, 192, 239, 259, 279, 291, 300 Polyethylene, 72, 182, 300 Polymerase, 66, 92, 300 Polymers, 300, 303, 314 Polymorphic, 259, 300 Polypeptide, 236, 253, 267, 275, 297, 300, 325 Pons, 246, 301 Port, 177, 180, 196, 301 Port-a-cath, 301 Posterior, 17, 164, 236, 240, 241, 242, 250, 261, 280, 296, 301, 309, 313, 322 Postmenopausal, 295, 301 Postoperative, 3, 17, 31, 62, 71, 79, 91, 125, 127, 301 Postoperative Period, 62, 301 Postsynaptic, 291, 301, 311, 316 Post-traumatic, 6, 35, 53, 55, 289, 301 Potassium, 15, 23, 57, 301, 305 Potassium Channels, 23, 301 Potentiates, 63, 259, 279, 301 Potentiation, 120, 301, 311 Practice Guidelines, 214, 301 Precipitating Factors, 249, 301 Precipitation, 153, 179, 301 Precursor, 52, 55, 65, 240, 251, 257, 261, 262, 264, 282, 293, 298, 301, 302, 313, 320, 321 Predisposition, 62, 301 Pregnancy Maintenance, 301 Premedication, 89, 301 Prenatal, 20, 263, 302 Pressoreceptors, 242, 302 Presynaptic, 64, 105, 291, 302, 316
Index 341
Probe, 150, 184, 287, 302 Procaine, 282, 302 Progeny, 289, 302 Progesterone, 302, 314 Prognostic factor, 71, 302 Progression, 15, 25, 50, 144, 237, 302 Progressive, 10, 43, 73, 114, 174, 184, 249, 259, 261, 271, 291, 295, 300, 302, 321 Progressive disease, 174, 184, 302 Projection, 258, 279, 293, 302, 305, 306 Prone, 154, 302 Pro-Opiomelanocortin, 294, 302 Prophase, 25, 302, 316, 321 Prophylaxis, 302, 308, 322 Propofol, 78, 93, 302 Prospective Studies, 38, 302 Prostaglandin, 24, 116, 302 Prostaglandins A, 302, 303 Prostate, 161, 162, 244, 303, 320 Prostheses and Implants, 240, 303 Protease, 81, 253, 303 Protective Agents, 21, 178, 247, 303 Protein C, 13, 49, 54, 236, 242, 289, 303, 320, 321 Protein Kinases, 177, 303 Protein S, 13, 17, 19, 189, 244, 265, 269, 274, 303, 317 Proteolytic, 61, 253, 267, 303 Protocol, 17, 43, 47, 53, 60, 154, 303 Proton Pump, 28, 303 Protons, 235, 275, 280, 284, 303, 304, 305 Proximal, 11, 59, 71, 143, 180, 261, 290, 302, 304 Pseudotumor Cerebri, 280, 304 Psoriasis, 304, 308 Psychiatric, 244, 286, 304 Psychiatry, 15, 37, 87, 110, 133, 268, 304, 314, 323 Psychic, 304, 310 Psychomotor, 3, 259, 292, 304 Psychosis, 239, 304 Public Health, 20, 27, 50, 214, 304 Public Policy, 213, 304 Publishing, 67, 304 Pulmonary Artery, 27, 245, 304, 323 Pulmonary Edema, 115, 151, 168, 267, 281, 304 Pulmonary hypertension, 256, 304 Pulmonary Ventilation, 276, 304 Pulposus, 181, 305 Pulse, 32, 288, 305 Pupil, 256, 260, 289, 305
Purpura, 272, 305 Putamen, 14, 238, 243, 291, 305 Pyramidal Cells, 39, 259, 305 Q Quality of Life, 305, 315 Quinidine, 191, 252, 305 Quinine, 191, 252, 305 R Race, 261, 287, 305 Radiation therapy, 174, 183, 266, 275, 279, 305 Radioactive, 242, 245, 275, 277, 279, 283, 293, 305, 306, 309 Radiolabeled, 13, 305 Radiological, 297, 305 Radiopharmaceutical, 269, 306 Radiotherapy, 245, 305, 306 Randomized, 17, 31, 32, 35, 42, 45, 51, 67, 68, 80, 81, 97, 103, 111, 262, 306 Randomized clinical trial, 31, 32, 306 Ranitidine, 191, 306 Reactivation, 34, 306 Reactive Oxygen Species, 37, 41, 44, 47, 54, 93, 122, 306 Receptors, Nicotinic, 293, 306 Receptors, Serotonin, 306, 311 Recombinant, 26, 28, 244, 306, 322 Reconstitution, 61, 306 Recovery Room, 158, 306 Rectum, 245, 260, 268, 269, 277, 281, 303, 306 Recurrence, 125, 244, 306 Red blood cells, 265, 306, 309, 312 Red Nucleus, 241, 306 Reentry, 18, 307 Refer, 1, 253, 268, 269, 274, 279, 283, 290, 292, 304, 307, 310, 323 Reflex, 7, 10, 166, 307 Refractory, 55, 82, 182, 262, 307 Regeneration, 268, 306, 307 Regimen, 19, 262, 307 Rehabilitative, 51, 307 Relative Biological Effectiveness, 133, 307 Reliability, 20, 307 Remission, 244, 306, 307 Reperfusion, 14, 15, 17, 29, 30, 41, 44, 46, 47, 48, 50, 62, 64, 74, 116, 290, 307 Reperfusion Injury, 14, 48, 307 Reproductive cells, 270, 307 Resection, 67, 111, 131, 307 Reserpine, 114, 115, 307 Resorption, 275, 307
342 Hypothermia
Respiration, 29, 62, 145, 166, 178, 239, 248, 251, 256, 288, 307, 308 Respirator, 285, 308, 323 Respiratory distress syndrome, 70, 308 Respiratory failure, 63, 267, 308, 323 Respiratory Physiology, 308, 315, 322 Restoration, 30, 47, 63, 74, 103, 290, 306, 307, 308, 324 Retina, 256, 295, 308, 324 Retinal, 260, 295, 308, 324 Retinoids, 191, 308 Retinopathy, 191, 299, 308 Retrograde, 16, 60, 103, 180, 308 Retrospective, 38, 101, 104, 308 Retrospective study, 104, 308 Reverberant, 260, 308 Rheumatism, 276, 308 Ribose, 48, 66, 92, 234, 308 Rigidity, 154, 280, 284, 297, 299, 308 Risk factor, 4, 29, 88, 100, 111, 132, 249, 264, 308 Rod, 252, 308 Ryanodine, 54, 308 S Salicylate, 309 Salicylic, 309 Salicylic Acids, 309 Saline, 50, 103, 143, 170, 173, 309 Salivary, 258, 260, 267, 309 Salivary glands, 258, 260, 267, 309 Saphenous, 256, 309 Saphenous Vein, 256, 309 Saponins, 309, 314 Sarcoma, 123, 165, 309 Sarcoplasmic Reticulum, 54, 309 Satellite, 196, 294, 309 Scans, 53, 309 Schizoid, 309, 324 Schizophrenia, 16, 286, 309, 324 Schizotypal Personality Disorder, 309, 324 Sclera, 255, 309 Sclerosis, 164, 240, 280, 289, 309 Screening, 252, 309 Second Messenger Systems, 292, 310 Secondary tumor, 286, 310 Secretion, 165, 252, 274, 279, 281, 298, 306, 310 Secretory, 192, 291, 310, 316 Sedative, 22, 38, 158, 242, 274, 287, 310 Segregation, 252, 310 Seizures, 3, 14, 38, 130, 156, 259, 310
Selective estrogen receptor modulator, 310, 317 Semen, 303, 310 Semisynthetic, 288, 310 Senile, 295, 310 Sensitization, 28, 116, 310 Sensor, 54, 156, 177, 310 Sepsis, 160, 310 Septum, 241, 290, 310 Sequencing, 63, 310 Serotonin, 6, 9, 12, 38, 105, 126, 239, 246, 259, 268, 306, 307, 310, 311, 320 Serotonin Agonists, 311 Serotonin Antagonists, 126, 311 Serous, 264, 311 Serum, 81, 237, 253, 254, 306, 311, 320 Sex Characteristics, 234, 311 Sharpness, 311, 324 Shivering, 79, 114, 144, 151, 230, 311, 317 Shock, 22, 28, 34, 59, 73, 94, 104, 121, 152, 158, 160, 180, 182, 193, 232, 283, 311, 320 Side effect, 55, 64, 154, 165, 176, 192, 193, 205, 234, 235, 236, 239, 244, 257, 311, 315, 319 Signal Transduction, 6, 10, 16, 177, 247, 311 Skeletal, 11, 54, 252, 305, 309, 311, 320 Skeleton, 233, 281, 302, 311 Skull, 155, 257, 280, 311, 317 Sleep apnea, 162, 311 Sludge, 191, 312 Small intestine, 243, 261, 274, 276, 279, 312, 323 Smoke Inhalation Injury, 267, 312 Smooth muscle, 236, 237, 247, 255, 274, 289, 312, 315 Snoring, 162, 312 Social Support, 312, 314 Sodium, 45, 87, 191, 206, 305, 312, 315 Soft tissue, 83, 245, 311, 312 Solid tumor, 29, 59, 237, 261, 312 Solvent, 265, 271, 295, 312 Soma, 305, 312 Somatic, 11, 151, 165, 234, 249, 286, 288, 298, 312, 322 Somatic cells, 151, 249, 286, 288, 312 Sorbitol, 285, 312 Sound wave, 254, 312 Specialist, 220, 257, 260, 312 Species, 11, 12, 48, 58, 265, 274, 286, 287, 288, 295, 305, 306, 312, 313, 315, 319, 320, 324
Index 343
Specificity, 5, 26, 165, 235, 312 Sperm, 252, 307, 313, 320 Spermatids, 313 Spermatocytes, 25, 313 Spermatogonia, 313 Spermidine, 313 Spermine, 138, 313 Spinal Cord Injuries, 192, 313 Spinal Cord Ischemia, 117, 313 Spleen, 258, 284, 313 Splenectomy, 123, 313 Splenomegaly, 5, 313 Staging, 309, 313 Stagnation, 313, 319 Staphylococcus, 288, 313 Steel, 252, 313 Stent, 172, 313 Sterility, 257, 278, 313 Steroid, 115, 309, 313 Stimulant, 247, 259, 274, 287, 314, 316 Stimulus, 34, 58, 122, 255, 261, 262, 266, 278, 279, 280, 282, 307, 314, 318 Stomach, 233, 241, 260, 265, 269, 274, 279, 282, 291, 297, 298, 312, 313, 314 Stool, 277, 282, 314 Strand, 300, 314 Stress management, 59, 314 Stroke Volume, 151, 248, 314 Stroma, 280, 297, 314 Stromal, 34, 314 Stupor, 282, 290, 314 Styrene, 182, 314 Subacute, 6, 278, 314 Subarachnoid, 31, 75, 83, 91, 96, 104, 107, 122, 127, 132, 145, 172, 272, 280, 314 Subclavian, 71, 242, 245, 281, 314 Subclavian Artery, 71, 242, 314 Subclavian Vein, 242, 245, 281, 314 Subclinical, 278, 310, 314 Subcutaneous, 83, 107, 173, 234, 262, 294, 315 Subiculum, 274, 315 Subspecies, 312, 315 Substance P, 265, 286, 306, 310, 315 Substrate, 10, 22, 60, 62, 315 Sulfur, 152, 261, 287, 315 Sulfur Hexafluoride, 152, 315 Superior vena cava, 180, 245, 315 Superoxide, 15, 41, 315 Superoxide Dismutase, 15, 41, 315 Supplementation, 48, 62, 315 Supportive care, 33, 315
Suppression, 16, 26, 145, 315 Supraventricular, 59, 315 Survival Rate, 27, 133, 295, 315 Sweat, 192, 276, 298, 315 Sweat Glands, 192, 315 Sympathectomy, 192, 315 Sympathetic Nervous System, 10, 241, 292, 315, 316 Sympathomimetic, 259, 261, 265, 287, 293, 316 Symphysis, 303, 316 Symptomatic, 131, 238, 296, 316 Synapses, 291, 292, 316 Synapsis, 316 Synaptic, 29, 38, 63, 293, 311, 316 Synaptic Transmission, 293, 316 Synergistic, 21, 116, 316 Syringomyelia, 192, 316 Systemic disease, 192, 316 Systemic lupus erythematosus, 68, 316 Systems Analysis, 78, 316 Systolic, 44, 276, 316 T Tachycardia, 32, 230, 242, 316 Tachypnea, 242, 316 Tacrine, 191, 316 Tamoxifen, 191, 310, 317 Tardive, 239, 317 Telencephalon, 243, 317 Temazepam, 72, 317 Temporal, 6, 13, 18, 38, 46, 57, 60, 236, 274, 285, 317, 320 Temporal Lobe, 38, 236, 317 Tetracycline, 288, 317 Tetrahydrocannabinol, 13, 121, 247, 317 Thalamic, 14, 39, 241, 317 Thalamic Diseases, 241, 317 Thalamus, 14, 156, 246, 260, 317 Therapeutics, 207, 317 Thermogenesis, 11, 110, 317 Thermoregulation, 11, 61, 138, 160, 317 Thigh, 267, 271, 317 Third Ventricle, 276, 317 Thoracic Surgery, 71, 91, 93, 98, 104, 119, 123, 126, 145, 318 Thorax, 130, 197, 233, 284, 315, 318, 322 Threshold, 144, 266, 276, 318 Thrombin, 267, 300, 303, 318 Thrombocytes, 300, 318 Thrombocytopenia, 97, 236, 318 Thrombolytic, 64, 318 Thrombomodulin, 303, 318
344 Hypothermia
Thromboplastin, 231, 318 Thrombosis, 72, 170, 243, 280, 303, 314, 318 Thrombus, 75, 144, 196, 257, 278, 281, 290, 300, 318 Thyroid, 11, 62, 110, 160, 191, 231, 318, 321 Tidal Volume, 276, 318 Time Management, 314, 318 Tissue Culture, 26, 318 Tissue Survival, 178, 318 Tolerance, 7, 8, 13, 19, 20, 22, 26, 38, 58, 61, 65, 72, 116, 120, 124, 128, 177, 233, 270, 318 Tonic, 248, 256, 318 Tonsils, 162, 318 Tooth Preparation, 233, 318 Topical, 73, 115, 116, 206, 265, 275, 319 Torpor, 11, 319 Torsion, 278, 319 Toxic, iv, 37, 55, 191, 252, 258, 264, 277, 292, 293, 312, 314, 319 Toxicity, 52, 55, 86, 133, 261, 285, 319, 323 Toxicology, 13, 58, 115, 214, 231, 319 Toxins, 238, 263, 270, 278, 319 Tracer, 315, 319 Trachea, 246, 282, 285, 298, 318, 319 Traction, 252, 319 Transcription Factors, 30, 34, 59, 319 Transcutaneous, 123, 195, 319 Transduction, 7, 16, 165, 311, 319 Transfection, 244, 319 Transfusion, 5, 115, 126, 319 Transient Ischemic Attacks, 135, 144, 319 Transitional cells, 60, 319 Translation, 265, 319 Translational, 15, 28, 319 Translocation, 41, 265, 319 Transmitter, 63, 233, 241, 261, 266, 280, 285, 293, 316, 319 Transplantation, 5, 21, 48, 49, 90, 96, 126, 277, 319 Triage, 5, 320 Tricuspid Atresia, 256, 320 Tricyclic, 259, 320 Trigeminal, 34, 285, 320 Trigeminal Ganglion, 34, 320 Trigeminal Nerve, 320 Trigger zone, 239, 320 Troglitazone, 5, 191, 320 Tropomyosin, 289, 320 Troponin, 61, 289, 320 Tryptophan, 253, 310, 320
Tuberculosis, 255, 281, 284, 309, 320 Tuberculostatic, 281, 320 Tubulin, 287, 320 Tumor marker, 244, 320 Tumor Necrosis Factor, 37, 320 Tumour, 114, 122, 269, 321 Tunica Intima, 263, 321 Turbinates, 162, 321 Tyrosine, 127, 261, 321 U Ulcer, 196, 321 Ultrafiltration, 17, 273, 321 Ultrasonography, 196, 321 Unconscious, 232, 237, 241, 258, 276, 321 Univalent, 275, 296, 321 Uraemia, 296, 321 Urea, 315, 321 Uremia, 4, 281, 321 Ureter, 283, 321 Urethra, 303, 321, 322 Urinary, 247, 252, 275, 277, 294, 321, 322 Urinary tract, 321, 322 Urinate, 322, 324 Urine, 244, 257, 261, 277, 294, 321, 322 Urology, 92, 103, 131, 193, 322 Uterus, 162, 251, 292, 302, 322 Uvula, 312, 322 V Vaccination, 5, 40, 322 Vaccine, 303, 322 Vagal, 156, 322 Vagus Nerve, 156, 322 Valves, 180, 322, 323 Vascular Resistance, 236, 243, 322 Vasculitis, 296, 322 Vasoconstriction, 9, 73, 154, 265, 322 Vasodilatation, 119, 322 Vasodilation, 9, 84, 154, 322 Vasodilator, 236, 246, 261, 274, 290, 293, 298, 322 Vector, 319, 322 Vegetative, 45, 51, 322 Vein, 86, 174, 180, 237, 240, 280, 293, 297, 309, 314, 315, 322 Vena, 174, 322 Venous, 145, 149, 170, 171, 180, 240, 242, 243, 246, 250, 282, 294, 303, 320, 322 Venous blood, 170, 246, 250, 282, 322 Ventilation, 166, 248, 265, 322, 323 Ventilator, 153, 285, 308, 323 Ventricle, 184, 236, 241, 256, 274, 304, 305, 316, 317, 320, 323
Index 345
Ventricular, 32, 44, 93, 95, 115, 147, 151, 163, 236, 256, 262, 275, 290, 320, 323 Ventricular Dysfunction, 262, 323 Ventricular fibrillation, 32, 95, 163, 323 Ventricular Pressure, 44, 323 Ventriculostomy, 55, 323 Venules, 245, 247, 264, 287, 323 Vertebrae, 181, 279, 313, 323 Vesicular, 274, 323 Vestibular, 272, 323 Vestibule, 253, 291, 323 Veterinary Medicine, 213, 323 Villi, 275, 323 Vinca Alkaloids, 323 Vincristine, 124, 320, 323 Vinyl Chloride, 191, 323 Viral, 34, 101, 165, 183, 184, 233, 263, 278, 319, 323 Viral vector, 165, 323 Virulence, 241, 319, 324 Virus, 5, 34, 165, 242, 250, 270, 299, 319, 323, 324 Viscera, 286, 312, 324 Visceral, 242, 322, 324 Visceral Afferents, 242, 322, 324
Viscosity, 233, 245, 324 Visual Acuity, 34, 324 Vitreoretinal, 315, 324 Vitro, 273, 324 Vivo, 10, 55, 62, 184, 324 Void, 42, 324 W White blood cell, 4, 238, 244, 252, 282, 284, 288, 293, 299, 324 Windpipe, 298, 318, 324 Withdrawal, 7, 8, 20, 54, 61, 160, 259, 324 Womb, 322, 324 Wound Healing, 268, 324 Wound Infection, 95, 201, 324 Wounds, Gunshot, 313, 324 X Xenograft, 29, 237, 324 X-ray, 60, 151, 231, 249, 254, 268, 269, 285, 293, 305, 306, 309, 324 Y Yeasts, 269, 298, 324 Z Zygote, 254, 324 Zymogen, 303, 325
346 Hypothermia
Index 347
348 Hypothermia
