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

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

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Methylprednisolone: 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: 0-597-84497-6 1. Methylprednisolone-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on methylprednisolone. 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 METHYLPREDNISOLONE ........................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Methylprednisolone....................................................................... 8 E-Journals: PubMed Central ....................................................................................................... 25 The National Library of Medicine: PubMed ................................................................................ 26 CHAPTER 2. NUTRITION AND METHYLPREDNISOLONE ................................................................. 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Methylprednisolone ..................................................................... 61 Federal Resources on Nutrition ................................................................................................... 64 Additional Web Resources ........................................................................................................... 64 CHAPTER 3. DISSERTATIONS ON METHYLPREDNISOLONE ............................................................. 67 Overview...................................................................................................................................... 67 Dissertations on Methylprednisolone .......................................................................................... 67 Keeping Current .......................................................................................................................... 67 CHAPTER 4. CLINICAL TRIALS AND METHYLPREDNISOLONE ....................................................... 69 Overview...................................................................................................................................... 69 Recent Trials on Methylprednisolone .......................................................................................... 69 Keeping Current on Clinical Trials ............................................................................................. 71 CHAPTER 5. PATENTS ON METHYLPREDNISOLONE........................................................................ 73 Overview...................................................................................................................................... 73 Patents on Methylprednisolone ................................................................................................... 73 Patent Applications on Methylprednisolone................................................................................ 78 Keeping Current .......................................................................................................................... 80 CHAPTER 6. BOOKS ON METHYLPREDNISOLONE ........................................................................... 81 Overview...................................................................................................................................... 81 Chapters on Methylprednisolone ................................................................................................. 81 CHAPTER 7. PERIODICALS AND NEWS ON METHYLPREDNISOLONE ............................................. 85 Overview...................................................................................................................................... 85 News Services and Press Releases................................................................................................ 85 Newsletter Articles ...................................................................................................................... 87 Academic Periodicals covering Methylprednisolone.................................................................... 88 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 89 Overview...................................................................................................................................... 89 U.S. Pharmacopeia....................................................................................................................... 89 Commercial Databases ................................................................................................................. 90 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 95 Overview...................................................................................................................................... 95 NIH Guidelines............................................................................................................................ 95 NIH Databases............................................................................................................................. 97 Other Commercial Databases....................................................................................................... 99 APPENDIX B. PATIENT RESOURCES ............................................................................................... 101 Overview.................................................................................................................................... 101 Patient Guideline Sources.......................................................................................................... 101 Finding Associations.................................................................................................................. 106 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 109 Overview.................................................................................................................................... 109 Preparation................................................................................................................................. 109 Finding a Local Medical Library................................................................................................ 109 Medical Libraries in the U.S. and Canada ................................................................................. 109

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ONLINE GLOSSARIES................................................................................................................ 115 Online Dictionary Directories ................................................................................................... 115 METHYLPREDNISOLONE DICTIONARY............................................................................. 117 INDEX .............................................................................................................................................. 183

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

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

Asthma and Impotence: The Story of an Unexpected Connection Source: JAAPA. Journal of the American Academy of Physician Assistants. 13(6): 59-60, 62, 68, 70. June 2000. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: In this case report, the author describes a man who was seeking relief of a debilitating respiratory illness (asthma) who also told his primary care clinician that he was deeply concerned about his erectile dysfunction (ED, formerly called impotence). The author explores the etiology (causes) of ED, including vascular, endocrinologic, neurologic, drug induced, psychological, or traumatic. The author notes that, in

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Methylprednisolone retrospect, it was clearly inappropriate to refer this patient to an internist. Instead, the primary care clinician should have taken a complete history and performed a physical examination. The workup for ED is fairly straightforward and can be started by a primary care provider. The workup should include history, physical examination, and laboratory tests, as well as investigation of the patient's relationship with his sexual partner. Many treatment options are available, including systemic drug therapy or adjustment of ongoing drug therapy, surgical intervention, and mechanical devices to simulate physiologic erections. In the patient described in the case report, it was concluded that primary hypogonadism was the patient's underlying condition. The methylprednisolone prescribed for his asthma probably activated the androgen receptors, and this improved his ED. 3 tables. 19 references.

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Effect of Race and Immunosuppression in Renal Transplantation: Three-Year Survival Results from a US Multicenter, Randomized Trial Source: Transplantation Proceedings. 30(4): 1355-1358. June 1998. Contact: Available from Appleton and Lange. P.O. Box 86, Congers, NY 10920-0086. (203) 406-4623. Summary: It is often reported that African American kidney transplant recipients have higher rates and more severe episodes of acute rejection and poorer graft survival compared with other racial groups. This article reports on a study that compared the results at 3 years posttransplant of tacrolimus (Prograf) based versus cyclosporine (Sandimmune) based immunosuppression in African American and Caucasian patients who received a cadaveric kidney transplant. Of the 412 patients enrolled, 104 (25.2 percent) were African American and 237 (57.5 percent) were Caucasian. All rejection episodes were treated similarly for patients in both treatment groups (methylprednisolone 7 mg per kg intravenous for 3 days followed by oral prednisone taper). Information on patient and graft survival was available for all patients up to 3 years posttransplant or time of death. Three year patient survival was 89.3 percent and 91.7 percent in African Americans treated with tacrolimus and cyclosporine, respectively; corresponding rates in Caucasian patients were 92.1 percent and 91 percent, respectively. The causes of death were similar between treatment groups and race. Three year graft survival was 82.1 percent and 75.9 percent for African Americans treated with tacrolimus and cyclosporine, respectively; corresponding rates for Caucasians were 80.7 percent and 74.5 percent, respectively. The number of graft failures (graft loss excluding death) was higher in the cyclosporine treated patients, regardless of race. Graft failure due to rejection was lower in tacrolimus treated African American patients (7.1 percent) compared to cyclosporine patients (18.8 percent). The data continue to show that African American patients require higher doses of tacrolimus to achieve blood levels comparable to Caucasian patients. The higher doses, however, did not result in an increase in the occurrence of malignancies or opportunistic infections in the long term. The study will be continued, following patients through 5 years posttransplant. 2 figures. 2 tables. 5 references. (AA-M).

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Treatment of Lupus Nephritis Source: Seminars in Nephrology. 20(3): 265-276. May 2000. Contact: Available from W.B. Saunders Company. Periodicals Department. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: Patients with lupus nephritis pose a therapeutic challenge and stimulate investigation of innovative treatment strategies. This article reviews those current and

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potential strategies that may optimize management of lupus nephritis. The clinical presentations of lupus nephritis can vary from asymptomatic hematuria (blood in the urine) or proteinuria (protein in the urine) to acute nephritic or nephrotic syndromes and from rapidly progressive glomerulonephritis to insidious chronic renal insufficiency. Although patient survival and renal function outcomes have improved over the last 4 decades, contemporary immunosuppressive regimens are not consistently effective and often require extended courses (resulting in negative drug effects and toxicity). Several strategies are under investigation to induce remissions more rapidly and to reduce the risk of long courses of cytotoxic drug therapy. The combination of pulse methylprednisolone and pulse cyclophosphamide may be more effective than pulse cyclophosphamide alone for patients with relatively severe proliferative lupus nephritis. A particularly vigorous strategy employs immunoablative cyclophosphamide, with or without stem cell rescue. Several studies of sequential immunosuppressive therapy are in progress. It is anticipated that long term toxicities can be lessened by substituting various maintenance agents (e.g., azathioprine or mycophenolate mofetil) after initial cyclophosphamide therapy has induced a renal responses. Innovative approaches (e.g., costimulatory blockade) offer the hope of more effective treatments without the risks of contemporary regimens. 2 figures. 2 tables. 88 references. •

Membranoproliferative Glomerulonephritis in Childhood: Factors Affecting Prognosis Source: International Urology and Nephrology. 29(6): 711-716. 1997. Contact: Available from VSP, P.O. Box 346, 3700 AH Zeist, The Netherlands. 31306925790. Fax 31306932081. E-mail: [email protected]. Summary: This article describes a study undertaken to identify the factors affecting prognosis in membranoproliferative glomerulonephritis (MPGN) in childhood. MPGN is a distinctive form of chronic glomerulonephritis with a 15 to 67 percent progression to end stage renal disease (ESRD). The study examined 64 male and 32 female pediatric patients diagnosed with MPGN from 1975 to 1995. Their age range was 2 to 17 years. All patients initially received oral corticosteroid therapy. Remission was achieved in 22.9 percent. The unresponsive 77.1 percent received either cyclophosphamide or pulse methylprednisolone, and 25.4 percent and 50.0 percent of these patients entered complete remission, respectively. The overall 1 year renal survivals of the MPGN patients were 90.1 percent, and 5 year and 10 year survival rates were 81.9 percent and 61 percent, respectively. At multivariate analysis, the factors affecting renal prognosis were hematuria (blood in the urine) at presentation and low hemoglobin values. The article suggests that more aggressive immunosuppressive therapy should in instituted in patients unresponsive to steroids and that the aforementioned risk factors are higher for the development of renal failure. 2 figures. 2 tables. 8 references.

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Tonsillectomy and Steroid Pulse Therapy Significantly Impact on Clinical Remission in Patients with IgA Nephropathy Source: American Journal of Kidney Diseases. 38(4): 736-743. October 2001. Contact: Available from W.B. Saunders Company. Periodicals Department, 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Summary: This article reports on a retrospective investigation of kidney (renal) outcome in 329 patients with immunoglobulin A (IgA) nephropathy (kidney disease) with an observation period longer than 36 months in the authors' renal unit between 1977 and

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Methylprednisolone 1995. Clinical remission, renal progression, and the impact of covariates were estimated. In 157 of 329 patients (48 percent), disappearance of urinary abnormalities (clinical remission) was obtained. None of these 157 patients showed progressive deterioration, defined as a 50 percent increase in serum creatinine (Scr) level from baseline, during the observation period. Conversely, in patients without clinical remission, the estimate of probability of progressive deterioration was 21 percent (plus or minus 5 percent) at 10 years. In the multivariate Cox regression model with 13 independent covariates, initial Scr level, histological score, tonsillectomy, and high dose methylprednisolone therapy had a significant impact on clinical remission, whereas proteinuria, age, sex, levels of hematuria, blood pressure, conventional steroid therapy, ACE inhibitor therapy, and cyclophosphamide therapy had no significant effect. These findings indicate that interventions aimed at achieving clinical remission have provided encouraging results applicable to managing patients with IgA nephropathy. 7 figures. 3 tables. 27 references.

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Treatment of Focal Segmental Glomerulosclerosis Source: Seminars in Nephrology. 20(3): 309-317. May 2000. Contact: Available from W.B. Saunders Company. Periodicals Department. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452. Summary: This article reviews the treatment of focal segmental glomerulosclerosis (FSGS), a problem that has been increasing in incidence over the past 2 decades that may currently be the most common form of primary nephrotic syndrome in the United States. Nephrotic patients with FSGS who do not achieve a remission in proteinuria (protein in the urine) usually advance to end stage renal disease (ESRD) within 5 to 10 years. Although initially felt to be a steroid resistant disease, especially in adults, recent studies show significant responsiveness to more prolonged courses of steroids. For patients with steroid resistant or steroid dependent FSGS, cyclosporine A and cytotoxic agents have been shown to be effective in clinical trials. Other agents used include pulse methylprednisolone, azathioprine, tacrolimus, mycophenolate mofetil, and combination therapy. For recurrent FSGS after kidney transplantation, plasmapheresis is often used but appears not to be as efficacious in adults as in the pediatric population. 3 tables. 89 references.

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Ulcerative Duodenitis with Ulcerative Colitis: Is It Crohn's Disease Or Really Ulcerative Colitis? (editorial) Source: Journal of Clinical Gastroenterology. 32(2): 97. February 2001. Contact: Available from Lippincott Williams and Wilkins, Inc. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300. Summary: This editorial comments on an accompanying article in which two patients present the dilemma in differentiating between Crohn's disease and ulcerative colitis (the two subtypes of inflammatory bowel disease, IBD). The first case was that of a man, 31, with a history of left sided colitis who subsequently developed erosive duodenitis responsive to methylprednisolone. The second case was that of a woman, 30, with pancolitis who was admitted for closure of an ileostomy after a staged subtotal proctocolectomy with ileoproctostomy and diverting ileostomy. Her hospital course was complicated by the development of ulcerative duodenitis, again responsive to methylprednisolone. Crohn's disease may involve the stomach, the duodenum, or both, usually in conjunction with a more distal disease, although this is not always the case. Ulcerative colitis, on the other hand, is a disease of the colon almost always involving the rectum. The authors conclude that upper gastrointestinal tract inflammation (such as

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duodenitis) warrants further observation and maximum documentation to sustain the issue of whether ulcerative colitis can involve the upper gastrointestinal tract. They note that there might be a third type of IBD, whether occurring from a separate origin or arising from conversion of one type of IBD to the other. 8 references. •

Joint and Soft-tissue Injection Source: Postgraduate Medicine. 103(2):125-128,130-134; February 1998. Summary: This journal article for health professionals presents guidelines for when and how to use steroid-injection therapy and what cautions to use to avoid complications. Diseases commonly treated by joint injection include inflammatory arthritis, crystalline arthritis, and osteoarthritis. Corticosteroid injections may be used to treat various localized musculoskeletal disorders and systemic inflammatory conditions. Although cortisone was the first agent used for joint injection, more potent and less soluble agents are now available, including triamcinolone hexacetonide and methylprednisolone. Definite contraindications to intra-articular corticosteroid injections include suspected infection, bacteremia, the presence of a prosthetic joint, and preceding injury or fracture. Although efficacy is difficult to establish, studies have found that joint injection is effective in rheumatoid arthritis, other forms of inflammatory and crystalline arthritis, tendinitis, and bursitis. Possible complications of corticosteroid injections include adrenal suppression, iatrogenic infection, hemarthrosis, postinjection exacerbation of inflammation, steroid arthropathy, soft-tissue atrophy, and pigmentation changes in the overlying skin. 15 references, 8 figures, and 3 tables.

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Bilateral Temporal Arteritis Source: Journal of the American Academy of Dermatology. 46(2): S14-S15. February 2002. Summary: This journal article provides health professionals with information on bilateral temporal arteritis. Temporal arteritis is a giant cell arteritis that affects large or medium sized elastic arteries. Often, only one temporal artery is affected. The article presents the case of a 68 year old woman who had both temporal arteries involved simultaneously. The woman had a sudden onset of pain in her left temporal region, and, a few days later, the same symptoms occurred on the other side as well. The woman was treated with methylprednisolone at an initial dose of 120 milligrams per day. The dose was tapered, and after 2 weeks, erythrocyte sedimentation rate and C-reactive protein were normal and the clinical findings abated. The article briefly discusses the cause, clinical manifestations, and treatment of bilateral temporal arteritis. 2 figures and 10 references. (AA-M).

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Connective Tissue Disease Update: Focus on Dermatomyositis Source: Consultant. 39(10): 2867-2870,2872,2875. October 1999. Summary: This journal article, the final part of a three part series on connective tissue diseases, provides health professionals with information on the manifestations, pathogenesis, diagnosis, and treatment of dermatomyositis. Dermatomyositis and polymyositis are the two most common idiopathic inflammatory diseases of muscle. Although their cause remains unknown, hypotheses focus on an autoimmune reaction, a viral infection, and a drug reaction. The cutaneous lesions of dermatomyositis are pathognomonic and are nearly always present by the time proximal muscle weakness manifests itself. Macular or papular erythematous lesions overlying the bony prominences of the elbows, knees, and knuckles occur in 70 percent of patients.

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Methylprednisolone Another, although more subtle, marker of dermatomyositis is an erythematous blush around the eyes. Gastrointestinal, musculoskeletal, cardiovascular, and pulmonary manifestations may also occur. Diagnostic tests include measurement of serum creatine kinase and various antibody levels, electromyography, and muscle biopsy. The mainstay of therapy is systemic corticosteroids, such as prednisone in a single daily dose of 1 to 2 milligrams (mg)/kilogram. For patients whose condition fails to respond to therapy, physicians should consider high dose or pulse therapy with methylprednisolone, especially for patients who have juvenile dermatomyositis. Azathioprine may be used as an adjunct to glucocorticoid therapy. Alternatives for adults with disease refractory to glucocorticoids include 40 to 50 mg of methotrexate once a week for 6 to 10 weeks, intravenous gamma globulin, and antimalarials such as 250 to 500 mg/day of chloroquine and 200 to 400 mg/day of hydroxychloroquine. Physical therapy to restore muscle strength and function is imperative. 2 figures, 3 tables, and 17 references. (AA-M).

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

Project Title: ALTERATIONS IN ENDOTHELIAL CELL METABOLISM DURING HEART TRANSPLANT REJECTION Principal Investigator & Institution: Revkin, James H.; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002 Summary: Heart transplantation is now an acceptable treatment alternative for select patients with end-stage heart disease. The five year survival for transplant recipients is over 70%. Unfortunately up to 40% of these transplant recipients will develop transplant coronary artery disease, a vasculopathy which is diffuse but generally remains undetected until its late states. It may be a form of chronic vascular rejection and when present, ultimately results in left ventricular dysfunction and failure of the graft. The investigators plan to test the hypothesis that vascular tissue, in particular endothelial cells, will reveal abnormalities in metabolism during heart transplant rejection, despite

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

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preserved coronary perfusion. The multiple indicator dilution technique will be used to assess adenosine uptake in an isolated rat heterotopic heart transplant preparation. The investigators will compare the endothelial adenosine flux in control syngeneic heart allografts to that of allogeneic rejecting heart allografts. Adenosine flux will also be assessed in a group of allogeneic heterotopic heart transplants from rats treated with cyclosporine and methylprednisolone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CALPAIN IN THE PATHOPHYSIOLOGY OF DEMYELINATING DISEASE Principal Investigator & Institution: Banik, Naren L.; Professor; Neurology; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2002; Project Start 01-JUL-1999; Project End 30-JUN-2004 Summary: (Verbatim from the Applicant's Abstract) Multiple Sclerosis (MS) is a debilitating autoimmune demyelinating disease, which leads to paralysis and other functional disabilities. The factors responsible for myelin destruction in MS are not clearly understood. Thus, a pathophysiological/therapeutic study to minimize or prevent myelin damage and maximize functional recovery is warranted. Findings from animals with experimental allergic encephalomyelitis (EAE), an animal model for MS, demonstrate increased calpain activity and expression concomitant with myelin protein degradation in the CNS signifying a pivotal role for calpain in the mechanism of myelin breakdown. Using calpain inhibitors and methylprednisolone (MP) alone and in combination as therapeutic agents could inhibit myelin protein degradation, protect oligodendrocytes, and delay or prevent development of the disease. In this project, we will focus our studies on the following specific aims: 1. Define the time-course of calpain expression and activity in the spinal cord and spleen/lymph nodes in animals with EAE. 2. Examine the effects of calpain inhibitors and anti-inflammatory agents affecting myelin protein degradation which could delay or prevent the development of EAE. 3. Study the role of calpain in the induction of apoptosis in vitro in neural cells and how calpain inhibitors affect apoptotic death in glial/inflammatory cells in EAE. To support these specific aims, the following experiments are proposed: 1) Determine calpain/calpapstatin activity, expression (mRNA, protein), and the specific cellular localization (by double immunofluorescence staining) in spinal cord and spleen/lymph nodes at various times after challenge; 2) Examine the effects of cell-permeable calpain inhibitors alone and in combination with methylprednisolone in EAE development; 3) Determine calpain/calpapstatin activity, expression, and cellular localization in treated verses untreated animals and correlate these findings with the extent and type of cell death in the CNS; 4) Determine the effects of cytokines on intracellular calcium levels, calpain activation, and apoptosis in glial cell cultures; 5) Examine calpain expression, activity, and secretion from activated MPP-specific T cells and determine immunogenicity of MBP peptides generated by these cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CLINICAL TRAILS IN PEDIATRIC RHEUMATOLOGY Principal Investigator & Institution: Lovell, Daniel J.; Professor; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, Oh 45229 Timing: Fiscal Year 2002; Project Start 01-APR-2000; Project End 31-MAR-2005 Summary: (Taken from the applicant's abstract): This application is focused on the performance of two prospective, multicentered trials in children with juvenile

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Methylprednisolone rheumatoid arthritis (JRA). In addition, this career development grant is intended to enhance the ability of many pediatric rheumatology centers in North America to perform trials to determine the efficacy and safety of currently used but untested and also newly developed drugs in children with JRA by increasing the ability of the principal investigator (PI) to focus on the direction and coordination of the efforts of the Pediatric Rheumatology Collaborative Study Group (PRCSG) of which the PI is the chairman. The PRCSG is a consortium of over 45 academic pediatric rheumatology centers that have performed over 30 trials in children with JRA. Trial 1: Osteopenia is a significant and frequent complication of JRA. This research proposal includes a prospective, randomized, multicenter, placebo-controlled trial (RCT) to determine the efficacy of daily oral calcium supplementation (1000 mg/day of calcium carbonate) for two years to increase total body bone mineral density (TB BMD) by 10% (1.5 SD) compared to placebo treatment. In addition, the persistence of the treatment effect will be determined for 1.5 years after the RCT. This will be the first longitudinal study of bone mineralization in JRA and the control group will demonstrate the natural history of bone mineralization. Trial 2: This research proposal also includes a prospective, randomized, actively controlled, open clinical trial to determine the efficacy of combination drug therapy to induce prolonged drug-free remission in children with severe systemic JRA (sJRA). Patients will be enrolled early in the disease course but eligibility criteria will select those with a 115% risk of developing severe, erosive polyarthritis. One therapy regimen is composed of intravenous methylprednisolone for 3 consecutive days, intravenous cyclophosphamide on the third day, and up to 20 mg/M2/wk of methotrexate. The second pulse therapy regimen is identical to the first, except no cyclophosphamide is given. Up to 5 cycles of these regimens may be given over a 9-month period. Patients in both groups may also receive background medications including 1 non-steroidal anti-inflammatory drug and up to 0.5 mg/kg/d of oral prednisone. The short and intermediate (0-18 months) safety of these treatment regimens will be compared. Long-term goals: 1. Assess the efficacy and safety of current and emerging pharmacologic and biologic treatments as adjunctive therapy to calcium in JRA patients with osteopenia. 2. Determine the long-term efficacy and safety of these treatment regimens in sJRA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CORTICOSEROID PHARMACODYNAMICS

PHARMACOKINETICS

AND

Principal Investigator & Institution: Jusko, William J.; Professor; Pharmaceutical Sciences; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2002; Project Start 01-JUL-1977; Project End 30-JUN-2005 Summary: Major factors determining corticosteroid receptor binding and pharmacodynamics will be measured and improved mathematical models for quantitating the pharmacokinetics and pharmacodynamics (PK/PD) of corticosteroids will be sought. These important drugs exert their hormonal, immunosuppressive, and anti-inflammatory effects by diffusion into cells, reversible binding to cytosolic receptors, and then either have direct effects on biochemical processes or produce inhibition or stimulation of gene/mRNA-mediated synthesis of diverse effector proteins or enzymes. Realistic and comprehensive PK/PD models of corticosteroid action are feasible which permit more mechanistic insights into drug, dosage, and interaction factors which determine their effects. One specific aim is to extend our current genemediated models of steroid PK/PD in rats (measuring steroid disposition, hepatic

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receptors and mRNA, and hepatic TAT mRNA and TAT enzyme) to account for chronic dose effects, which are often highly deleterious. The second aim is to generalize our "fourth-generation" receptor/gene PK/PD model for methylprednisolone to other steroids based on advanced QSAR principles and the expectation that alterations in pharmacokinetics and receptor binding will account for differences in responses. The third aim will be to evolve improved methods for assessing drug interactions for indirect response processes with focus on joint effects of prednisolone and COX-2 inhibitors. The fourth aim seeks to utilize quantitative gene array techniques to compare types and time patterns of suppression and enhanced expression of diverse genes altered by corticosteroids. These studies will improve the pharmacologic rationale of corticosteroid therapy as well as continue the generation of important pharmacodynamic models which apply to drugs causing effects by complex and indirect mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: D XYLOSE & METHYLPREDNISOLONE HYPERSENSITITIVITY VASTICULITIS

ABSORPTION

IN

Principal Investigator & Institution: Pachman, Lauren; Northwestern University Office of Sponsored Research Chicago, Il 60611 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DHEA IN RE-ESTABLISHING CONNECTIVITY AFTER SCI Principal Investigator & Institution: Compagnone, Nathalie A.; Ob, Gyn and Reproductive Scis; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 06-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Spinal cord injury (SCI) is devastating. Not only does it reduce the ability to move but also the ability to control bladder/bowel movements and sexual functions. It affects mostly young men since 60% of SCI victims are 30 year old or younger. Current treatment of SCI is unsuccessful and relies only on use of methylprednisolone, which is controversial since its outcome on functional recovery is poor. Hence the need for a better and safer treatment of SCI. To identify molecules that may be active in the re-establishment of connectivity in the injured spinal cord we have developed a strategy of identifying molecular cues involved in the organization of the developing spinal cord during embryogenesis. We have identified endogenously synthesized steroid compounds, neurosteroids, that are involved in the organization of the developing nervous system. We have demonstrated that the neurosteroid, DHEA, promotes motor neuron induction and enhances the axonal growth of neuronal populations participating in sensory-motor circuits during embryogenesis. This suggested that DHEA may be effective in regenerating the disrupted connections affected by SCI. To test this hypothesis we have developed a mouse model of moderate contusive SCI that mimics traumatism occurring in humans. Our preliminary results have established that DHEA promotes neurological recovery after moderate SCI. We are proposing to confirm these results and to establish the efficiency of DHEA in promoting regain of function by using both behavioral testing and histopathology, (aim 1). We will particularly determine if DHEA has neuroprotective properties toward motor neurons. In aim 2 we will determine the

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Methylprednisolone concentration of DHEA delivered to the injured spinal cord and if this level can be optimized by different therapeutic regimen. We will also determine if SCI modulates the neurosteroidogenesis and if treatment with DHEA further modifies neurosteroidogenesis along the time course of neurologic recovery. We will then determine the mechanisms by which DHEA affects locomotor recovery by studying axonal regeneration and sprouting within circuits that control movements (aim 3) and circuits that control non-voluntary contractile muscles such as the bladder (aim 4). Finally, since locomotor recovery does not only occur through axonal regrowth but rather derives from reducing the growth inhibition in the microenvironment proximal to the site of injury and since DHEA has been reported to control reactive microglia, we will study the effect of our treatment in the development of microglial inflammation and scar formation in both experimental groups (aim 5). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECTS OF NEFAZODONE ON HYPOTHALAMIC-PITUITARY ADRENAL AXIS Principal Investigator & Institution: Carson, Stanley; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ENDOGENOUS REPAIR MECHANISMS AFTER SPINAL CORD INJURY Principal Investigator & Institution: Bresnahan, Jacqueline C.; Professor and Associate Dean; Biomedical Informatics; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2002; Project Start 10-FEB-1999; Project End 31-JAN-2004 Summary: The final functional outcome of spinal cord injury (SCI) is the result of an interplay between secondary degenerative events and endogenous mechanisms of repair. We now know that the secondary injury process includes the induction of programmed cell death in both glia and neurons. We also know that there are substantial reparative events in the cord after injury that involve growth and trophic factors. Exciting new information on the stimulation of proliferating progenitor cells after injury to the CNS suggest that more repair may be possible than previously imagined. We have developed models of contusion spinal cord injury in rats that mimic some of the clinical features of SCI in man. Recovery occurs over time in the face of continuing apoptotic cell death. At the same time, ependymal zone cells as well as cells in the white proliferate and appear to contribute to repair at the lesion margins. In addition, new axonal growth can be seen entering the lesion area. Using these observations as a background, we will examine the effects of methylprednisolone (MP) and basic fibroblast growth factor (bFGF) on these cellular events after SCI. MP is the current Agold standard@ of clinical treatment of acute SCI, but its mechanisms of action are not fully understood. BFGF is a promising treatment for brain and spinal trauma that is likely to retard apoptosis and drive cellular proliferation of CNS progenitor cells. We will study recovery of function and the effects of MP and bFGF after both contusion and dorsal hemisection SCI using established behavior methods. We will examine the effect of these agents on apoptotic cell death of neurons and glia, and on cell proliferation and phenotypic expression. We will examine the effects of combination

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treatments on behavior and the regeneration of the corticospinal tract, which will be used a barometer of axonal growth in these two lesion types. The results are expected to provide further information on the biology of SCI as well as an assessment of potential therapies that could reach the clinic in a short time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HEMOSTASIS CONSORTIUM Principal Investigator & Institution: George, James N.; Professor of Medicine; Medicine; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This proposal describes the capacity of the University of Oklahoma Health Sciences Center and the University of Texas Southwestern Medical Center at Dallas to support a Core Clinical Center for the Transfusion Medicine/Hemostasis Clinical Research Network. Key personnel have expertise in hemostasis, transfusion medicine, protocol design, Clinical trial execution, and data analysis. Programs for mentoring trainees and junior faculty are described. Protocols are proposed that address important unresolved issues in hemostasis. Protocol 1: Initial management of patients with thrombotic thrombocytopenic purpura (TTP): plasma exchange treatment (standard therapy) compared to plasma exchange treatment plus high-dose glucocorticoid. Plasma exchange treatment has proven efficacy for TTP, however some patients have multiple exacerbations and require prolonged treatment. Glucocorticoids are of unproven efficacy, possibly because previously reported patients have heterogeneous etiologies. Recent observations that autoantibodies to von Willebrand factor-cleaving protease are the etiology for TTP in many patients provide a rationale for immunosuppressive treatment. It is hypothesized that high-dose glucocorticoid (methylprednisolone, 1,000 mg for 3 days followed by prednisone, 1 mg/kg/day) will improve clinical outcomes. Superior outcomes with glucocorticoid treatment would suggest further investigation of immunosuppressive regimens. Protocol 2: Initial management of children with idiopathic thrombocytopenic purpura (ITP): anti-D (standard therapy) compared to observation. The most controversial topic addressed by the American Society of Hematology (ASH) ITP Practice Guideline was the initial management of childhood ITP. The majority opinion of the ASH panel favored drug treatment over observation, consistent with recent surveys of the American Society of Pediatric Hematology/Oncology. However guidelines by the British Paedriatric Haematology Group recommend observation alone as appropriate initial management. Randomized clinical trials have demonstrated that the platelet count recovers more rapidly with treatment, but no studies have described the effect of drug treatment on clinical outcomes of bleeding and quality-of life. It is postulated that new episodes of severe bleeding will be equivalent between children treated with anti-D or managed by observation alone, and that the quality-of-life of children and their parents will be better when managed with observation alone. Equivalent clinical outcomes would support the practice of avoiding expensive treatment with potential harms and limited world-wide availability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MEDI507 IN TREATMENT OF GRADE II GRAFT VERSUS HOST DISEASE Principal Investigator & Institution: Laughlin, Mary; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106

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Methylprednisolone Timing: Fiscal Year 2002 Summary: The primary objective is to assess safety of four dose levels of MEDI-507 combined with methylprednisolone for initial treatment of at least grade II acute GVHD in stem cell or bone marow allograft recipients. The secondary objectives are: 1) To evaluate the effect of MEDI-507 administration on the absolute lymphocyte count and the dynamics of lymphocyte phenotypes CD3 and CD16(+)56(+) 2) To describe serum concentrations and pharmacokinetics of MEDI-507 in GVHD patients 3) To describe CD2 receptor occupancy by MEDI-507 4) To describe the change in organ stage and GVHD grade at 12,30,44,60, and 100 days following treatment 5) To describe the total dose of corticosteroids administered for 30 days 6) To describe MEDI-507 immunogenicity 7) To describe survival and the occurrence of chronic GVHD, opportunistic infections, malignancy and lymphoproliferative disorder until Study Day 364. Treatment: Study therapy consist of study drug (placebo or MEDI-507) administered with corticosteroids. Intravenous methylprednisolone (at least 2mg/kg/day) must be administered between eight and 24 hours prior to the initial study drug infusion and for at least 72 hours after initial receipt of study drug. Methylprednisolone (at least 2mg/kg/day) may be started up to 72 hours prior to receipt of study drug. An equivalent dose of oral or IV corticosteroid may be substituted for methylprednisolone 72 hours after initial study drug. The total duration of corticosteroid treatment must be at least ten days. The study drug will be administered intravenously on study Days 0,3,6, and 9. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: METHYLPREDNISOLONE TREATMENT IN ACUTE SPINAL CORD INJURY Principal Investigator & Institution: Hsu, Chung Y.; Professor and Head of Cerebrovascular d; Neurology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: (Verbatim from the Applicant's Abstract) Methylprednisolone (MP), a synthetic glucocorticoid (GC), is the only proven therapeutic agent for acute spinal cord injury (SCI). The therapeutic action of MP in SCI has been previously attributed to its antioxidant action. Tirilazad, a GC analog with more potent antioxidant action than MP but little GC activity, is less effective than MP in recent clinical SCI trials. This finding suggests that the therapeutic efficacy of MP in SCI may be more related to its GC activity than antioxidant action. An inflammatory reaction has been extensively documented after SCI. GCs including MP are among the most potent anti-inflammatory agents ever developed. The anti-inflammatory action of GC is mediated by a receptor mechanism involving a nuclear receptor, glucocorticoid receptor (GR). GC (ligand) binds to GR (receptor) forming an activated GR (aGR). aGR is a transcription factor serving dual and complimentary roles to confer a broad spectrum of anti-inflammatory actions: (1) binding to the nuclear glucocorticoid response element (GRE) to transactivate anti-inflammatory genes; and (2) inhibiting 2 key pro-inflammatory transcription factors, NF-B and AP-1, to transrepress pro-inflammatory genes. In contrast to the anti-inflammatory effects of GCs, the antioxidant action of MP or tirilazad does NOT involve a receptor mechanisms. This project is designed to explore the molecular mechanisms of MP action in SCI focusing on receptor-mediated events. We will test a central hypothesis that the therapeutic effect of MP in SCI is mediated at least in part by a receptor mechanism involving aGR. First, we will study antiinflammatory effects of MP in SCI involving aGR mediated events. Second, we will

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examine whether anti-inflammatory actions of MP in SCI can be blocked by a potent GR antagonist, RU486. Third, GR agonists with variable potencies will be tested for their effects on the post-traumatic inflammatory reaction. Fourth, the therapeutic significance of GR in SCI will be assessed by comparing MP effects with selected GR agonists and antagonists in functional and morphological outcome studies. The overall objective of this project is to establish that a receptor mechanism involving aGR contributes to the therapeutic effects of MP in SCI. The ultimate goal is to develop more effective therapeutic strategies for SCI based on a better understanding of the mechanism of MP action. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEUROPROTECTION BY A METALLOPORPHYRIN IN SPINAL INJURY Principal Investigator & Institution: Liu, Danxia; Associate Professor; Neurology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): Spinal cord injury (SCI) is a major health care issue, causing immense hardships to its victims and their families. The initial injury is worsened by secondary "autodestructive" processes caused by over production of harmful substances by injured cells. The PI's long-term focus in studying SCI is to identify endogenous toxic substances that cause secondary damage and to explore the pathways by which they cause cell death in order to develop therapeutic strategies to prevent such death. Methylprednisolone (MP) is the only drug approved for SCI treatment; however side effects limit its utility. Therefore it is urgent to discover more effective, less toxic therapeutic agents to reduce secondary injury. Reactive species (RS) identified as mediators of secondary injury after SCI induce cell death by two hypothesized pathways: 1) SCI-induced RS initiate oxidation of major cellular components, thereby destroying cells; 2) Other SCI-induced toxic agents (e.g. glutamate) induce RS formation, which in turn potentiate toxicity of non-RS toxins. Due to this feedback amplification mechanism, RS are produced longer after SCI than are some nonRS toxins; this provides a longer therapeutic window for scavenging RS. Mn (III) tetrakis (benzoic acid) porphyrin (MnTBAP), a novel superoxide dismutase mimetic and a broad spectrum RS scavenger, is cell permeable, active, stable, nontoxic, and scavenges superoxide anion, hydrogen peroxide, and peroxynitrite. It appears significantly superior to MP. The goal of this project is thus to explore the therapeutic potential of MnTBAP for SCI treatment and its mechanism of action in vivo. Specific Aim 1 is to explore the therapeutic potential and action site of MnTBAP to reduce secondary injury using a standard mechanical SCI model. The effect of MnTBAP will be compared with that of MP. The PI's group has demonstrated RS as initiators to induce oxidative damage and cell death. Specific Aims 2 and 3 will explore the role of RS as death signaling messengers to potentiate toxicity of non-RS toxins and the action site of MnTBAP in this hypothesized pathway. A novel overall secondary chemical injury model will be used. It separates secondary chemical events from initial mechanical injury by sampling extracellular death signals in the extracellular fluid of an injured rat spinal cord and administering them directly into the cord of an uninjured rat by a microcannula inserted laterally through the cords of both rats to induce secondary cell death. To explore the role of RS and effect of MnTBAP in delayed Glu toxicity, Glu will be administered at the SCI-induced concentration and duration into the rat spinal cord through a microdialysis fiber to induce cell death. The ability of MnTBAP to scavenge RS, prevent oxidation of proteins, DNA and membrane lipids, reduce activation of caspases and death of

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Methylprednisolone different types of cells, particularly by apoptosis, and ameliorate neurological dysfunction will be assessed by comparing the results of MnTBAP- and saline-treated experiments. Production of RS and biomarkers of oxidation will be measured by HPLC, visualized by fluorescent probes and specific antibodies. Apoptosis of each cell type will be characterized by double staining with TUNEL and cell specific antibodies, Hoechst 33342 staining and electron microscopy. Activation of caspases in each cell types will be characterized by double staining. The immunohistochemical stained cells will be counted to determine the effect of MnTBAP on cell death. The therapeutic potential of MnTBAP will be assessed by behavioral tests. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NOVEL EX VIVO GENE THERAPY FOR SPINAL CORD INJURY Principal Investigator & Institution: Trivedi, Alpa A.; Mandalmed, Inc. Lakeside Medical Center San Francisco, Ca 94132 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2003 Summary: (provided by applicant): The goal of the Phase I research is to develop ex vivo gene therapy that will achieve long-term, localized delivery of human neurotrophin-3 (hNT-3) in the rat contusion model of spinal cord injury. Our overall goal is to develop cell-based delivery of neurotrophins and other proteins as therapy for acute spinal cord injury. The following are the Phase I specific aims: Aim 1: To test functional recovery in response to NT-3 in rat spinal cord injury model. Aim 2: To test the effect of methylprednisotone on NT-3 based recovery of injured rats. In Phase II research we will develop a stereotaxic injection method to introduce cells into the injured spinal cords of rats, and study the effect of delaying implantation (24 to 48 hours post-injury) on cell survival, protein production, and functional recovery. Besides NT-3, we also will transduce cells with virus that produces brain-derived neurotrophic factor (BDNF), and look at its effect alone and in combination with NT-3 on functional recovery in animal models. Based on the results in Phase I we will continue working with methylprednisolone. We will test the system in a primate model, and develop human cells towards beginning Phase I clinical trials. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: OPTIMAL GLOMERULOSCLEROSIS

TREATMENT

OF

FOCAL

SEGMENTAL

Principal Investigator & Institution: Fine, Richard N.; Pediatrics; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Focal segmental glomerulosclerosis (FSGS) is the most common glomerular lesion leading to ESRD in Children. Approximately one-fifth of the steroid resistant patients with FSGS (SRFSGS) will respond to cyclospodne (CS). Those unresponsive patients will progress over a variable time interval to ESRD. The rate of progression is particularly severe in African-American and Hispanic children. To date no controlled trial with novel immunomodulatory agent(s) has demonstrated efficacy inducing a complete remission in SRFSGS patients who fail to respond to CS. The Specific Aims of this proposal are to compare two regimens: (a) low-dose CS and sirolimus, and (b) intravenous methylprednisolone and cyclophosphamide in patients with SRFSGS who do not respond with a complete remission to a 16 week course of CS and low-dose prednisone in order to determine which regimen is more efficacious with

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fewer side-effects. An additional Specific Aim will attempt to predict progression in patients with SRFSGS by Sirius Red staining and by detecting fibrogenic cytokines in renal biopsy tissue at enrollment and 18 months after randomization. Additionally, 125Iiothalamate will be compared with Cystatin C as a measure of glomerular filtration rate (GFR) in order to determine if the latter is an acceptable "gold standard" for serial measurement of GFR in patients with SRFSGS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHASE II STUDY OF HU23F2G IN ACUTE EXCERBATIONS OF MULTIPLE SCLEROSIS Principal Investigator & Institution: Brooks, Benjamin R.; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PRE-CLINICAL STUDIES OF SPINAL-CORD INJURY REPAIR Principal Investigator & Institution: Kalderon, Nurit; Sloan-Kettering Institute for Cancer Res New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 22-AUG-2000; Project End 31-JUL-2005 Summary: Adapted from the Investigator's Abstract): Repair mechanisms are activated in response to injury in the adult spinal cord; these begin wound healing and reconstructing the cord tissue including the regrowth of severed axons. However, at about the 4th week after the injury, the natural inherent repair is aborted and decay processes take over yielding a permanent wound gap. The severed nerve fibers fail to cross the wound gap, leaving the cord beyond the site of injury permanently disconnected from the brain and the related muscles become and remain paralyzed. The long-term goal of our research is to identify the mechanisms by which the intrinsic repair is aborted. Identifying the ~who" and understanding the ~how~ will enable us to develop therapeutic clinical strategies for facilitating the intrinsic repair thereby preventing paralysis. Thus far, by using x-irradiation in an analytical setting as used to eradicate proliferating cells-it has been possible to identify one cell, the reactive astrocyte, that plays an important role in discontinuing the wound healing processes. Further, it was possible to demonstrate that the destructive outcome of injury can be averted and the natural inherent repair of structure and motor function can be attained provided that reactive glia at the damage site are destroyed by x-ray therapy targeted at the right time after transection injury in adult rat spinal cord. The objective of this proposal is to establish the methods to transform a strategy which is effective in the experimental setting into a strategy effective in a clinical setting in facilitating structural and functional repair in injured spinal cord. The parameters of radiation therapy protocols that are clinically safe for the human spinal cord are very well defined and in routine use to eradicate tumor cells. These clinical radiation parameters will be used by themselves and in conjunction with the clinical procedures currently used in human spinal cord injury, such as drugs to prevent secondary damage and protect the spared fibers tracts. The efficacy of these in facilitating intrinsic repair will be examined in transection and contusion injuries in the rat spinal cord. Studies in each of the specific aims are focused on identifying the parameters (e.g., window of opportunity for the therapy) and defining the conditions (e.g., dose protocol) at which repair is facilitated. Analysis of repair is conducted using magnetic resonance imaging of the lesion site at

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Methylprednisolone the cord, quantitative histologic and electrophysiologic methods and behavioral methods. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PULSE CYCLOPHOSPHAMIDE FOLLOWED BY TREATMENT W/ITH AVONEX Principal Investigator & Institution: Weiner, Howard L.; Robert L. Kroc Professor of Neurology; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This is a randomized trial of two standard approaches to therapy of patients with multiple sclerosis remaining active despite therapy with beta-interferons. One arm receives cytoxan plus solumedrol plus continued beta-interferons, while the other receives only solumedrol plus beta-interferons. There will be 20 patients at BWH and 20 at MGH, stratified for disease severity assessed by number of gadolinium lesions. This is an investigator-initiated, industry sponsored clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PULSE THERAPY TRIAL IN BETA INTERFERON RESISTANT ACTIVE Principal Investigator & Institution: Smith, Derek R.; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 05-JUL-1999; Project End 30-JUN-2003 Summary: This will be a trial to test the clinical and radiographic efficacy of monthly pulse infusion therapy in beta-interferon-resistant active MS patients. While betainterferon medications have been shown to reduce disease activity in relapsing remitting MS patients, many patients continue to have active disease despite being on these medications. There is evidence that treatment of these patients with pulse methylprednisolone, pulse mitoxantrone or pulse cyclophosphamide may effectively reduce disease activity in these patients and potentially allow them to be stable maintained on beta-interferon therapy thereafter. This study is designed to randomize beta-interferon non-responsive patients for six months of treatment to either monthly intravenous pulse cyclophosphamide plus methylprednisolone or monthly intravenous pulse mitoxantrone plus methylprednisolone or monthly intravenous methylprednisolone alone. Patients will be maintained on beta-interferon and followed over 24 months. 20 patients will be enrolled per arm. MRI number of gadolinium enhancing lesions and T2 lesion volume will be the principal outcome measures while clinical scores and immunologic studies will be secondary outcome measures. Measurement of adverse events will also be an important component. Thus far the applicant's research has focused on immunologic studies in MS with the goal of understanding the mechanism of action of drugs used to treat the disease. We have found that the treatment of MS patients with some of these agents results in a number of changes, notably increases of IL-4 secretion associated with eosinophilia and decreases in IL-12. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RANDOMIZED THERAPEUTIC TRIALS IN PEDIATRIC HEART DISEASE Principal Investigator & Institution: Newburger, Jane W.; Associate Cardiologist-InChief; Children's Hospital (Boston) Boston, Ma 021155737

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Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant) This grant application proposes two randomized, double-blind, placebo-controlled trials to be performed in the Pediatric Heart Disease Clinical Research Network. Our shorter-term trial will study the efficacy and safety of pulse steroid therapy, when added to conventional therapy with intravenous gamma globulin (IVIG) plus aspirin, in treatment of acute Kawasaki disease. Patients will be randomly assigned to receive either methylprednisolone (IVMP), 30 mg/kg, plus conventional therapy (i.e., "IVMP plus IVIG") versus placebo plus conventional therapy ("IVIG alone"). Our first aim is to test the hypothesis that treatment of acute Kawasaki disease with IVMP plus IVIG is more effective than treatment with IVIG alone. Our primary efficacy outcome variables will be BSA-adjusted coronary artery dimensions (zscores) for the proximal right, left main, and proximal left anterior descending coronary arteries; number of days of fever after completion of initial IVIG infusion; and C-reactive protein at 2 weeks after illness onset. Our second aim is to test the hypothesis that children treated with IMP plus IVIG will have fewer adverse effects than those treated with IVIG alone. Our primary safety outcome will be the prevalence of all adverse side effects. The structure of the study will allow us to explore and identify factors other than the two treatment strategies (e.g., immune gene polymorphisms) that relate to the occurrence of-coronary artery abnormalities. The KD trial will span less than two years from onset of enrollment to preliminary data. Our longer-term trial evaluates the efficacy of beta-blocker therapy in retarding progressive aortic root dilation and valvular aortic regurgitation in patients after the arterial switch operation (ASO). Patients will be randomly assigned to receive either propranolol (2-4 mg/kg/day) or placebo. Our first aim is to assess the effect of propranolol therapy on the rate of aortic root dilation after the ASO. The primary outcome variable is the change in aortic root size during two years of treatment, assessed as the aortic root diameter adjusted for body surface area (BSA). A second specific aim is to assess the incidence and magnitude of adverse effects of propranolol therapy. The primary end-point will be the change in the Physical Health Summary and Psychosocial Health Summary scores of the CHQ-50 at one and two years of therapy compared to pre-therapy. A third specific aim is to evaluate the role of collagen and fibrillin in the pathogenesis of aortic root dilation after the ASO by analyzing single nucleotide polymorphisms (SNPs) in candidate genes: fibrillin and Collagen types 3al, 5al, and 5a2 genes. The primary endpoint is the identification of SNPs that are significantly associated with severity of aortic root dilation. The ASO trial will involve an enrollment period of two years and a follow-up period of 2 years. Both trials are expected to yield information important to clinical practice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF NHE3 BY GLUCOCORTICOIDS, SGK1 AND NHERF2 Principal Investigator & Institution: Yun, Chang-Hyon C.; Medicine; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): The stimulative effect of glucocorticoids on the maintenance of fluid and electrolyte balance has been known for more than two decades. Pharmacological doses of methylprednisolone stimulated Na+ absorption in small animals. However, molecular mechanisms underlying this activation remain elusive. Na+/H+ exchanger NHE3 in the brush border membrane of intestine and kidney plays a major role in transepithelial Na+ absorption. We previously

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Methylprednisolone demonstrated that methylprednisolone in rabbits specifically stimulated NHE3 mRNA in ileum without affecting NHE1 mRNA levels. Others have shown that glucocorticoids specifically activated NHE3 mRNA in ileum, proximal colon and renal proximal tubules. These results suggest that glucocorticoids activate NHE3 activity by gene expression of NHE3. However, we recently found using Caco-2 cells that dexamethasone activates NHE3 transport without affecting NHE3 mRNA expression. This non-transcriptional activation of NHE3 by dexamethasone was demonstrated in OK cells, suggesting that transcriptional activation of NHE3 may not be the only determining factor in glucocorticoid-stimulation of NHE3. We found that dexamethasone enhanced NHE3 activity only in the presence of a NHE3 regulatory protein, NHERF2. We identified serum- and glucocorticoids-induced protein kinase 1, SGK1, as a protein interacting with PDZ domains of NHERF2. We demonstrated that SGK1 activated NHE3 activity and expression of "kinase-dead" SGK1 in OK cells markedly blocked the dexamethasone effect, demonstrating the importance of SGKI. We also showed that SGK1 directly phosphorylated NHE3 in vitro suggesting phosphorylation-dependent regulation of NHE3. In this application, we propose to investigate: (1) the roles of SGK1 and NHERF2 in activation of NHE3 by glucocorticoids; (2) molecular mechanisms underlying the activation of NHE3 by SGK1 and NHERF2 in response to glucocorticoid; and (3) the interaction between SGK1, NHERF2 and NHE3. This proposal will resolve complexity in NHE3 regulation by glucocorticoids, and enhance our understanding of protein-protein interaction in regulation of membrane transport proteins. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ROLE PATHOPHYSIOLOGY

OF

CYCLOOXYGENASE

2

IN

BRAIN

TRAUMA

Principal Investigator & Institution: Dash, Pramod K.; Professor; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2003 Summary: Striking randomly, traumatic brain injury (TBI) is a "silent epidemic" which affects two to four million persons each year. The consequences of TBI in these patients, having a mean age of 29.5 years, pose a tremendous loss to family and society in terms of potential productive years of life. Unfortunately, no effective therapies for human head injury are available. The injury to the CNS can be categorized as either primary or secondary. Primary injury results from immediately physical damage as a consequence of trauma and is difficult, it not impossible, to prevent. Secondary injuries are delayed pathological events occurring within minutes, hours, or days after the primary trauma and lead to further damage of the nervous system. Inflammatory responses are major components of secondary injury and are thought to be key contributors to TBI pathophysiology. Prostaglandins, potent mediators of inflammation, are produced via the action of cyclooxygenase-1 and 2 [Cox-1 and COX-2, also known as PGH synthase 1 and 2]. Cox-1 is constitutively expressed in most tissue and is responsible for the physiological production of prostaglandins. In contrast, COX-2 is inducible and is responsible for the elevated production of prostaglandins. A considerable amount of evidence from several experimental systems indicates that COX-2 plays a critical role in inflammation. However, the mechanism(s) of inflammatory responses following TBI has not been elucidated. Our preliminary studies indicate that enhanced Cox-2 expression is associated with experimental TBI. Based on these and other findings, the proposal has three specific aims: (1) to test the hypothesis that induction of Cox-2 contributes to TBI pathophysiology, (2) to test the hypothesis that TBI-induced activation of NFkappaB

Studies

21

[nuclear factor kappa B], ATF [activating transcription factor], and/or C/EBP [CCAAT/enhancer binding protein] lead to Cox-2 induction; and (3) to test the hypothesis that the anti- inflammatory agents methylprednisolone and IL-10 attenuate Cox-2 expression. The experiments outlined in this proposal will provide a unique opportunity to both unravel the cellular and molecular mechanisms of TBI- induced inflammation and provide the foundation for therapeutic strategies which will be invaluable in the treatment of TBI. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SCHWANN CELLS, NEUROTROPHINS AND SPINAL CORD REGROWTH Principal Investigator & Institution: Xu, Xiao M.; Associate Professor; Neurological Surgery; University of Louisville University of Louisville Louisville, Ky 40292 Timing: Fiscal Year 2002; Project Start 15-MAY-1998; Project End 30-JUN-2003 Summary: The basic goal of this application is to utilize a hemisection model of the spinal cord in which a gap is created and a mini-guidance channel filled with Schwann cells is inserted. In addition, the model incorporates two additional elements that are intended to maximize the elongation of regenerating axons into the distal cord. These are the administration of methylprednisilone plus the slow release of various neurotrophins via an osmotic mini-pump just caudal to the bridge. Taken together the specific aims of this model could be described as one with a most comprehensive attempt to maximize regeneration into the host cord tissue caudal to a Schwann cell bridged lesion. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SPINAL GLYCOPROTEIN

CORD

INJURY,

METHYLPREDNISOLONE

&

P

Principal Investigator & Institution: Bernards, Christopher M.; Anesthesiology; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 10-MAY-1999; Project End 30-APR-2004 Summary: Spinal cord injuries causing permanent neurologic damage affect approximately 280,000 Americans. The only currently available therapy shown to reduce the severity of neurologic damage is massive intravenous doses of a glucocorticoid (methylprednisolone) administered during the first 3-48 hrs after injury. Unfortunately, the benefit of methylprednisolone therapy in terms of neurologic recovery is relatively small and the deleterious side effects of huge, immunesuppressive glucocorticoid doses are significant (e.g., sepsis, pneumonia). In fact, there is reason to believe that the deleterious systemic side-effects of high dose methylprednisolone therapy may actually ameliorate some of the potential neurologic benefit. Thus, developing drug delivery strategies that increase the bioavailability of methylprednisolone in the spinal cord and therefore allow a parallel reduction in the required systemic dose may significantly improve outcome. To achieve this goal of improved therapeutic index requires a thorough understanding of methylprednisolone's pharmacokinetics. Unfortunately this information is not currently available. In addition, it is essential to understand why the bioavailability of methylprednisolone in the spinal cord is so poor after intravenous methylprednisolone administration. To achieve these goals we propose the following aims: 1. To thoroughly define methylprednisolone's compartmental pharmacokinetics (spinal cord, plasma, cerebrospinal fluid) following intrathecal and intravenous administration. 2. To identify the role of p-glycoprotein in

22

Methylprednisolone limiting methylprednisolone penetration of the blood-spinal cord barrier. 3. To identify p-glycoprotein inhibitors that increase the spinal cord bioavailability of intravenously and intrathecally administered methylprednisolone. 4. To determine whether increased spinal cord bioavailability of methylprednisolone decreases secondary damage following spinal cord injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: THE DUKE-UNC-CH PEDIATRIC CARDIOLOGY CLINICAL CENTER Principal Investigator & Institution: Anderson, Page a W.; Professor; Pediatrics; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant) Duke University Medical Center and the University of North Carolina at Chapel Hill Medical Center (UNC-CH) will form a Clinical Center in the Pediatric Heart Disease Clinical Research Network. Duke will be the primary site and UNC-CH the subsite. The likely success of this proposed collaboration is supported by the previous and ongoing joint participation by the Centers at multiple levels and over many years. These interactions include collaborations in patient care, post-graduate education, and federally funded clinical research in which Duke and UNC-CH have both been primary and subsites. The longstanding research programs at the centers have studied a broad range of issues relevant to pediatric heart disease, including the pathophysiologic basis of the post-cardiopulmonary bypass (CPB) syndrome, dysrhythmias, and altered ventricular function in patients with congenital cardiac defects and heart failure. The studies have ranged from the contractile proteins to the in vivo heart of the patient and have examined the treatment of dysrhythmias, catheterbased device implantation, and testing the efficacy and safety of pharmacologic drugs. Annually our combined programs have over 11,000 outpatient visits and perform in excess of 600 cardiac catheterizations, 8,000 echocardiograms, 200 electrophysiological interventions/ablations, 150 catheter-based interventions, and 490 pediatric cardiac surgical procedures. The proposed double blind randomized controlled trials are: a long-term study of three years duration, carvedilol efficacy and safety in the Fontan patient with depressed ventricular function; a short-term study of two years duration, the efficacy and safety of methylprednisolone in preventing the post-CPB syndrome in the infant. The primary objective of the carvedilol trial is the Clinical Global Assessment by the physician. In the adult with heart failure, greater sympathetic nervous system activation is associated with worse clinical course. Carvedilol has been found to improve quality of life and decrease mortality in these patients. Our trial will test the hypothesis that carvedilol improves quality of life, clinical course, and ejection fraction in the Fontan patient. Methylprednisolone is widely used and thought to be efficacious in decreasing the morbidity of the post-CPB syndrome. We will test the hypothesis that methylprednisolone decreases PICU stay, maintains normal vascular permeability, prevents renal and hepatic damage, and improves the clinical course. We look forward to participating in the Network and improving the care of infants and children with congenital and acquired heart disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DISEASE

TRANSGENIC

XENOTRANSPLANTS

FOR

HUNTINGTON'S

Principal Investigator & Institution: Isacson, Ole; Professor; Mc Lean Hospital (Belmont, Ma) Belmont, Ma 02478

Studies

23

Timing: Fiscal Year 2002; Project Start 01-JAN-1992; Project End 31-MAR-2004 Summary: (Verbatim from the Applicant's Abstract) Brain cell transplantation research has shown that structural and functional repair of the adult brain is possible. We are testing the functional hypothesis that embryonic striatal neurons can replace neurons lost in adult primate striatum and improve signs of Huntinton's disease (HD). The lack of an optimal human donor cell source in a clinical scenario has led us to utilize zenogeneic (here transgenic pig) embryonic donor cells. Our preliminary in vivo data show that successful xenografts survival in the primate brain requires immunosuppression by cyclosporine, azathiopirne, methylprednisolone and complement inhibition (CD59 transgenic donor tissue and monoclonal antibodies against complement C5). To test the functional hypothesis, we proposed the following experiments: We will transplant CD59 complement aggregation inhibitor expressing transgenic porcine fetal striatal (E35 LGE) cells to the caudate-putamen of non-human primate (Macaca mulatta) with neuronal loss similar to that seen in HD. To determine how functional recovery depends on survival and growth of porcine striatal transplants, we will collect physiological in vivo data by PET/MRI/MRS and behavioral data by examining motor and cognitive function. The physiological analysis of LBE graft function by in vivo imaging and behavioral assays is followed by detailed morphological studies. Combine, these studies will provide essential data on the relationship between structural and functional integration of embryonic neuronal xenografts in a HD primate model. These experiments will improve our knowledge of basal ganglia function and plasticity, as well as determine parameters for optimal cell transplantation in patients with neurological disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TRANSPORT OF NEUROTROPHIC CYTOKINES AFTER SPINAL CORD INJURY Principal Investigator & Institution: Pan, Weihong; Neuroscience; Tulane University of Louisiana New Orleans, La New Orleans, La 70112 Timing: Fiscal Year 2004; Project Start 01-MAR-2004; Project End 28-FEB-2008 Summary: Adequate neurotrophic support is essential for spinal cord regeneration; however, production of neurotrophins and neurotrophic cytokines at the site of spinal cord injury (SCI) is insufficient. The blood-brain/blood-spinal cord barrier (BBB/BSCB) mediates permeation of selective neurotrophic cytokines from the periphery. We propose that the transport system for leukemia inhibitory factor (LIF) at the BSCB is upregulated after SCI, and that enhanced transport of LIF benefits functional recovery. To test the hypothesis that LIF crosses the BSCB by receptor-related transport and that the transport system is upregulated after SCI, we will measure blood-to-spinal cord transfer of 12SI-LIF, test the effects of different classes of transport inhibitors, and compare the results with that of epidermal growth factor (125I-EGF). We expect that 12SI-LIF entry will be decreased by a LIF receptor antibody whereas 12SI-EGF entry will be decreased by polycationic peptides and dansylcadaverin but not by an EGF receptor antibody. This will support the concept that LIF crosses the BSCB by receptor-mediated transport while EGF does so by adsorptive endocytosis. We will further determine spinal cord uptake of 125I-LIF and 1251-EGF in various regions and time course after injury, compare the results with those of permeability markers (radioactively labeled albumin and inulin as indicators of barrier disruption), and test the effects of receptor antibodies and endocytosis inhibitors on the increased radiotracer uptake after SCI. We expect that SCI upregulates receptor-related transport (for LIF) without affecting adsorptive transcytosis (for EGF), and that enhanced LIF transport correlates with

24

Methylprednisolone increased endothelial LIFRalpha receptor expression. To test the hypothesis that LIF benefits spinal cord regeneration after crossing the BSCB, we will determine histological and electrophysiological evidence of axonal regeneration. We expect that tract tracing, neurofilament staining, and intraspinal conduction of evoked potentials will be increased by LIF treatment after peripheral delivery when its transport is upregulated. These changes will coincide with improved behavioral performance. To test the hypothesis that methylprednisolone potentiates the therapeutic effects of LIF and upregulates LIF transport, we will examine not only these regeneration parameters but also transport efficacy after methylprednisolone or combined treatment. By completing these studies, we will have demonstrated that transport of neurotrophic cytokines after SCI can be modulated to facilitate functional restoration. Therefore, the BBB/BSCB is not a simple barrier but also a gate for spinal cord regeneration. Understanding the mechanisms of cytokine transport at this regulatory interface would help in the design of new approaches to treat SCI. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: USE OF CLENBUTEROL FOR ENHANCEMENT OF STEM CELL THERAPY Principal Investigator & Institution: Zeman, Richard J.; Motogen, Inc. 3 Pine View Rd Mount Kisco, Ny 10549 Timing: Fiscal Year 2002; Project Start 15-APR-2002; Project End 14-APR-2003 Summary: (provided by applicant): The overall goal of this project is to demonstrate the ability of the beta2-adrenoceptor agonist, clenbuterol, and adult stem cell transplantation in combination to oppose irreversible loss of locomotor function due to contusion, the most common type of spinal cord injury (SCI). At present, only methylprednisolone has been shown to have efficacy in humans for SCI However, the extent of recovery is limited so that additional or alternative treatments are needed. Potentially superior countermeasures are available, but require a demonstration of efficacy in an appropriate animal model of spinal cord contusion injury prior to use in patients. The proposed studies are an outgrowth of previous work in which Beta2agonists or transplantation of adult pluripotent stem cells into the contusion site enhanced recovery of locomotor function following SCI in rats. Recovery of locomotor function, in turn, correlated with sparing of myelinated white matter and successful transplantion. We will determine the efficacy of clenbuterol and stem cell transplantation used in combination for sparing and regenerating spinal cord tissue and improving locomotor function following contusion in an established model of SCI developed by the Multicenter Animal Spinal Cord Injury Study (MASCIS). Optimization of Beta2-agonist treatment and stem cell transplantation into the contused spinal cord may lead to a therapeutic modality for SCI. PROPOSED COMMERCIAL APPLICATION: This project will lead to a treatment for spinal cord injury based on activating stem cells directly or indirectly with clenbuterol after injection of the stem cells into the injury site. The method will be patented, licensed and marketed as a new therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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25

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 “methylprednisolone” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for methylprednisolone in the PubMed Central database: •

Effect of methylprednisolone on bacterial clearance and endotoxin liberation during experimental sepsis induced by gram-negative bacteria. by Flynn PM, Shenep JL, Stokes DC, Hildner WK, Mackert PW, Snellgrove RL, Rehg JE.; 1986 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=262192

•

Effect of methylprednisolone on entry of ampicillin and gentamicin into cerebrospinal fluid in experimental pneumococcal and Escherichia coli meningitis. by Scheld WM, Brodeur JP.; 1983 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=184626

•

Effects of glycyl-L-glutamine and methylprednisolone on maintenance of acetylcholinesterase of transected rat sciatic nerves. by Koelle GB, Han MS.; 1990 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=55193

•

Effects of Methylprednisolone on Intracellular Bacterial Growth. by Meduri GU, Kanangat S, Bronze M, Patterson DR, Meduri CU, Pak C, Tolley EA, Schaberg DR.; 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=96243

•

Enhancement of experimental bacteremia and endocarditis caused by dysgonic fermenter (DF-2) bacterium after treatment with methylprednisolone and after splenectomy. by Butler T, Johnston KH, Gutierrez Y, Aikawa M, Cardaman R.; 1985 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=261511

•

Fatty acid composition of the major phospholipids of Pneumocystic carinii: comparison with those in the lungs of normal and methylprednisoloneimmunosuppressed rats. by Guo Z, Beach DH, Kaneshiro ES.; 1996 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173933

•

Injection with methylprednisolone proximal to the carpal tunnel: randomised double blind trial. by Dammers JW, Veering MM, Vermeulen M.; 1999 Oct 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28242

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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Methylprednisolone

•

Methylprednisolone for acute spinal cord injury: not a standard of care. by Hugenholtz H.; 2003 Apr 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153684

•

Methylprednisolone inhibits the alternative and amplification pathways of complement. by Weiler JM, Packard BD.; 1982 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=347706

•

Phospholipid composition of Pneumocystis carinii carinii and effects of methylprednisolone immunosuppression on rat lung lipids. by Guo Z, Kaneshiro ES.; 1995 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173148

•

Superiority of methylprednisolone over dexamethasone for induction of Pneumocystis carinii infection in rats. by Sukura A, Soveri T, Lindberg LA.; 1991 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=270323

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

A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of tension-type headache. Author(s): Porta M. Source: Current Review of Pain. 2000; 4(1): 31-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10998713

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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27

•

A double-blind clinical trial of mitoxantrone versus methylprednisolone in relapsing, secondary progressive multiple sclerosis. Author(s): van de Wyngaert FA, Beguin C, D'Hooghe MB, Dooms G, Lissoir F, Carton H, Sindic CJ. Source: Acta Neurol Belg. 2001 December; 101(4): 210-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11851027

•

A prospective randomized trial of megadose methylprednisolone and high dose dexamethasone for traumatic optic neuropathy. Author(s): Chuenkongkaew W, Chirapapaisan N. Source: J Med Assoc Thai. 2002 May; 85(5): 597-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12188391

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A randomized and comparative study of intravenous immunoglobulin and mega dose methylprednisolone treatments in children with acute idiopathic thrombocytopenic purpura. Author(s): Erduran E, Aslan Y, Gedik Y, Orhan F. Source: Turk J Pediatr. 2003 October-December; 45(4): 295-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14768792

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A randomized placebo-controlled trial to assess the efficacy of antiinflammatory therapy with methylprednisolone in unstable angina (MUNA trial). Author(s): Azar RR, Rinfret S, Theroux P, Stone PH, Dakshinamurthy R, Feng YJ, Wu AH, Range G, Waters DD. Source: European Heart Journal. 2000 December; 21(24): 2026-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11102253

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A randomized, phase III, double-blind, placebo-controlled trial of intrapleural instillation of methylprednisolone acetate in the management of malignant pleural effusion. Author(s): North SA, Au HJ, Halls SB, Tkachuk L, Mackey JR. Source: Chest. 2003 March; 123(3): 822-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12628884

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A small inhibitor of the interaction between Bax and Bcl-X(L) can synergize with methylprednisolone to induce apoptosis in Bcl-X(L)-overexpressing breast-cancer cells. Author(s): Tan YJ, Teng E, Ting AE. Source: Journal of Cancer Research and Clinical Oncology. 2003 August; 129(8): 437-48. Epub 2003 July 16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12884026

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A transcranial magnetic stimulation study evaluating methylprednisolone treatment in multiple sclerosis. Author(s): Fierro B, Salemi G, Brighina F, Buffa D, Conte S, La Bua V, Piazza A, Savettieri G. Source: Acta Neurologica Scandinavica. 2002 March; 105(3): 152-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11886356

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Acute lupus peritonitis during treatment of lupus nephritis: successful treatment with methylprednisolone pulse therapy. Author(s): Uzu T, Chikamori Y, Yamato M, Iwatani H, Kakihara M, Yamauchi A. Source: Nephron. 2000 December; 86(4): 511-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11124606

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Acute necrotizing eosinophilic myocarditis successfully treated by high dose methylprednisolone. Author(s): Watanabe N, Nakagawa S, Fukunaga T, Fukuoka S, Hatakeyama K, Hayashi T. Source: Japanese Circulation Journal. 2001 October; 65(10): 923-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11665801

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Administration of methylprednisolone to prevent severe ovarian hyperstimulation syndrome in patients undergoing in vitro fertilization. Author(s): Lainas T, Petsas G, Stavropoulou G, Alexopoulou E, Iliadis G, Minaretzis D. Source: Fertility and Sterility. 2002 September; 78(3): 529-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12215328

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Arsenic trioxide and methylprednisolone use different signal transduction pathways in leukemic differentiation. Author(s): Yuksel S, Saydam G, Uslu R, Sanli UA, Terzioglu E, Buyukececi F, Omay SB. Source: Leukemia Research. 2002 April; 26(4): 391-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11839383

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Atrial fibrillation associated with systemic lupus erythematosus and use of methylprednisolone. Author(s): Aslam AK, Vasavada BC, Sacchi TJ, Khan IA. Source: American Journal of Therapeutics. 2001 July-August; 8(4): 303-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11441330

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•

Benefit of high-dose methylprednisolone in comparison with conventional-dose prednisolone during remission induction therapy in childhood acute lymphoblastic leukemia for long-term follow-up. Author(s): Yetgin S, Tuncer MA, Cetin M, Gumruk F, Yenicesu I, Tunc B, Oner AF, Toksoy H, Koc A, Aslan D, Ozyurek E, Olcay L, Atahan L, Tuncbilek E, Gurgey A. Source: Leukemia : Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 2003 February; 17(2): 328-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12592331

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Cerebral volume changes in multiple sclerosis patients treated with high-dose intravenous methylprednisolone. Author(s): Hoogervorst EL, Polman CH, Barkhof F. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2002 October; 8(5): 4159. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12356209

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Cerebrospinal fluid levels of nitric oxide metabolites predict response to methylprednisolone treatment in multiple sclerosis and optic neuritis. Author(s): Sellebjerg F, Giovannoni G, Hand A, Madsen HO, Jensen CV, Garred P. Source: Journal of Neuroimmunology. 2002 April; 125(1-2): 198-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11960657

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Changes of the MS functional composite and EDSS during and after treatment of relapses with methylprednisolone in patients with multiple sclerosis. Author(s): Patzold T, Schwengelbeck M, Ossege LM, Malin JP, Sindern E. Source: Acta Neurologica Scandinavica. 2002 March; 105(3): 164-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11886358

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Chronic urticaria associated with intra-articular methylprednisolone. Author(s): Pollock B, Wilkinson SM, MacDonald Hull SP. Source: The British Journal of Dermatology. 2001 June; 144(6): 1228-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422047

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Clinical course of children with immune thrombocytopenic purpura treated with intravenous immunoglobulin G or megadose methylprednisolone or observed without therapy. Author(s): Duru F, Fisgin T, Yarali N, Kara A. Source: Pediatric Hematology and Oncology. 2002 June; 19(4): 219-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12051587

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Methylprednisolone

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Clinico-laboratory study of methylprednisolone and cyclophosphamide treatment in patients with multiple sclerosis relapse. Author(s): Manova MG, Kostadinova II, Rangelov AA. Source: Folia Med (Plovdiv). 2000; 42(3): 20-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11347331

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Clinicopathologic correlates predict the outcome in children with steroid-resistant idiopathic nephrotic syndrome treated with pulse methylprednisolone therapy. Author(s): Kirpekar R, Yorgin PD, Tune BM, Kim MK, Sibley RK. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2002 June; 39(6): 1143-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12046024

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Combination of tacrolimus, methotrexate, and methylprednisolone prevents acute but not chronic graft-versus-host disease in unrelated bone marrow transplantation. Author(s): Ogawa H, Soma T, Hosen N, Tatekawa T, Tsuboi A, Oji Y, Tamaki H, Kawakami M, Ikegame K, Murakami M, Fujioka T, Kim EH, Oka Y, Sugiyama H. Source: Transplantation. 2002 July 27; 74(2): 236-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12151737

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Combination therapy with granisetron, methylprednisolone and droperidol as an antiemetic prophylaxis in CDDP-induced delayed emesis for gynecologic cancer. Author(s): Sagae S, Ishioka S, Fukunaka N, Terasawa K, Kobayashi K, Sugimura M, Nishioka Y, Kudo R, Minami M. Source: Oncology. 2003; 64(1): 46-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12457031

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Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Author(s): Illei GG, Austin HA, Crane M, Collins L, Gourley MF, Yarboro CH, Vaughan EM, Kuroiwa T, Danning CL, Steinberg AD, Klippel JH, Balow JE, Boumpas DT. Source: Annals of Internal Medicine. 2001 August 21; 135(4): 248-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11511139

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Combined initial cyclophosphamide with repeated methylprednisolone pulse therapy for severe paraquat poisoning from dermal exposure. Author(s): Lin NC, Lin JL, Lin-Tan DT, Yu CC. Source: Journal of Toxicology. Clinical Toxicology. 2003; 41(6): 877-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14677801

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Combined intravenous pulse methylprednisolone and oral cyclosporine A in the treatment of corneal graft rejection: 5-year experience. Author(s): Young AL, Rao SK, Cheng LL, Wong AK, Leung AT, Lam DS. Source: Eye (London, England). 2002 May; 16(3): 304-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12032722

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Combined methylprednisolone and dexamethasone therapy for paraquat poisoning. Author(s): Chen GH, Lin JL, Huang YK. Source: Critical Care Medicine. 2002 November; 30(11): 2584-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12441774

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Comparative study of lymphocyte-suppressive potency between prednisolone and methylprednisolone in rheumatoid arthritis. Author(s): Hirano T, Tsuboi N, Homma M, Oka K, Takekoshi T, Tahara K, Takanashi H, Abe H, Urata Y, Hayashi T. Source: Immunopharmacology. 2000 September; 49(3): 411-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10996038

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Comparison between two high-dose methylprednisolone schedules in the treatment of acute hepatic cellular rejection in liver transplant recipients: a controlled clinical trial. Author(s): Volpin R, Angeli P, Galioto A, Fasolato S, Neri D, Barbazza F, Merenda R, Del Piccolo F, Strazzabosco M, Casagrande F, Feltracco P, Sticca A, Merkel C, Gerunda G, Gatta A. Source: Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2002 June; 8(6): 527-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12037783

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Comparison of an intravenous pulse of methylprednisolone versus oral corticosteroid in severe acute rheumatic carditis: a randomized clinical trial. Author(s): Camara EJ, Braga JC, Alves-Silva LS, Camara GF, da Silva Lopes AA. Source: Cardiology in the Young. 2002 March; 12(2): 119-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12018715

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Comparison of the effects of 2 doses of methylprednisolone on pain, swelling, and trismus after third molar surgery. Author(s): UStun Y, Erdogan O, Esen E, Karsli ED. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2003 November; 96(5): 535-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14600686

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Methylprednisolone

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Complications associated with the prophylactic use of methylprednisolone during surgical stabilization after spinal cord injury. Author(s): Molano Mdel R, Broton JG, Bean JA, Calancie B. Source: Journal of Neurosurgery. 2002 April; 96(3 Suppl): 267-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990833

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Corneal allograft rejection: has the time come for intravenous pulsed methylprednisolone? A debate. Author(s): Thiel MA, Ross CA, Coster DJ. Source: Clinical & Experimental Ophthalmology. 2000 December; 28(6): 398-404. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11202460

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Correspondence: Treatment OF The Neuroblastoma-associated Opsoclonusmyoclonus-ataxia (oma) Syndrome With High-dose METHYLPREDNISOLONE. Author(s): Emir S, Akyuz C, Buyukpamukcu M. Source: Medical and Pediatric Oncology. 2003 February; 40(2): 139. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12461808

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Crescentic, proliferative IgA nephropathy: clinical and histological response to methylprednisolone and intravenous cyclophosphamide. Author(s): Tumlin JA, Lohavichan V, Hennigar R. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 July; 18(7): 1321-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12808169

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Cyclosporine, methotrexate, and methylprednisolone compared with cyclosporine and methotrexate for the prevention of graft-versus-host disease in bone marrow transplantation from HLA-identical sibling donor: a prospective randomized study. Author(s): Ruutu T, Volin L, Parkkali T, Juvonen E, Elonen E. Source: Blood. 2000 October 1; 96(7): 2391-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11001889

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Deep intramuscular methylprednisolone for the treatment of cystoid macular oedema in uveitis. Author(s): Tehrani NN, Saeed T, Murray PI. Source: Eye (London, England). 2000 October; 14 Pt 5: 691-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11116686

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Degradation of methylprednisolone sodium succinate in a diluent-containing vial. Author(s): Ulsaker G, Teien G. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2002 December 15; 59(24): 2456-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12503350

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Dexamethasone and methylprednisolone in treatment of indirect traumatic optic neuropathy. Author(s): Kitthaweesin K, Yospaiboon Y. Source: J Med Assoc Thai. 2001 May; 84(5): 628-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11560210

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Does an IV bolus of methylprednisolone relieve dyspnea in asthma exacerbations? Author(s): Noseda A, De Bruyne I, De Maertelaer V, Yernault JC. Source: Chest. 2000 December; 118(6): 1530-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11115436

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Dynamic thermography of the knee joints in rheumatoid arthritis (RA) in the course of the first therapy of the patient with methylprednisolone. Author(s): Rusch D, Follmann M, Boss B, Neeck G. Source: Zeitschrift Fur Rheumatologie. 2000; 59 Suppl 2: Ii/131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11155795

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Early complications of high-dose methylprednisolone sodium succinate treatment in the follow-up of acute cervical spinal cord injury. Author(s): Matsumoto T, Tamaki T, Kawakami M, Yoshida M, Ando M, Yamada H. Source: Spine. 2001 February 15; 26(4): 426-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11224891

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Editorial: recommendations regarding the use of methylprednisolone in acute spinal cord injury: making sense out of the controversy. Author(s): Fehlings MG. Source: Spine. 2001 December 15; 26(24 Suppl): S56-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11805611

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Effect of itraconazole on the pharmacokinetics of prednisolone and methylprednisolone and cortisol secretion in healthy subjects. Author(s): Lebrun-Vignes B, Archer VC, Diquet B, Levron JC, Chosidow O, Puech AJ, Warot D. Source: British Journal of Clinical Pharmacology. 2001 May; 51(5): 443-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422002

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Methylprednisolone

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Effect of methylprednisolone on coagulation. Author(s): Pandit HB, Spillert CR. Source: Journal of the National Medical Association. 1999 August; 91(8): 453-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12656434

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Effect of methylprednisolone on CYP3A4-mediated drug metabolism in vivo. Author(s): Villikka K, Varis T, Backman JT, Neuvonen PJ, Kivisto KT. Source: European Journal of Clinical Pharmacology. 2001 September; 57(6-7): 457-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11699609

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Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barre syndrome: randomised trial. Author(s): van Koningsveld R, Schmitz PI, Meche FG, Visser LH, Meulstee J, van Doorn PA; Dutch GBS study group. Source: Lancet. 2004 January 17; 363(9404): 192-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14738791

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Effect of prolonged low-dose methylprednisolone therapy in acute exacerbation of idiopathic pulmonary fibrosis. Author(s): Nishiyama O, Shimizu M, Ito Y, Kume H, Suzuki R, Yokoi T, Yamaki K. Source: Respiratory Care. 2001 July; 46(7): 698-701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11403701

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Effects of IV methylprednisolone on brain atrophy in relapsing-remitting MS. Author(s): Zivadinov R, Rudick RA, De Masi R, Nasuelli D, Ukmar M, Pozzi-Mucelli RS, Grop A, Cazzato G, Zorzon M. Source: Neurology. 2001 October 9; 57(7): 1239-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11591843

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Effects of methylprednisolone and aprotinin on phospholipase D activity of leukocytes in systemic inflammatory response induced by cardiopulmonary bypass. Author(s): Wu M, Lu YB, Jiang B, Xu SW, Chen RK, Zhou HL. Source: Acta Pharmacologica Sinica. 2001 October; 22(10): 913-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11749774

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Effects of methylprednisolone on intracellular bacterial growth. Author(s): Meduri GU, Kanangat S, Bronze M, Patterson DR, Meduri CU, Pak C, Tolley EA, Schaberg DR. Source: Clinical and Diagnostic Laboratory Immunology. 2001 November; 8(6): 1156-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11687457

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Effects of pulse methylprednisolone on macrophage chemotactic protein-1 and macrophage inflammatory protein-1alpha in rheumatoid synovium. Author(s): Wong PK, Cuello C, Bertouch JV, Roberts-Thomson PJ, Ahern MJ, Smith MD, Youssef PP. Source: The Journal of Rheumatology. 2001 December; 28(12): 2634-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11764208

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Effects of the neurokinin1 receptor antagonist aprepitant on the pharmacokinetics of dexamethasone and methylprednisolone. Author(s): McCrea JB, Majumdar AK, Goldberg MR, Iwamoto M, Gargano C, Panebianco DL, Hesney M, Lines CR, Petty KJ, Deutsch PJ, Murphy MG, Gottesdiener KM, Goldwater DR, Blum RA. Source: Clinical Pharmacology and Therapeutics. 2003 July; 74(1): 17-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12844131

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Efficacy of methylprednisolone and urokinase pulse therapy for severe HenochSchonlein nephritis. Author(s): Kawasaki Y, Suzuki J, Nozawa R, Suzuki S, Suzuki H. Source: Pediatrics. 2003 April; 111(4 Pt 1): 785-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12671112

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Efficacy of methylprednisolone pulse therapy on neuroleptic malignant syndrome in Parkinson's disease. Author(s): Sato Y, Asoh T, Metoki N, Satoh K. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 May; 74(5): 574-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12700295

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Efficacy of methylprednisolone pulse therapy versus infliximab in the treatment of severe flares of chronic polyarthritis. Author(s): Nossent HC, Bakland G, Aslaksen HK, Olsen G, Nordvag BY. Source: Scandinavian Journal of Rheumatology. 2001; 30(6): 335-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11846051

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Epstein-Barr virus-associated lymphoproliferative disease occurring in a patient with sarcoidosis treated by methotrexate and methylprednisolone. Author(s): Theate I, Michaux L, Dardenne S, Guiot Y, Briere J, Emile FJ, Fabiani B, Detry R, Gaulard P; Groupe d'Etude des Lymphomes de l'Adulte (GELA). Source: European Journal of Haematology. 2002 October; 69(4): 248-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12431245

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Methylprednisolone

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Evaluation of perioperative administration of methylprednisolone sodium succinate and urinary trypsin inhibitor for prevention of surgical stress. Author(s): Shimanuki K, Satake M. Source: Fukushima J Med Sci. 1999 December; 45(2): 93-107. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11039606

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Failure to administer methylprednisolone for acute traumatic spinal cord injury-a prospective audit of 100 patients from a regional spinal injuries unit. Author(s): Molloy S, Middleton F, Casey AT. Source: Injury. 2002 September; 33(7): 575-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12208059

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Febrile ulceronecrotic Mucha-Habermann's disease managed with methylprednisolone semipulse and subsequent methotrexate therapies. Author(s): Ito N, Ohshima A, Hashizume H, Takigawa M, Tokura Y. Source: Journal of the American Academy of Dermatology. 2003 December; 49(6): 11428. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639403

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Gadolinium-enhanced magnetic resonance imaging predicts response to methylprednisolone in multiple sclerosis. Author(s): Sellebjerg F, Jensen CV, Larsson HB, Frederiksen JL. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 February; 9(1): 1027. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12617276

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Gastric antral vascular ectasia in systemic sclerosis: complete resolution with methylprednisolone and cyclophosphamide. Author(s): Lorenzi AR, Johnson AH, Davies G, Gough A. Source: Annals of the Rheumatic Diseases. 2001 August; 60(8): 796-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11454645

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Gemcitabine, cisplatin and methylprednisolone chemotherapy (GEM-P) is an effective regimen in patients with poor prognostic primary progressive or multiply relapsed Hodgkin's and non-Hodgkin's lymphoma. Author(s): Chau I, Harries M, Cunningham D, Hill M, Ross PJ, Archer CD, Norman AR, Wotherspoon A, Koh DM, Gill K, Uzzell M, Prior Y, Catovsky D. Source: British Journal of Haematology. 2003 March; 120(6): 970-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648066

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Grapefruit juice can increase the plasma concentrations of oral methylprednisolone. Author(s): Varis T, Kivisto KT, Neuvonen PJ. Source: European Journal of Clinical Pharmacology. 2000 September; 56(6-7): 489-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11049012

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Hepatic veno-occlusive disease (VOD) with complete occlusion of liver venules after tandem autologous stem cell transplantation-- successful treatment with high-dose methylprednisolone and defibrotide. Author(s): Sayer HG, Will U, Schilling K, Vogt T, Wollina K, Hoffken K. Source: Journal of Cancer Research and Clinical Oncology. 2002 March; 128(3): 148-52. Epub 2002 January 22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11935301

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High dose intravenous methylprednisolone pulse therapy versus oral prednisone for thyroid-associated ophthalmopathy. Author(s): Kauppinen-Makelin R, Karma A, Leinonen E, Loyttyniemi E, Salonen O, Sane T, Setala K, Viikari J, Heufelder A, Valimaki M. Source: Acta Ophthalmologica Scandinavica. 2002 June; 80(3): 316-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12059873

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High dose methylprednisolone must be given for 24 or 48 hours after acute spinal cord injury. Author(s): Bracken MB. Source: Bmj (Clinical Research Ed.). 2001 April 7; 322(7290): 862-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11290648

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High-dose infusional ifosfamide, etoposide plus methylprednisolone followed by dexamethasone, high-dose ara-C and cisplatinum and autologous stem cell transplantation for refractory or relapsed aggressive non-Hodgkin's lymphoma. Author(s): Salar A, Martino R, Perea G, Ribera JM, Lopez-Guillermo A, Guardia R, Escoda L, Altes A, Sierra J, Montserrat E. Source: Haematologica. 2002 October; 87(10): 1028-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12368156

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High-dose methylprednisolone for acute closed spinal cord injury--only a treatment option. Author(s): Hugenholtz H, Cass DE, Dvorak MF, Fewer DH, Fox RJ, Izukawa DM, Lexchin J, Tuli S, Bharatwal N, Short C. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 2002 August; 29(3): 227-35. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12195611

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High-dose methylprednisolone may do more harm for spinal cord injury. Author(s): Qian T, Campagnolo D, Kirshblum S. Source: Medical Hypotheses. 2000 November; 55(5): 452-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11058428

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High-dose methylprednisolone reduces cytokine-induced adhesion molecules on human brain endothelium. Author(s): Gelati M, Corsini E, Dufour A, Massa G, Giombini S, Solero CL, Salmaggi A. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 2000 August; 27(3): 241-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10975537

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High-dose methylprednisolone therapy in multiple sclerosis increases serum uric acid levels. Author(s): Toncev G, Milicic B, Toncev S, Samardzic G. Source: Clinical Chemistry and Laboratory Medicine : Cclm / Fescc. 2002 May; 40(5): 505-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12113297

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High-dose methylprednisolone therapy in multiple sclerosis induces apoptosis in peripheral blood leukocytes. Author(s): Leussink VI, Jung S, Merschdorf U, Toyka KV, Gold R. Source: Archives of Neurology. 2001 January; 58(1): 91-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176941

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High-dose methylprednisolone therapy in pure red cell aplasia. Author(s): Kadikoylu G, Bolaman Z, Barutca S. Source: The Annals of Pharmacotherapy. 2002 January; 36(1): 55-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11816258

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High-dose methylprednisolone treatment of hepatic veno-occlusive disease in a child with Wilms tumor. Author(s): Akyuz C, CaClar K, Emir S, Buyukpamukcu M. Source: Pediatric Hematology and Oncology. 2003 June; 20(4): 345-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12746168

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High-dose oral methylprednisolone therapy in childhood hemangiomas. Author(s): Uysal KM, Olgun N, Erbay A, Sarialioglu F. Source: Pediatric Hematology and Oncology. 2001 July-August; 18(5): 335-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452405

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Hypothalamic-pituitary sarcoidosis with hypopituitarism. Long-term remission with methylprednisolone pulse therapy. Author(s): Molina A, Mana J, Villabona C, Fernandez-Castaner M, Soler J. Source: Pituitary. 2002 January; 5(1): 33-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12638724

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Idiopathic thrombocytopenic purpura treated with pulsed high dose methylprednisolone followed by platelet transfusion. Author(s): Kano H, Kanda H. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 May; 22(3): 318-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521514

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IgE-mediated anaphylactic reaction induced by succinate ester of methylprednisolone. Author(s): Burgdorff T, Venemalm L, Vogt T, Landthaler M, Stolz W. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2002 October; 89(4): 425-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12392389

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Immune parameters associated with early treatment effects of high-dose intravenous methylprednisolone in multiple sclerosis. Author(s): Wang HY, Matsui M, Araya S, Onai N, Matsushima K, Saida T. Source: Journal of the Neurological Sciences. 2003 December 15; 216(1): 61-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14607304

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Immunosuppressive therapy for myelodysplastic syndrome: efficacy of methylprednisolone pulse therapy with or without cyclosporin A. Author(s): Yamada T, Tsurumi H, Kasahara S, Hara T, Sawada M, Moriwaki H. Source: Journal of Cancer Research and Clinical Oncology. 2003 August; 129(8): 485-91. Epub 2003 July 10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12856174

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In vitro incubation of bone marrow and peripheral stem cells with vincristine and methylprednisolone: functional T-cell depletion for haploidentical and autologous transplants. Author(s): Fragonas E, Perticarari S, Presani G, Rabusin M, Andolina M, Mangiarotti MA. Source: Haematologica. 2000 November; 85(11 Suppl): 86-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11268331

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Increase of matrix metalloproteinase-9 in peripheral blood of multiple sclerosis patients treated with high doses of methylprednisolone. Author(s): Mirowska D, Wicha W, Czlonkowski A, Czlonkowska A, Weber F. Source: Journal of Neuroimmunology. 2004 January; 146(1-2): 171-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14698860

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Infantile hemangioendothelioma treated with high dose methylprednisolone pulse therapy. Author(s): Park EA, Seo JW, Lee SW, Choi HY, Lee SJ. Source: Journal of Korean Medical Science. 2001 February; 16(1): 127-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11289392

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Inflammatory response associated with cardiopulmonary bypass and effect of methylprednisolone. Author(s): Corbi PJ, Rahmati M, Lecron JC. Source: The Journal of Thoracic and Cardiovascular Surgery. 2001 November; 122(5): 1052-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11689826

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Injection with methylprednisolone for carpal tunnel syndrome. Study does not show long term benefits of injection for the syndrome. Author(s): Hayward AC. Source: Bmj (Clinical Research Ed.). 2000 March 4; 320(7235): 646. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10744412

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Injection with methylprednisolone for carpal tunnel syndrome. Study is needed to determine best treatment for this syndrome. Author(s): Davies T. Source: Bmj (Clinical Research Ed.). 2000 March 4; 320(7235): 646. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10744413

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Interferon beta-1b and intravenous methylprednisolone promote lesion recovery in multiple sclerosis. Author(s): Richert ND, Ostuni JL, Bash CN, Leist TP, McFarland HF, Frank JA. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2001 February; 7(1): 4958. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11321194

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Intrathecal methylprednisolone for intractable postherpetic neuralgia. Author(s): Kotani N, Kushikata T, Hashimoto H, Kimura F, Muraoka M, Yodono M, Asai M, Matsuki A. Source: The New England Journal of Medicine. 2000 November 23; 343(21): 1514-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11087880

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Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Srinivasan B. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1021; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280324

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Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Niebergall H, Priebe HJ. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1020; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280323

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Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Lewis G. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1020; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280322

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Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Zetlaoui PJ, Cosserat J. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1020-1; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280321

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Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Nelson DA, Landau WM. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1019; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280320

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Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Lampe JB, Hindinger C, Reichmann H. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1019-20; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280319

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Intratunical bupivacaine and methylprednisolone instillation for scrotal pain after testicular sperm retrieval procedures. Author(s): Talu GK, Erdogru T, Kaplancan T, Bahceci M. Source: Asian Journal of Andrology. 2003 March; 5(1): 65-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12647006

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Intravenous immunoglobulin or high-dose methylprednisolone, with or without oral prednisone, for adults with untreated severe autoimmune thrombocytopenic purpura: a randomised, multicentre trial. Author(s): Godeau B, Chevret S, Varet B, Lefrere F, Zini JM, Bassompierre F, Cheze S, Legouffe E, Hulin C, Grange MJ, Fain O, Bierling P; French ATIP Study Group. Source: Lancet. 2002 January 5; 359(9300): 23-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11809183

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Intravenous methylprednisolone for aseptic meningitis in Vogt-Koyanagi-Harada syndrome. Author(s): Solaro C, Messmer Uccelli M. Source: European Neurology. 2000; 44(2): 129-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965172

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Intravenous pulse methylprednisolone therapy in eye disease: effect on glucose tolerance. Author(s): Feldman-Billard S, Lissak B, Benrabah R, Kassaei R, Heron E. Source: Ophthalmology. 2003 December; 110(12): 2369-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14644720

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Intravenous pulses of methylprednisolone for systemic lupus erythematosus. Author(s): Badsha H, Edwards CJ. Source: Seminars in Arthritis and Rheumatism. 2003 June; 32(6): 370-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12833245

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Lack of relationships between cumulative methylprednisolone dose and bone mineral density in healthy men and postmenopausal women with chronic low back pain. Author(s): Dubois EF, Wagemans MF, Verdouw BC, Zwinderman AH, Van Boxtel CJ, Dekhuijzen PN, Schweitzer DH. Source: Clinical Rheumatology. 2003 February; 22(1): 12-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12605311

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Lidocaine and methylprednisolone in management of herpes zoster and post-herpetic neuralgia. Author(s): Gintautas J, Abraham Y, Doss NW, Ghobriel A, Kashem A, Fogler RJ. Source: Proc West Pharmacol Soc. 2002; 45: 73. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12434534

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Low-dose intravenous methylprednisolone or conservative treatment in the management of traumatic optic neuropathy. Author(s): Yip CC, Chng NW, Au Eong KG, Heng WJ, Lim TH, Lim WK. Source: Eur J Ophthalmol. 2002 July-August; 12(4): 309-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12220002

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Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications. Author(s): Badsha H, Kong KO, Lian TY, Chan SP, Edwards CJ, Chng HH. Source: Lupus. 2002; 11(8): 508-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12220105

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Management of cutaneous hemangiomas: a retrospective analysis of 1109 cases and comparison of conventional dose prednisolone with high-dose methylprednisolone therapy. Author(s): Akyuz C, Yaris N, Kutluk MT, Buyukpamukcu M. Source: Pediatric Hematology and Oncology. 2001 January-February; 18(1): 47-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11205840

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Medium-sized arterial vasculitis associated with vascular deposits of immunoglobin E. Favorable response to intravenous methylprednisolone and cyclophosphamide. Author(s): Lavalle C, Santos-Argumedo L, Hernandez-Cueto A, Luria-Perez R, Gonzalez-Bonilla C. Source: Archives of Medical Research. 2002 March-April; 33(2): 195-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11886722

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Megadose methylprednisolone for Evans syndrome. Author(s): Ozsoylu S. Source: Pediatric Hematology and Oncology. 2000 December; 17(8): 725-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11127409

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Megadose methylprednisolone for granulocytic sarcoma. Author(s): Ozsoylu S. Source: Acta Haematologica. 2001; 105(2): 118. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11408719

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Megadose methylprednisolone for Kasabach-Merritt syndrome. Author(s): Ozsoylu S. Source: European Journal of Pediatrics. 2003 July; 162(7-8): 562; Author Reply 563-4. Epub 2003 May 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12748852

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Megadose methylprednisolone for promyelocytic leukemia. Author(s): Ozsoylu S. Source: Pediatric Hematology and Oncology. 2000 December; 17(8): 723. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11127408

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Methylprednisolone acetate versus oral prednisolone in moderately active ulcerative colitis. Author(s): Sood A, Midha V, Sood N, Kaushal V, Awasthi G. Source: Indian J Gastroenterol. 2002 January-February; 21(1): 11-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11871829

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Methylprednisolone acts on peripheral blood mononuclear cells and endothelium in inhibiting migration phenomena in patients with multiple sclerosis. Author(s): Gelati M, Corsini E, De Rossi M, Masini L, Bernardi G, Massa G, Boiardi A, Salmaggi A. Source: Archives of Neurology. 2002 May; 59(5): 774-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12020259

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Methylprednisolone and acute spinal cord injury: an update of the randomized evidence. Author(s): Bracken MB. Source: Spine. 2001 December 15; 26(24 Suppl): S47-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11805609

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Methylprednisolone and spinal cord injury. Author(s): Young W. Source: Journal of Neurosurgery. 2002 January; 96(1 Suppl): 141-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11795708

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Methylprednisolone and spinal cord injury. Author(s): Bracken MB. Source: Journal of Neurosurgery. 2002 January; 96(1 Suppl): 140-1; Author Reply 142. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11795707

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Methylprednisolone concentrations in the vitreous and the serum after pulse therapy. Author(s): Behar-Cohen FF, Gauthier S, El Aouni A, Chapon P, Parel JM, Renard G, Chauvaud D. Source: Retina (Philadelphia, Pa.). 2001; 21(1): 48-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11217929

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Methylprednisolone does not benefit patients undergoing coronary artery bypass grafting and early tracheal extubation. Author(s): Chaney MA, Durazo-Arvizu RA, Nikolov MP, Blakeman BP, Bakhos M. Source: The Journal of Thoracic and Cardiovascular Surgery. 2001 March; 121(3): 561-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11241092

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Methylprednisolone effect on brain volume and enhancing lesions in MS before and during IFNbeta-1b. Author(s): Rao AB, Richert N, Howard T, Lewis BK, Bash CN, McFarland HF, Frank JA. Source: Neurology. 2002 September 10; 59(5): 688-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12221158

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Methylprednisolone for acute spinal cord injury: not a standard of care. Author(s): Hugenholtz H. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 April 29; 168(9): 1145-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12719318

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Methylprednisolone in acute spinal cord injuries. Author(s): O'Connor PA, McCormack O, Gavin C, Dungan R, Kirke C, McCormack D, O'Byrne J, Stephens M, McManus F, Walsh M. Source: Ir J Med Sci. 2003 January-March; 172(1): 24-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12760459

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Methylprednisolone in acute spinal cord injury: fact or fantasy? Author(s): Walker J, Criddle LM. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2001 August; 27(4): 401-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11468638

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

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Methylprednisolone may improve lumbosacral radiculoplexus neuropathy. Author(s): Dyck PJ, Norell JE, Dyck PJ. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 2001 August; 28(3): 224-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11513340

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Methylprednisolone pulse therapy in Japanese children with severe lupus nephritis. Author(s): Tanaka H, Tateyama T, Waga S. Source: Pediatric Nephrology (Berlin, Germany). 2001 October; 16(10): 817-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11605789

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Methylprednisolone suleptanate Pharmacia Corp. Author(s): Paggiaro P. Source: Curr Opin Investig Drugs. 2000 September; 1(1): 97-103. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11249603

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Methylprednisolone therapy for acute rejection: too much of a good thing? Author(s): Goddard S, Adams DH. Source: Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2002 June; 8(6): 535-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12037784

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Methylprednisolone use in acute spinal cord injury. Author(s): Acland RH, Anthony A, Inglis GS, Walton DI, Xiong X. Source: N Z Med J. 2001 March 9; 114(1127): 99. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11297147

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Methylprednisolone, an alternative to dexamethasone in very premature infants at risk of chronic lung disease. Author(s): Andre P, Thebaud B, Odievre MH, Razafimahefa H, Zupan V, Dehan M, Lacaze-Masmonteil T. Source: Intensive Care Medicine. 2000 October; 26(10): 1496-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11126262

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Modeling interactions between adrenal suppression and T-helper lymphocyte trafficking during multiple dosing of methylprednisolone. Author(s): Chow FS, Sharma A, Jusko WJ. Source: Journal of Pharmacokinetics and Biopharmaceutics. 1999 December; 27(6): 55975. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11153446

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Modified ESHAP as salvage chemotherapy for recurrent or refractory non-Hodgkin's lymphoma: results of a single-center study of 32 patients. Modified etoposide, methylprednisolone, cytarabine and cisplatin. Author(s): Ozturk MA, Barista I, Altundag MK, Turker A, Yalcin S, Celik I, Gullu I, Guler N, Ozisik Y, Kars A, Kansu E, Baltali E, Tekuzman G. Source: Chemotherapy. 2002 December; 48(5): 252-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476042

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Modulation of aspirin-insensitive eicosanoid biosynthesis by 6-methylprednisolone in unstable angina. Author(s): Cipollone F, Ganci A, Greco A, Panara MR, Pasquale M, Di Gregorio D, Porreca E, Mezzetti A, Cuccurullo F, Patrignani P. Source: Circulation. 2003 January 7; 107(1): 55-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12515743

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Morphological analysis of articular cartilage biopsies from a randomized, clinical study comparing the effects of 500-730 kDa sodium hyaluronate (Hyalgan) and methylprednisolone acetate on primary osteoarthritis of the knee. Author(s): Guidolin DD, Ronchetti IP, Lini E, Guerra D, Frizziero L. Source: Osteoarthritis and Cartilage / Oars, Osteoarthritis Research Society. 2001 May; 9(4): 371-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11399102

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Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis. Author(s): Pasquali Ronchetti I, Guerra D, Taparelli F, Boraldi F, Bergamini G, Mori G, Zizzi F, Frizziero L. Source: Rheumatology (Oxford, England). 2001 February; 40(2): 158-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11257152

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Non-myeloablative conditioning regimen of fludarabine, busulfan, anti-thymocyte globulin, and methylprednisolone for allogeneic peripheral blood hematopoietic cell transplantation. Author(s): Lee KH, Lee JH, Lee JH, Kim WK, Chi HS, Lee JS. Source: Haematologica. 2001 September; 86(9): 999-1001. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11532635

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OKT3 versus methylprednisolone for primary treatment of rejection: a retrospective evaluation. Author(s): Meijer RT, Keur I, Surachno S, ten Berge IJ, Schellekens PT. Source: Transplantation Proceedings. 2001 May; 33(3): 2196-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11377501

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Oral megadose methylprednisolone therapy for refractory Diamond-Blackfan anemia. International Diamond-Blackfan Anemia Study Group. Author(s): Buchanan GR; International Diamond-Blackfan Anemia Study Group. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2001 August-September; 23(6): 353-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11563769

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Outcome of severe encephalomyelitis in children: effect of high-dose methylprednisolone and immunoglobulins. Author(s): Shahar E, Andraus J, Savitzki D, Pilar G, Zelnik N. Source: Journal of Child Neurology. 2002 November; 17(11): 810-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12585719

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Pemphigus vulgaris IgG and methylprednisolone exhibit reciprocal effects on keratinocytes. Author(s): Nguyen VT, Arredondo J, Chernyavsky AI, Kitajima Y, Pittelkow M, Grando SA. Source: The Journal of Biological Chemistry. 2004 January 16; 279(3): 2135-46. Epub 2003 November 04. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14600150

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Pharmacokinetic and pharmacodynamic interactions between diltiazem and methylprednisolone in healthy volunteers. Author(s): Booker BM, Magee MH, Blum RA, Lates CD, Jusko WJ. Source: Clinical Pharmacology and Therapeutics. 2002 October; 72(4): 370-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12386639

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Pharmacokinetics and pharmacodynamics of methylprednisolone after one bolus dose compared with two dose fractions. Author(s): Uhl A, Czock D, Boehm BO, Zellner D, Mertz A, Keller F. Source: Journal of Clinical Pharmacy and Therapeutics. 2002 August; 27(4): 281-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12174030

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Pharyngolaryngeal lesions in patients undergoing cervical spine surgery through the anterior approach: contribution of methylprednisolone. Author(s): Pedram M, Castagnera L, Carat X, Macouillard G, Vital JM. Source: European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2003 February; 12(1): 84-90. Epub 2002 December 04. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12592551

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Postoperative analgesia by epidural methylprednisolone after posterolateral thoracotomy. Author(s): Blanloeil Y, Bizouarn P, Le Teurnier Y, Le Roux C, Rigal JC, Sellier E, Nougarede B. Source: British Journal of Anaesthesia. 2001 October; 87(4): 635-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11878738

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Predictors of poor renal outcome in patients with lupus nephritis treated with combined pulses of cyclophosphamide and methylprednisolone. Author(s): Cortes-Hernandez J, Ordi-Ros J, Labrador M, Segarra A, Tovar JL, Balada E, Vilardell-Tarres M. Source: Lupus. 2003; 12(4): 287-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12729052

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Preoperative administration of methylprednisolone attenuates cytokine-induced respiratory failure after esophageal resection. Author(s): Takeda S, Takeda S, Kim C, Ikezaki H, Nakanishi K, Sakamoto A, Okawa K, Miyashita M, Sasajima K, Tajiri T, Tanaka K, Ogawa R. Source: Journal of Nippon Medical School = Nihon Ika Daigaku Zasshi. 2003 February; 70(1): 16-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12646971

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Prevention of post-herpetic neuralgia: acyclovir and prednisolone versus epidural local anesthetic and methylprednisolone. Author(s): Pasqualucci A, Pasqualucci V, Galla F, De Angelis V, Marzocchi V, Colussi R, Paoletti F, Girardis M, Lugano M, Del Sindaco F. Source: Acta Anaesthesiologica Scandinavica. 2000 September; 44(8): 910-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10981565

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Proliferation of myeloid lineage cells and apoptosis of lymphoblastic leukemic cells induced by short-course high-dose methylprednisolone in patients with acute lymphoblastic leukemia. Author(s): Yildiran A, Erduran E, Tekelioglu Y, Dilber E, Gedik Y. Source: Turk J Pediatr. 2002 April-June; 44(2): 116-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12026198

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Prolonged methylprednisolone treatment suppresses systemic inflammation in patients with unresolving acute respiratory distress syndrome: evidence for inadequate endogenous glucocorticoid secretion and inflammation-induced immune cell resistance to glucocorticoids. Author(s): Meduri GU, Tolley EA, Chrousos GP, Stentz F. Source: American Journal of Respiratory and Critical Care Medicine. 2002 April 1; 165(7): 983-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11934726

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Prophylactic treatment of episodic cluster headache with intravenous bolus of methylprednisolone. Author(s): Mir P, Alberca R, Navarro A, Montes E, Martinez E, Franco E, Cayuela A, Lozano P. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 December; 24(5): 318-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14716526

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Pulmonary embolism after intra-articular injection of methylprednisolone and hyaluronate. Author(s): Famularo G, Liberati C, Sebastiani GD, Polchi S. Source: Clin Exp Rheumatol. 2001 May-June; 19(3): 355. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407098

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Pulse methylprednisolone treatment of idiopathic steroid-resistant nephrotic syndrome. Author(s): Yorgin PD, Krasher J, Al-Uzri AY. Source: Pediatric Nephrology (Berlin, Germany). 2001 March; 16(3): 245-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11322372

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Pulse methylprednisolone treatment of idiopathic steroid-resistant nephrotic syndrome. Author(s): Bagga A, Srivastava RN. Source: Pediatric Nephrology (Berlin, Germany). 2002 April; 17(4): 299; Author Reply 300-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11956887

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Pulse methylprednisolone, cyclosporine, and ace inhibitor therapy decreases proteinuria in two siblings with familial focal segmental glomerulosclerosis. Author(s): Yorgin PD, Belson A, Higgins J, Alexander SR. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2001 June; 37(6): E44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11382715

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Questionnaire survey of the views of the delegates at the European Cervical Spine Research Society meeting on the administration of methylprednisolone for acute traumatic spinal cord injury. Author(s): Molloy S, Price M, Casey AT. Source: Spine. 2001 December 15; 26(24): E562-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11740372

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Randomized trial of high-dose methylprednisolone versus intravenous immunoglobulin for the treatment of acute idiopathic thrombocytopenic purpura in children. Author(s): Ancona KG, Parker RI, Atlas MP, Prakash D. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2002 October; 24(7): 540-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12368690

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Recovery after high-dose methylprednisolone and delayed evacuation: a case of spinal epidural hematoma. Author(s): Ghaly RF. Source: Journal of Neurosurgical Anesthesiology. 2001 October; 13(4): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11733665

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Relationship between IgM antibody to human cytomegalovirus, virus load, donor and recipient serostatus, and administration of methylprednisolone as risk factors for cytomegalovirus disease after liver transplantation. Author(s): Emery VC, Cope AV, Sabin CA, Burroughs AK, Rolles K, Lazzarotto T, Landini MP, Brojanac S, Wise J, Maine GT. Source: The Journal of Infectious Diseases. 2000 December; 182(6): 1610-5. Epub 2000 October 26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11069231

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Remission of acute myeloblastic leukemia after severe pneumonia treated with highdose methylprednisolone. Author(s): Shimohakamada Y, Shinohara K, Fukuda N. Source: International Journal of Hematology. 2001 August; 74(2): 173-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11594518

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Retinal and choroidal microvascular embolization with methylprednisolone. Author(s): Gupta V, Sharma SC, Gupta A, Dogra MR. Source: Retina (Philadelphia, Pa.). 2002 June; 22(3): 382-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12055481

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Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review. Author(s): Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer EA. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2000 November; 23(5): 449-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11085349

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Secretory transport of methylprednisolone possibly mediated by P-glycoprotein in Caco-2 cells. Author(s): Oka A, Oda M, Saitoh H, Nakayama A, Takada M, Aungst BJ. Source: Biological & Pharmaceutical Bulletin. 2002 March; 25(3): 393-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11913542

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Serial contrast-enhanced magnetic resonance imaging and spectroscopic imaging of acute multiple sclerosis lesions under high-dose methylprednisolone therapy. Author(s): Schocke MF, Berger T, Felber SR, Wolf C, Deisenhammer F, Kremser C, Seppi K, Aichner FT. Source: Neuroimage. 2003 October; 20(2): 1253-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14568494

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Severe arthralgia and myalgia due to high-dose methylprednisolone pulse therapy cured by potassium infusion in a patient with diffuse proliferative lupus nephritis. Author(s): Odabas AR, Cetinkaya R, Selcuk Y, Kaya H. Source: Nephron. 2001 January; 87(1): 95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174035

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Severe bradycardia after a methylprednisolone “minipulse” treatment. Author(s): Pudil R, Hrncir Z. Source: Archives of Internal Medicine. 2001 July 23; 161(14): 1778-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11485514

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Short-term complete remission of a patient with human T lymphotropic virus type-1 associated adult T-cell leukemia/lymphoma with pancytopenia by sequential highdose methylprednisolone and cyclosporin A. Author(s): Ma Y, Li Z, Chen G, Dong P, Jiang Y, Zeng Y. Source: Chinese Medical Journal. 2001 April; 114(4): 428-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11780471

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Sirolimus steady-state trough concentrations are not affected by bolus methylprednisolone therapy in renal allograft recipients. Author(s): Backman L, Kreis H, Morales JM, Wilczek H, Taylor R, Burke JT. Source: British Journal of Clinical Pharmacology. 2002 July; 54(1): 65-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12100227

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Soluble P-selectin, interleukin 6, and thrombopoietin levels in children with acute and chronic idiopathic thrombocytopenic purpura and their relationship with megadose methylprednisolone therapy: a pilot study. Author(s): Olcay L, Yenicesu I, Yetgin S. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2002 December; 24(9): 742-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12468916

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Stability and compatibility of methylprednisolone acetate and ropivacaine hydrochloride in polypropylene syringes for epidural administration. Author(s): Robustelli della Cuna FS, Mella M, Magistrali G, Ricci M, Losurdo A, Goglio AM. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2001 September 15; 58(18): 1753-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11571819

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Stability of methylprednisolone sodium succinate in pediatric parenteral nutrition mixtures. Author(s): Gellis C, Sautou-Miranda V, Arvouet A, Vasson MP, Chopineau J. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2001 June 15; 58(12): 1139-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11449858

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Steatohepatitis during methylprednisolone therapy for ulcerative colitis exacerbation. Author(s): Candelli M, Nista EC, Pignataro G, Zannoni G, de Pascalis B, Gasbarrini G, Gasbarrini A. Source: Journal of Internal Medicine. 2003 March; 253(3): 391-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12603510

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Successful conversion from prednisolone to methylprednisolone for immunosuppression: a case report. Author(s): Sekido H, Matsuo K, Takeda K, Morioka D, Kubota T, Tanaka K, Endo I, Togo S, Inayama Y, Nakatani Y, Hirano T, Shimada H. Source: Transplantation Proceedings. 2003 February; 35(1): 223-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12591373

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Successful recovery after high-dose intravenous methylprednisolone in acute hemorrhagic leukoencephalitis. Author(s): Meilof JF, Hijdra A, Vermeulen M. Source: Journal of Neurology. 2001 October; 248(10): 898-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11697528

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Successful therapy of pure red cell aplasia secondary to plasma cell dyscrasia with bolus methylprednisolone. Author(s): Matsuhashi Y, Tasaka T, Uehara E, Kamei T, Tamura T, Nagai M. Source: Intern Med. 2001 August; 40(8): 802-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11518129

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Successful treatment of mesenteric vasculitis caused by Henoch-Schonlein purpura with methylprednisolone pulse therapy. Author(s): Wang L, Huang FC, Ko SF, Cheng MT. Source: Clinical Rheumatology. 2003 May; 22(2): 140-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740680

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Successful treatment of recurrent, intractable hyperemesis gravidarum with methylprednisolone. A case report. Author(s): Chan LY, Lam MH, Lau TK, Chin RK. Source: J Reprod Med. 2003 April; 48(4): 293-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12746996

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Successful treatment of refractory anemia by high-dose methylprednisolone associated with an increment in CD68-positive cells in bone marrow. Author(s): Motomura S, Motoji T, Okutomi K, Nishikawa T, Kasajima T, Mizoguchi H. Source: American Journal of Hematology. 2001 February; 66(2): 80-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11421303

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Summary statement: the use of methylprednisolone in acute spinal cord injury. Author(s): Fehlings MG; Spine Focus Panel. Source: Spine. 2001 December 15; 26(24 Suppl): S55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11805610

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Suprascapular nerve block (using bupivacaine and methylprednisolone acetate) in chronic shoulder pain. Author(s): Shanahan EM, Ahern M, Smith M, Wetherall M, Bresnihan B, FitzGerald O. Source: Annals of the Rheumatic Diseases. 2003 May; 62(5): 400-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12695149

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Systemic sclerosis and interstitial lung disease: a pilot study using pulse intravenous methylprednisolone and cyclophosphamide to assess the effect on high resolution computed tomography scan and lung function. Author(s): Griffiths B, Miles S, Moss H, Robertson R, Veale D, Emery P. Source: The Journal of Rheumatology. 2002 November; 29(11): 2371-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12415594

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Targeted methylprednisolone acetate/hyaluronidase/clonidine injection after diagnostic epiduroscopy for chronic sciatica: a prospective, 1-year follow-up study. Author(s): Geurts JW, Kallewaard JW, Richardson J, Groen GJ. Source: Regional Anesthesia and Pain Medicine. 2002 July-August; 27(4): 343-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12132057

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Thalidomide-induced morbilliform rash: diagnosis and continuation of therapy, premedicated with methylprednisolone. Author(s): J Fam Pract. 2002 Oct;51(10):824 Source: Dermatology (Basel, Switzerland). 2002; 204(4): 365-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12401149

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The analysis of eosinophil and lymphocyte phenotype following single dose of highdose methylprednisolone in two siblings with marked hypereosinophilia. Author(s): Uckan D, Hicsonmez G, Tunc B, Cetin M, Tezcan I, Tuncer M. Source: Clinical and Laboratory Haematology. 2001 February; 23(1): 33-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422228

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The effect of combined therapy with immunoadsorption and high-dose intravenous methylprednisolone on myasthenia gravis. Author(s): Munakata R, Utsugisawa K, Nagane Y, Yamagata M, Oikawa M, Obara D, Tohgi H. Source: European Neurology. 2002; 48(2): 115-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12187003

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The effect of methylprednisolone on cytokine concentration and leukocyte adhesion molecule expression in an isolated cardiopulmonary bypass system. Author(s): Gormley SM, Armstrong MA, McMurray TJ, McBride WT. Source: Cytokine. 2003 June 7; 22(5): 149-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12842763

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The effect of short-course high-dose methylprednisolone on peripheral blood CD34+ progenitor cells of children with acute leukemia during remission induction therapy. Author(s): Tunc B, Oner AF, Hicsonmez G. Source: Turk J Pediatr. 2002 January-March; 44(1): 1-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11858371

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The effect of short-course high-dose methylprednisolone on peripheral blood lymphocyte subsets in children with acute leukemia during remission induction treatment. Author(s): Tunc B, Oner AF, Hicsonmez G. Source: Leukemia Research. 2003 January; 27(1): 19-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12479848

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The effect of short-term prophylactic methylprednisolone on the incidence and severity of postpericardiotomy syndrome in children undergoing cardiac surgery with cardiopulmonary bypass. Author(s): Mott AR, Fraser CD Jr, Kusnoor AV, Giesecke NM, Reul GJ Jr, Drescher KL, Watrin CH, Smith EO, Feltes TF. Source: Journal of the American College of Cardiology. 2001 May; 37(6): 1700-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11345387

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The effects of high dose methylprednisolone on apoptosis in children with acute lymphoblastic leukemia. Author(s): Uckan D, Yetgin S, Cetin M, Ozyurek E, Okur H, Aslan D, Tuncer M. Source: Clinical and Laboratory Haematology. 2003 February; 25(1): 35-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12542440

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The effects of pulse methylprednisolone on matrix metalloproteinase and tissue inhibitor of metalloproteinase-1 expression in rheumatoid arthritis. Author(s): Wong P, Cuello C, Bertouch JV, Roberts-Thomson PJ, Ahern MJ, Smith MD, Youssef PP. Source: Rheumatology (Oxford, England). 2000 October; 39(10): 1067-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11035124

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The prehospital administration of intravenous methylprednisolone lowers hospital admission rates for moderate to severe asthma. Author(s): Knapp B, Wood C. Source: Prehosp Emerg Care. 2003 October-December; 7(4): 423-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14582090

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The role of intravenous methylprednisolone pulses in the management of rheumatoid arthritis. Author(s): Smith MD, Roberts-Thomson PJ, Ahern MJ. Source: Rheumatology (Oxford, England). 2000 November; 39(11): 1296-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11085818

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The role of methylprednisolone in acute spinal cord injuries. Author(s): Nesathurai S. Source: The Journal of Trauma. 2001 August; 51(2): 421-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11493816

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The role of short course of high-dose methylprednisolone in children with acute myeloblastic leukemia (FAB M2) presented with myeloid tumor. Author(s): Hicsonmez G, Cetin M, Aslan D, Ozyurek E. Source: Pediatric Hematology and Oncology. 2003 July-August; 20(5): 373-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12775535

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The use of methylprednisolone. Author(s): Bracken MB. Source: Journal of Neurosurgery. 2000 October; 93(2 Suppl): 340-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11012076

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Therapy with pulse methylprednisolone and short course pulse cyclophosphamide for diffuse proliferative glomerulonephritis. Author(s): Mosca M, Neri R, Giannessi S, Pasquariello A, Puccini R, Bencivelli W, Bombardieri S. Source: Lupus. 2001; 10(4): 253-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11341101

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Time-variant increase in methylprednisolone clearance in patients with acute respiratory distress syndrome: a population pharmacokinetic study. Author(s): Yates CR, Vysokanov A, Mukherjee A, Ludden TM, Tolley E, Meduri GU, Dalton JT. Source: Journal of Clinical Pharmacology. 2001 April; 41(4): 415-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11304898

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Treatment of allergic alveolitis with methylprednisolone pulse therapy. Author(s): Chen C, Kleinau I, Niggemann B, Weinhold N, Wahn U, Paul K. Source: Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology. 2003 February; 14(1): 66-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12603714

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Treatment of blastic phase chronic myeloid leukemia with mitoxantrone, cytosine arabinoside and high dose methylprednisolone. Author(s): Bolaman Z, Koseoglu M, Ayyildiz O, Kadikoylu G, Sonmez HM, Demir S, Muftuoglu E. Source: Haematologia. 2002; 32(1): 49-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12243555

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Treatment of Kasabach-Merritt syndrome by megadose methylprednisolone. Author(s): Ozsoylu S. Source: Pediatric Hematology and Oncology. 2002 July-August; 19(5): 373-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12078869

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Treatment of lymphocytic hypophysitis by high-dose methylprednisolone pulse therapy. Author(s): Yamagami K, Yoshioka K, Sakai H, Fukumoto M, Yamakita T, Hosoi M, Ishii T, Sato T, Tanaka S, Fujii S. Source: Intern Med. 2003 February; 42(2): 168-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12636236

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Treatment of refractory juvenile idiopathic arthritis via pulse therapy using methylprednisolone and cyclophosphamide. Author(s): de Castro TC, Terreri MT, Len C, Hilario MO. Source: Sao Paulo Medical Journal = Revista Paulista De Medicina. 2003 May 5; 121(3): 117-20. Epub 2003 August 08. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12920473

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Treatment of vulvar vestibulitis with submucous infiltrations of methylprednisolone and lidocaine. An alternative approach. Author(s): Murina F, Tassan P, Roberti P, Bianco V. Source: J Reprod Med. 2001 August; 46(8): 713-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11547644

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Treatment with methylprednisolone in relapses of multiple sclerosis patients: immunological evidence of immediate and short-term but not long-lasting effects. Author(s): Martinez-Caceres EM, Barrau MA, Brieva L, Espejo C, Barbera N, Montalban X. Source: Clinical and Experimental Immunology. 2002 January; 127(1): 165-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11882048

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Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. Author(s): Chang CH, Stanton RP, Glutting J. Source: The Journal of Bone and Joint Surgery. British Volume. 2002 April; 84(3): 407-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12002502

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Up-regulation of serine/threonine protein phosphatase type 2A regulatory subunits during methylprednisolone-induced differentiation of leukaemic HL-60 cells. Author(s): Aydin HH, Selvi N, Saydam G, Tobu M, Uzunoglu S, Uslu R, Buyukkececi F, Omay SB. Source: Clinical and Laboratory Haematology. 2000 October; 22(5): 271-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11122267

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Urticaria to methylprednisolone sodium hemisuccinate. Author(s): Borja JM, Galindo PA, Feo F, Gomez E. Source: Allergy. 2001 August; 56(8): 791. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11488681

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Use of high-dose methylprednisolone pulse therapy in patients with progressive and stable vitiligo. Author(s): Seiter S, Ugurel S, Tilgen W, Reinhold U. Source: International Journal of Dermatology. 2000 August; 39(8): 624-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10971735

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Usefulness of Tc-99m ECD brain SPECT to evaluate the effects of methylprednisolone pulse therapy in lupus erythematosus with brain involvement: a preliminary report. Author(s): Liu FY, Huang WS, Kao CH, Yen RF, Wang JJ, Ho ST. Source: Rheumatology International. 2003 July; 23(4): 182-5. Epub 2003 January 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12856144

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Why do you prescribe methylprednisolone for acute spinal cord injury? A Canadian perspective and a position statement. Author(s): Hurlbert RJ, Moulton R. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 2002 August; 29(3): 236-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12195612

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

Finding Nutrition Studies on Methylprednisolone 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 “methylprednisolone” (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 “methylprednisolone” (or a synonym): •

Comparison of skin atrophy and vasoconstriction due to mometasone furoate, methylprednisolone and hydrocortisone. Author(s): Department of Dermatology, Ruhr University, Bochum, St. Josef Hospital, Bochum, Germany. Source: Hoffmann, K Auer, T Stucker, M Hoffmann, A Altmeyer, P J-Eur-AcadDermatol-Venereol. 1998 March; 10(2): 137-42 0926-9959

•

Comparison of the effects of melatonin and methylprednisolone in experimental spinal cord injury. Author(s): Department of Neurosurgery, Ankara Numune Hospital, Turkey. Source: Kaptanoglu, E Tuncel, M Palaoglu, S Konan, A Demirpence, E Kilinc, K JNeurosurg. 2000 July; 93(1 Suppl): 77-84 0022-3085

•

Effect of lazaroid U-74389G and methylprednisolone on endotoxin-induced shock in mice. Author(s): Department of Surgery II, Hiroshima University School of Medicine, Japan. Source: Fukuma, K Marubayashi, S Okada, K Yamada, K Kimura, A Dohi, K Surgery. 1999 April; 125(4): 421-30 0039-6060

•

Effect of methylprednisolone, tirilazad mesylate and vitamin E on lipid peroxidation after experimental spinal cord injury. Author(s): Department of Neurosurgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey. Source: Koc, R K Akdemir, H Karakucuk, E I Oktem, I S Menku, A Spinal-Cord. 1999 January; 37(1): 29-32 1362-4393

•

Effect of treatment with 21-aminosteroid U-74389G and glucocorticoid steroid methylprednisolone on somatosensory evoked potentials in rat spinal cord during mild compression. Author(s): Department of Neurosurgery, Military Clinical Hospital, Bydgoszcz, Poland. [email protected] Source: Harat, M Kochanowski, J J-Neurotrauma. 1999 February; 16(2): 187-93 0897-7151

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Effects of atropine, trimedoxime and methylprednisolone on the development of organophosphate-induced delayed polyneuropathy in the hen. Author(s): Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe. Source: Jokanovic, M Stepanovic Petrovic, R M Maksimovic, M Jovanovic, D Kosanovic, M Piperski, V Exp-Toxicol-Pathol. 2001 June; 53(2-3): 129-32 0940-2993

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Effects of G-CSF and high-dose methylprednisolone on peripheral stem cells, serum IL-3 levels and hematological parameters in acute lymphoblastic leukemia patients with neutropenia: a pilot study. Author(s): Pediatric Hematology Unit, Faculty of Medicine, Hacettepe University, Ankara, Turkey. Source: Ozbek, N Yetgin, S Tuncer, A M Leuk-Res. 2000 January; 24(1): 55-8 0145-2126

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Effects of methylprednisolone and dextromethorphan on lipid peroxidation in an experimental model of spinal cord injury. Author(s): Firat Universitesi, Tip Merkezi, Norosirurji Klinigi, Elazig, Turkey. [email protected] Source: Topsakal, C Erol, F S Ozveren, M F Yilmaz, N Ilhan, N Neurosurg-Revolume 2002 August; 25(4): 258-66 0344-5607

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•

High-dose methylprednisolone prevents vasospasm after subarachnoid hemorrhage through inhibition of protein kinase C activation. Author(s): Department of Neurosurgery, Hamamatsu University School of Medicine, 3600 Handacho, Hamamatsu, Shizuoka 431-3192, Japan. Source: Chen, Duo Nishizawa, Shigeru Yokota, Naoki Ohta, Seiji Yokoyama, Tetsuo Namba, Hiroki Neurol-Res. 2002 March; 24(2): 215-22 0161-6412

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Iatrogenic hyperadrenocorticism in a cat following a short therapeutic course of methylprednisolone acetate. Author(s): Department of Clinical Veterinary Science, Division of Companion Animals, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, UK. Source: Ferasin, L J-Feline-Med-Surg. 2001 June; 3(2): 87-93 1098-612X

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Kinetics of hydrolysis of dextran-methylprednisolone succinate, a macromolecular prodrug of methylprednisolone, in rat blood and liver lysosomes. Author(s): School of Pharmacy, Texas Tech University Health Sciences Center, 1300 Coulter, Amarillo, TX 79106, USA. [email protected] Source: Mehvar, R Dann, R O Hoganson, D A J-Control-Release. 2000 July 31; 68(1): 5361 0168-3659

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Methylprednisolone and vitamin E therapy in perinatal hypoxic-ischemic brain damage in rats. Author(s): Department of Neurosurgery, Gulhane School of Medicine, Ankara, Turkey. Source: Daneyemez, M Kurt, E Cosar, A Yuce, E Ide, T Neuroscience. 1999; 92(2): 693-7 0306-4522

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Methylprednisolone does not enhance the surfactant effects on oxygenation and histology in paraquat-induced rat lung injury. Author(s): Department of Pediatrics, Taipei Medical University Hospital, 252 Wu Hsing Street, Taipei 110, Taiwan. [email protected] Source: Chen, C M Su, B Hsu, C C Wang, L F Intensive-Care-Med. 2002 August; 28(8): 1138-44 0342-4642

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Multicenter clinical trial for evaluating methylprednisolone pulse treatment of idiopathic optic neuritis in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG). Author(s): Department of Ophthalmology, Kitasato University School of Medicine, Sagamihara, Japan. Source: Wakakura, M Mashimo, K Oono, S Matsui, Y Tabuchi, A Kani, K Shikishima, K Kawai, K Nakao, Y Tazawa, Y Kiyosawa, M Abe, H Ohba, N Yago, K Maeda, S Sugita, M Ishikawa, S Jpn-J-Ophthalmol. 1999 Mar-April; 43(2): 133-8 0021-5155

•

The role of free oxygen radicals in noise induced hearing loss: effects of melatonin and methylprednisolone. Author(s): Department of Otorhinolaryngology, Medical School, Firat University, Tip Fakultesi, KBB Anabilim Dali, 23119, Elazig, Turkey. [email protected] Source: Karlidag, T Yalcin, S Ozturk, A Ustundag, B Gok, U Kaygusuz, I Susaman, N Auris-Nasus-Larynx. 2002 April; 29(2): 147-52 0385-8146

•

Treatment of human B-cell precursor leukemia in SCID mice by using a combination of the anti-CD19 immunotoxin B43-PAP with the standard chemotherapeutic drugs vincristine, methylprednisolone, and L-asparaginase. Author(s): Biotherapy Program, University of Minnesota, Minneapolis, USA. Source: Ek, O Gaynon, P Zeren, T Chelstrom, L M Myers, D E Uckun, F M LeukLymphoma. 1998 September; 31(1-2): 143-9 1042-8194

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The following is a specific Web list relating to methylprednisolone; 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: •

Food and Diet Tendinitis Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. DISSERTATIONS ON METHYLPREDNISOLONE Overview In this chapter, we will give you a bibliography on recent dissertations relating to methylprednisolone. 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 “methylprednisolone” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on methylprednisolone, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Methylprednisolone 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 methylprednisolone. 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: •

Pharmacodynamics and Pharmacogenomics of Methylprednisolone on Glucose Regulation by Jin, Jin Yan; PhD from State University of New York at Buffalo, 2003, 456 pages http://wwwlib.umi.com/dissertations/fullcit/3102376

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 4. CLINICAL METHYLPREDNISOLONE

TRIALS

AND

Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning methylprednisolone.

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

Phase II Randomized Study of Muromonab-CD3, Cyclosporine, Methylprednisolone, and Prednisone in Patients With Giant Cell Myocarditis Condition(s): Myocarditis; Giant Cell Myocarditis Study Status: This study is currently recruiting patients. Sponsor(s): Mayo Clinic Purpose - Excerpt: Objectives: I. Assess the effect of immunosuppression with muromonab-CD3, cyclosporine, methylprednisolone, and prednisone versus standard care in terms of death, heart transplantation, or left ventricular assistive device placement in patients with giant cell myocarditis. II. Compare left ventricular ejection fraction prior to and after 4 weeks of treatment in these arms. III. Compare the degree of myocardial inflammatory infiltrate prior to and after 4 weeks of treatment in these arms. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004482

8

These are listed at www.ClinicalTrials.gov.

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•

Methylprednisolone Phase II Study of Methylprednisolone and Xylose Absorption in Children with Hypersensitivity Vasculitis Associated with Connective Tissue Disease Condition(s): Vasculitis, Hypersensitivity; Connective Tissue Diseases Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); Children's Memorial Hospital, Chicago Purpose - Excerpt: Objectives: I. Assess xylose absorption and blood levels of neopterin and von Willebrand factor antigen in children with active hypersensitivity vasculitis associated with connective tissue disease. II. Correlate the bioavailability and kinetic rate constant of absorption of oral methylprednisolone with that of xylose. III. Compare the bioavailability and kinetic rate constant of absorption of oral methylprednisolone during active and quiescent disease in the same child. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004357

•

Pixantrone, Cytarabine, Methylprednisolone, and Cisplatin in Treating Patients With Aggressive Non-Hodgkin's Lymphoma in First Relapse Condition(s): recurrent adult diffuse large cell lymphoma; anaplastic large cell lymphoma; recurrent adult diffuse mixed cell lymphoma; recurrent adult immunoblastic large cell lymphoma; recurrent grade 3 follicular lymphoma; recurrent adult Burkitt's lymphoma Study Status: This study is currently recruiting patients. Sponsor(s): Theradex Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy, such as pixantrone, cytarabine, methylprednisolone, and cisplatin, work in different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy in treating patients who have relapsedaggressivenon-Hodgkin's lymphoma. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00069966

•

Cyclophosphamide, Rituximab, and Either Prednisone or Methylprednisolone in Treating Patients With Lymphoproliferative Disease After Solid Organ Transplantation Condition(s): post-transplant lymphoproliferative disorder Study Status: This study is not yet open for patient recruitment. Sponsor(s): Children's Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy such as cyclophosphamide, prednisone, and methylprednisolone use different ways to stop

Clinical Trials 71

cancer cells from dividing so they stop growing or die. Monoclonal antibodies such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Combining cyclophosphamide and either prednisone or methylprednisolone with rituximab may be effective in treating lymphoproliferative disease following organtransplantation. PURPOSE: Phase II trial to study the effectiveness of combining cyclophosphamide and either prednisone or methylprednisolone with rituximab in treating patients who have Epstein-Barr viruspositive lymphoproliferative disease following organ transplantation. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00066469

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

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

•

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

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

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

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

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

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

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

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•

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

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

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

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

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

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

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

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CHAPTER 5. PATENTS ON METHYLPREDNISOLONE 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 “methylprednisolone” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on methylprednisolone, we have not necessarily excluded non-medical patents in this bibliography.

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

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

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

Galenical forms of corticoids for administration perlingually and sublingually and process for their preparation Inventor(s): Ayache; Jean-Jacques (Grenoble, FR), Ayache; Josiane (Grenoble, FR), Bruttmann; Georges (Grenoble, FR), Pedrali; Patrick (Annecy, FR), Robert; Serge (Braine le Chateau, BE) Assignee(s): Medibrevex (grenoble, Fr) Patent Number: 5,061,493 Date filed: October 7, 1988 Abstract: In these new galenical forms the corticoid is contained, in strictly controlled and reproducible amounts, in solid supports provided for an extended release of the active ingredient perlingually and sublingually.The corticoid is preferably methylprednisolone.The galenical forms can be prepared as follows:dissolving the corticoid in a solvent,preparing dilutions with different concentrations,fractionating each of these dilutions into subdilutions,impregnating by multi-impregnation or fractionated impregnation a pharmaceutically acceptable solid support with each of the subdilutions, each of said impregnation stages being followed by a drying in forced air dried at a temperature not more than 35.degree. C. Excerpt(s): This invention relates to new galenical forms of corticoids for administration perlingually and sublingually and a process for their preparation. After the first publications of CARRYER in 1950, numerous publications have confirmed the beneficial effects of glucocorticoids in human therapy. The glucocorticoids used are synthetic derivatives. Corticoids are recommended especially for their anti- inflammatory effects, which allows their use in a vast field of human pathology. Web site: http://www.delphion.com/details?pn=US05061493__

•

Pharmaceutical compositions containing a corticosteroid substance Inventor(s): Baglioni; Alessandro (Monza, IT), Sportoletti; Giancarlo (Milan, IT) Assignee(s): Italfarmaco S.p.a. (milan, It) Patent Number: 4,282,217 Date filed: June 25, 1980 Abstract: Pharmaceutical compositions containing a corticosteroid and an ester of Larginine with an aliphatic alcohol exhibit a synergistic effect in the protection against shock. The corticosteroid may be 6-.alpha.-methylprednisolone-21-hemisuccinate sodium salt and the L-arginine ester may be the methyl ester in the form of the hydrochloride salt. Excerpt(s): The present invention relates to natural corticosuprarenal hormones and their synthetic derivatives. It is well known that these hormones exhibit a very high therapeutic activity, but the bioloigical activity of these compounds unfortunately lack in specificity and this lack in specificity of activity is probably responsible for several side effects which are observed during treatment with cortisone and cortisone type compounds. Obviously, it has been desirable to fine compositions which include

Patents 75

cortisone and cortisone-type compounds and derivatives of cortison-type compounds and which are more specific in therapeutic activity, so that the treatment may be effective even at a lower dosage. Clearly, if the object of improving the specificity of cortisone and cortisone-type compounds is achieved, it will be possible to decrease the side effects and to achieve effective treatment at a lower dosage. The crux of the present invention resides in the finding that the therapeutic activity of 6-.alpha.-methylprednisolone-21-hemisuccinate, which is considered as a typical case of corticosteroid substances, is substantially increased in a pharmaceutical preparation which contains, in addition to the corticosteroid, also an ester of L-arginine with an aliphatic alcohol. The amount of the L-arginine ester which is necessary to cause the synergistic effect may vary over a wide range, but molar ratio of the two substances of 1:1 may be used. It has now been found that pharmaceutical preparations which contain, for instance 6-.alpha.methyl-prednisolone-21-hemisuccinate in the form of its sodium salt or an equivalent salt together with an ester of L-arginine with an aliphatic alcohol, in the form of a salt, for instance the hydrochloride salt, exhibit an activity substantially greater in the protection from shock caused by endotoxins and anaphylactic shock, which activity is substantially greater than the activity resulting from some of the individual components, used separately. More specifically, with an equal dose, the effect of protection achieved in accordance with the present invention is substantially greater than what may be foreseen on the basis of the activity of the compounds used separately. It is, therefore, obvious that the combination of the corticosteroid and the arginine ester results in a synergism of the therapeutical effects. Web site: http://www.delphion.com/details?pn=US04282217__ •

Preparation of lipophile:hydroxypropylcyclodextrin complexes by a method using cosolubilizers Inventor(s): Irie; Tetsumi (Kumamoto, JP), Pitha; Josef (Baltimore, MD), TorresLabandeira; Juan J. (Coruna, ES) Assignee(s): The United States of America AS Represented by the Secretary of the (washington, Dc) Patent Number: 5,120,720 Date filed: September 20, 1990 Abstract: The dissolution of lipophilic compounds in aqueous solutions of hydroxypropylcyclodextrins can be accelerated by the addition of co-solubilizers, such as ethanol or ammonia, which again can be removed, together with water, by evaporation or by freeze-drying leaving lipophile: hydroxypropylcyclodextrin complexes as a residue. The co-solubilizer method was used successfully with steroid drugs (5-androstene-3.beta.,17.beta.-diol, 4-androstene-3,17-dione, dehydroepiandrosterone, dexamethasone, 5-.alpha.-dihydro-testosterone, 6methylprednisolone, and testosterone), peptides (gramicidin S) and a macrocyclic antibiotic (amphotericin B). The complexes prepared in this manner were amorphous and possessed satisfactory stability. Excerpt(s): The present invention relates to inclusion complexes between lipophilic compounds and hydroxypropylcyclodextrin complexes and to methods for preparing such utilizing co-solubilizers. The solubility in water of many lipophilic compounds may be increased through the formation of inclusion complexes with cyclodextrins and their derivatives. Szejtli in Cyclodextrin Technology (pp. 186-306) gives many examples of the uses of such solubilization in pharmaceuticals. In a majority of the described

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Methylprednisolone pharmaceutical applications underivatized cyclodextrins, which are crystalline, or crystalline derivatives thereof are utilized to increase the water solubility of lipophilic compounds. However, improvements in solubility could also be obtained when amorphous derivatives of cyclodextrins were used instead of crystalline derivatives (e.g., hydroxypropylcyclodextrins). (J. Pitha, U.S. Pat. No. 4,727,064; B. W. Muller, U.S. Pat. No. 4,764,604). Complexes of cyclodextrins and their crystalline derivatives with lipophiles have often been prepared by co-dissolution of components in water (Szejtli, 1.c., pp. 80-90). In some instances (e.g., vitamin D.sub.3, Szejtli, 1.c., pp. 85 and 268) addition of an organic solvent (ethanol, acetone) was necessary, but such solvents could be used only sparingly since they precipitated the cyclodextrins utilized. Today, when such cyclodextrin complexes are prepared on a technical scale, a solid phase method of preparation (kneading of components) is the method of choice. Web site: http://www.delphion.com/details?pn=US05120720__

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Process for improving the therapeutic efficacy of fat-soluble corticosteroids and composition for carrying out this process Inventor(s): Laugier; Jean-Pierre (Antony, FR), Ringenbach; Francois (Bourg-la-Reine, FR), Segot; Evelyne (Nogent-sur-Marne, FR), Simonnet; Jean-Thierry (Paris, FR), Touzan; Philippe M. (Vanves, FR) Assignee(s): L'oreal (paris, Fr) Patent Number: 5,190,936 Date filed: June 13, 1990 Abstract: The process consists in dissolving a corticosteroid in the lipid phase of nonionic amphiphilic lipid vesicles consisting of one or more lipid lamellae.Composition for carrying out the above process, in which the vesicles are dispersed in an aqueous phase D, have an average diameter of between 10 and 5,000 nm and contain as corticosteroids 17- and/or 21-mono- or -diesters of hydrocortisone, cortisone, prednisone, prednisolone or 6-methylprednisolone, the corticosteroids representing 0.5 to 2.5% by weight of the total lipids of the lamellae. Excerpt(s): The present invention relates to a process for improving the therapeutic efficacy of corticosteroids and to a composition for carrying out this process. Corticosteroids are hormonal derivatives extracted from the cortex of the adrenal capsules or obtained synthetically, and which contain a cyclopentanophenanthrene ringsystem. They are antiinflammatory agents used, in particular, in the treatment of certain skin diseases, such as contact eczema or atopic dermatitis. In this case, the corticosteroids are generally used in the form of an ointment mixed with fats, and are applied topically at fairly large doses frequently producing adverse side effects such as cutaneous atrophy and depigmentation. To avoid the adverse side effects, an effort is hence made, for a given therapeutic treatment, to use the smallest possible amounts of corticosteroids. One of the ways of obtaining this result consists in improving the therapeutic efficacy of a corticosteroid so that it is as high as possible for a specified dose. Any improvement in this therapeutic efficacy is very important, since it enables treatments to be prolonged and hence increases the chances of cure of the disease under treatment. Web site: http://www.delphion.com/details?pn=US05190936__

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Skin burn treatment Inventor(s): Grana; Luis (Park Ridge, IL) Assignee(s): University of Health Sciences/the Chicago Medical School (north Chicago, Il) Patent Number: 4,732,755 Date filed: April 28, 1983 Abstract: A new method for treatment of skin burn is disclosed. A known material, sodium polyacrylate, has been discovered to be useful in the treatment of burns. The method of treatment includes spreading sodium polyacrylate powder as a dressing over the skin burn area, and wetting the powder, such as by spraying with sterilized distilled water until the powder becomes moist. The outer wetted surface of the moistened powder layer dries to provide a parchment like surface. Such a dressing may be maintained in position over the skin burn area for about 2-3 weeks, operating to control loss of water from the body through the burn area, avoiding capillary permeability, and appearing to prevent infection of the burn area. The dressing may be selectively removed or is sloughed off, and is eventually pushed off by the growth of new tissue under the bottom surface of the protective layer. Sodium polyacrylate (PANa) may be used by itself, or mixed with an anti-inflammatory, or with an antibiotic. The appropriate antibiotic may be determined by culture and sensitivity testing of the site. PANa plus methylprednisolone was the most effective healing combination tested. Excerpt(s): This invention relates to a method of treating skin burn and to new use of a known substance having unexpectedly useful properties for the treatment of skin burns. The skin is the largest organ of the mammalian body and normally serves several critical functions. One of the primary functions of intact human skin is the control of loss of water from the body and the prevention of bacterial infection. The intact skin of humans and mammalian animals serves as a highly efficient barrier to the evaporation of body water and the loss of body heat. The most external layer of the epidermis is cornified. It is a very effective moisture barrier and prevents evaporation of the body water. Large burns destroy the water proof barrier, thus permitting dehydration of the body. A second immediate problem, caused within 12-24 hours after burns, is vascular injury. It has been shown that after thermal injury, capillary permeability is markedly increased. The capillaries become freely permeable with extravasation of fluid and proteins into the interstitial tissue. Web site: http://www.delphion.com/details?pn=US04732755__

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Use of derivatives of 6.alpha.-methylprednisolone as an antiemetic Inventor(s): Pittman, Jr.; Johnny M. (Memphis, TN) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,302,452 Date filed: November 21, 1980 Abstract: Use of water soluble 21-polybasic esters methylhydrocortisone and their salts as an antiemetic.

of

1-dehydro-6.alpha.-

Excerpt(s): This invention relates to a method of using water soluble 21-polybasic esters of 1-dehydro-6.alpha.-methylhydrocortisone and their salts for the prevention of nausea and vomiting caused by chemotherapy. One of the most incapacitating problems in the

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Methylprednisolone administration of chemotherapeutics in the treatment of cancer is the nausea and vomiting caused thereby. These conditions are most pronounced in cases where the drug is administered intravenously. The nausea and vomiting is, in general, experienced from one-half to forty-eight hours after administration of the chemotherapeutic. This condition also seems to be more severe with the use of the newer and more effective chemotherapeutics; for example, Adriamycin and Cis-Platinum. Water soluble 21polybasic esters of 1-dehydro-6.alpha.-methylhydrocortisone, their salts and methods for preparing them are described in U.S. Pat. No. 2,897,218. Pittermann et al., Wiener Medizinische Wochenschrift, No. 14/1974, pp. 216-221, discloses that Prednisolone can be used to control nausea and vomiting resulting from the use of Peptichemio in chemotherapy. Also, the instant Applicant is aware that Dexamethasone has been used to prevent nausea and vomiting in chemotherapy. Other antiemetics have been used in efforts to prevent nausea and vomiting resulting from chemotherapy. They include Compazine, Tigan and Thorazine. Many of these antiemetics have the side effect of narcotizing the patient to such a degree that they suffer hangovers that last for up to a week. Insofar as Applicant knows, water soluble 21-dibasic esters of 1-dehydro-6.alpha.methylhydrocortisone and their salts have never been used as an aid to prevent nausea and vomiting in chemotherapy. Web site: http://www.delphion.com/details?pn=US04302452__

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Use of high doses of derivatives of 6.alpha.-methylprednisolone for the acute treatment of stroke syndrome Inventor(s): Braughler; J. Mark (Kalamazoo, MI), Hall; Edward D. (Portage, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,554,271 Date filed: February 24, 1984 Abstract: Use of water soluble 21-dibasic esters of 1-dehydro-6.alpha.methylhydrocortisone for the acute treatment of stroke syndrome in humans. Excerpt(s): This invention relates to a method of using high doses of water soluble 21dibasic esters of 1-dehydro-6.alpha.-methylhydrocortisone for the acute treatment of stroke syndrome in humans, a condition with sudden onset caused by acute vascular lesions of the brain, such as hemorrhage, embolism, thrombosis, or rupturing aneurysm, which may be marked by hemiplegia or hemiparesis, vertigo, numbness, aphasia, and dysarthria; it is often followed by permanent neurologic damage. Stroke syndrome is also commonly known as stroke, cerebrovascular accident and CVA. 1-Dehydro6.alpha.-methylhydrocortisone (6.alpha.-methylprednisolone) is a known pharmaceutical for treating inflammation. Web site: http://www.delphion.com/details?pn=US04554271__

Patent Applications on Methylprednisolone 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 10

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

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several years.) The following patent applications have been filed since December 2000 relating to methylprednisolone: •

Intravascular delivery of methylprednisolone Inventor(s): Sirhan, Motasim; (Sunnyvale, CA), Yan, John; (Los Gatos, CA) Correspondence: Townsend And Townsend And Crew, Llp; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20020082677 Date filed: February 13, 2001 Abstract: The present invention provides improved devices and methods for minimizing and/or inhibiting restenosis and hyperplasia after intravascular intervention. In particular, the present invention provides luminal prostheses which allow for programmed and controlled methylprednisolone delivery with increased efficacy to selected locations within a patient's vasculature to inhibit restenosis. An intraluminal delivery prosthesis may comprise an expansible structure and means on or within the structure for releasing methylprednisolone into the body lumen to inhibit smooth muscle cell proliferation. Excerpt(s): This application claims the benefit of Provisional Application No. 60/258,024, filed Dec. 22, 2000, under 37 C.F.R.sctn.1.78(a)(3), the full disclosure of which is incorporated herein by reference. The present invention relates generally to medical devices and methods. More particularly, the present invention provides luminal prostheses, such as vascular stents and grafts, which allow for controlled substance delivery for inhibiting restenosis in a blood vessel following balloon angioplasty or other interventional treatments. A number of percutaneous intravascular procedures have been developed for treating stenotic atherosclerotic regions of a patient's vasculature to restore adequate blood flow. The most successful of these treatments is percutaneous transluminal angioplasty (PTA). In PTA, a catheter, having an expansible distal end usually in the form of an inflatable balloon, is positioned in the blood vessel at the stenotic site. The expansible end is expanded to dilate the vessel to restore adequate blood flow beyond the diseased region. Other procedures for opening stenotic regions include directional arthrectomy, rotational arthrectomy, laser angioplasty, stenting, and the like. While these procedures have gained wide acceptance (either alone or in combination, particularly PTA in combination with stenting), they continue to suffer from significant disadvantages. A particularly common disadvantage with PTA and other known procedures for opening stenotic regions is the frequent occurrence of restenosis. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Therapeutic use of ganglioside GM1 in the treatment of spinal cord injury Inventor(s): Leon, Alberta; (Padova, IT), Massarotti, Marino; (Padova, IT), Toffano, Gino; (Padova, IT) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030153517 Date filed: April 18, 2002

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Methylprednisolone Abstract: The invention relates to a method for amelioration of neurological outcome in humans with spinal cord damage by administration of ganglioside GM.sub.1. Another object of the present invention is to provide combination therapies for the treatment of spinal cord damage comprised of the administration of the ganglioside GM.sub.1 and other drugs which have therapeutical benefit in patients with spinal cord damage, preferably methylprednisolone. Excerpt(s): Spinal cord injury is a devastating injury with, today, no significantly useful therapy. Emergency medical treatment for spinal-cord injury patients has included prompt triage and intensive rehabilitation. These therapies have somewhat increased or optimized remaining neurologic functions in those patients and prevented further injury to the spinal cord. However, only a minority of patients ever achieve any major neurologic recovery. As a result, no effective acute treatment or rehabilitation therapy is presently available for the approximately 10,000 patients per year which suffer from major spinal cord injury and the consequent permanent disability. Development of effective treatments is also made more difficult because it is difficult to extrapolate to therapy in humans from animal studies. There is significant controversy about whether any and which animal models best simulate spinal cord injuries in humans, about whether the models are reproducible, and therefore whether studies in animals provide useful information for possible human therapy. It is, therefore, one object of the present invention to provide a method for neurological recovery in humans with spinal cord injury by administration of the ganglioside GM.sub.1. It is another object of the present invention to provide a combination therapy for the treatment of spinal cord injury comprised of administration of the ganglioside GM.sub.1 and preferably methylprednisolone. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with methylprednisolone, 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 “methylprednisolone” (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 methylprednisolone. You can also use this procedure to view pending patent applications concerning methylprednisolone. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON METHYLPREDNISOLONE Overview This chapter provides bibliographic book references relating to methylprednisolone. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on methylprednisolone include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Oral and Parenteral Corticoids Source: in Peppercorn, M.A., ed. Therapy of Inflammatory Bowel Disease: New Medical and Surgical Approaches. New York, NY: Marcel Dekker, Inc. 1990. p. 3-34. Contact: Available from Marcel Dekker, Inc. P.O. Box 5005, Monticello, NY 12701-5185. (800) 228-1160 or (212) 696-9000. Fax (914) 796-1772. E-mail: [email protected]. PRICE: $190.00. ISBN: 0824781694. Summary: Both oral and parenteral corticosteroids are widely used for the treatment of inflammatory bowel disease (IBD) and their efficacy is well known. This chapter, from a book about new medical and surgical approaches to the treatment of IBD, discusses the pharmacokinetics, clinical investigations, mechanism of action, and adverse reactions to a number of corticosteroids. Specific drugs considered include: prednisone and prednisolone; cortisone and hydrocortisone; and other corticoid agents, including methylprednisolone. Details of the use of these drugs for ulcerative colitis, Crohn's

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Methylprednisolone disease, and for patient who are pregnant or breastfeeding, are presented. Adverse reactions and complications resulting from the use of corticosteroids are discussed at length. 176 references.

•

Medical Problem: How is it Treated? Source: in Trachter, A.B. Coping with Crohn's Disease. Oakland, CA: New Harbinger Publications, Inc. 2001. p.37-52. Contact: Available from New Harbinger Publications, Inc. 5674 Shattuck Avenue, Oakland, California 94609. (800) 748-6273 or (510) 652-0215. Fax: (510) 652-5472. E-mail: [email protected]. Website: http://www.newharbinger.com/contactus.htm. PRICE: $15.95 plus shipping and handling. ISBN: 1572242655. Summary: Crohn's disease (CD) is a chronic gastrointestinal inflammatory disease that may affect any part of the digestive tract. The disease process can be somewhat mild, or it can be devastating. However, the diagnosis of any chronic medical condition can be overwhelming. This chapter is from a book that offers a comprehensive discussion of the emotional and physical aspects of living with a chronic illness. The book provides basic medical information, but it is primarily designed to be used as a tool to aid the activities of daily life, as well as to promote a healthy lifestyle, despite the disease. In this chapter, the author outlines the medical treatment options that may be undertaken to cope with the symptoms of the disease. Topics include making lifestyle changes to accommodate taking medications; medications and their effects, including nonspecific medications, antidiarrheal agents and pain medications, antibiotics, medications to avoid, corticosteroids (prednisone and methylprednisolone), sulfasalazine (azulfidine), 5ASA drugs (aminosalicylates), immunomodulators, cyclosporine, methotrexate, infliximab (Remicade), and interluken 10/11; handling emotional reactions to medications, including depression and sleep disturbances; and what happens if one stops taking medications, including the role of maintenance medications.

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Appropriate Use of Corticosteroids in Inflammatory Bowel Disease Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 363-366. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: [email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: This chapter on the use of corticosteroids in managing inflammatory bowel disease (IBD) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and ulcerative colitis (UC), together known as IBD. Glucocorticoids are a mainstay for the treatment of severe IBD. The efficacy of corticosteroids to induce remission in both CD and Ulcerative Colitis (UC) has been well established in large randomized controlled trials. At times, a focus on adverse events has diminished the recognition of the usefulness of corticosteroids. The authors suggest approaches for the appropriate use of corticosteroids, including corticosteroid-sparing strategies, in patients with IBD. Corticosteroids used in the treatment of IBD are prednisone, prednisolone, methylprednisolone, and budesonide. Prednisone and prednisolone have comparable glucocorticoid potency, whereas methylprednisolone is slightly more potent. In IBD, their use should be restricted to severe, active disease, with the aim of inducing

Books

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remission. Simple dosing considerations can decrease the possibility of serious side effects. For example, steroids should be given as a single morning dose to coincide with the natural circadian rhythm of endogenous (naturally occurring in the body) corticosteroids. Corticosteroid sparing strategies incorporate the use of nutrition, budesonide, aminosalicylates, antibiotics, azathioprine and 6 mercaptopurine (immunomodulators), methotrexate, cyclosporine, and anti-tumor necrosis factor alpha. 13 references.

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CHAPTER 7. PERIODICALS METHYLPREDNISOLONE

AND

NEWS

ON

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

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

Value of methylprednisolone for acute spinal cord injury questioned Source: Reuters Industry Breifing Date: April 26, 2002

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Methylprednisolone

•

Intrathecal methylprednisolone effective for postherpetic neuralgia Source: Reuters Industry Breifing Date: November 22, 2000

•

Methylprednisolone cuts leukotriene synthesis in asthma Source: Reuters Medical News Date: December 22, 1999

•

Clarithromycin inhibits methylprednisolone clearance in asthmatics Source: Reuters Medical News Date: July 14, 1999

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Pulse methylprednisolone effective for subset of severe alopecia areata patients Source: Reuters Medical News Date: November 30, 1998

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Methylprednisolone Relieves Cluster Headache Symptoms Source: Reuters Medical News Date: April 02, 1998

•

Pulse Cyclophosphamide, Methylprednisolone Effective For Severe Systemic Juvenile RA Source: Reuters Medical News Date: October 21, 1997 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 “methylprednisolone” (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.

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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 “methylprednisolone” (or synonyms). If you know the name of a company that is relevant to methylprednisolone, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “methylprednisolone” (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 “methylprednisolone” (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 methylprednisolone: •

Chronic Pain and Disability of Whiplash May Be Prevented by Prompt Administration of a Drug Used in Spinal Cord Injury Source: Lifeline: The Newsletter of the National Chronic Pain Outreach Association. p. 15-16. Summer 1999. Contact: Available from National Chronic Pain Outreach Association. P.O. Box 274, Millboro, VA 24460. (540) 862-9437. Fax (540) 862-9485. E-mail: [email protected]. Summary: This newsletter article for health professionals and people who have chronic pain reports on the use of a drug used in spinal cord injury to prevent chronic pain and disability of whiplash. Whiplash is an extension/flexion injury to the neck that frequently occurs from a rear hit motor vehicle accident. A study has found that methylprednisolone (MPS), a powerful synthetic corticosteroid, may help prevent chronic pain and other symptoms following whiplash. Patients participating in the study received either high-dose MPS or placebo. At 6 month followup there was a significant difference in prevalence of disabling symptoms between the treated and placebo groups. No one in the MPS group was still on sick leave, but four participants in the placebo group were still on sick leave and taking analgesics daily for neck and radiating pain in their arms. Early initiation of treatment with MPS is crucial because posttraumatic decrease in blood flow to the injury site results in decreased MPS uptake. Although high-dose MPS cannot be recommended for whiplash patients until additional

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Methylprednisolone studies are conducted, a single 30 milligram per kilogram dose of MPS is virtually without harmful effects.

Academic Periodicals covering Methylprednisolone Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to methylprednisolone. In addition to these sources, you can search for articles covering methylprednisolone 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 8. 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 methylprednisolone. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with methylprednisolone. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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Methylprednisolone

The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to methylprednisolone: Corticosteroids Glucocorticoid Effects •

Systemic - U.S. Brands: Acetocot; A-hydroCort; Amcort; A-MethaPred; Aristocort; Aristocort Forte; Aristopak; Aristospan; Articulose-50; ArticuloseL.A.; Celestone; Celestone Phosphate; Celestone Soluspan; Cinalone 40; Cinonide 40; Clinacort; Clinalog; Cordrol; Cortastat; Cortastat 10; Cortastat LA; Cortef; Cortone Acetate; Cotolone; Dalalone; Dalalone D.P.; Dalalone L.A.; Decadrol; Decadron; Decadron Elixir; Decadron-LA; Decadron Phosphate; Decaject; Decaject-LA; Delta-Cortef; Deltasone; DepMedalone 40; DepMedalone 80; Depoject-40; Depoject-80; Depo-Medrol; Depopred; Depo-Predate; Dexacorten; Dexacorten-LA; Dexamethasone Intensol; Dexasone; Dexasone L.A.; Dexone; Dexone 0.75; Dexone 1.5; Dexone; Dexone LA; Duralone-40; Duralone-80; Hexadrol; Hexadrol Phosphate; Hydrocortone; Hydrocortone Acetate; Hydrocortone Phosphate; Kenacort; Kenacort Diacetate; Kenaject-40; Kenalog-10; Kenalog-40; Ken-Jec 40; Key-Pred; Key-Pred SP; Liquid Pred; Med-Jec-40; Medralone 80; Medrol; Meprolone; Methacort 40; Methacort 80; Methylcotolone; Meticorten; Mymethasone; Nor-Pred T.B.A.; Orasone 1; Orasone 5; Orasone 108; Orasone 20; Orasone 50; Pediapred; Predacort 50; Predacorten; Predacorten 80; Predalone 50; Predalone T.B.A.; Predate-50; Predate S; Predate TBA; Predcor-25; Predcor-50; Predcor-TBA; Predicort-RP; Pred-Ject-50; Prednicot; Prednisone Intensol; Pred-Pak 45; Pred-Pak 79; Prelone; Primethasone; Robalog; Selestoject1; Solu-Cortef; Solu-Medrol; Solurex; Solurex LA; Sterapred; Sterapred DS; Tac-39; Tramacort-D; Triam-A; Triam-Forte; Triamolone 40; Triamonide 40; Tri-Kort; Trilog; Trilone; Tristoject http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202018.html

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

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.

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

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APPENDICES

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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 Institute11: •

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/

11

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.12 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:13 •

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

12

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). 13 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 Gateway14 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.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “methylprednisolone” (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 13396 25 1017 59 43 14540

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 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.18 Simply search by “methylprednisolone” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

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

15

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

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 Biologists19 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.20 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.21 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/.

19 Adapted 20

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

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

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Methylprednisolone Autoimmune Diseases http://www.nlm.nih.gov/medlineplus/autoimmunediseases.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Multiple Sclerosis http://www.nlm.nih.gov/medlineplus/multiplesclerosis.html Spinal Cord Injuries http://www.nlm.nih.gov/medlineplus/spinalcordinjuries.html Vasculitis http://www.nlm.nih.gov/medlineplus/vasculitis.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “methylprednisolone” (or synonyms). The following was recently posted: •

(1) Part I. Guidelines for the management of severe traumatic brain injury. In: Management and prognosis of severe traumatic brain injury. (2) Update notice. Guidelines for the management of severe traumatic brain injury: cerebral perfusion pressure Source: American Association of Neurological Surgeons - Medical Specialty Society; 2000 (revised 2003); 165 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3794&nbr=3020&a mp;string=methylprednisolone

•

Allergic rhinitis and its impact on asthma Source: Allergic Rhinitis and its Impact on Asthma Workshop Group - Independent Expert Panel; 2001 November; 188 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3421&nbr=2647&a mp;string=methylprednisolone

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•

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American Gastroenterological Association medical position statement: short bowel syndrome and intestinal transplantation Source: American Gastroenterological Association - Medical Specialty Society; 2003 April; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3795&nbr=3021&a mp;string=methylprednisolone

•

ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery Source: American Society of Health-System Pharmacists - Professional Association; 1999; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1875&nbr=1101&a mp;string=methylprednisolone

•

Asthma Source: University of Michigan Health System - Academic Institution; 1996 December (revised 2000 Jan); 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2281&nbr=1507&a mp;string=methylprednisolone

•

Clinical practice guideline for the management of rheumatoid arthritis Source: Advanced Research Techniques in the Health Services - Private For Profit Research Organization; 2001; 170 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3683&nbr=2909&a mp;string=methylprednisolone

•

Determination of cervical spine stability in trauma patients (update of the 1997 EAST cervical spine clearance document) Source: Eastern Association for the Surgery of Trauma - Professional Association; 2000; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2623&nbr=1849&a mp;string=methylprednisolone

•

Disorders of the neck and upper back Source: Work Loss Data Institute - Public For Profit Organization; 2003; 109 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3803&nbr=3030&a mp;string=methylprednisolone

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•

Methylprednisolone Evidence based clinical practice guideline for managing an acute exacerbation of asthma Source: Cincinnati Children's Hospital Medical Center - Hospital/Medical Center; 1998 July 20 (revised 2002 September 3); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3444&nbr=2670&a mp;string=methylprednisolone

•

Expert Panel Report: guidelines for the diagnosis and management of asthma. Update on selected topics Source: National Asthma Education and Prevention Program - Federal Government Agency [U.S.]; 1997 (revised 2002 Nov); 79 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3495&nbr=2721&a mp;string=methylprednisolone

•

Global initiative for asthma. Global strategy for asthma management and prevention Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1995 January (revised 2002); 176 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3203&nbr=2429&a mp;string=methylprednisolone

•

Glomerulonephritis Source: National Committee on Renal Care (Singapore); 2001 October; 132 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2971&nbr=2197&a mp;string=methylprednisolone

•

Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients Source: American Society for Blood and Marrow Transplantation - Professional Association; 2000 October 20; 126 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2573&nbr=1799&a mp;string=methylprednisolone

•

Long-term management of asthma Source: Finnish Medical Society Duodecim - Professional Association; 2001 January 4 (revised 2001 December 30); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3375&nbr=2601&a mp;string=methylprednisolone

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Lung cancer. Palliative care Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3653&nbr=2879&a mp;string=methylprednisolone

•

Practice parameter: the role of corticosteroids in the management of acute monosymptomatic optic neuritis. Report of the Quality Standards Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 June; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2831&nbr=2057&a mp;string=methylprednisolone

•

Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines Source: American Society of Clinical Oncology - Medical Specialty Society; 1999 September; 37 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2149&nbr=1375&a mp;string=methylprednisolone

•

The diagnosis and management of urticaria: a practice parameter part I: acute urticaria/angioedema part II: chronic urticaria/angioedema Source: American Academy of Allergy, Asthma and Immunology - Medical Specialty Society; 2000 December; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3622&nbr=2848&a mp;string=methylprednisolone

•

The diagnosis and treatment of adult asthma Source: New Zealand Guidelines Group - Private Nonprofit Organization; 2002 September; 101 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3462&nbr=2688&a mp;string=methylprednisolone

•

The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of multiple myeloma: an evidence-based review Source: American Society for Blood and Marrow Transplantation - Professional Association; 2003 January; 34 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3859&nbr=3070&a mp;string=methylprednisolone

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•

Methylprednisolone VHA/DOD clinical practice guideline for the management of chronic obstructive pulmonary disease. Source: Department of Defense - Federal Government Agency [U.S.]; 1999 August; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2584&nbr=1810&a mp;string=methylprednisolone 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 methylprednisolone. 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 methylprednisolone. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with methylprednisolone. 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 methylprednisolone. For more

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information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “methylprednisolone” (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 “methylprednisolone”. 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 “methylprednisolone” (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 “methylprednisolone” (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.22

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

22

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)23: •

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/

23

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

Finding Medical Libraries 111

•

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/

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

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

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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/

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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

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

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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/

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

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

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

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

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

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

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

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

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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

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

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

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

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

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

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

•

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

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

•

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

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METHYLPREDNISOLONE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablation: The removal of an organ by surgery. [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] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH]

ACE Inhibitor: A type of drug used to lower blood pressure. Studies indicate that it may also help prevent or slow the progression of kidney disease in people with diabetes. [NIH] Acetone: A colorless liquid used as a solvent and an antiseptic. It is one of the ketone bodies produced during ketoacidosis. [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] Acetylcholinesterase: An enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. In the CNS, this enzyme plays a role in the function of peripheral neuromuscular junctions. EC 3.1.1.7. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]

Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acyclovir: Functional analog of the nucleoside guanosine. It acts as an antimetabolite, especially in viruses. It is used as an antiviral agent, especially in herpes infections. [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

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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] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [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] Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU]

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Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkylating Agents: Highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning. Many are used as antineoplastic agents, but most are very toxic, with carcinogenic, mutagenic, teratogenic, and immunosuppressant actions. They have also been used as components in poison gases. [NIH]

Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Allogeneic: Taken from different individuals of the same species. [NIH] Allograft: An organ or tissue transplant between two humans. [NIH] 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 particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [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] Alveolitis: Inflammation of an alveolus. Called also odontobothritis. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] 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] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of

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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] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [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] Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Anaplastic large cell lymphoma: A rare agressive form of lymphoma (cancer that begins in cells of the lymphatic system) that is usually of T-cell origin. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] 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] 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] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the capillaries, and characterized by development of giant wheals. [EU] 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] 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] 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] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

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

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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] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Aplasia: Lack of development of an organ or tissue, or of the cellular products from an organ or tissue. [EU] 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] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH]

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Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthralgia: Pain in the joint. [NIH] Arthropathy: Any joint disease. [EU] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Asparaginase: A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1. [NIH] Aspartate: A synthetic amino acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Aspergillosis: Infections with fungi of the genus Aspergillus. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [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 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] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] 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] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that

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produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autologous bone marrow transplantation: A procedure in which bone marrow is removed from a person, stored, and then given back to the person after intensive treatment. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] 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] 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] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] 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] Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic

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autonomic nervous system. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [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] Biopterin: A natural product that has been considered as a growth factor for some insects. [NIH]

Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastomycosis: A fungal infection that may appear in two forms: 1) a primary lesion characterized by the formation of a small cutaneous nodule and small nodules along the lymphatics that may heal within several months; and 2) chronic granulomatous lesions characterized by thick crusts, warty growths, and unusual vascularity and infection in the middle or upper lobes of the lung. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a

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network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bone Cysts: Benign unilocular lytic areas in the proximal end of a long bone with well defined and narrow endosteal margins. The cysts contain fluid and the cyst walls may contain some giant cells. Bone cysts usually occur in males between the ages 3-15 years. [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 Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It 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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Budesonide: A glucocorticoid used in the management of asthma, the treatment of various skin disorders, and allergic rhinitis. [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]

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Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Busulfan: An anticancer drug that belongs to the family of drugs called alkylating agents. [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 Carbonate: Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Calpain: Cysteine proteinase found in many tissues. Hydrolyzes a variety of endogenous proteins including neuropeptides, cytoskeletal proteins, proteins from smooth muscle, cardiac muscle, liver, platelets and erythrocytes. Two subclasses having high and low calcium sensitivity are known. Removes Z-discs and M-lines from myofibrils. Activates phosphorylase kinase and cyclic nucleotide-independent protein kinase. [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] Capillary Permeability: Property of blood capillary walls that allows for the selective exchange of substances. Small lipid-soluble molecules such as carbon dioxide and oxygen move freely by diffusion. Water and water-soluble molecules cannot pass through the endothelial walls and are dependent on microscopic pores. These pores show narrow areas (tight junctions) which may limit large molecule movement. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiac Surgical Procedures: Surgery performed on the heart. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH]

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Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Caspases: A family of intracellular cysteine endopeptidases. They play a key role in inflammation and mammalian apoptosis. They are specific for aspartic acid at the P1 position. They are divided into two classes based on the lengths of their N-terminal prodomains. Caspases-1,-2,-4,-5,-8, and -10 have long prodomains and -3,-6,-7,-9 have short prodomains. EC 3.4.22.-. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] 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 Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH]

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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] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] 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] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] 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] Chemotherapeutics: Noun plural but singular or plural in constructions : chemotherapy. [EU]

Chemotherapy: Treatment with anticancer drugs. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chloroquine: The prototypical antimalarial agent with a mechanism that is not well understood. It has also been used to treat rheumatoid arthritis, systemic lupus erythematosus, and in the systemic therapy of amebic liver abscesses. [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

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important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clenbuterol: A substituted phenylaminoethanol that has beta-2 adrenomimetic properties at very low doses. It is used as a bronchodilator in asthma. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH]

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Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, 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] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [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] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] 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 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] 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] Computational Biology: A field of biology concerned with the development of techniques

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for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] 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 tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [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] 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] 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] Contrast Sensitivity: The ability to detect sharp boundaries (stimuli) and to detect slight changes in luminance at regions without distinct contours. Psychophysical measurements of this visual function are used to evaluate visual acuity and to detect eye disease. [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] Controlled clinical trial: A clinical study that includes a comparison (control) group. The

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comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Contusion: A bruise; an injury of a part without a break in the skin. [EU] 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] 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] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary 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 Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune

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response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] 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] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclodextrins: A homologous group of cyclic glucans consisting of alpha-1,4 bound glucose units obtained by the action of cyclodextrin glucanotransferase on starch or similar substrates. The enzyme is produced by certain species of Bacillus. Cyclodextrins form inclusion complexes with a wide variety of substances. [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] Cyst: A sac or capsule filled with fluid. [NIH] Cysteine Endopeptidases: Endopeptidases which have a cysteine involved in the catalytic process. This group of enzymes is inactivated by sulfhydryl reagents. EC 3.4.22. [NIH] Cystoid: Like a bladder or a cyst. [NIH] Cytarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Cytokine: Small but highly potent protein that modulates the activity of many cell types,

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including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Defibrotide: A drug under study for the prevention of veno-occlusive disease, a rare complication of high-dose chemotherapy and stem cell transplantation in which small veins in the liver become blocked. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Dehydroepiandrosterone: DHEA. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [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] Depigmentation: Removal or loss of pigment, especially melanin. [EU] 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] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough

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center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [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] 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] 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] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilate: Relax; expand. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disposition: A tendency either physical or mental toward certain diseases. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [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] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] 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] Duodenitis: An irritation of the first part of the small intestine (duodenum). [NIH]

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Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysarthria: Imperfect articulation of speech due to disturbances of muscular control which result from damage to the central or peripheral nervous system. [EU] Dyscrasia: A term formerly used to indicate an abnormal mixture of the four humours; in surviving usages it now is roughly synonymous with 'disease' or 'pathologic condition'. [EU] Dyspnea: Difficult or labored breathing. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] 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] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [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] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryogenesis: The process of embryo or embryoid formation, whether by sexual (zygotic) or asexual means. In asexual embryogenesis embryoids arise directly from the explant or on intermediary callus tissue. In some cases they arise from individual cells (somatic cell embryoge). [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis.

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[EU]

Emphysema: A pathological accumulation of air in tissues or organs. [NIH] 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] Encephalomyelitis: A general term indicating inflammation of the brain and spinal cord, often used to indicate an infectious process, but also applicable to a variety of autoimmune and toxic-metabolic conditions. There is significant overlap regarding the usage of this term and encephalitis in the literature. [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] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH]

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Enteropeptidase: A specialized proteolytic enzyme secreted by intestinal cells. It converts trypsinogen into its active form trypsin by removing the N-terminal peptide. EC 3.4.21.9. [NIH]

Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophil: A polymorphonuclear leucocyte with large eosinophilic granules in its cytoplasm, which plays a role in hypersensitivity reactions. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Ependymal: It lines the cavities of the brain's ventricles and the spinal cord and slowly divides to create a stem cell. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [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] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach.

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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] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoked Potentials: The electric response evoked in the central nervous system by 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] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

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 Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical,

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

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] 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] 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] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Fludarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] 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] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Gadolinium: An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors. [NIH] Galenical: 1. Usually cap: of or relating to Galen or his medical principles or method. 2. Constituting a galenical. [EU] 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]

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Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglioside: Protein kinase C's inhibitor which reduces ischemia-related brain damage. [NIH]

Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] 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 Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] 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] 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]

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Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulosclerosis: Scarring of the glomeruli. It may result from diabetes mellitus (diabetic glomerulosclerosis) or from deposits in parts of the glomerulus (focal segmental glomerulosclerosis). The most common signs of glomerulosclerosis are proteinuria and kidney failure. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] 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]

Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU]

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Gonads: The gamete-producing glands, ovary or testis. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Graft Survival: The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Gramicidin: Antibiotic mixture that is one of the two principle components of tyrothricin from Bacillus brevis. Gramicidin C or S is a cyclic, ten-amino acid polypeptide and gramicidins A, B, D, etc., seem to be linear polypeptides. The mixture is used topically for gram-positive organisms. It is toxic to blood, liver, kidneys, meninges, and the olfactory apparatus. [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] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granisetron: A serotonin receptor (5HT-3 selective) antagonist that has been used as an antiemetic for cancer chemotherapy patients. [NIH] 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] 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] Gynecologic cancer: Cancer of the female reproductive tract, including the cervix, endometrium, fallopian tubes, ovaries, uterus, and vagina. [NIH] Haematemesis: The vomiting of blood. [EU]

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Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [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] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [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]

Hemarthrosis: Bleeding into the joints. It may arise from trauma or spontaneously in patients with hemophilia. [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] Hematopoietic Stem Cell Transplantation: The transference of stem cells from one animal or human to another (allogeneic), or within the same individual (autologous). The source for the stem cells may be the bone marrow or peripheral blood. Stem cell transplantation has been used as an alternative to autologous bone marrow transplantation in the treatment of a variety of neoplasms. [NIH] Hematuria: Presence of blood in the urine. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemiplegia: Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical spinal cord diseases; peripheral nervous system diseases; and other conditions may manifest as hemiplegia. The term hemiparesis (see paresis) refers to mild to moderate weakness involving one side of the body. [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] 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] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH]

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Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatic Veins: Veins which drain the liver. [NIH] Hepatic Veno-Occlusive Disease: Blockage of the small- or medium-sized hepatic veins due to nonthrombotic subendothelial edema which may progress to fibrosis. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] 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] Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Hyaluronidase: An enzyme that splits hyaluronic acid and thus lowers the viscosity of the acid and facilitates the spreading of fluids through tissues either advantageously or disadvantageously. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic 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]

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Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperemesis: Excessive vomiting. [EU] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypopituitarism: Diminution or cessation of secretion of one or more hormones from the anterior pituitary gland (including LH; FSH; somatotropin; and corticotropin). This may result from surgical or radiation ablation, non-secretory pituitary neoplasms, metastatic tumors, infarction, pituitary apoplexy, infiltrative or granulomatous processes, and other conditions. [NIH] Hypoxic: Having too little oxygen. [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] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Immune Complex Diseases: Group of diseases mediated by the deposition of large soluble complexes of antigen and antibody with resultant damage to tissue. Besides serum sickness and the arthus reaction, evidence supports a pathogenic role for immune complexes in many other systemic immunologic diseases including glomerulonephritis, systemic lupus erythematosus and polyarteritis nodosa. [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] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH]

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Immunophilins: Members of a family of highly conserved proteins which are all cis-trans peptidyl-prolyl isomerases (peptidylprolyl isomerase). They bind the immunosuppressant drugs cyclosporine; tacrolimus and sirolimus. They possess rotomase activity, which is inhibited by the immunosuppressant drugs that bind to them. EC 5.2.1.- [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] 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] Immunotoxin: An antibody linked to a toxic substance. Some immmunotoxins can bind to cancer cells and kill them. [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] Impotence: The inability to perform sexual intercourse. [NIH] Impregnation: 1. The act of fecundation or of rendering pregnant. 2. The process or act of saturation; a saturated condition. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Induction therapy: Treatment designed to be used as a first step toward shrinking the cancer and in evaluating response to drugs and other agents. Induction therapy is followed by additional therapy to eliminate whatever cancer remains. [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]

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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] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] 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] Instillation: . [EU] 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] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH]

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Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [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] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Itraconazole: An antifungal agent that has been used in the treatment of histoplasmosis, blastomycosis, cryptococcal meningitis, and aspergillosis. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Joint Capsule: The sac enclosing a joint. It is composed of an outer fibrous articular capsule and an inner synovial membrane. [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] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH]

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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] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] 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] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [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] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] 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

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independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [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] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [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] Lupus Nephritis: Glomerulonephritis associated with systemic lupus erythematosus. It is classified into four histologic types: mesangial, focal, diffuse, and membranous. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

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Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphocyte Subsets: A classification of lymphocytes based on structurally or functionally different populations of cells. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lymphoproliferative: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macroglia: A type of neuroglia composed of astrocytes. [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] Macrophage Inflammatory Protein-1: A chemokine that is chemotactic for neutrophils and monocytes, stimulates macrophages, and may play a role in regulating hematopoiesis. Its two variants, MIP-1alpha and MIP-1beta, are 60% homologous to each other. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely

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expressed in behaviour. [EU] Masseter Muscle: A masticatory muscle whose action is closing the jaws. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maxillary Artery: A branch of the external carotid artery which distributes to the deep structures of the face (internal maxillary) and to the side of the face and nose (external maxillary). [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] 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] Megakaryocytes: Very large bone marrow cells which release mature blood platelets. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mercaptopurine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [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] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU]

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Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [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] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [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] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milligram: A measure of weight. A milligram is approximately 450,000-times smaller than a pound and 28,000-times smaller than an ounce. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] 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]

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Mitoxantrone: An anthracenedione-derived antineoplastic agent. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Neurons: Neurons which activate muscle cells. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the drugs less effective. [NIH] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [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] Myalgia: Pain in a muscle or muscles. [EU]

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Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycophenolate mofetil: A drug that is being studied for its effectiveness in preventing graft-versus-host disease and autoimmune disorders. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelodysplastic syndrome: Disease in which the bone marrow does not function normally. Also called preleukemia or smoldering leukemia. [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] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoclonus: Involuntary shock-like contractions, irregular in rhythm and amplitude, followed by relaxation, of a muscle or a group of muscles. This condition may be a feature of some central nervous systems diseases (e.g., epilepsy, myoclonic). Nocturnal myoclonus may represent a normal physiologic event or occur as the principal feature of the nocturnal myoclonus syndrome. (From Adams et al., Principles of Neurology, 6th ed, pp102-3). [NIH] Myofibrils: Highly organized bundles of actin, myosin, and other proteins in the cytoplasm of skeletal and cardiac muscle cells that contract by a sliding filament mechanism. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] 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] Neopterin: A pteridine derivative present in body fluids; elevated levels result from immune system activation, malignant disease, allograft rejection, and viral infections. (From Stedman, 26th ed) Neopterin also serves as a precursor in the biosynthesis of biopterin. [NIH] Neostriatum: The phylogenetically newer part of the corpus striatum consisting of the caudate nucleus and putamen. It is often called simply the striatum. [NIH] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU]

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Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] 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] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [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] Neuropeptides: Peptides released by neurons as intercellular messengers. Many neuropeptides are also hormones released by non-neuronal cells. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neurotrophins: A nerve growth factor. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light

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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] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] 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] Opacity: Degree of density (area most dense taken for reading). [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic disc: The circular area (disc) where the optic nerve connects to the retina. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Optic Neuritis: Inflammation of the optic nerve. Commonly associated conditions include autoimmune disorders such as multiple sclerosis, infections, and granulomatous diseases.

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Clinical features include retro-orbital pain that is aggravated by eye movement, loss of color vision, and contrast sensitivity that may progress to severe visual loss, an afferent pupillary defect (Marcus-Gunn pupil), and in some instances optic disc hyperemia and swelling. Inflammation may occur in the portion of the nerve within the globe (neuropapillitis or anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis). [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [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] 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] Ovarian Hyperstimulation Syndrome: Syndrome composed of a combination of ovarian enlargement and an acute fluid shift out of the intravascular space. The enlargement is caused by ovarian cyst formation and the fluid shift may result in ascites, hydrothorax, or generalized edema. The syndrome is most usually seen as a complication of ovulation induction, a treatment for infertility. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovulation Induction: Techniques for the artifical induction of ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

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] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [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]

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Pancytopenia: Deficiency of all three cell elements of the blood, erythrocytes, leukocytes and platelets. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] 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] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] 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] 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]

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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] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral stem cells: Immature cells found circulating in the bloodstream. New blood cells develop from peripheral stem cells. [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] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Perivascular: Situated around a vessel. [EU] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] P-Glycoprotein: A 170 kD transmembrane glycoprotein from the superfamily of ABC transporters. It serves as an ATP-dependent efflux pump for a variety of chemicals, including many antineoplastic agents. Overexpression of this glycoprotein is associated with multidrug resistance. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] 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] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived

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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] Phosphorylase: An enzyme of the transferase class that catalyzes the phosphorylysis of a terminal alpha-1,4-glycosidic bond at the non-reducing end of a glycogen molecule, releasing a glucose 1-phosphate residue. Phosphorylase should be qualified by the natural substance acted upon. EC 2.4.1.1. [NIH] Phosphorylated: Attached to a phosphate group. [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] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Apoplexy: Sudden hemorrhage or ischemic necrosis involving the pituitary gland which may be associated with acute visual loss, severe headache, meningeal signs, cranial nerve palsies, panhypopituitarism, and rarely coma. The most common cause is hemorrhage (intracranial hemorrhages) related to a pituitary adenoma. Ischemia, meningitis, intracranial hypertension, and other disorders may be associated with this condition. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Pituitary Neoplasms: Neoplasms which arise from or metastasize to the pituitary gland. The majority of pituitary neoplasms are adenomas, which are divided into non-secreting and secreting forms. Hormone producing forms are further classified by the type of hormone they secrete. Pituitary adenomas may also be characterized by their staining properties (adenoma, basophil; adenoma, acidophil; and adenoma, chromophobe). Pituitary tumors may compress adjacent structures, including the hypothalamus, several cranial nerves, and the optic chiasm. Chiasmal compression may result in bitemporal hemianopsia. [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

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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 Exchange: Removal of plasma and replacement with various fluids, e.g., fresh frozen plasma, plasma protein fractions (PPF), albumin preparations, dextran solutions, saline. Used in treatment of autoimmune diseases, immune complex diseases, diseases of excess plasma factors, and other conditions. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] 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 Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelet Transfusion: The transfer of blood platelets from a donor to a recipient or reinfusion to the donor. [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]

Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [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] Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. [NIH]

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Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyarthritis: An inflammation of several joints together. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] 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] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postpericardiotomy Syndrome: A febrile illness associated with pericardial and sometimes pleuropulmonary reaction that often follows extensive pericardiotomy. [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] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH]

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Preleukemia: Conditions in which the abnormalities in the peripheral blood or bone marrow represent the early manifestations of acute leukemia, but in which the changes are not of sufficient magnitude or specificity to permit a diagnosis of acute leukemia by the usual clinical criteria. [NIH] Preoperative: Preceding an operation. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prickle: Several layers of the epidermis where the individual cells are connected by cell bridges. [NIH] Primary endpoint: The main result that is measured at the end of a study to see if a given treatment worked (e.g., the number of deaths or the difference in survival between the treatment group and the control group). What the primary endpoint will be is decided before the study begins. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] 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] Proctocolectomy: An operation to remove the colon and rectum. Also called coloproctectomy. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promyelocytic leukemia: A type of acute myeloid leukemia, a quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. [NIH]

Prophylaxis: An attempt to prevent disease. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids,

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primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [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] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] 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 Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [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] Purines: A series of heterocyclic compounds that are variously substituted in nature and are

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known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] 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] Pyrimidines: A family of 6-membered heterocyclic compounds occurring in nature in a wide variety of forms. They include several nucleic acid constituents (cytosine, thymine, and uracil) and form the basic structure of the barbiturates. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] 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] 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] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [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]

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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] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [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] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma. [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 Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [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] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [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] Remission Induction: Therapeutic act or process that initiates a response to a complete or partial remission level. [NIH] Remission induction therapy: The initial chemotherapy a person receives to bring about a

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remission. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [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] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retrobulbar: Behind the pons. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rituximab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. [NIH] Rod: A reception for vision, located in the retina. [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] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of

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epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sciatica: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the L4, L5, S1 or S2 spinal nerve roots; often associated with intervertebral disk displacement); or lesions of the cauda equina. [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] Sebaceous: Gland that secretes sebum. [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] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] 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

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have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sirolimus: A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. [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] Skin graft: Skin that is moved from one part of the body to another. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoldering leukemia: Disease in which the bone marrow does not function normally. Also called preleukemia or myelodysplastic syndrome. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and

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processes that influence the life of an individual or community. [NIH] Social Security: Government sponsored social insurance programs. [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] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatotropin: A small peptide hormone released by the anterior pituitary under hypothalamic control. Somatotropin, or growth hormone, stimulates mitosis, cell growth, and, for some cell types, differentiation in many tissues of the body. It has profound effects on many aspects of gene expression and metabolism. [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 the extents of these reactions. [NIH] Spectroscopic: The recognition of elements through their emission spectra. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sperm retrieval: The doctor removes sperm from a man's reproductive tract (testis or epididymis) using a fine needle or another instrument. [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 Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal Injuries: Injuries involving the vertebral column. [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord

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at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Stabilization: The creation of a stable state. [EU] Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] 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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [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]

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Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Submucous: Occurring beneath the mucosa or a mucous membrane. [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]

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] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] 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] 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] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU]

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Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] 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] 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 Arteries: Arteries arising from the external carotid or the maxillary artery and distributing to the temporal region. [NIH] Tendinitis: Inflammation of tendons and of tendon-muscle attachments. [EU] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [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

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cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [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] Thermography: Measurement of the regional temperature of the body or an organ by infrared sensing devices, based on self-emanating infrared radiation. [NIH] Thoracotomy: Surgical incision into the chest wall. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Thrombopoietin: A humoral factor that controls blood platelet production through stimulation of megakaryocyte populations. Bone marrow megakaryocytes increase in both size and number in response to exposure to thrombopoietin. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU]

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Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] 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] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Trimedoxime: Cholinesterase reactivator used as an antidote in alkyl phosphate poisoning. [NIH]

Trismus: Spasmodic contraction of the masseter muscle resulting in forceful jaw closure. This may be seen with a variety of diseases, including tetanus, as a complication of radiation therapy, trauma, or in association with neoplastic conditions. [NIH] Trophic: Of or pertaining to nutrition. [EU] Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tyrothricin: A polypeptide antibiotic mixture obtained from Bacillus brevis. It consists of a mixture of three tyrocidines (60%) and several gramicidins (20%) and is very toxic to blood, liver, kidneys, meninges, and the olfactory apparatus. It is used topically. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH]

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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] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] 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] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] 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 Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

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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] Vertebral: Of or pertaining to a vertebra. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vial: A small bottle. [EU] 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] Viral: Pertaining to, caused by, or of the nature of virus. [EU] 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] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [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] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [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]

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Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

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INDEX A Abdominal, 117, 118, 136, 153, 154, 160, 162, 178 Abdominal Pain, 117, 153, 162, 178 Ablation, 117, 147 Acceptor, 117, 152, 160 ACE, 6, 50, 117 ACE Inhibitor, 50, 117 Acetone, 76, 117, 151 Acetylcholine, 117, 130, 158, 159 Acetylcholinesterase, 25, 117 Acute leukemia, 55, 117, 166 Acute lymphoblastic leukemia, 29, 49, 56, 62, 117 Acute lymphocytic leukemia, 117 Acute myeloid leukemia, 117, 166 Acyclovir, 49, 117 Adaptability, 117, 128 Adaptation, 117, 156, 164 Adenine, 118, 168 Adenosine, 9, 118, 163 Adipocytes, 118, 132, 151 Adjunctive Therapy, 10, 118 Adjustment, 4, 117, 118 Adrenal Cortex, 118, 133, 134, 146, 166 Adrenergic, 118, 122, 166 Adsorptive, 23, 118 Adverse Effect, 19, 118, 172 Afferent, 118, 151, 160, 174 Affinity, 118, 123, 135, 152, 173 Agonist, 24, 118 Albumin, 23, 118, 164, 176 Algorithms, 119, 125 Alimentary, 119, 161 Alkaline, 119, 127 Alkaloid, 119, 123 Alkylating Agents, 119, 127 Allergic Rhinitis, 102, 119, 126 Allogeneic, 9, 47, 119, 144, 145 Allograft, 14, 32, 52, 119, 157 Alopecia, 86, 119, 134 Alpha Particles, 119, 168 Alpha-1, 119, 134, 163 Alternative medicine, 86, 119 Alveolitis, 57, 119 Amino acid, 119, 121, 122, 123, 134, 143, 144, 147, 153, 161, 166, 167, 171, 175, 177, 178

Amino Acid Sequence, 119, 121 Ammonia, 75, 119, 143 Ampicillin, 25, 119 Amplification, 15, 26, 119 Anaesthesia, 48, 119, 148 Anal, 120, 152, 156 Analgesics, 87, 120 Analog, 14, 117, 120, 135 Anaphylatoxins, 120, 131 Anaplastic, 70, 120 Anaplastic large cell lymphoma, 70, 120 Anatomical, 120, 123, 129, 132, 148, 155, 171 Androgens, 118, 120, 133 Anemia, 47, 54, 120, 156 Anesthesia, 54, 120, 138, 166 Aneurysm, 78, 120 Angina, 27, 47, 120, 166 Angina Pectoris, 120, 166 Angioedema, 105, 120 Angiogenesis, 120, 154 Angioplasty, 79, 120 Animal model, 9, 16, 24, 80, 120 Anions, 118, 120, 150, 175 Antagonism, 121, 136 Antibacterial, 121, 173 Antibiotic, 75, 77, 119, 121, 126, 144, 161, 173, 178 Antibodies, 16, 23, 121, 123, 153, 156, 164 Antibody, 8, 23, 51, 118, 121, 131, 146, 147, 148, 150, 156, 168, 170, 173, 181 Antidote, 121, 178 Antiemetic, 30, 77, 121, 122, 144 Antifungal, 121, 150, 172 Antigen, 70, 118, 121, 131, 142, 146, 147, 148, 155 Antigen-Antibody Complex, 121, 131 Anti-infective, 121, 146 Anti-inflammatory, 9, 10, 14, 77, 121, 123, 133, 135, 143, 165 Anti-Inflammatory Agents, 9, 14, 121, 123, 133 Antimetabolite, 117, 121, 155 Antineoplastic, 119, 121, 133, 134, 155, 156, 162, 165, 172, 180 Antineoplastic Agents, 119, 121, 162, 180 Antioxidant, 14, 121 Antipsychotic, 121, 158

184

Methylprednisolone

Antiseptic, 117, 122 Antitussive, 122, 136 Antiviral, 117, 122, 149 Anus, 120, 122, 126, 131 Anxiety, 122, 166 Aorta, 122, 127, 133, 179 Apathy, 122, 158 Aphasia, 78, 122 Aplasia, 38, 53, 122 Apoptosis, 9, 12, 16, 27, 38, 49, 56, 122, 128 Aqueous, 75, 76, 122, 124, 135, 146 Arachidonic Acid, 122, 167 Arginine, 74, 75, 120, 122, 159, 178 Arterial, 19, 43, 122, 133, 147, 167 Arteries, 7, 19, 122, 125, 126, 133, 155, 157, 176 Arterioles, 122, 126, 127 Arteritis, 7, 123 Artery, 7, 8, 19, 120, 122, 123, 133, 137, 138, 141, 154, 161, 167 Arthralgia, 52, 123 Arthropathy, 7, 123 Articular, 7, 29, 47, 50, 123, 150, 151, 160 Articulation, 123, 137 Aseptic, 42, 123, 174 Asparaginase, 63, 123 Aspartate, 123, 136 Aspartic, 123, 128 Aspartic Acid, 123, 128 Aspergillosis, 123, 150 Aspirin, 19, 47, 123 Astrocytes, 123, 153, 155 Asymptomatic, 5, 123 Ataxia, 123, 176 Atopic, 76, 123 Atrium, 123, 127, 133, 179 Atrophy, 7, 34, 62, 76, 123 Atropine, 62, 123, 124 Auditory, 123, 140 Autoantibodies, 13, 123, 124 Autoantigens, 123, 124 Autoimmune disease, 124, 156, 164 Autologous, 37, 39, 124, 145 Autologous bone marrow transplantation, 124, 145 Autonomic, 117, 122, 124, 125, 162, 174, 175 Autonomic Nervous System, 124, 125, 162, 175 Axonal, 11, 12, 24, 124 Axons, 17, 21, 124, 158, 159, 174

B Bacteremia, 7, 25, 124 Bacteria, 121, 124, 137, 138, 144, 155, 171, 173, 177, 178, 179 Bactericidal, 124, 140 Bacterium, 25, 124 Basal Ganglia, 23, 122, 123, 124, 168 Basal Ganglia Diseases, 123, 124 Base, 118, 124, 135, 150, 176 Basophils, 124, 144, 151 Belladonna, 123, 124 Benign, 125, 126, 145, 157, 168 Benzoic Acid, 15, 125 Bilateral, 7, 125, 161 Bile, 125, 141, 152, 174 Bilirubin, 118, 125 Bioavailability, 21, 70, 125 Biochemical, 10, 121, 125, 160, 162, 171 Biological response modifier, 125, 149 Biomarkers, 16, 125 Biopsy, 8, 17, 125, 161 Biopterin, 125, 157 Biotechnology, 25, 26, 86, 97, 125 Bladder, 11, 125, 134, 141, 156, 167, 179 Blastomycosis, 125, 150 Blood Coagulation, 125, 127 Blood Glucose, 125, 145 Blood Platelets, 125, 154, 164, 171 Blood pressure, 6, 117, 125, 147, 156, 173 Body Fluids, 125, 126, 157, 173, 178 Bolus, 33, 48, 49, 52, 53, 126 Bolus infusion, 126 Bone Cysts, 58, 126 Bone Marrow, 30, 32, 39, 54, 58, 117, 124, 126, 134, 142, 144, 145, 153, 154, 156, 157, 166, 172, 174 Bone Marrow Transplantation, 30, 32, 126 Bowel, 11, 81, 82, 120, 126, 136, 149, 150, 162, 172, 174, 178 Bowel Movement, 11, 126, 136, 174 Brachytherapy, 126, 149, 150, 168, 181 Bradycardia, 52, 126 Bradykinin, 126, 159, 164 Branch, 113, 126, 137, 153, 154, 161, 173, 177 Breakdown, 9, 126, 136, 142 Broad-spectrum, 119, 126 Bronchitis, 126, 130 Bronchodilator, 126, 130 Buccal, 126, 152 Budesonide, 82, 126 Bupivacaine, 41, 54, 126, 151

Index 185

Burns, 77, 126 Burns, Electric, 126 Bursitis, 7, 127 Busulfan, 47, 127 C Calcium, 9, 10, 127, 131, 136, 154, 172 Calcium Carbonate, 10, 127 Callus, 127, 137 Calpain, 9, 127 Capillary, 77, 126, 127, 142, 180 Capillary Permeability, 77, 126, 127 Capsules, 76, 127, 142 Carbohydrate, 127, 133, 143, 165 Carbon Dioxide, 127, 142, 179 Carcinogenic, 119, 127, 149, 174 Cardiac, 22, 56, 127, 133, 138, 151, 157, 174 Cardiac catheterization, 22, 127 Cardiac Surgical Procedures, 22, 127 Cardiopulmonary, 22, 34, 40, 55, 56, 127 Cardiopulmonary Bypass, 22, 34, 40, 55, 56, 127 Cardioselective, 128, 166 Cardiovascular, 8, 40, 45, 128, 171 Carpal Tunnel Syndrome, 40, 128 Case report, 3, 53, 54, 128, 130 Case series, 128, 130 Caspases, 15, 128 Catheter, 22, 79, 128, 138 Catheterization, 120, 128 Cauda Equina, 128, 171 Caudal, 21, 128, 165 Cell Death, 9, 12, 15, 122, 128, 140, 142 Cell Differentiation, 128, 172 Cell Division, 124, 128, 140, 144, 155, 163 Cell membrane, 128, 135, 163 Cell proliferation, 12, 79, 128, 172 Cell Survival, 16, 128, 144 Cell Transplantation, 23, 24, 47, 128 Central Nervous System, 117, 124, 129, 140, 142, 143, 145, 155, 156, 157, 159, 171 Central Nervous System Infections, 129, 145 Cerebellar, 123, 129, 169 Cerebral, 29, 102, 123, 124, 129, 145, 167, 176 Cerebral Cortex, 123, 129 Cerebrospinal, 21, 25, 29, 129 Cerebrospinal fluid, 21, 25, 29, 129 Cerebrovascular, 14, 78, 124, 129, 177 Cerebrum, 129, 176 Cervical, 33, 48, 50, 103, 129, 145, 154 Cervix, 129, 141, 144

Character, 120, 129, 135 Chemotactic Factors, 129, 131 Chemotherapeutics, 78, 129 Chemotherapy, 36, 46, 70, 77, 103, 129, 135, 144, 169 Chest wall, 129, 177 Chin, 54, 129, 154 Chloroquine, 8, 129 Cholesterol, 125, 129, 152, 154, 174 Choline, 117, 129 Chondrocytes, 130, 141 Chromatin, 122, 130, 159 Chromosomal, 119, 130 Chronic Obstructive Pulmonary Disease, 106, 130 Chronic renal, 5, 130 Circadian, 83, 130 Circadian Rhythm, 83, 130 Cisplatin, 36, 46, 70, 130 Clear cell carcinoma, 130, 135 Clenbuterol, 24, 130 Clinical Medicine, 130, 165 Clinical study, 47, 130, 132 Clinical trial, 6, 8, 10, 13, 16, 18, 27, 63, 69, 71, 97, 130, 132, 134, 136, 167, 168, 169 Cloning, 125, 130 Coagulation, 34, 125, 130, 146, 164 Codeine, 130, 135 Cognition, 130, 158 Colitis, 6, 82, 131 Collagen, 19, 119, 131, 132, 140, 142, 146, 154, 164, 166 Collagen disease, 131, 146 Collapse, 126, 131 Colloidal, 118, 131 Colon, 6, 20, 131, 149, 151, 166, 178 Combination chemotherapy, 70, 131 Combination Therapy, 6, 80, 131 Complement, 23, 26, 120, 131, 164 Complete remission, 5, 16, 52, 131, 169 Complete response, 131 Computational Biology, 97, 131 Computed tomography, 54, 132 Computerized tomography, 132 Concomitant, 9, 132 Conduction, 24, 132 Conjugated, 125, 132 Connective Tissue, 7, 70, 126, 131, 132, 135, 141, 142, 152, 154, 170, 171, 176 Connective Tissue Cells, 132 Connective Tissue Diseases, 7, 70, 132 Consciousness, 120, 132

186

Methylprednisolone

Constipation, 122, 132, 162 Constitutional, 132, 157 Constriction, 132, 150, 179 Constriction, Pathologic, 132, 179 Contractile Proteins, 22, 132 Contractility, 132, 137 Contraindications, ii, 7, 132 Contrast Sensitivity, 132, 160 Control group, 10, 132, 166, 168 Controlled clinical trial, 31, 132, 169 Contusion, 12, 16, 17, 24, 133 Conventional therapy, 19, 133 Conventional treatment, 133 Coordination, 10, 133, 156 Cor, 133, 147 Cornea, 133, 171, 179 Corneum, 133, 139 Coronary, 8, 19, 45, 120, 133, 155, 157 Coronary Artery Bypass, 45, 133 Coronary Thrombosis, 133, 155, 157 Corpus, 133, 142, 157, 166, 180 Cortex, 63, 76, 133, 140, 169 Corticosteroid, 5, 7, 10, 14, 31, 74, 75, 76, 82, 87, 133, 165, 174 Cortisol, 33, 118, 134 Cortisone, 7, 74, 76, 81, 134, 135, 165 Cranial, 134, 145, 158, 159, 162, 163 Craniocerebral Trauma, 124, 134, 145, 177 Creatine, 8, 134 Creatine Kinase, 8, 134 Creatinine, 6, 134 Cues, 11, 134 Curative, 134, 177 Cutaneous, 7, 43, 76, 125, 134, 152 Cyclic, 127, 134, 144, 159 Cyclodextrins, 75, 134 Cyclophosphamide, 5, 6, 10, 16, 18, 30, 32, 36, 43, 49, 54, 57, 58, 70, 86, 134 Cyclosporine, 4, 6, 9, 23, 31, 32, 50, 69, 82, 83, 134, 148 Cyst, 126, 134, 160 Cysteine Endopeptidases, 128, 134 Cystoid, 32, 134 Cytarabine, 46, 70, 134 Cytokine, 24, 38, 49, 55, 134, 172 Cytomegalovirus, 51, 135 Cytoplasm, 122, 124, 128, 132, 135, 139, 144, 156, 157, 159 Cytosine, 57, 135, 168 Cytotoxic, 5, 6, 105, 135, 168, 172 Cytotoxicity, 130, 135

D Defibrotide, 37, 135 Degenerative, 12, 135, 160, 170 Dehydration, 77, 135 Dehydroepiandrosterone, 75, 135 Deletion, 122, 135 Dendrites, 135, 158 Density, 10, 42, 135, 152, 159, 173 Depigmentation, 76, 135, 180 Depolarization, 135, 172 Dermal, 30, 135 Dermatitis, 76, 135, 137 Dermis, 120, 135 DES, 35, 120, 135 Deuterium, 135, 146 Dexamethasone, 20, 26, 27, 31, 33, 35, 37, 46, 75, 78, 135 Dextromethorphan, 62, 135 Diabetes Mellitus, 136, 143, 145, 149 Diagnostic procedure, 73, 86, 136 Diaphragm, 136, 164 Digestion, 119, 125, 126, 136, 150, 152, 174, 179 Digestive system, 72, 136 Digestive tract, 82, 136, 172 Dilatation, 120, 136, 166, 179 Dilate, 79, 136 Dilation, 19, 126, 136 Diltiazem, 48, 136 Dilution, 9, 136 Direct, iii, 10, 89, 130, 136, 169 Disinfectant, 136, 140 Disposition, 10, 136 Distal, 6, 21, 79, 124, 133, 136, 167 Dizziness, 136, 180 Dorsal, 12, 136, 165, 174 Double-blind, 19, 27, 136 Drive, ii, vi, 3, 4, 5, 6, 12, 61, 136 Drug Interactions, 11, 90, 136 Duodenitis, 6, 136 Duodenum, 6, 125, 136, 137, 174 Dura mater, 137, 154, 160 Dysarthria, 78, 137 Dyscrasia, 53, 137 Dyspnea, 33, 137, 167 E Eczema, 76, 137 Edema, 120, 137, 146, 158, 159, 160 Effector, 10, 117, 131, 137 Efficacy, 7, 10, 13, 14, 16, 17, 18, 19, 22, 24, 27, 35, 39, 76, 79, 81, 82, 137 Ejection fraction, 22, 69, 137

Index 187

Elastic, 7, 137, 173, 175 Elastin, 131, 132, 137, 140 Electrocoagulation, 130, 137 Electrolyte, 19, 133, 137, 155, 165, 173 Electromyography, 8, 137 Electrophysiological, 22, 24, 137, 179 Emboli, 51, 137 Embolism, 50, 78, 137 Embolization, 51, 137 Embryo, 128, 137, 148 Embryogenesis, 11, 137 Emesis, 30, 137 Emphysema, 130, 138 Encephalitis, 138 Encephalomyelitis, 9, 48, 138 Endarterectomy, 120, 138 Endocarditis, 25, 138 Endocardium, 138 Endocrine Glands, 138 Endocytosis, 23, 138 Endogenous, 12, 15, 49, 83, 124, 127, 137, 138, 178 Endometrium, 138, 144 Endothelial cell, 8, 138, 141 Endothelium, 38, 44, 138, 159 Endothelium, Lymphatic, 138 Endothelium, Vascular, 138 Endothelium-derived, 138, 159 Endotoxin, 25, 62, 138, 178 End-stage renal, 130, 138 Energy balance, 138, 151 Enhancer, 21, 138 Enteropeptidase, 139, 178 Environmental Health, 96, 98, 139 Enzymatic, 119, 127, 131, 139, 154 Enzyme, 11, 117, 123, 134, 137, 139, 142, 144, 146, 150, 163, 164, 167, 169, 172, 175, 180 Eosinophil, 55, 139 Eosinophilia, 18, 139 Eosinophilic, 28, 139 Ependymal, 12, 139 Epidemic, 20, 139 Epidermal, 23, 139, 151 Epidermal Growth Factor, 23, 139 Epidermis, 77, 133, 135, 139, 146, 150, 151, 166, 168 Epidural, 48, 49, 51, 53, 139 Epithelial, 139 Epithelial Cells, 139 Epithelium, 138, 139 Erectile, 3, 139

Erection, 139 Erythema, 139, 179 Erythrocytes, 120, 126, 127, 139, 161 Esophageal, 49, 139 Esophagus, 136, 139, 174 Ethanol, 75, 76, 140 Etoposide, 37, 46, 140 Evacuation, 51, 132, 140 Evoked Potentials, 24, 62, 140 Exogenous, 137, 138, 140 Extensor, 140, 180 External-beam radiation, 140, 150, 168, 181 Extracellular, 15, 123, 132, 138, 140, 154, 155, 173 Extracellular Matrix, 132, 140, 154 Extracellular Matrix Proteins, 140, 154 Extracellular Space, 140, 155 Extravasation, 77, 140, 145 Extremity, 140, 154, 161, 171 F Fallopian tube, 140, 144 Family Planning, 97, 140 Fat, 76, 118, 122, 126, 133, 137, 140, 151, 152, 156, 170, 173, 175, 176 Fatigue, 140, 145 Fatty acids, 118, 141, 143, 166 Febrile, 36, 141, 165 Femoral, 127, 141 Femoral Artery, 127, 141 Fibrillation, 28, 141 Fibrin, 125, 141, 162 Fibroblast Growth Factor, 12, 141 Fibrosis, 141, 146, 167, 171 Flexion, 87, 141 Fludarabine, 47, 141 Fold, 141, 154 Forearm, 125, 141, 154 Free Radicals, 121, 141 Fructose, 141, 150 Fundus, 141 Fungistatic, 125, 141 G Gadolinium, 18, 36, 141 Galenical, 74, 141 Gallbladder, 117, 136, 141 Gamma Rays, 141, 168 Ganglia, 117, 124, 142, 158, 162, 174, 175 Ganglioside, 79, 80, 142 Gas, 119, 127, 142, 146, 153, 159, 170, 179 Gas exchange, 142, 170, 179 Gastric, 36, 139, 142

188

Methylprednisolone

Gastrointestinal, 6, 8, 82, 126, 140, 142, 171, 175, 178 Gastrointestinal tract, 6, 140, 142, 171, 178 Gelatin, 142, 143, 177 Gene, 10, 16, 19, 20, 125, 142, 164, 173 Gene Expression, 20, 142, 173 Gene Therapy, 16, 142 Genotype, 142, 162 Gestation, 142, 161 Giant Cells, 126, 142, 171 Gland, 118, 134, 142, 152, 160, 161, 163, 167, 171, 174, 175, 177 Globus Pallidus, 124, 142, 168 Glomerular, 16, 142, 143, 150, 170 Glomerular Filtration Rate, 17, 142 Glomeruli, 143 Glomerulonephritis, 5, 57, 104, 143, 147, 152 Glomerulosclerosis, 6, 16, 50, 143 Glomerulus, 142, 143, 157 Glucans, 134, 143 Glucocorticoid, 8, 13, 14, 20, 21, 49, 62, 82, 90, 126, 135, 143, 146, 165 Glucose, 42, 67, 125, 134, 136, 143, 145, 149, 163, 170 Glucose tolerance, 42, 143 Glucose Tolerance Test, 143 Glutamate, 15, 136, 143 Glutamic Acid, 143, 158, 166 Glutamine, 25, 143 Glycerol, 143, 163 Glycerophospholipids, 143, 163 Glycine, 119, 125, 143, 158, 171 Glycoprotein, 22, 51, 142, 143, 162, 178 Gonadal, 143, 174 Gonads, 144, 147 Governing Board, 144, 165 Grade, 14, 70, 144 Graft, 4, 8, 23, 30, 31, 32, 144, 146, 157 Graft Rejection, 31, 144 Graft Survival, 4, 144 Grafting, 45, 133, 144, 148 Graft-versus-host disease, 30, 32, 144, 157 Gramicidin, 75, 144 Gram-negative, 25, 144 Gram-Negative Bacteria, 25, 144 Gram-positive, 144 Granisetron, 30, 144 Granulocytes, 144, 151, 172, 180 Gravis, 55, 144 Growth factors, 144, 155 Guanylate Cyclase, 144, 159

Gynecologic cancer, 30, 144 H Haematemesis, 137, 144 Hair follicles, 135, 145, 180 Headache, 26, 49, 86, 145, 163 Headache Disorders, 145 Heart failure, 22, 145, 159, 167 Heart Transplantation, 69, 145 Hemarthrosis, 7, 145 Hematoma, 51, 145 Hematopoiesis, 145, 153 Hematopoietic Stem Cell Transplantation, 105, 145 Hematuria, 5, 6, 145 Hemiparesis, 78, 145 Hemiplegia, 78, 145 Hemodialysis, 127, 145 Hemoglobin, 5, 120, 139, 145 Hemoglobinopathies, 142, 145 Hemophilia, 145 Hemorrhage, 63, 78, 134, 137, 145, 146, 163, 168, 174 Hemostasis, 13, 146, 171 Hepatic, 10, 22, 31, 37, 38, 118, 143, 146 Hepatic Veins, 146 Hepatic Veno-Occlusive Disease, 38, 146 Hereditary, 132, 145, 146 Heredity, 142, 146 Herpes, 42, 117, 146 Herpes Zoster, 42, 146 Histology, 63, 146 Homologous, 134, 142, 146, 153, 175 Hormonal, 10, 76, 123, 133, 146 Hormone, 45, 130, 133, 134, 135, 146, 149, 151, 163, 166, 170, 172, 173, 176, 177 Horny layer, 139, 146 Host, 21, 144, 146, 180 Humoral, 144, 146, 177 Hyaluronidase, 54, 146 Hydrocortisone, 62, 76, 81, 146 Hydrogen, 15, 117, 124, 127, 135, 140, 146, 152, 156, 159, 160, 167, 175 Hydrogen Peroxide, 15, 146, 152, 175 Hydrolysis, 63, 117, 123, 130, 146, 162, 167, 178 Hydroxylysine, 131, 147 Hydroxyproline, 119, 131, 147 Hyperemesis, 54, 147 Hyperplasia, 79, 147 Hypersensitivity, 70, 139, 147, 170 Hypertension, 133, 145, 147, 163, 166 Hyperthyroidism, 45, 147, 166

Index 189

Hypertrophy, 133, 147 Hypogonadism, 4, 147 Hypopituitarism, 38, 147 Hypoxic, 63, 147 I Id, 64, 102, 103, 104, 105, 106, 112, 114, 147 Idiopathic, 7, 13, 27, 30, 34, 39, 50, 52, 58, 63, 147, 170 Ileostomy, 6, 147 Ileum, 20, 147 Illusion, 147, 180 Immune Complex Diseases, 121, 147, 164 Immune response, 121, 124, 134, 144, 147, 148, 175, 180 Immune system, 147, 148, 153, 156, 157, 179, 180 Immunofluorescence, 9, 147 Immunoglobulin, 5, 27, 29, 34, 42, 50, 121, 147, 156 Immunologic, 18, 129, 147, 168 Immunophilins, 148, 172 Immunosuppressant, 119, 148, 155, 172 Immunosuppressive, 5, 10, 13, 39, 134, 143, 148, 176 Immunosuppressive therapy, 5, 39, 148 Immunotoxin, 63, 148 Impairment, 123, 148, 154 Implant radiation, 148, 149, 150, 168, 181 Implantation, 16, 22, 148 Impotence, 3, 139, 148 Impregnation, 74, 148 In vitro, 9, 20, 28, 39, 142, 148, 176 In vivo, 15, 22, 23, 34, 142, 148, 155, 176 Incision, 148, 150, 177 Incubation, 39, 148 Indicative, 148, 161, 179 Induction, 9, 11, 12, 20, 26, 120, 122, 148, 160 Induction therapy, 148 Infarction, 147, 148 Infection, 7, 26, 77, 123, 125, 129, 135, 138, 148, 152, 153, 158, 159, 161, 170, 175, 179, 180 Infertility, 148, 160 Infiltration, 143, 149, 166 Inflammatory bowel disease, 6, 81, 82, 149 Infusion, 14, 18, 19, 52, 149, 178 Ingestion, 143, 149, 165 Inhalation, 149, 165 Initiation, 87, 149, 178 Inlay, 149, 170 Innervation, 149, 154, 162, 171, 177

Inorganic, 130, 149, 156 Instillation, 27, 41, 149 Insulator, 149, 156 Insulin, 143, 149, 151 Interferon, 18, 40, 149, 153 Interferon-alpha, 149 Internal Medicine, 30, 52, 53, 149, 170 Internal radiation, 149, 150, 168, 181 Interstitial, 54, 77, 126, 140, 149, 150, 157, 170, 181 Intervertebral, 149, 152, 171 Intervertebral Disk Displacement, 149, 152, 171 Intestinal, 103, 139, 143, 150, 153 Intestine, 19, 126, 150, 151 Intracellular, 9, 25, 34, 128, 148, 150, 154, 159, 165, 172 Intracellular Membranes, 150, 154 Intramuscular, 32, 150, 161 Intravascular, 79, 150, 160 Intrinsic, 17, 118, 150 Inulin, 23, 142, 150 Invasive, 150, 153 Involuntary, 124, 141, 150, 157 Ions, 124, 137, 146, 150 Irradiation, 17, 150, 181 Ischemia, 120, 123, 142, 150, 163 Isoenzyme, 134, 150 Itraconazole, 33, 150 J Joint, 7, 11, 22, 58, 123, 150, 160, 174, 176 Joint Capsule, 150, 176 K Kb, 96, 150 Keratin, 150, 151 Keratinocytes, 48, 151 Ketoacidosis, 117, 151 Ketone Bodies, 117, 151 Kidney Disease, 5, 30, 50, 72, 96, 117, 151 Kidney stone, 151, 179 Kidney Transplantation, 6, 151 Kinetic, 70, 151 L Labile, 131, 151 Large Intestine, 136, 150, 151, 169, 172 Leptin, 45, 151 Leucocyte, 119, 139, 151, 153 Leukemia, 23, 28, 29, 51, 52, 55, 56, 57, 63, 117, 142, 151, 166 Leukocytes, 34, 38, 124, 126, 129, 144, 149, 151, 156, 159, 161, 178 Levorphanol, 135, 151

190

Methylprednisolone

Library Services, 112, 151 Lidocaine, 42, 58, 151 Ligaments, 133, 151 Linkages, 143, 145, 151 Lipid, 62, 76, 127, 130, 143, 149, 152, 156 Lipid Peroxidation, 62, 152 Lipophilic, 75, 152 Lipopolysaccharide, 144, 152 Lipoprotein, 144, 152 Liver Transplantation, 31, 46, 51, 152 Localization, 9, 152 Localized, 7, 16, 120, 132, 145, 148, 152, 159, 163, 176, 179 Locomotion, 152, 163 Locomotor, 12, 24, 152 Longitudinal study, 10, 152 Low Back Pain, 42, 152 Lumbar, 128, 149, 152, 171, 177 Lumen, 79, 138, 152 Lupus, 4, 28, 30, 43, 46, 49, 52, 57, 59, 102, 152, 176 Lupus Nephritis, 4, 28, 30, 46, 49, 52, 152 Lymph, 9, 129, 138, 152, 153, 171, 175 Lymph node, 9, 129, 152, 153, 171 Lymphatic, 120, 138, 148, 152, 153, 154, 159, 165, 174 Lymphatic system, 120, 152, 153, 174 Lymphoblastic, 49, 153 Lymphoblasts, 117, 153 Lymphocyte, 14, 31, 46, 55, 121, 153 Lymphocyte Count, 14, 153 Lymphocyte Subsets, 55, 153 Lymphocytic, 58, 153 Lymphoid, 121, 151, 153 Lymphoma, 36, 37, 46, 52, 63, 70, 120, 153 Lymphoproliferative, 14, 35, 70, 71, 153 Lysine, 147, 153, 178 Lytic, 126, 153 M Macroglia, 153, 155 Macrophage, 35, 153 Macrophage Inflammatory Protein-1, 35, 153 Magnetic Resonance Imaging, 17, 36, 52, 153 Malabsorption, 153, 172 Malabsorption syndrome, 153, 172 Malignancy, 14, 153 Malignant, 27, 35, 121, 153, 156, 157, 168, 171 Malignant tumor, 153, 156 Malnutrition, 118, 123, 153

Mammary, 133, 153 Manifest, 124, 145, 153 Masseter Muscle, 154, 178 Matrix metalloproteinase, 39, 56, 154 Maxillary, 154, 176 Maxillary Artery, 154, 176 Median Nerve, 128, 154 MEDLINE, 97, 154 Medullary, 135, 154, 168 Megakaryocytes, 154, 177 Melanin, 135, 154 Membrane Lipids, 15, 154, 163 Meninges, 129, 134, 137, 144, 154, 173, 178 Meningitis, 25, 42, 150, 154, 163 Menopause, 154, 165, 166 Mental, iv, 8, 72, 96, 98, 129, 130, 136, 140, 154, 167, 179 Mental Disorders, 72, 154 Mercaptopurine, 83, 154 Mesenchymal, 139, 154 Mesenteric, 54, 154 Mesentery, 154, 162 Metabolite, 154, 166 Metastasis, 154, 155 Metastatic, 147, 155 Methotrexate, 8, 10, 30, 32, 35, 36, 82, 83, 155 MI, 78, 115, 155 Microbe, 155, 177 Microdialysis, 15, 155 Microglia, 12, 123, 155 Microorganism, 155, 161, 180 Microscopy, 16, 155 Migration, 44, 155 Milligram, 88, 155 Mineralization, 10, 155 Mineralocorticoids, 118, 133, 155 Mitosis, 122, 155, 173 Mitotic, 140, 155 Mitoxantrone, 18, 27, 57, 156 Modification, 119, 156, 168 Molecular, 11, 14, 19, 21, 97, 99, 125, 132, 156, 175, 177, 178 Molecule, 55, 121, 124, 127, 131, 137, 138, 145, 146, 156, 160, 163, 168, 169, 172 Monitor, 134, 156, 159 Monoclonal, 23, 71, 150, 156, 168, 170, 181 Monoclonal antibodies, 23, 71, 156, 170 Monocytes, 151, 153, 156 Mononuclear, 44, 156, 178 Morphological, 15, 23, 47, 137, 156 Motion Sickness, 156, 157

Index 191

Motor Neurons, 11, 156 Mucosa, 152, 156, 175 Mucus, 156, 178 Multidrug resistance, 156, 162 Multiple Myeloma, 105, 156 Multiple sclerosis, 18, 27, 28, 29, 30, 36, 38, 39, 40, 44, 52, 58, 156, 159 Multivariate Analysis, 5, 156 Muscle Proteins, 132, 156 Myalgia, 52, 156 Myasthenia, 55, 157 Mycophenolate mofetil, 5, 6, 157 Mydriatic, 136, 157 Myelin, 9, 156, 157 Myelodysplastic syndrome, 39, 157, 172 Myocardial infarction, 133, 155, 157, 166 Myocarditis, 28, 69, 157 Myocardium, 120, 155, 157 Myoclonus, 157 Myofibrils, 127, 157 N Nausea, 77, 103, 121, 122, 157, 179 NCI, 1, 70, 71, 95, 157 Need, 3, 11, 81, 87, 107, 130, 154, 157, 177, 178 Neoplasm, 157, 171 Neoplastic, 146, 153, 157, 178 Neopterin, 70, 157 Neostriatum, 157, 168 Nephritis, 5, 35, 157 Nephropathy, 5, 32, 151, 157 Nephrosis, 157 Nephrotic, 5, 6, 30, 50, 157, 158 Nephrotic Syndrome, 5, 6, 30, 50, 158 Nerve Fibers, 17, 158, 173, 177 Nerve Growth Factor, 158 Nervous System, 11, 20, 118, 124, 129, 158, 162, 175 Neural, 9, 118, 146, 155, 158 Neuralgia, 42, 49, 158, 165 Neuritis, 63, 158, 160 Neuroblastoma, 158 Neuroleptic, 35, 121, 158 Neurologic, 3, 12, 21, 78, 80, 158 Neuromuscular, 117, 158 Neuromuscular Junction, 117, 158 Neuronal, 11, 23, 158 Neurons, 12, 23, 135, 142, 156, 158, 174, 175 Neuropathy, 27, 33, 43, 45, 158, 171 Neuropeptides, 127, 158 Neurotoxicity, 136, 158

Neurotransmitter, 117, 118, 119, 123, 126, 143, 158, 172, 175 Neurotrophins, 16, 21, 23, 158 Neutrons, 119, 150, 158, 168 Neutrophils, 144, 151, 153, 159 Nitric Oxide, 29, 159 Nitrogen, 119, 120, 134, 140, 143, 159, 178 Nuclear, 14, 21, 124, 141, 159 Nuclei, 119, 142, 153, 155, 158, 159, 167 Nucleic acid, 135, 159, 168 Nucleus, 122, 124, 130, 134, 135, 141, 142, 149, 156, 157, 159, 167, 168, 176 O Oedema, 32, 159 Opacity, 135, 159 Opportunistic Infections, 4, 14, 104, 159 Optic disc, 159, 160 Optic Nerve, 159, 160, 170, 171 Optic Neuritis, 29, 63, 105, 159 Orbital, 160 Organ Transplantation, 70, 71, 160 Osmosis, 160 Osmotic, 21, 118, 160 Osteoarthritis, 7, 47, 160 Outpatient, 22, 160 Ovarian Hyperstimulation Syndrome, 28, 160 Ovaries, 144, 160, 172 Ovulation, 160 Ovulation Induction, 160 Oxidation, 15, 117, 121, 152, 160 Oxygenation, 63, 160 Oxygenator, 127, 160 P Pachymeningitis, 154, 160 Palliative, 105, 160, 177 Pancreas, 117, 125, 136, 149, 160, 178 Pancytopenia, 52, 161 Paralysis, 9, 17, 145, 161 Parenteral, 53, 81, 161 Parenteral Nutrition, 53, 161 Paresis, 145, 158, 161 Parietal, 161, 162, 164 Parotid, 161, 171 Partial remission, 161, 169 Pathogen, 148, 161 Pathogenesis, 7, 19, 161 Pathologic, 122, 125, 133, 137, 147, 161, 173 Pathologic Processes, 122, 161 Pathophysiology, 20, 161 Penicillin, 119, 121, 161

192

Methylprednisolone

Peptide, 119, 139, 141, 150, 151, 161, 167, 173 Percutaneous, 79, 161 Perfusion, 9, 102, 161 Pericardium, 161, 176 Perinatal, 63, 161 Perioperative, 36, 161 Peripheral blood, 38, 39, 44, 47, 55, 145, 149, 161, 166 Peripheral Nervous System, 137, 145, 158, 162, 175 Peripheral Nervous System Diseases, 145, 162 Peripheral stem cells, 39, 62, 144, 162 Peritoneal, 159, 162 Peritoneal Cavity, 159, 162 Peritoneum, 154, 162 Peritonitis, 28, 162 Perivascular, 155, 162 Peroneal Nerve, 162, 171 P-Glycoprotein, 21, 162 Phagocytosis, 155, 162 Pharmaceutical Preparations, 75, 140, 142, 162 Pharmacodynamics, 10, 48, 67, 162 Pharmacokinetic, 48, 57, 162 Pharmacologic, 10, 11, 22, 103, 120, 162, 177 Phenotype, 55, 162 Phospholipases, 162, 172 Phospholipids, 25, 140, 152, 154, 162 Phosphorus, 127, 163 Phosphorylase, 127, 163 Phosphorylated, 20, 163 Phosphorylation, 20, 163 Photocoagulation, 130, 163 Physical Examination, 4, 163 Physiologic, 4, 118, 150, 157, 163, 169 Physiology, 118, 137, 163 Pigmentation, 7, 163 Pilot study, 52, 54, 62, 163 Pituitary Apoplexy, 147, 163 Pituitary Gland, 133, 141, 147, 163 Pituitary Neoplasms, 147, 163 Plants, 119, 123, 124, 127, 129, 143, 150, 163, 170, 177 Plaque, 120, 163 Plasma, 13, 21, 36, 45, 53, 118, 121, 128, 138, 142, 143, 145, 146, 155, 156, 164 Plasma cells, 121, 156, 164 Plasma Exchange, 13, 164 Plasma protein, 118, 138, 164

Plasmapheresis, 6, 164 Plasticity, 23, 164 Platelet Activation, 164, 172 Platelet Aggregation, 120, 159, 164 Platelet Count, 13, 164 Platelet Transfusion, 39, 164 Platelets, 127, 159, 161, 164 Platinum, 78, 130, 164 Pleura, 164 Pleural, 27, 159, 164 Pleural cavity, 159, 164 Pleural Effusion, 27, 164 Plexus, 154, 165, 171 Pneumonia, 21, 51, 132, 165 Podophyllotoxin, 140, 165 Poisoning, 30, 31, 157, 165, 178 Polyarthritis, 10, 35, 165 Polysaccharide, 121, 165 Posterior, 120, 123, 136, 160, 165, 171 Postherpetic Neuralgia, 40, 41, 86, 165 Postmenopausal, 42, 165 Postnatal, 165, 174 Postpericardiotomy Syndrome, 56, 165 Postsynaptic, 165, 172 Post-traumatic, 15, 145, 165 Potassium, 52, 155, 165 Potentiate, 15, 165 Potentiation, 165, 172 Practice Guidelines, 98, 102, 105, 165 Precursor, 63, 122, 130, 134, 137, 139, 157, 165, 166, 178 Prednisolone, 11, 29, 31, 33, 43, 44, 49, 53, 75, 76, 78, 81, 82, 155, 165 Prednisone, 4, 8, 10, 13, 16, 37, 42, 69, 70, 76, 81, 82, 165 Preleukemia, 157, 166, 172 Preoperative, 49, 51, 166 Prevalence, 19, 87, 166 Prickle, 151, 166 Primary endpoint, 19, 166 Probe, 155, 166 Procaine, 151, 166 Proctocolectomy, 6, 166 Prodrug, 63, 166 Progesterone, 166, 174 Progression, 5, 6, 16, 117, 120, 166 Progressive, 5, 6, 19, 27, 36, 59, 128, 130, 144, 160, 164, 166, 167, 170 Proline, 131, 147, 166 Promyelocytic leukemia, 44, 166 Prophylaxis, 30, 166 Propranolol, 19, 166

Index 193

Prospective study, 152, 166 Prostaglandins, 20, 122, 166 Prostate, 125, 167, 178 Prosthesis, 79, 167 Protease, 13, 131, 167 Protein C, 118, 119, 150, 152, 156, 167 Protein S, 125, 167 Proteinuria, 5, 6, 50, 143, 156, 158, 167 Proteolytic, 119, 131, 139, 167 Protocol, 13, 17, 167 Protons, 119, 146, 167, 168 Proximal, 7, 12, 19, 20, 25, 126, 136, 167 Pruritic, 137, 167 Psychic, 154, 167 Psychomotor, 158, 167 Public Policy, 97, 167 Pulmonary, 8, 34, 50, 125, 133, 139, 167, 175, 179 Pulmonary Artery, 125, 167, 179 Pulmonary Fibrosis, 34, 167 Pupil, 133, 136, 157, 160, 167 Purines, 167, 171 Purpura, 13, 27, 29, 39, 42, 50, 52, 54, 168 Putamen, 23, 124, 157, 168 Pyrimidines, 168, 171 Q Quality of Life, 22, 168 Quiescent, 70, 168, 180 R Race, 4, 155, 168 Radiation, 17, 103, 120, 140, 141, 147, 149, 150, 168, 177, 178, 181 Radiation therapy, 17, 103, 140, 149, 150, 168, 178, 181 Radioactive, 146, 148, 149, 150, 156, 159, 168, 181 Radiolabeled, 150, 168, 181 Radiological, 161, 168 Radiotherapy, 126, 150, 168, 181 Random Allocation, 168 Randomization, 17, 168 Randomized, 4, 10, 13, 18, 19, 22, 27, 31, 32, 44, 47, 50, 69, 82, 137, 168, 169 Randomized clinical trial, 13, 31, 169 Randomized Controlled Trials, 22, 82, 169 Receptor, 10, 14, 23, 35, 118, 121, 136, 140, 144, 169, 171, 172 Recombination, 142, 169 Recovery of Function, 12, 169 Rectum, 6, 122, 126, 131, 136, 142, 149, 151, 166, 167, 169 Recurrence, 130, 169

Red Nucleus, 123, 169 Reductase, 155, 169 Refer, 1, 4, 126, 131, 136, 146, 152, 158, 159, 169, 177 Refraction, 169, 173 Refractory, 8, 37, 46, 47, 54, 58, 137, 169 Regeneration, 12, 13, 21, 23, 141, 169 Regimen, 10, 12, 16, 36, 47, 137, 169 Regurgitation, 19, 169 Relapse, 30, 70, 169 Remission, 5, 6, 10, 16, 29, 38, 51, 55, 82, 169 Remission Induction, 29, 55, 169 Remission induction therapy, 29, 55, 169 Renal failure, 5, 170 Resection, 49, 170, 172 Respiratory distress syndrome, 49, 57, 170 Respiratory failure, 49, 170 Restoration, 24, 170, 181 Retina, 44, 51, 159, 170, 179, 180 Retrobulbar, 160, 170 Retrospective, 5, 43, 47, 170 Retroviral vector, 142, 170 Rheumatism, 42, 170 Rheumatoid, 7, 10, 31, 33, 35, 56, 103, 129, 131, 170 Rheumatoid arthritis, 7, 10, 31, 33, 56, 103, 129, 131, 170 Rheumatology, 10, 35, 42, 47, 54, 56, 59, 170 Rhinitis, 102, 170 Ribose, 118, 170 Risk factor, 5, 51, 166, 170 Rituximab, 70, 71, 170 Rod, 124, 170 S Salivary, 135, 136, 170, 175 Salivary glands, 135, 136, 170 Saphenous, 133, 170 Saphenous Vein, 133, 170 Saponins, 170, 174 Sarcoidosis, 35, 38, 170 Sarcoma, 43, 171 Sciatic Nerve, 25, 162, 171, 177 Sciatica, 54, 171 Sclera, 171, 179 Sclerosis, 9, 29, 36, 40, 54, 102, 131, 156, 171 Screening, 130, 171 Sebaceous, 135, 171, 180 Secretion, 9, 18, 33, 49, 130, 133, 139, 147, 155, 156, 171, 179

194

Methylprednisolone

Secretory, 51, 147, 171 Sediment, 171 Sedimentation, 7, 171 Segmental, 6, 16, 50, 143, 171, 174 Segmentation, 171 Semisynthetic, 140, 171 Sepsis, 21, 25, 171 Septic, 123, 171 Serine, 58, 171, 178 Serotonin, 122, 144, 158, 171, 178 Serous, 138, 164, 171 Serum, 6, 8, 14, 20, 38, 44, 62, 118, 120, 131, 134, 147, 155, 162, 171, 178 Sex Characteristics, 120, 172, 176 Shock, 62, 74, 75, 146, 157, 172, 178 Short Bowel Syndrome, 103, 172 Side effect, 15, 19, 21, 74, 76, 78, 83, 89, 118, 122, 134, 172, 177 Signal Transduction, 28, 172 Signs and Symptoms, 169, 172 Sirolimus, 16, 52, 148, 172 Skeletal, 120, 134, 156, 157, 172 Skeleton, 150, 172 Skin graft, 172, 174 Skull, 134, 172, 176 Small intestine, 136, 137, 146, 147, 150, 172, 178 Smoldering leukemia, 157, 172 Smooth muscle, 79, 120, 126, 127, 132, 172, 175 Social Environment, 168, 172 Social Security, 169, 173 Sodium, 33, 36, 47, 53, 58, 74, 75, 77, 155, 173 Soft tissue, 126, 172, 173 Solvent, 74, 76, 117, 140, 143, 160, 173 Somatic, 137, 146, 155, 162, 173 Somatotropin, 147, 173 Sound wave, 132, 173 Specialist, 107, 136, 173 Species, 15, 119, 124, 128, 134, 155, 156, 160, 168, 173, 175, 178, 180, 181 Specificity, 74, 118, 166, 173 Spectroscopic, 52, 173 Spectrum, 14, 15, 155, 173 Sperm, 41, 120, 173 Sperm retrieval, 41, 173 Spinal Cord Diseases, 145, 173 Spinal Injuries, 36, 173 Spinal Nerve Roots, 171, 173 Spinous, 139, 151, 174 Spleen, 9, 135, 153, 171, 174

Splenectomy, 25, 174 Sprains and Strains, 152, 174 Stabilization, 32, 174 Standard therapy, 13, 174 Stem cell transplantation, 24, 37, 135, 145, 174 Stem Cells, 24, 145, 162, 174 Stents, 79, 174 Sterile, 123, 174 Sterility, 28, 134, 148, 174 Steroid, 5, 6, 7, 10, 11, 16, 19, 30, 50, 62, 75, 134, 170, 174 Steroid therapy, 6, 19, 174 Stimulus, 132, 136, 140, 149, 174 Stomach, 6, 117, 136, 139, 141, 142, 143, 146, 157, 162, 172, 174 Stool, 131, 151, 174 Stress, 36, 124, 134, 157, 170, 174, 179 Striatum, 23, 142, 157, 174 Stroke, 72, 78, 96, 174 Subacute, 148, 175 Subarachnoid, 63, 145, 175 Subclinical, 148, 175 Subcutaneous, 118, 120, 137, 159, 161, 175 Submaxillary, 139, 175 Submucous, 58, 175 Subspecies, 173, 175 Substance P, 154, 171, 175 Superoxide, 15, 175 Superoxide Dismutase, 15, 175 Supplementation, 10, 175 Suppression, 7, 11, 46, 133, 175 Suppressive, 21, 31, 175 Surfactant, 63, 175 Survival Rate, 5, 175 Sympathetic Nervous System, 22, 124, 175 Synaptic, 158, 172, 175 Synergistic, 74, 75, 175 Synovial, 47, 150, 175, 176 Synovial Fluid, 176 Synovial Membrane, 47, 150, 176 Systemic lupus erythematosus, 28, 42, 43, 129, 131, 147, 152, 176 Systemic therapy, 129, 176 T Tachycardia, 124, 176 Tachypnea, 124, 176 Tacrolimus, 4, 6, 30, 148, 176 Telencephalon, 124, 129, 176 Temporal, 7, 145, 176 Temporal Arteries, 7, 176 Tendinitis, 7, 65, 176

Index 195

Tendon, 127, 176 Teratogenic, 119, 136, 176 Testicular, 41, 176 Testis, 144, 173, 176 Testosterone, 75, 169, 176 Tetanus, 176, 178 Thalamic, 123, 176 Thalamic Diseases, 123, 176 Therapeutics, 28, 35, 48, 91, 177 Thermal, 77, 159, 177 Thermography, 33, 177 Thoracotomy, 48, 177 Threonine, 58, 171, 177 Thrombopoietin, 52, 177 Thrombosis, 78, 167, 174, 177 Thyroid, 37, 147, 177 Thyroid Gland, 147, 177 Thyroxine, 118, 177 Tibial Nerve, 171, 177 Tin, 128, 164, 177 Tolerance, 117, 143, 177 Tomography, 132, 177 Topical, 140, 146, 177 Toxic, iv, 15, 119, 123, 135, 138, 144, 148, 158, 165, 177, 178 Toxicity, 5, 15, 30, 136, 177 Toxicology, 30, 51, 98, 177 Toxin, 26, 138, 176, 177 Trachea, 177, 178 Transcription Factors, 14, 178 Transduction, 172, 178 Transfection, 125, 142, 178 Transfusion, 13, 178 Transplantation, 4, 8, 23, 24, 30, 31, 32, 46, 47, 53, 103, 104, 105, 130, 178 Trauma, 12, 20, 56, 103, 145, 169, 178 Triage, 80, 178 Trimedoxime, 62, 178 Trismus, 31, 178 Trophic, 12, 178 Trypsin, 36, 139, 178 Tryptophan, 131, 171, 178 Tumor marker, 125, 178 Tumor Necrosis Factor, 83, 178 Tyrothricin, 144, 178 U Ulcerative colitis, 6, 44, 53, 81, 82, 149, 178 Unconscious, 147, 178 Uremia, 170, 179 Urethra, 167, 179 Uric, 38, 168, 179 Urinary, 6, 36, 179

Urine, 5, 6, 125, 134, 139, 145, 151, 167, 179 Urokinase, 35, 179 Urticaria, 29, 58, 105, 179 Uterus, 129, 133, 138, 141, 144, 160, 166, 179 Uvea, 179 Uveitis, 32, 179 V Vaccine, 167, 179 Vacuoles, 138, 179 Vagina, 129, 135, 144, 179 Vascular, 3, 8, 22, 36, 43, 77, 78, 79, 120, 135, 138, 145, 148, 159, 173, 177, 179 Vasculitis, 43, 54, 70, 102, 179 Vasoconstriction, 62, 179 Vasodilators, 159, 179 Vein, 120, 150, 159, 161, 170, 179 Venous, 159, 164, 167, 179 Venous blood, 164, 179 Ventricle, 133, 167, 179 Ventricular, 8, 22, 69, 133, 137, 179 Ventricular Dysfunction, 8, 137, 179 Ventricular Function, 22, 179 Venules, 37, 126, 127, 138, 180 Vertebrae, 149, 173, 180 Vertebral, 173, 180 Vertigo, 78, 180 Vesicular, 146, 180 Veterinary Medicine, 97, 180 Vial, 33, 180 Vinca Alkaloids, 180 Vincristine, 39, 63, 180 Viral, 7, 138, 142, 157, 178, 180 Virulence, 177, 180 Virus, 16, 35, 51, 52, 71, 129, 138, 142, 149, 164, 170, 178, 180 Viscosity, 146, 180 Vitiligo, 59, 180 Vitreous, 44, 170, 180 Vitreous Body, 170, 180 Vitro, 180 Vivo, 16, 23, 180 Vulgaris, 48, 180 W White blood cell, 117, 121, 151, 153, 156, 164, 180 Windpipe, 177, 180 Wound Healing, 17, 141, 154, 181 X Xenograft, 120, 181 X-ray, 17, 132, 141, 150, 159, 168, 181 X-ray therapy, 17, 150, 181

196

Y

Methylprednisolone Yeasts, 162, 181