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

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

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VARICOSE VEINS 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., 1960Varicose Veins: 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: 0-597-84182-9 1. Varicose Veins-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 varicose veins. 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 VARICOSE VEINS ....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Varicose Veins .............................................................................. 4 E-Journals: PubMed Central ......................................................................................................... 8 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND VARICOSE VEINS ............................................................................. 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Varicose Veins ............................................................................. 53 Federal Resources on Nutrition ................................................................................................... 55 Additional Web Resources ........................................................................................................... 56 CHAPTER 3. ALTERNATIVE MEDICINE AND VARICOSE VEINS....................................................... 57 Overview...................................................................................................................................... 57 National Center for Complementary and Alternative Medicine.................................................. 57 Additional Web Resources ........................................................................................................... 60 General References ....................................................................................................................... 65 CHAPTER 4. DISSERTATIONS ON VARICOSE VEINS......................................................................... 67 Overview...................................................................................................................................... 67 Dissertations on Varicose Veins .................................................................................................. 67 Keeping Current .......................................................................................................................... 67 CHAPTER 5. PATENTS ON VARICOSE VEINS ................................................................................... 69 Overview...................................................................................................................................... 69 Patents on Varicose Veins ........................................................................................................... 69 Patent Applications on Varicose Veins........................................................................................ 92 Keeping Current ........................................................................................................................ 102 CHAPTER 6. BOOKS ON VARICOSE VEINS ..................................................................................... 103 Overview.................................................................................................................................... 103 Book Summaries: Online Booksellers......................................................................................... 103 The National Library of Medicine Book Index ........................................................................... 105 Chapters on Varicose Veins ....................................................................................................... 106 CHAPTER 7. MULTIMEDIA ON VARICOSE VEINS .......................................................................... 109 Overview.................................................................................................................................... 109 Bibliography: Multimedia on Varicose Veins ............................................................................ 109 CHAPTER 8. PERIODICALS AND NEWS ON VARICOSE VEINS ....................................................... 111 Overview.................................................................................................................................... 111 News Services and Press Releases.............................................................................................. 111 Academic Periodicals covering Varicose Veins.......................................................................... 113 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................. 115 Overview.................................................................................................................................... 115 U.S. Pharmacopeia..................................................................................................................... 115 Commercial Databases ............................................................................................................... 116 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 121 Overview.................................................................................................................................... 121 NIH Guidelines.......................................................................................................................... 121 NIH Databases........................................................................................................................... 123 Other Commercial Databases..................................................................................................... 125 The Genome Project and Varicose Veins ................................................................................... 125 APPENDIX B. PATIENT RESOURCES ............................................................................................... 129 Overview.................................................................................................................................... 129 Patient Guideline Sources.......................................................................................................... 129

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Finding Associations.................................................................................................................. 134 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 137 Overview.................................................................................................................................... 137 Preparation................................................................................................................................. 137 Finding a Local Medical Library................................................................................................ 137 Medical Libraries in the U.S. and Canada ................................................................................. 137 ONLINE GLOSSARIES................................................................................................................ 143 Online Dictionary Directories ................................................................................................... 145 VARICOSE VEINS DICTIONARY ............................................................................................ 147 INDEX .............................................................................................................................................. 191

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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 varicose veins 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 varicose veins, 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 varicose veins, 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 varicose veins. 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 varicose veins, 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 varicose veins. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON VARICOSE VEINS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on varicose veins.

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

Klippel-Trenaunay-Weber Syndrome: Literature Review and Case Report Source: Pediatric Dentistry. 16(3): 231-235. May-June 1994. Summary: This article presents a case report of a 5-year-old male patient with KlippelTrenaunay-Weber (KTW) syndrome, or angio-osteohypertrophy. KTW syndrome is characterized by limb hypertrophy, varicose veins, and vascular nevus. The orofacial manifestations include early eruption of permanent teeth and hemifacial hypertrophy. This patient had facial assymetry, limb abnormalities, and a thumb-sucking habit. Cephalometric analysis revealed a Class II open bite occlusion. The authors discuss the ongoing issues for the care of this patient. They note that the major problem associated with dental management of patients with this syndrome is excessive hemorrhage from any oral hemangiomatotic lesions and delayed healing of surgical wounds. In addition,

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due to the premature eruption of permanent teeth, patient planning must be based on dental age, rather than on chronological age. 7 figures. 1 table. 35 references. (AA-M). •

Shiatsu Source: Positive Health. Number 24: 61-64. December-January 1998. Summary: This journal article presents a general overview of Shiatsu, which is a physical therapy applied at floor level with minimum physical effort by the therapist. Shiatsu uses Oriental Medicine as its theoretical framework and is a method of selfdevelopment that has the effect of focusing the mind and grounding the body and the mind. The history, environment, tools, and theoretical basis of Shiatsu are discussed. Three broad categories of Shiatsu technique are detailed: tonification, dispersal, and calming. According to the author, there are several essential techniques of Shiatsu: motivation; steadiness of breath; keeping a low center of gravity; relaxation and comfort; empty mind; support rather than force; positive connection; correctly angled pressure; technical ability, continuity, and fluency; and empathy. The article also lists contraindications to Shiatsu, including acute fevers; contagious diseases; internal bleeding; blood clots; touch phobia; severe burns; bruises or swellings; fracture sites and areas of acute muscle or ligament injuries; cuts, local inflammation, and infection; twisted intestines; and varicose veins during pregnancy. This journal article contains 4 photographs and details on 2 resources.

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

Project Title: APPROACH

GENES

FOR

VASCULAR

MORPHOGENESIS:

A

GENETIC

Principal Investigator & Institution: Wang, Qing; Cleveland Clinic Foundation 9500 Euclid Ave Cleveland, Oh 44195 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2004

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

Studies

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Summary: The long-term objective of our research is to discover the molecular mechanisms involved in the development of the cardiovascular system. We use the human genetic approach as the window into the genetic processes involved in the development of the heart and blood vessels. We are currently using this approach to identify the first gene for Klippel-Trenaunay syndrome (KTS), which is a vascular disease comprised of capillary, lymphatic, and venous malformations associated with bony and soft tissue hypertrophy. Because KTS is a vascular anomaly, we propose that KTS pathogenesis involves the disruption of the key genes for vascular morphogenesis during embryonic development. We have characterized a KTS translocation involving chromosomes 5 and 11, and identified a novel vascular gene, VEG5Q (Vascular Endothelial Gene on 5q), as the strong candidate gene for KTS. The goals of this proposal are to use these unique resources to functionally characterize the VEG5Q gene, to investigate its normal function involved in vascular morphogenesis, and to elucidate the pathogenic mechanisms of KTS-associated mutations. The specific aims are: 1) Molecular characterization of VEG5Q, a novel vascular gene and a strong candidate for KTS. 2) To generate mouse models that will elucidate the role of VEG5Q in vascular morphogenesis. 3) To identify proteins that interact with VEG5Q. 4) Genotypephenotype correlation studies of KTS patients and identification/characterization of genes associated with 11p translocation breakpoint. 5) Identification of genes which are differentially expressed in KTS patients using the Gene-Chip technology. The successful accomplishment of goals in this study should allow us to understand the molecular mechanisms underlying KTS as well as other common vascular disorders such as varicose veins and venous malformations. The availability of KTS genes provides the groundwork and offers the exciting possibility of characterizing the molecular mechanisms underlying vascular morphogenesis. Moreover, understanding the genetic mechanisms underlying KTS offers possibilities for treatment of KTS as well as conditions such as cancer that depend on angiogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NORTH AMERICAN STUDY OF TREATMENT FOR REFRACTORY ASCITES (NASTRA) Principal Investigator & Institution: Benner, Kent G.; Associate Professor of Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001 Summary: Participants in this research study have been diagnosed with cirrhosis and increased pressure in the veins supplying blood to the liver (portal hypertension). Due to this increased back pressure in the veins bringing blood into the liver, fluid has accumulated in the abdominal cavity (ascites) which is not responding to treatment with water pills (diuretics) and is requiring frequent drainage of this fluid. This has also caused large varicose veins to develop along the lining of the esophagus, stomach and/or intestine. The purpose of this study is to determine if a relatively new investigational (experimental) procedure called transjugular intrahepatic portosystemic shunt (TIPS) can treat the severe fluid build up in the abdomen more effectively than the standard drainage procedures. In other patients with advanced liver disease who have had internal bleeding from veins in the esophagus under abnormally high-pressure (esophageal varices), the TIPS procedure decreases further bleeding by diverting blood flow from these veins. The purpose of this study is to determine if a similar diversion of blood from the veins with abnormally high pressure flowing into the liver with the TIPS will effectively treat abdominal fluid accumulation. The duration of study participation

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will be one year after beginning the study with subsequent follow-up until termination of the study, which will be up to 3 years after entry. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OCCUPATIONAL PHYSICAL ACTIVITY AND CIRCULATORY DISEASES Principal Investigator & Institution: Krause, Niklas; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): Low levels of physical activity have been identified as a major risk factor for cardiovascular disease. However, the evidence for this observation is primarily based on leisure time physical activity. The literature regarding occupational physical activity is controversial. The long-term health effects of different levels of energy expenditure and of different types of activity at work are unknown for most circulatory diseases. However, recent epidemiological research has shown a strong association between prolonged standing at work and hospitalization due to varicose veins, 4-year progression of carotid atherosclerosis, all-cause mortality, and a trend for cardiovascular mortality. The aim of the proposed research is to determine the longterm health effects of different types and levels of occupational physical activity on chronic circulatory diseases. This will be accomplished by an 11-year follow-up of 2682 middle-aged men enrolled in the population-based Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). The KIHD study has the most comprehensive set of biological, behavioral, social, and psychological risk factors of any study, allowing for the control of virtually all known possible confounders. For the first time, the impact of occupational physical activity will be evaluated prospectively on 11-year progression of carotid atherosclerosis and a wide range of specific circulatory diseases, including myocardial infarction, stroke, intermittent claudicating, hypertension, thrombophlebitis, and pulmonary embolism. Specifically, the following questions will be addressed: 1) Is the level of daily energy expenditure during work activities associated with circulatory disease and death? 2) Is the ratio of static/dynamic work predictive of morbidity and mortality? 3) Is a predominantly standing working position a risk factor for arteriovascular and venous diseases? 4) Is the impact of occupational physical activity on persons with existing is chemic heart disease or peripheral vascular disease different from the impact on healthy individuals? The long-term goals of this project are to yield useful information for (1) the primary prevention of chronic diseases of the circulatory system, associated disability, and premature death in the aging working population, and (2) the development of evidence-based recommendations for the optimal balance between static and dynamic work, working postures, and overall levels of occupational and leisure time physical activity, for both healthy people and those diagnosed with cardiovascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: PYCNOGENOL FOR TREATMENT OF ARM LYMPHEDEMA Principal Investigator & Institution: Hutson, Paul R.; Associate Professor; None; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 30-APR-2005 Summary: (provided by applicant): Lymphedema of the arm affects the function and self-image of approximately 600,000 of the 2 million breast cancer survivors in the United States. Chronic lymphedema can lead to recurrent infections and permanent

Studies

7

swelling, in some cases impairing function. Although various methods of massage and the use of non-elastic compression "sleeves" have been shown to decrease the severity of lymphedema, these methods of physical therapy are limited in terms of patient acceptance, compliance, and by the availability of trained therapists. There is presently no pharmacologic treatment that has proven effective in treating or preventing the development of lymphedema in women treated for breast cancer. We propose a doubleblind, placebo-controlled trial of an extract of the bark of the French maritime pine tree (Pycnogenol(r)) as a treatment for arm lymphedema in breast cancer survivors. Pycnogenol(r) is widely used in Europe for lymphedema of the leg and varicose veins, and is thought to act by several mechanisms including vascular permeability and vascular constriction. The development of such a therapeutic approach would therefore constitute a major breakthrough in the treatment of this common symptom of breast cancer lymphedema. Bioelectric impedance is a painless, quick, and easily-performed method of estimating the extracellular and total water volume of the body or segment, such as the arm. We will compare the correlation of both a single- and a multiplefrequency bioelectric impedance instrument in measuring change in arm volume to a standard assessment using water displacement. We expect that bioelectric impedance will prove faster and more sensitive to changes in extracellular water (lymphedema) than the water displacement method. We also propose to use a small oral dose of midazolam and single blood sampling to screen for effects of Pycnogenol(r) on the activity of the common drug metabolizing enzyme CYP3A4. For those subjects who are already receiving digoxin, we will use digoxin urine excretion to screen for effects of the botanical upon the activity of P-glycoprotein. Finally, we will continue the evaluation of a new questionnaire of lymphedema symptoms presently being tested as a tool for assessing the severity and improvement of symptoms with treatment. In summary, the successful completion of this research can be expected to provide an alternative therapy and new instruments for treating and measuring lymphedema. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SIGNALING HYPERTENSION

MECHANISMS

IN

BLOOD

VESSELS

IN

Principal Investigator & Institution: Watts, Stephanie W.; Associate Professor; Michigan State University 301 Administration Bldg East Lansing, Mi 48824 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: The projects in this Program Project proposal test the novel hypothesis that venomotor tone modulated by endothelin-1 (ET-1), partially through superoxide anion, is a contributor to the determination of systemic blood pressure. Differences in venous and arterial response to ET-1 are apparent, and these differences will be the focus of three specific aims of this project. First, veins are reported to lack ECE, a metalloprotease responsible for conversion of big ET-1 to ET-1. Second, ET-1 has a higher potency in contracting veins than arteries, and veins contract to the ETB receptor agonist sarafatoxin 6c while most arteries do not. Third, arterial vessel but not venous vessel contraction to ET is significantly reduced under conditions of hypertension. We will work with the deoxycorticosterone acetate (DOCA) salt model of hypertension as this model is ET-1 and superoxide anion-dependent. There is a significant gap in our knowledge as to ET-1 receptor pharmacology in veins, expression and processing of ET1 in veins, and why veins remain responsive to ET-1 under conditions of normal blood pressure. The following techniques will be used to fill in these gaps and examine 3 specific aims: 1) isolated tissue bath for isometric contraction; 2) Western analyses; 3) immunohistochemistry and confocal microscopy; 4) real time RT-PCR; and 5)

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Varicose Veins

chemiluminescent measurement of superoxide anion. Specific Aim 1: Big ET-1 processing is different in arteries and veins, and modifies vessel responsiveness to ET receptor agonists; Specific Aim 2: ETB receptors modulate venous but not arterial tone through directly modifying contraction, altering desensitization and modifying ETA receptor function; and Specific Aim 3: Veins are more sensitive than arteries to the contractile effect of superoxide, and venous ET receptor functioning is maintained in hypertension in part by enhanced superoxide anion production. These experiments will provide information regarding ET-1 function in veins and support that venous function should be considered as a determinant of blood pressure. This work is relevant to hypertension, but also to diseases of impaired venous function such as postural hypertension, varicose veins, etc. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “varicose veins” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for varicose veins in the PubMed Central database: •

What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. by Bradbury A, Evans C, Allan P, Lee A, Ruckley CV, Fowkes FG.; 1999 Feb 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27720

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

3 4

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

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

Studies

9

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

A comparison of colour duplex ultrasound with venography and varicography in the assessment of varicose veins. Author(s): Phillips GW, Paige J, Molan MP. Source: Clinical Radiology. 1995 January; 50(1): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7834969&dopt=Abstract

•

A comparison of duplex scanning and continuous wave Doppler in the assessment of primary and uncomplicated varicose veins. Author(s): Darke SG, Vetrivel S, Foy DM, Smith S, Baker S. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 1997 December; 14(6): 457-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9467520&dopt=Abstract

•

A new classification of varicose veins to compare various surgical strategies. Author(s): Berni A, Cavaiola S, Tombesi T, Mele R, Tromba L, Fiorellino A, Corbellini L. Source: Eur Rev Med Pharmacol Sci. 1997 September-October; 1(5): 157-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9630757&dopt=Abstract

•

A new device for prevention of postoperative haematoma in the surgery of varicose veins. Author(s): Raso AM, Rispoli P, Maggio D, Trogolo M, Sandrone N, Pezzuto D, Melloni D, Bellan A. Source: The Journal of Cardiovascular Surgery. 1997 April; 38(2): 177-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9201132&dopt=Abstract

•

A new method for the assessment of venous insufficiency in primary varicose veins using near-infrared spectroscopy. Author(s): Hosoi Y, Yasuhara H, Shigematsu H, Aramoto H, Komiyama T, Muto T. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1997 July; 26(1): 53-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9240322&dopt=Abstract

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A novel approach to the treatment of recurrent varicose veins. Author(s): Fassiadis N, Kianifard B, Holdstock JM, Whiteley MS. Source: International Angiology : a Journal of the International Union of Angiology. 2002 September; 21(3): 275-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12384651&dopt=Abstract

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A survey of the current management of varicose veins by members of the Vascular Surgical Society. Author(s): Lees TA, Beard JD, Ridler BM, Szymanska T. Source: Annals of the Royal College of Surgeons of England. 1999 November; 81(6): 40717. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10655896&dopt=Abstract

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ABC of arterial and venous disease. Varicose veins. Author(s): London NJ, Nash R. Source: Bmj (Clinical Research Ed.). 2000 May 20; 320(7246): 1391-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10818035&dopt=Abstract

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Abnormal deposition of extracellular matrix proteins by cultured smooth muscle cells from human varicose veins. Author(s): Sansilvestri-Morel P, Nonotte I, Fournet-Bourguignon MP, Rupin A, Fabiani JN, Verbeuren TJ, Vanhoutte PM. Source: Journal of Vascular Research. 1998 March-April; 35(2): 115-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9588875&dopt=Abstract

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Accuracy of hand-held Doppler in planning the operation for primary varicose veins. Author(s): Rautio T, Perala J, Biancari F, Wiik H, Ohtonen P, Haukipuro K, Juvonen T. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2002 November; 24(5): 450-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435347&dopt=Abstract

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Acquired localized elastolysis associated with varicose veins. Author(s): Bayle-Lebey P, Periole B, Daste G, Sans B, Marguery MC, El Sayed F, Bazex J, Griffiths WA. Source: Clinical and Experimental Dermatology. 1995 November; 20(6): 492-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8857345&dopt=Abstract

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Acute massive pulmonary embolism following high ligation combined with compression sclerotherapy for varicose veins report of a case. Author(s): Yamaki T, Nozaki M, Sasaki K. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1999 April; 25(4): 321-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10417591&dopt=Abstract

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Advantages of the lateral approach for re-exploration of the sapheno-femoral junction for recurrent varicose veins. Author(s): Belardi P, Lucertini G. Source: Cardiovascular Surgery (London, England). 1994 December; 2(6): 772-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7858998&dopt=Abstract

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Ambulatory conservative hemodynamic management of varicose veins: critical analysis of results at 3 years. Author(s): Cappelli M, Lova RM, Ermini S, Turchi A, Bono G, Bahnini A, Franceschi C. Source: Annals of Vascular Surgery. 2000 July; 14(4): 376-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10943791&dopt=Abstract

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An ambulatory treatment of varicose veins associating surgical section and sclerotherapy of large saphenous veins (3S technique). Preliminary study with results at one year. Author(s): Vin F, Chleir F, Allaert FA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1996 January; 22(1): 65-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8556260&dopt=Abstract

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Angiovideo-assisted hemodynamic correction of varicose veins. Author(s): Zamboni P, Feo C, Marcellino MG, Manfredini R, Vettorello GF, De Anna D. Source: International Angiology : a Journal of the International Union of Angiology. 1995 June; 14(2): 202-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8609448&dopt=Abstract

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Application of Doppler/ultrasound examination for varicose veins in a provincial hospital. Author(s): Vallance S. Source: The Australian and New Zealand Journal of Surgery. 1995 November; 65(11): 787-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7487727&dopt=Abstract

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Ask the doctors. I have prominent varicose veins on both legs. They hurt, and I don't like how they look. How can I get rid of them? Author(s): Francis GS, Bhatt DL. Source: Heart Advis. 2003 February; 6(2): 8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625273&dopt=Abstract

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Assessment of wall structure and composition of varicose veins with reference to collagen, elastin and smooth muscle content. Author(s): Travers JP, Brookes CE, Evans J, Baker DM, Kent C, Makin GS, Mayhew TM. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 1996 February; 11(2): 230-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8616659&dopt=Abstract

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Audit of introduction of hand-held Doppler and duplex ultrasound in the management of varicose veins. Author(s): Pleass HC, Holdsworth JD. Source: Annals of the Royal College of Surgeons of England. 1996 November; 78(6): 4946. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8943630&dopt=Abstract

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Bilateral versus unilateral high ligation and stripping of the greater saphenous vein for varicose veins. Author(s): Rivlin E, Haddad M, Landau O, Nudelman I, Zelikovski A. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1991; 20(3): 267-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1950145&dopt=Abstract

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Biochemical analysis of dermal connective tissue in subjects affected by primary uncomplicated varicose veins. Author(s): Andreotti L, Cammelli D, Sampognaro S, Allori A, Baldoni D, Bussotti A, Cortini P, Di Giovine F, Sterrantino G. Source: Angiology. 1985 May; 36(5): 265-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4025937&dopt=Abstract

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Blood circulation in varicose veins of the lower extremities. Author(s): Bjordal RI. Source: Angiology. 1972 March; 23(3): 163-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5018615&dopt=Abstract

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Blood oxygen saturation and dye-dilution studies in the investigation of the aetiology of varicose veins. Author(s): Schraibman IG. Source: The Australian and New Zealand Journal of Surgery. 1966 November; 36(2): 13644. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5333186&dopt=Abstract

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By the way, doctor. I am a postmenopausal woman (age 56) with serious varicose veins. I would appreciate information on exercises to increase my lower body strength without making my varicose veins worse than they already are. Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2000 November; 8(3): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11063552&dopt=Abstract

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Can interposition of a silicone implant after sapheno-femoral ligation prevent recurrent varicose veins? Author(s): De Maeseneer MG, Giuliani DR, Van Schil PE, De Hert SG. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2002 November; 24(5): 445-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435346&dopt=Abstract

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Case report: successful treatment of varicose veins with acupuncture. Author(s): Bodenheim R. Source: Am J Acupunct. 1999; 27(1-2): 23-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10513095&dopt=Abstract

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Causes of re-recurrence after polytetrafluoroethylene patch saphenoplasty for recurrent varicose veins. Author(s): Maharaj D, Naraynsingh V, Ramdass M. Source: The British Journal of Surgery. 2001 May; 88(5): 730. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360964&dopt=Abstract

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Causes of re-recurrence after polytetrafluoroethylene patch saphenoplasty for recurrent varicose veins. Author(s): Chandrasekar TS, Balasubramanian SP. Source: The British Journal of Surgery. 2001 March; 88(3): 469. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11260118&dopt=Abstract

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Causes of re-recurrence after polytetrafluoroethylene patch saphenoplasty for recurrent varicose veins. Author(s): Bhatti TS, Whitman B, Harradine K, Cooke SG, Heather BP, Earnshaw JJ. Source: The British Journal of Surgery. 2000 October; 87(10): 1356-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11044161&dopt=Abstract

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Cervical radiculopathy due to epidural varicose veins. Author(s): Lai PH, Ho JT, Wang JS, Pan HB. Source: Ajr. American Journal of Roentgenology. 1999 March; 172(3): 841-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10063901&dopt=Abstract

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Changes of elastic and collagen fibers in varicose veins. Author(s): Wali MA, Eid RA. Source: International Angiology : a Journal of the International Union of Angiology. 2002 December; 21(4): 337-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518113&dopt=Abstract

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Clinical and hand-held Doppler examination of primary varicose veins. Author(s): Campbell B. Source: Annals of the Royal College of Surgeons of England. 2001 July; 83(4): 287-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518384&dopt=Abstract

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Clinical examination of varicose veins--a validation study. Author(s): Thompson JF, Campbell WB. Source: Annals of the Royal College of Surgeons of England. 2001 March; 83(2): 146-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11320931&dopt=Abstract

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Clinical examination of varicose veins--a validation study. Author(s): Kim J, Richards S, Kent PJ. Source: Annals of the Royal College of Surgeons of England. 2000 May; 82(3): 171-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10858678&dopt=Abstract

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Clinical, functional and quality of life changes after balneokinesis with sulphurous water in patients with varicose veins. Author(s): Mancini S Jr, Piccinetti A, Nappi G, Mancini S, Caniato A, Coccheri S. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2003 February; 32(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677762&dopt=Abstract

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Clinicopathological evidence that neovascularisation is a cause of recurrent varicose veins. Author(s): Nyamekye I, Shephard NA, Davies B, Heather BP, Earnshaw JJ. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 1998 May; 15(5): 412-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9633496&dopt=Abstract

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Colour flow duplex in the assessment of varicose veins. Author(s): Khaira HS, Parnell A. Source: Clinical Radiology. 1995 August; 50(8): 583-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7656535&dopt=Abstract

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Comparison of clinical outcome of stripping and CHIVA for treatment of varicose veins in the lower extremities. Author(s): Maeso J, Juan J, Escribano J, Allegue NM, Di Matteo A, Gonzalez E, Matas M. Source: Annals of Vascular Surgery. 2001 November; 15(6): 661-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11769147&dopt=Abstract

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Comparison of surgery and ultrasound guided sclerotherapy for treatment of saphenous varicose veins: must the criteria for assessment be the same? Author(s): Guex JJ, Isaacs MN. Source: International Angiology : a Journal of the International Union of Angiology. 2000 December; 19(4): 299-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11305726&dopt=Abstract

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Complications following re-exploration of the groin for recurrent varicose veins. Author(s): Hayden A, Holdsworth J. Source: Annals of the Royal College of Surgeons of England. 2001 July; 83(4): 272-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518377&dopt=Abstract

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Compression stockings prophylaxis of emergent varicose veins in pregnancy: a prospective randomised controlled study. Author(s): Thaler E, Huch R, Huch A, Zimmermann R. Source: Swiss Medical Weekly : Official Journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology. 2001 December 1; 131(45-46): 659-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835115&dopt=Abstract

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Conservative hemodynamic surgery for varicose veins. Author(s): Criado E, Lujan S, Izquierdo L, Puras E, Gutierrez M, Fontcuberta J. Source: Semin Vasc Surg. 2002 March; 15(1): 27-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840423&dopt=Abstract

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Coronary artery ectasia, aneurysm of the basilar artery and varicose veins: common presentation or generalized defect of the vessel wall? A case report. Author(s): Triantafillidi H, Rizos I, Androulakis A, Stratos K, Arvaniti C, Toutouzas P. Source: Angiology. 2001 April; 52(4): 287-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11330513&dopt=Abstract

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Cyclic nucleotides and production of prostanoids in human varicose veins. Author(s): Nemcova S, Gloviczki P, Rud KS, Miller VM. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 November; 30(5): 876-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10550185&dopt=Abstract

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Day care after operations for hernia or varicose veins: a controlled trial. Author(s): Ruckley CV, Cuthbertson C, Fenwick N, Prescott RJ, Garraway WM. Source: The British Journal of Surgery. 1978 July; 65(7): 456-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=352473&dopt=Abstract

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Diagnosis and treatment of varicose veins: a review. Author(s): Goldman MP, Weiss RA, Bergan JJ. Source: Journal of the American Academy of Dermatology. 1994 September; 31(3 Pt 1): 393-413; Quiz 414-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8077464&dopt=Abstract

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Diagnostic and surgical approaches to recurrent varicose veins of lower limbs. Author(s): Canonico S, Campitiello F, Lauletta V, Pacifico F, Sciaudone G. Source: Panminerva Medica. 1997 December; 39(4): 287-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9478069&dopt=Abstract

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Diagnostic value of plasma thrombin-antithrombin III complex and D-dimer concentration in patients with varicose veins for exclusion of deep-vein thrombosis. Author(s): Kawasaki T, Shinoki N, Iwamoto S, Fujimura H, Yoshikawa N, Ohta Y, Ikeda M, Ariyoshi H, Shibuya T, Monden M. Source: Thrombosis Research. 1998 July 15; 91(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9722026&dopt=Abstract

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Diameter-reflux relationship in perforating veins of patients with varicose veins. Author(s): Sandri JL, Barros FS, Pontes S, Jacques C, Salles-Cunha SX. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 November; 30(5): 867-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10550184&dopt=Abstract

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Differential diagnosis of varicose veins. Author(s): Jarrett F. Source: Journal of the Royal Society of Medicine. 2000 May; 93(5): 279. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10884791&dopt=Abstract

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Differntiation of primary from secondary varicose veins by Doppler ultrasound and strain gauge plethysmography. Author(s): Barnes RW, Ross EA, Strandness DE Jr. Source: Surg Gynecol Obstet. 1975 August; 141(2): 207-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1154229&dopt=Abstract

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Diverticular disease and varicose veins. Author(s): Latto C. Source: American Heart Journal. 1975 August; 90(2): 274. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1155331&dopt=Abstract

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Do varicose veins affect quality of life? Results of an international population-based study. Author(s): Kurz X, Lamping DL, Kahn SR, Baccaglini U, Zuccarelli F, Spreafico G, Abenhaim L; VEINES Study Group. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 October; 34(4): 641-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11668318&dopt=Abstract

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Does calcium dobesilate (doxium) improve the microcirculation and the musculovenous pump in patients with varicose veins? Author(s): Baricevic J. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1980; 9(3): 240-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7434908&dopt=Abstract

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Doppler testing as an important conservation measure in the treatment of varicose veins. Author(s): Large J. Source: The Australian and New Zealand Journal of Surgery. 1984 August; 54(4): 357-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6237638&dopt=Abstract

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Double-blind plethysmographic study of venous effects of heptaminol adenosine phosphate in patients with primary varicose veins. Author(s): Schmidt C, Gavoille R, Perez P, Schmitt J. Source: European Journal of Clinical Pharmacology. 1989; 37(1): 37-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2591460&dopt=Abstract

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Duodenal varicose veins. Author(s): Linder S, Wiechel KL. Source: Surgical Endoscopy. 1991; 5(1): 31-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1871672&dopt=Abstract

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Duplex scanning for recurrent varicose veins. Author(s): Englund R. Source: The Australian and New Zealand Journal of Surgery. 1996 September; 66(9): 61820. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8859163&dopt=Abstract

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Duplex scanning may be used selectively in patients with primary varicose veins. Author(s): Kent PJ, Weston MJ. Source: Annals of the Royal College of Surgeons of England. 1998 November; 80(6): 38893. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10209404&dopt=Abstract

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Duplex sonographic evaluation of the sapheno-femoral venous junction in patients with recurrent varicose veins after surgical treatment. Author(s): Benabou JE, Molnar LJ, Cerri GG. Source: Journal of Clinical Ultrasound : Jcu. 1998 October; 26(8): 401-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9783247&dopt=Abstract

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Duplex ultrasonography of recurrent varicose veins. Author(s): Quigley FG, Raptis S, Cashman M. Source: Cardiovascular Surgery (London, England). 1994 December; 2(6): 775-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7858999&dopt=Abstract

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Duplex ultrasound in the pre-operative assessment of varicose veins. Author(s): Dixon PM. Source: Australasian Radiology. 1996 November; 40(4): 416-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8996903&dopt=Abstract

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Duplex ultrasound mapping of sites of deep to superficial incompetence in primary varicose veins. Author(s): Quigley FG, Raptis S, Cashman M, Faris IB. Source: The Australian and New Zealand Journal of Surgery. 1992 April; 62(4): 276-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1550517&dopt=Abstract

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Durability of reflux-elimination by a minimal invasive CHIVA procedure on patients with varicose veins. A 3-year prospective case study. Author(s): Escribano JM, Juan J, Bofill R, Maeso J, Rodriguez-Mori A, Matas M. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 February; 25(2): 159-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12552478&dopt=Abstract

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Effect of elastic compression stockings in patients with varicose veins and healthy controls measured by strain gauge plethysmography. Author(s): Hirai M, Iwata H, Hayakawa N. Source: Skin Res Technol. 2002 November; 8(4): 236-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12423542&dopt=Abstract

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Effect of hydroxyethylrutosides on blood oxygen levels and venous insufficiency symptoms in varicose veins. Author(s): McEwan AJ, McArdle CS. Source: British Medical Journal. 1971 April 17; 2(754): 138-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5581491&dopt=Abstract

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Elastic fibers in saphenous varicose veins. Author(s): Porto LC, Azizi MA, Pelajo-Machado M, Matos da SP, Lenzi HL. Source: Angiology. 2002 March-April; 53(2): 131-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11952102&dopt=Abstract

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Endoscope-assisted correction of primary varicose veins. Author(s): Lin SD, Tsai CC, Lin TM, Lee SS, Chang KP, Lai CS. Source: Annals of Plastic Surgery. 2000 March; 44(3): 241-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10735215&dopt=Abstract

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Endoscope-assisted management of varicose veins in the posterior thigh, popliteal fossa, and calf area. Author(s): Lin SD, Chang KP, Lu DK, Lee SS, Lin TM, Tsai CC, Lai CS. Source: Annals of Plastic Surgery. 2002 January; 48(1): 10-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773725&dopt=Abstract

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Endothelin receptors in the aetiology and pathophysiology of varicose veins. Author(s): Agu O, Hamilton G, Baker DM, Dashwood MR. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2002 February; 23(2): 165-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11863336&dopt=Abstract

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Endovenous laser photocoagulation (EVLP) for varicose veins. Author(s): Chang CJ, Chua JJ. Source: Lasers in Surgery and Medicine. 2002; 31(4): 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355571&dopt=Abstract

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Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using an 810 nm diode laser. Author(s): Navarro L, Min RJ, Bone C. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 February; 27(2): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207682&dopt=Abstract

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Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. Author(s): Rautio T, Ohinmaa A, Perala J, Ohtonen P, Heikkinen T, Wiik H, Karjalainen P, Haukipuro K, Juvonen T. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 May; 35(5): 958-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12021712&dopt=Abstract

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Enzymes in the wall of normal and varicose veins. Histochemical study. Author(s): Urbanova D, Prerovsky I. Source: Angiologica. 1972; 9(1): 53-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4266492&dopt=Abstract

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Epidemiology of varicose veins. Author(s): Callam MJ. Source: The British Journal of Surgery. 1994 February; 81(2): 167-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8156326&dopt=Abstract

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Epidemiology of varicose veins. A review. Author(s): Evans CJ, Fowkes FG, Hajivassiliou CA, Harper DR, Ruckley CV. Source: International Angiology : a Journal of the International Union of Angiology. 1994 September; 13(3): 263-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7822904&dopt=Abstract

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Evaluating and improving health-related quality of life in patients with varicose veins. Author(s): Smith JJ, Garratt AM, Guest M, Greenhalgh RM, Davies AH. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 October; 30(4): 710-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10514210&dopt=Abstract

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Evaluation of different systems for clinical quantification of varicose veins. Author(s): Cornu-Thenard A, De Vincenzi I, Maraval M. Source: J Dermatol Surg Oncol. 1991 April; 17(4): 345-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2040748&dopt=Abstract

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Experience with subfascial ligation for varicose veins in Tanzania: a brief communication. Author(s): Malliwah JA, Aziz MR, Amir H. Source: Hiroshima J Med Sci. 1992 September; 41(3): 57-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1293068&dopt=Abstract

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Expression of elastic components in healthy and varicose veins. Author(s): Bujan J, Gimeno MJ, Jimenez JA, Kielty CM, Mecham RP, Bellon JM. Source: World Journal of Surgery. 2003 August; 27(8): 901-5. Epub 2003 June 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784143&dopt=Abstract

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Expression of molecular mediators of apoptosis and their role in the pathogenesis of lower-extremity varicose veins. Author(s): Ascher E, Jacob T, Hingorani A, Tsemekhin B, Gunduz Y. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 May; 33(5): 1080-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331852&dopt=Abstract

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Extensive tissue necrosis following high-concentration sclerotherapy for varicose veins. Author(s): Bergan JJ, Weiss RA, Goldman MP. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2000 June; 26(6): 535-41; Discussion 541-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10848933&dopt=Abstract

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External banding valvuloplasty of the superficial femoral vein in the treatment of recurrent varicose veins. Author(s): Guarnera G, Furgiuele S, Mascellari L, Bianchini G, Camilli S. Source: International Angiology : a Journal of the International Union of Angiology. 1998 December; 17(4): 268-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10204660&dopt=Abstract

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External reinforcement of varicose veins with PTFE prosthesis in infrainguinal bypass surgery -- clinical results. Author(s): Neufang A, Dorweiler B, Espinola-Klein C, Reinstadler J, Kirsch D, Schmiedt W, Oelert H. Source: The Thoracic and Cardiovascular Surgeon. 2003 April; 51(2): 62-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12730812&dopt=Abstract

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Fatal hemorrhage caused by varicose veins. Author(s): Morrow PL, Hardin NJ, Karn CM, Beloin R, McDowell RW. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1994 June; 15(2): 100-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8074099&dopt=Abstract

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Fatal pulmonary embolism following compression sclerotherapy for varicose veins. Author(s): McMaster P, Everett WG. Source: Postgraduate Medical Journal. 1973 July; 49(573): 517-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4793498&dopt=Abstract

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Fiber intake, constipation, and risk of varicose veins in the general population: Edinburgh Vein Study. Author(s): Lee AJ, Evans CJ, Hau CM, Fowkes FG. Source: Journal of Clinical Epidemiology. 2001 April; 54(4): 423-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11297893&dopt=Abstract

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Foam-sclerotherapy, surgery, sclerotherapy, and combined treatment for varicose veins: a 10-year, prospective, randomized, controlled, trial (VEDICO trial). Author(s): Belcaro G, Cesarone MR, Di Renzo A, Brandolini R, Coen L, Acerbi G, Marelli C, Errichi BM, Malouf M, Myers K, Christopoulos D, Nicolaides A, Geroulakos G, Vasdekis S, Simeone E, Ricci A, Ruffini I, Stuard S, Ippolito E, Bavera P, Georgiev M, Corsi M, Scoccianti M, Cornelli U, Caizzi N, Dugall M, Christopoulos D, Veller M, Venniker R, Cazaubon M, Griffin M. Source: Angiology. 2003 May-June; 54(3): 307-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785023&dopt=Abstract

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Foot-volumetry before and after surgical treatment of patients with varicose veins. Author(s): Norgren L. Source: Acta Chir Scand. 1975; 141(2): 129-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1154965&dopt=Abstract

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Functional assessment of patients undergoing day-care surgery for varicose veins or hernia: results from a randomised controlled trial. Author(s): Prescott RJ, Ruckley CV, Garraway WM, Cuthbertson CJ, Fenwick N. Source: Health Bull (Edinb). 1979 March; 37(2): 82-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=220205&dopt=Abstract

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General surgical waiting lists and the management of varicose veins. Author(s): Salmond GC, O'Connor EM. Source: N Z Med J. 1973 November 14; 78(502): 394-400. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4520460&dopt=Abstract

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Genetics of varicose veins of the lower extremities. Author(s): Hauge M, Gundersen J. Source: Human Heredity. 1969; 19(5): 573-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5365895&dopt=Abstract

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Geometry of varicose veins segments. Author(s): Pascale K. Source: Biomed Tech (Berl). 1991 June; 36(6): 145-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1883928&dopt=Abstract

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Glycosaminoglycans of normal veins and their alterations in varicose veins and varicose veins complicated by thrombophlebitis. Author(s): Wolanska M, Sobolewski K, Glowinski S, Kowalewski R, Plonski A. Source: European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes. 2001; 33(1): 28-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11340269&dopt=Abstract

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Glyvenol therapy in varicose veins an evaluation of its effectiveness. Author(s): Kakande I. Source: East Afr Med J. 1981 July; 58(7): 532-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6895499&dopt=Abstract

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Gross anatomy of primary varicose veins observed in endoscopic surgery. Author(s): Lin SD, Chang KP, Yang YL, Lee SS, Lin TM, Tsai CC, Lai CS. Source: Annals of Plastic Surgery. 2002 December; 49(6): 559-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461435&dopt=Abstract

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Haemostatic factors and risk of varicose veins and chronic venous insufficiency: Edinburgh Vein Study. Author(s): Lee AJ, Lowe GD, Rumley A, Ruckley CV, Fowkes FG. Source: Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis. 2000 December; 11(8): 775-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11132657&dopt=Abstract

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Hand-held Doppler as a screening test in primary varicose veins. Author(s): Pardy BJ. Source: The British Journal of Surgery. 1998 March; 85(3): 424; Author Reply 424-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9529511&dopt=Abstract

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Hand-held Doppler as a screening test in primary varicose veins. Author(s): Abu-Own A, Coleridge Smith PD. Source: The British Journal of Surgery. 1998 March; 85(3): 424; Author Reply 424-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9529510&dopt=Abstract

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Hand-held Doppler as a screening test in primary varicose veins. Author(s): Campbell WB, Niblett PG, Ridler BM, Peters AS, Thompson JF. Source: The British Journal of Surgery. 1997 November; 84(11): 1541-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9393274&dopt=Abstract

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Hazards of sclerotherapy of varicose veins--their prevention and treatment of complications. Author(s): Orbach EJ. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1979; 8(2): 170-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=463292&dopt=Abstract

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Hemodynamic assessment of femoropopliteal venous reflux in patients with primary varicose veins. Author(s): Sakurai T, Matsushita M, Nishikimi N, Nimura Y. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1997 August; 26(2): 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9279313&dopt=Abstract

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Hemorrhoids and varicose veins: a review of treatment options. Author(s): MacKay D. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2001 April; 6(2): 126-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11302778&dopt=Abstract

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Hemorrhoids, varicose veins and deep vein thrombosis: epidemiologic features and suggested causative factors. Author(s): Burkitt DP. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1975 September; 18(5): 483-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1175115&dopt=Abstract

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High endogenous estradiol is associated with increased venous distensibility and clinical evidence of varicose veins in menopausal women. Author(s): Ciardullo AV, Panico S, Bellati C, Rubba P, Rinaldi S, Iannuzzi A, Cioffi V, Iannuzzo G, Berrino F. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2000 September; 32(3): 544-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10957662&dopt=Abstract

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Histochemical studies on the wall of human varicose veins: the saphenous varicose vein. Author(s): Wegmann R, Olivier C, Rettori R. Source: Ann Histochim. 1974 October-December; 19(4): 285-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4282217&dopt=Abstract

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Histomorphological and pathobiochemical changes of varicose veins. A possible explanation of the development of varicosis. Author(s): Lengyel I, Acsady G. Source: Acta Morphol Hung. 1990; 38(3-4): 259-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1966351&dopt=Abstract

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Histopathological changes in venous grafts and in varicose and non-varicose veins. Author(s): Charles AK, Gresham GA. Source: Journal of Clinical Pathology. 1993 July; 46(7): 603-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8157743&dopt=Abstract

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How long do compression bandages maintain their pressure during ambulatory treatment of varicose veins? Author(s): Raj TB, Goddard M, Makin GS. Source: The British Journal of Surgery. 1980 February; 67(2): 122-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7362941&dopt=Abstract

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Identification of arteriovenous anastomoses by duplex ultrasound. Implications for the treatment of varicose veins. Author(s): Kanter A, Gardner M, Isaacs M. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1995 October; 21(10): 885-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7551746&dopt=Abstract

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Imbalance in the synthesis of collagen type I and collagen type III in smooth muscle cells derived from human varicose veins. Author(s): Sansilvestri-Morel P, Rupin A, Badier-Commander C, Kern P, Fabiani JN, Verbeuren TJ, Vanhoutte PM. Source: Journal of Vascular Research. 2001 November-December; 38(6): 560-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740155&dopt=Abstract

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Improving the preoperative assessment of varicose veins. Author(s): Salaman RA, Salaman JH. Source: The British Journal of Surgery. 1997 December; 84(12): 1748. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9448636&dopt=Abstract

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Improving the preoperative assessment of varicose veins. Author(s): Singh S, Lees TA, Donlon M, Harris N, Beard JD. Source: The British Journal of Surgery. 1997 June; 84(6): 801-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9189092&dopt=Abstract

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In reference to “In vitro evaluation of endothelial and smooth muscle function of primary varicose veins”. Author(s): Sayers RD, Watt PA, Thurston H, Bell PR. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1993 July; 18(1): 138-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8326652&dopt=Abstract

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In vitro evaluation of endothelial and smooth muscle function of primary varicose veins. Author(s): Lowell RC, Gloviczki P, Miller VM. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1992 November; 16(5): 679-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1433654&dopt=Abstract

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In vivo injection of dipyridamole stimulates the synthesis of prostacyclin-like substances in human varicose veins. Author(s): Fahr A, Langer R, Sziegoleit W, Beitz J, Krause P, Forster W. Source: Biomed Biochim Acta. 1984; 43(3): K6-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6378192&dopt=Abstract

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Incompetent perforating veins are associated with recurrent varicose veins. Author(s): Rutherford EE, Kianifard B, Cook SJ, Holdstock JM, Whiteley MS. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2001 May; 21(5): 458-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11352523&dopt=Abstract

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Increased mast cell infiltration in familial varicose veins: pathogenetic implications? Author(s): Kakkos SK, Zolota VG, Peristeropoulou P, Apostolopoulou A, Geroukalos G, Tsolakis IA. Source: International Angiology : a Journal of the International Union of Angiology. 2003 March; 22(1): 43-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771855&dopt=Abstract

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Increased mast cell infiltration in varicose veins of the lower limbs: a possible role in the development of varices. Author(s): Yamada T, Tomita S, Mori M, Sasatomi E, Suenaga E, Itoh T. Source: Surgery. 1996 May; 119(5): 494-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8619202&dopt=Abstract

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Increased prostacyclin and thromboxane A2 formation in human varicose veins. Author(s): Haynes DF, Kerstein MD, Roberts MP, Bell WH 3rd, Rush DS, Kadowitz PJ, McNamara DB. Source: The Journal of Surgical Research. 1990 September; 49(3): 228-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2118584&dopt=Abstract

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Increased TIMP/MMP ratio in varicose veins: a possible explanation for extracellular matrix accumulation. Author(s): Badier-Commander C, Verbeuren T, Lebard C, Michel JB, Jacob MP. Source: The Journal of Pathology. 2000 September; 192(1): 105-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10951407&dopt=Abstract

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Influence of pentoxifylline administered in vivo on the synthesis of PGI2 in human varicose veins. Author(s): Fahr A, Langer R, Sziegoleit W, Albert H, Liebal H, Mest HJ. Source: Biomed Biochim Acta. 1988; 47(10-11): S238-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3073763&dopt=Abstract

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Injection compression sclerotherapy for varicose veins. Author(s): Oswal D, Kanchan RS, Kalbande MB. Source: J Indian Med Assoc. 1989 August; 87(8): 188-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2621362&dopt=Abstract

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Injection of varicose veins and spider veins. Author(s): Conrad P. Source: Aust Fam Physician. 1987 April; 16(4): 451, 453-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3593113&dopt=Abstract

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Injection sclerotherapy for varicose veins. Author(s): Tisi PV, Beverley CA. Source: Cochrane Database Syst Rev. 2002; (1): Cd001732. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869605&dopt=Abstract

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Injection-compression treatment of varicose veins. Author(s): Tretbar LL, Pattisson PH. Source: American Journal of Surgery. 1970 October; 120(4): 539-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5507344&dopt=Abstract

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Injection-compression treatment of varicose veins. A follow-up study. Author(s): Dejode LR. Source: The British Journal of Surgery. 1970 April; 57(4): 285-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5437924&dopt=Abstract

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Intimal changes in varicose veins: an ultrastructural study. Author(s): Wali MA, Eid RA. Source: J Smooth Muscle Res. 2002 June; 38(3): 63-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596886&dopt=Abstract

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Is recurrence of varicose veins after surgery unavoidable? Author(s): De Maeseneer MG, Van Schil PE, Philippe MM, Vanmaele RG, Eyskens EJ. Source: Acta Chir Belg. 1995 January-February; 95(1): 21-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7900486&dopt=Abstract

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Just another case of varicose veins? Author(s): Travis RC, Rowan DM, Miller J. Source: The British Journal of Radiology. 1990 July; 63(751): 581-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2167744&dopt=Abstract

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Lateral thigh varicose veins: a phlebographic study. Author(s): Thomas ML, Chan O. Source: The British Journal of Radiology. 1988 May; 61(725): 372-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3382867&dopt=Abstract

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Leech therapy for complicated varicose veins. Author(s): Bapat RD, Acharya BS, Juvekar S, Dahanukar SA. Source: The Indian Journal of Medical Research. 1998 June; 107: 281-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9701897&dopt=Abstract

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Left ventricular function in varicose veins. Author(s): Singh K, Sood S. Source: Indian J Physiol Pharmacol. 2002 January; 46(1): 111-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12024949&dopt=Abstract

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Left-leg varicose veins and deep-vein thrombosis. Author(s): Frohn MJ. Source: Lancet. 1976 November 6; 2(7993): 1019-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=62230&dopt=Abstract

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Leg blood and central circulation at varying blood volumes. A peroperative study of nine young patients with varicose veins. Author(s): Brismar B, Cronestrand R, Jorfeldt L, Juhlin-Dannfelt A, Bergenwald L. Source: Scand J Thorac Cardiovasc Surg. 1977; 11(2): 159-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=897622&dopt=Abstract

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Leg blood flow and central circulation at various blood volumes: a peroperative study of nine patients with varicose veins. Author(s): Brismar B, Cronestrand R, Jorfeldt L, Juhlin-Dannfelt A. Source: Clin Sci Mol Med. 1977 October; 53(4): 349-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=913059&dopt=Abstract

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Letter: Pulsatile varicose veins in tricuspid insufficiency. Author(s): Gordon M, Berris B. Source: Jama : the Journal of the American Medical Association. 1976 June 21; 235(25): 2719. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=946882&dopt=Abstract

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Letter: Support for varicose veins. Author(s): Holford CP. Source: British Medical Journal. 1976 March 13; 1(6010): 649. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1252869&dopt=Abstract

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Letter: Treatment of varicose veins. Author(s): Strandness DE. Source: Lancet. 1976 June 26; 1(7974): 1418. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=59065&dopt=Abstract

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Letter: Varicose veins in developing countries. Author(s): Hobbs JT. Source: Lancet. 1976 July 31; 2(7979): 259. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=59275&dopt=Abstract

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Letter: Varicose veins in developing countries. Author(s): Phillips C, Burkitt DP. Source: British Medical Journal. 1976 May 8; 1(6018): 1148. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1268604&dopt=Abstract

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Lifestyle factors and the risk of varicose veins: Edinburgh Vein Study. Author(s): Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FG. Source: Journal of Clinical Epidemiology. 2003 February; 56(2): 171-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654412&dopt=Abstract

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Ligation, stripping, and excision of varicose veins. Author(s): Dale WA. Source: Surgery. 1970 February; 67(2): 389-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5411307&dopt=Abstract

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Local transdermal glyceryl trinitrate has an antiinflammatory action on thrombophlebitis induced by sclerosis of leg varicose veins. Author(s): Berrazueta JR, Fleitas M, Salas E, Amado JA, Poveda JJ, Ochoteco A, Sanchez de Vega MJ, Ruiz de Celis G. Source: Angiology. 1994 May; 45(5): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8172381&dopt=Abstract

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Long cotton wool rolls as compression enhancers in macrosclerotherapy for varicose veins. Author(s): Tazelaar DJ, Neumann HA, De Roos KP. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1999 January; 25(1): 38-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9935092&dopt=Abstract

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Long saphenous stripping is favored in treating varicose veins. Author(s): Neglen P. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 October; 27(10): 901-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11722531&dopt=Abstract

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Long saphenous vein saving surgery for varicose veins. Author(s): Hammarsten J, Campanello M, Pederson P. Source: Eur J Vasc Surg. 1993 November; 7(6): 763-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8270089&dopt=Abstract

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Long saphenous vein saving surgery for varicose veins. A long-term follow-up. Author(s): Hammarsten J, Pedersen P, Cederlund CG, Campanello M. Source: Eur J Vasc Surg. 1990 August; 4(4): 361-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2204548&dopt=Abstract

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Lower limb venous dynamics in normal persons and children of patients with varicose veins. Author(s): Reagan B, Folse R. Source: Surg Gynecol Obstet. 1971 January; 132(1): 15-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5538807&dopt=Abstract

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Lysosomal enzymes and superoxide production in polymorphonuclear leukocytes of patients with primary varicose veins. Author(s): Stvrtinova V, Ferencikova J. Source: Cor Vasa. 1992; 34(3): 255-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1339112&dopt=Abstract

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Management of sudden profuse bleeding from varicose veins. Author(s): McCarthy WJ, Dann C, Pearce WH, Yao JS. Source: Surgery. 1993 February; 113(2): 178-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8430366&dopt=Abstract

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Management of varicose veins according to reason for presentation. Author(s): O'Leary DP, Chester JF, Jones SM. Source: Annals of the Royal College of Surgeons of England. 1996 May; 78(3 ( Pt 1)): 2146. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8779508&dopt=Abstract

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Management of varicose veins by surgery and by injection. Author(s): Lewis MR. Source: J Tenn Med Assoc. 1982 January; 75(1): 11-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7087450&dopt=Abstract

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Management of varicose veins during pregnancy. Author(s): Nabatoff RA, Pincus JA. Source: Obstetrics and Gynecology. 1970 December; 36(6): 928-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5530606&dopt=Abstract

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Massive haemorrhage from vaginal varicose veins in patient with liver cirrhosis. Author(s): Eriksson LS, Hardstedt C, Law DH, Thulin L. Source: Lancet. 1982 May 22; 1(8282): 1180. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6122951&dopt=Abstract

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Mast cell infiltration in the wall of varicose veins. Author(s): Haviarova Z, Weismann P, Pavlikova D, Durdik S, Kovac P, Stvrtinova V, Mraz P. Source: Acta Histochemica. 2002; 104(4): 357-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553702&dopt=Abstract

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Matrix metalloproteinase-9 and urokinase-type plasminogen activator in varicose veins. Author(s): Kosugi I, Urayama H, Kasashima F, Ohtake H, Watanabe Y. Source: Annals of Vascular Surgery. 2003 May; 17(3): 234-8. Epub 2003 April 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704537&dopt=Abstract

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Measuring varicose veins in population surveys. Author(s): Evans CJ, Fowkes FG. Source: Journal of Epidemiology and Community Health. 1994 April; 48(2): 212-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8189182&dopt=Abstract

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Medicolegal action following treatment for varicose veins. Author(s): Tennant WG, Ruckley CV. Source: The British Journal of Surgery. 1996 March; 83(3): 291-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8665178&dopt=Abstract

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Mesh tube-calibrated varicose veins for coronary artery bypass grafting. Author(s): Moritz A, Grabenwoger F, Wolner E. Source: The Annals of Thoracic Surgery. 1994 January; 57(1): 240-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8279907&dopt=Abstract

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Mesh tube--constricted varicose veins used as bypass grafts for infrainguinal arterial reconstruction. Author(s): Moritz A, Grabenwoger F, Raderer F, Ptakovsky H, Staudacher M, Magometschnigg H, Ullrich R, Wolner E. Source: Archives of Surgery (Chicago, Ill. : 1960). 1992 April; 127(4): 416-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1558494&dopt=Abstract

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Microvascular changes in venous hypertension due to varicose veins after standardized application of Essaven gel--a placebo-controlled, randomized study. Author(s): Cesarone MR, De Sanctis MT, Incandela L, Belcaro G, Griffin M. Source: Angiology. 2001 December; 52 Suppl 3: S11-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775643&dopt=Abstract

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Minimally invasive surgery for primary varicose veins: limited invaginated axial stripping and tributary (hook) stab avulsion. Author(s): Goren G, Yellin AE. Source: Annals of Vascular Surgery. 1995 July; 9(4): 401-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8527344&dopt=Abstract

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Misclassification in a questionnaire survey of varicose veins. Author(s): Laurikka J, Laara E, Sisto T, Tarkka M, Auvinen O, Hakama M. Source: Journal of Clinical Epidemiology. 1995 September; 48(9): 1175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7636520&dopt=Abstract

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Modern treatment of varicose veins. Author(s): Coleridge Smith PD, Scurr JH. Source: The British Journal of Surgery. 1988 July; 75(7): 725. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3416139&dopt=Abstract

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Modern treatment of varicose veins. Author(s): Eklof B. Source: The British Journal of Surgery. 1988 April; 75(4): 297-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3282595&dopt=Abstract

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Morphologic characteristics of varicose veins: possible role of metalloproteinases. Author(s): Woodside KJ, Hu M, Burke A, Murakami M, Pounds LL, Killewich LA, Daller JA, Hunter GC. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2003 July; 38(1): 162-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12844106&dopt=Abstract

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Morphological alterations of non-varicose and varicose veins. (A morphological contribution to the discussion on pathogenesis of varicose veins). Author(s): Leu HJ, Vogt M, Pfrunder H. Source: Basic Research in Cardiology. 1979 July-August; 74(4): 435-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=508238&dopt=Abstract

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Muller's ambulatory phlebectomy for varicose veins of the foot. Author(s): De Roos KP, Neumann HA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1998 April; 24(4): 465-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9568204&dopt=Abstract

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Myelopathy due to epidural varicose veins of the cervicothoracic junction. Case report. Author(s): Dickman CA, Zabramski JM, Sonntag VK, Coons S. Source: Journal of Neurosurgery. 1988 December; 69(6): 940-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3193200&dopt=Abstract

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New technology and recurrent varicose veins. Author(s): Bergan JJ. Source: Lancet. 1996 July 27; 348(9022): 210-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8684195&dopt=Abstract

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New treatments for varicose veins. Author(s): Campbell B. Source: Bmj (Clinical Research Ed.). 2002 March 23; 324(7339): 689-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11909771&dopt=Abstract

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New trends and operative techniques in the management of varicose veins. Author(s): Villavicencio JL. Source: Hawaii Med J. 2000 June; 59(6): 249-52. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10916239&dopt=Abstract

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Noninvasive quantitation of deep venous incompetence: primary vs secondary varicose veins. Author(s): Barnes RW, Ross EA, Strandness DE Jr. Source: Surg Forum. 1974; 25(0): 252-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4439180&dopt=Abstract

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Non-saphenofemoral venous reflux in the groin in patients with varicose veins. Author(s): Jiang P, van Rij AM, Christie RA, Hill GB, Thomson IA. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2001 June; 21(6): 550-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11397031&dopt=Abstract

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Nursing care study. Varicose veins and heart failure: towards a peaceful end. Author(s): Cysewski A. Source: Nurs Mirror. 1979 June 7; 148(23): 40-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=256103&dopt=Abstract

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On the aetiology of primary varicose veins. Author(s): Schraibman I. Source: The Australian and New Zealand Journal of Surgery. 1966 May; 35(4): 281-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5220083&dopt=Abstract

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Operating for varicose veins. Author(s): Buchanan JL, Wilde RC, Yates AJ, Longabaugh EE. Source: Postgraduate Medicine. 1969 August; 46(2): 136-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5802712&dopt=Abstract

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Operation for secondary varicose veins. Author(s): Woods JM. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1973 March; 16(2): 110-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4689883&dopt=Abstract

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Operations for hernia and varicose veins in a day-bed unit. Author(s): Goulbourne IA, Ruckley CV. Source: British Medical Journal. 1979 September 22; 2(6192): 712-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=509075&dopt=Abstract

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Operative treatment of varicose veins. Author(s): Waibel P. Source: Prog Surg. 1973; 11: 1-36. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4568418&dopt=Abstract

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Ordinary varicose veins as an expression of congenital hemangioma. Author(s): Edwards EA, O'Connor JF. Source: Surg Gynecol Obstet. 1966 June; 122(6): 1245-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5941846&dopt=Abstract

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Outpatient percutaneous ligation of varicose veins. Author(s): Rivlin S. Source: Proc R Soc Med. 1977 January; 70(1): 54. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=859834&dopt=Abstract

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Outpatient percutaneous ligation of varicose veins. Author(s): Scott A, Dormandy J. Source: Proc R Soc Med. 1976 November; 69(11): 852-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=794884&dopt=Abstract

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Oxygen tension in blood from varicose veins. Author(s): Haeger KH, Lindell SE. Source: The Journal of Cardiovascular Surgery. 1966 January-February; 7(1): 69-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5905141&dopt=Abstract

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Oxygenation of blood in varicose veins. Author(s): Wali MA. Source: Afr J Med Med Sci. 2002 September; 31(3): 219-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751560&dopt=Abstract

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Oxyphenbutazone and indomethacin treatment following surgery for varicose veins. Author(s): Jaakkola K, Iisalo E, Kanto J, Koskinen EH. Source: Curr Ther Res Clin Exp. 1976 August; 20(2): 134-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=821713&dopt=Abstract

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Past and current understanding of the pathophysiology of muscle cramps: why treatment of varicose veins does not relieve leg cramps. Author(s): Jansen PH, Lecluse RG, Verbeek AL. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 1999 May; 12(3): 222-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10461641&dopt=Abstract

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Pathogenesis of varicose veins. Author(s): Golledge J, Quigley FG. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 April; 25(4): 319-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651169&dopt=Abstract

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Patient satisfaction after ambulatory phlebectomy of varicose veins in the foot. Author(s): de Roos KP, Nieman F, Neumann HA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2002 November; 28(11): 1027-30; Discussion 1030. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12460298&dopt=Abstract

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Patterns of reflux and severity of varicose veins in the general population--Edinburgh Vein Study. Author(s): Allan PL, Bradbury AW, Evans CJ, Lee AJ, Vaughan Ruckley C, Fowkes FG. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2000 November; 20(5): 470-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11112468&dopt=Abstract

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Persistent sciatic vessels, varicose veins, and lower limb hypertrophy: an unusual case or discrete clinical syndrome? Author(s): Parry DJ, Aldoori MI, Hammond RJ, Kessel DO, Weston M, Scott DJ. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 August; 36(2): 396-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170223&dopt=Abstract

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Pharmacological assessment of adrenergic receptors in human varicose veins. Author(s): Miller VM, Rud KS, Gloviczki P. Source: International Angiology : a Journal of the International Union of Angiology. 2000 June; 19(2): 176-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10905803&dopt=Abstract

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Plasma matrix metalloproteinase-9 as a marker of blood stasis in varicose veins. Author(s): Jacob MP, Cazaubon M, Scemama A, Prie D, Blanchet F, Guillin MC, Michel JB. Source: Circulation. 2002 July 30; 106(5): 535-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147532&dopt=Abstract

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Powered phlebectomy (TriVex) in treatment of varicose veins. Author(s): Cheshire N, Elias SM, Keagy B, Kolvenbach R, Leahy AL, Marston W, Pannier-Fischer F, Rabe E, Spitz GA. Source: Annals of Vascular Surgery. 2002 July; 16(4): 488-94. Epub 2002 June 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12085123&dopt=Abstract

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Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Author(s): Tessari L, Cavezzi A, Frullini A. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2001 January; 27(1): 58-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231246&dopt=Abstract

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Preoperative assessment of primary varicose veins: a duplex study of venous incompetence. Author(s): Jutley RS, Cadle I, Cross KS. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2001 April; 21(4): 370-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11359340&dopt=Abstract

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Preoperative duplex imaging is required before all operations for primary varicose veins. Author(s): Broek TA. Source: The British Journal of Surgery. 1999 April; 86(4): 570. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10216041&dopt=Abstract

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Preoperative duplex imaging is required before all operations for primary varicose veins. Author(s): Khaira HS, Jewkes A, Jones B. Source: The British Journal of Surgery. 1999 April; 86(4): 569-70; Author Reply 571. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10216040&dopt=Abstract

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Preoperative duplex imaging is required before all operations for primary varicose veins. Author(s): Meyer FJ, Taylor PR, Burnand KG. Source: The British Journal of Surgery. 1999 April; 86(4): 569; Author Reply 571. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10216039&dopt=Abstract

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Preoperative duplex imaging is required before all operations for primary varicose veins. Author(s): Vrouenraets BC, Keeman JN. Source: The British Journal of Surgery. 1999 April; 86(4): 570. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10215840&dopt=Abstract

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Prevalence and characteristics of muscle cramps in patients with varicose veins. Author(s): Hirai M. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2000 November; 29(4): 269-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11141650&dopt=Abstract

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Prevalence and risk factors of varicose veins in lower extremities: mini-Finland health survey. Author(s): Sisto T, Reunanen A, Laurikka J, Impivaara O, Heliovaara M, Knekt P, Aromaa A. Source: The European Journal of Surgery = Acta Chirurgica. 1995 June; 161(6): 405-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7548376&dopt=Abstract

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Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. Author(s): Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Source: Journal of Epidemiology and Community Health. 1999 March; 53(3): 149-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10396491&dopt=Abstract

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Primary varicose veins: the sapheno-femoral junction, distribution of varicosities and patterns of incompetence. Author(s): Cooper DG, Hillman-Cooper CS, Barker SG, Hollingsworth SJ. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 January; 25(1): 53-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525812&dopt=Abstract

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Programmed cell death (Apoptosis) and its role in the pathogenesis of lower extremity varicose veins. Author(s): Ascher E, Jacob T, Hingorani A, Gunduz Y, Mazzariol F, Kallakuri S. Source: Annals of Vascular Surgery. 2000 January; 14(1): 24-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10629260&dopt=Abstract

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Pulsatile varicose veins. Author(s): Barnett N, Collyer TC, Weston M, Spark JI, Scott DJ. Source: Journal of the Royal Society of Medicine. 2000 January; 93(1): 29-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10700846&dopt=Abstract

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Radiofrequency ablation of the long saphenous vein without high ligation versus high ligation and stripping for primary varicose veins: pros and cons. Author(s): Harris EJ. Source: Semin Vasc Surg. 2002 March; 15(1): 34-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840424&dopt=Abstract

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Rationing of surgery for varicose veins based on the presence or absence of cosmetic symptoms. Author(s): Tiwari A, Douek M, Ackroyd JS. Source: Journal of Evaluation in Clinical Practice. 2002 November; 8(4): 425-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12421393&dopt=Abstract

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Recurrent varicose veins after short saphenous vein surgery: a duplex ultrasound study. Author(s): Tong Y, Royle J. Source: Cardiovascular Surgery (London, England). 1996 June; 4(3): 364-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8782938&dopt=Abstract

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Recurrent varicose veins following high ligation of long saphenous vein: a duplex ultrasound study. Author(s): Tong Y, Royle J. Source: Cardiovascular Surgery (London, England). 1995 October; 3(5): 485-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8574530&dopt=Abstract

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Recurrent varicose veins of both lower limbs due to bilateral ovarian vein incompetence. Author(s): Giannoukas AD, Dacie JE, Lumley JS. Source: Annals of Vascular Surgery. 2000 July; 14(4): 397-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10943794&dopt=Abstract

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Recurrent varicose veins. Author(s): Wali MA, Sheehan SJ, Colgan MP, Moore DJ, Shanik GD. Source: East Afr Med J. 1998 March; 75(3): 188-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9640821&dopt=Abstract

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Recurrent varicose veins. Author(s): Chant AD. Source: Lancet. 1996 September 7; 348(9028): 684-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8782772&dopt=Abstract

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Recurrent varicose veins: investigation of the pattern and extent of reflux with color flow duplex scanning. Author(s): Labropoulos N, Touloupakis E, Giannoukas AD, Leon M, Katsamouris A, Nicolaides AN. Source: Surgery. 1996 April; 119(4): 406-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8644005&dopt=Abstract

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Recurrent varicose veins: patterns of reflux and clinical severity. Author(s): Jiang P, van Rij AM, Christie R, Hill G, Solomon C, Thomson I. Source: Cardiovascular Surgery (London, England). 1999 April; 7(3): 332-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10386752&dopt=Abstract

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Re-exploration of the saphenofemoral junction in the treatment of recurrent varicose veins. Author(s): Viani MP, Poggi RV, Pinto A, Andreani SM, Spagnoli C, Maruotti RA. Source: Int Surg. 1996 October-December; 81(4): 382-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9127800&dopt=Abstract

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Regarding “High endogenous estradiol is associated with increased venous distensibility and clinical evidence of varicose veins in menopausal women”. Author(s): Szaky T. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 April; 35(4): 829; Author Reply 829-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932696&dopt=Abstract

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Regarding “High endogenous estradiol is associated with increased venous distensibility and clinical evidence of varicose veins in menopausal women”. Author(s): Georgiev M. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2001 May; 33(5): 1134-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331868&dopt=Abstract

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Regarding extensive tissue necrosis following high concentration sclerotherapy for varicose veins. Author(s): Fisher DA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2000 November; 26(11): 1082. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11096404&dopt=Abstract

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Regarding” Hemodynamic assessment of femoropopliteal venous reflux in patients with primary varicose veins”. Author(s): Lagattolla N, Burnand KG, Donald A, Lockhart S. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1998 February; 27(2): 388-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9510301&dopt=Abstract

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Responsiveness of the SF-36 and a condition-specific measure of health for patients with varicose veins. Author(s): Garratt AM, Ruta DA, Abdalla MI, Russell IT. Source: Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 1996 April; 5(2): 223-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8998491&dopt=Abstract

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Retrograde stripping of recurrent varicose veins. Author(s): Mitton D, Thornton M, Beard J. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2001 July; 22(1): 90-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11461110&dopt=Abstract

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Risk indicators for varicose veins in forty- to sixty-year-olds in the Tampere varicose vein study. Author(s): Laurikka JO, Sisto T, Tarkka MR, Auvinen O, Hakama M. Source: World Journal of Surgery. 2002 June; 26(6): 648-51. Epub 2002 March 01. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053212&dopt=Abstract

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Role of A-V shunting in varicose veins: therapeutic implications. Author(s): Haimovici H. Source: The Journal of Cardiovascular Surgery. 1995 April; 36(2): 109-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7790327&dopt=Abstract

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Role of the endothelium and blood stasis in the appearance of varicose veins. Author(s): Michiels C, Bouaziz N, Remacle J. Source: International Angiology : a Journal of the International Union of Angiology. 2002 March; 21(1): 1-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11941268&dopt=Abstract

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Role of the endothelium and blood stasis in the development of varicose veins. Author(s): Michiels C, Bouaziz N, Remacle J. Source: International Angiology : a Journal of the International Union of Angiology. 2002 June; 21(2 Suppl 1): 18-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515976&dopt=Abstract

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Sclerosing foam in the treatment of varicose veins and telangiectases: history and analysis of safety and complications. Author(s): Frullini A, Cavezzi A. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2002 January; 28(1): 11-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991262&dopt=Abstract

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Sclerotherapeutic agents used for treatment of spider and varicose veins: update 2002. Author(s): Weiss RA, Weiss MA. Source: J Drugs Dermatol. 2002 July; 1(1): 53-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847755&dopt=Abstract

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Sclerotherapy for the permanent eradication of varicose veins: theoretical and practical considerations. Author(s): Green D. Source: Journal of the American Academy of Dermatology. 1998 March; 38(3): 461-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9520030&dopt=Abstract

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Sclerotherapy for varicose veins of the lower legs in patients with dysplasminogenemia. Author(s): Ikeda M, Kawasaki T, Kambayashi J, Iwamoto S, Shinoki N, Nakamura T, Shibuya T, Monden M. Source: Surgery Today. 1997; 27(8): 714-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9306585&dopt=Abstract

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Sclerotherapy of varicose veins of the lower limbs. Consensus paper. North American Society of Phlebology. Author(s): Baccaglini U, Spreafico G, Castoro C, Sorrentino P. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1996 October; 22(10): 883-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9246172&dopt=Abstract

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Self-reported stress and subsequent hospital admissions as a result of hypertension, varicose veins and haemorrhoids. Author(s): Metcalfe C, Davey Smith G, Macleod J, Heslop P, Hart C. Source: Journal of Public Health Medicine. 2003 March; 25(1): 62-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669921&dopt=Abstract

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Smooth muscle cell modulation and cytokine overproduction in varicose veins. An in situ study. Author(s): Badier-Commander C, Couvelard A, Henin D, Verbeuren T, Michel JB, Jacob MP. Source: The Journal of Pathology. 2001 March; 193(3): 398-407. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11241422&dopt=Abstract

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Smooth muscle changes in varicose veins: an ultrastructural study. Author(s): Wali MA, Eid RA. Source: J Smooth Muscle Res. 2001 December; 37(5-6): 123-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12126039&dopt=Abstract

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Some aspects concerning the antioxidant capacity of venous blood in lower limbs varicose veins. Author(s): Siska IR, Avram J, Tatu C, Bunu C, Schneider F, Maties R. Source: Advances in Experimental Medicine and Biology. 1999; 471: 445-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10659178&dopt=Abstract

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Standing at work and varicose veins. Author(s): Tuchsen F, Krause N, Hannerz H, Burr H, Kristensen TS. Source: Scand J Work Environ Health. 2000 October; 26(5): 414-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11103840&dopt=Abstract

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Stripping operation with sclerotherapy for primary varicose veins due to greater saphenous vein reflux: three-year results. Author(s): Miyazaki K, Nishibe T, Sata F, Imai T, Kudo FA, Flores J, Miyazaki YJ, Yasuda K. Source: World Journal of Surgery. 2003 May; 27(5): 551-3. Epub 2003 April 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715221&dopt=Abstract

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Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. Author(s): Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1999 April; 29(4): 589-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10194484&dopt=Abstract

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Structural changes in the tunica intima of varicose veins: a histopathological and ultrastructural study. Author(s): Khan AA, Eid RA, Hamdi A. Source: Pathology. 2000 November; 32(4): 253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11186421&dopt=Abstract

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Superficial thrombophlebitis of the lower limbs in patients with varicose veins. Author(s): Unno N, Mitsuoka H, Uchiyama T, Yamamoto N, Saito T, Ishimaru K, Kaneko H, Nakamura S. Source: Surgery Today. 2002; 32(5): 397-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12061687&dopt=Abstract

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Superoxide radical concentration and superoxide dismutase (SOD) enzyme activity in varicose veins. Author(s): Wali MA, Suleiman SA, Kadoumi OF, Nasr MA. Source: Ann Thorac Cardiovasc Surg. 2002 October; 8(5): 286-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472411&dopt=Abstract

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Surgery for varicose veins: use of tourniquet. Author(s): Rigby KA, Palfreyman SJ, Beverley C, Michaels JA. Source: Cochrane Database Syst Rev. 2002; (4): Cd001486. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519558&dopt=Abstract

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Surgery of varicose veins on ambulatory basis. Early and late results. Author(s): Dimakakos P, Vlahos L, Papadimitriou J. Source: Int Surg. 1995 July-September; 80(3): 267-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8775618&dopt=Abstract

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Surgical management of varicose veins in advanced chronic venous insufficiency. Author(s): Cassina PC, Brunner U, Kessler W. Source: Current Problems in Dermatology. 1999; 27: 174-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10547744&dopt=Abstract

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Surgical treatment of varicose veins. Author(s): Wolf B, Brittenden J. Source: Journal of the Royal College of Surgeons of Edinburgh. 2001 June; 46(3): 154-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11478012&dopt=Abstract

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Synthesis of collagen is dysregulated in cultured fibroblasts derived from skin of subjects with varicose veins as it is in venous smooth muscle cells. Author(s): Sansilvestri-Morel P, Rupin A, Jaisson S, Fabiani JN, Verbeuren TJ, Vanhoutte PM. Source: Circulation. 2002 July 23; 106(4): 479-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135949&dopt=Abstract

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The coagulofibrinolytic state of patients with primary varicose veins of the lower legs. Author(s): Ikeda M, Kambayashi J, Iwamoto S, Shinoki N, Nakamura T, Shibuya T, Kawasaki T, Monden M. Source: Surgery Today. 1996; 26(12): 985-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9017960&dopt=Abstract

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The crochet hook method of stab avulsion phlebectomy for varicose veins. Author(s): Waddell BE, Harkins MB, Lepage PA, Modesto VL, Villavicencio JL. Source: American Journal of Surgery. 1996 September; 172(3): 278-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8862084&dopt=Abstract

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The effect of pregnancy on the lower-limb venous system of women with varicose veins. Author(s): Sparey C, Haddad N, Sissons G, Rosser S, de Cossart L. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 1999 October; 18(4): 294-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10550263&dopt=Abstract

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The place of duplex scanning for varicose veins and common venous problems. Author(s): Kerwat R, Shandall A. Source: Annals of the Royal College of Surgeons of England. 1997 July; 79(4): 308. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9244082&dopt=Abstract

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The place of duplex scanning for varicose veins and common venous problems. Author(s): Campbell WB, Halim AS, Aertssen A, Ridler BM, Thompson JF, Niblett PG. Source: Annals of the Royal College of Surgeons of England. 1996 November; 78(6): 4903. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8943629&dopt=Abstract

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The role of operative management of varicose veins in patients with lymphedema and/or lipedema of the legs. Author(s): Foldi M, Idiazabal G. Source: Lymphology. 2000 December; 33(4): 167-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191657&dopt=Abstract

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The role of radial reflux in the genesis of varicose veins. Author(s): Crotty TP. Source: Medical Hypotheses. 1996 December; 47(6): 449-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8961241&dopt=Abstract

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The selective use of duplex scanning in the pre-operative assessment of primary and uncomplicated varicose veins identifies patients with 'early' morphological disease. Author(s): Olapade-Olaopa EO, Dikko BU, Foy DM, Darke SG. Source: Afr J Med Med Sci. 2000 March; 29(1): 35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11379465&dopt=Abstract

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The treatment of varicose veins with external stenting to the saphenofemoral junction. Author(s): Lane RJ, Cuzzilla ML, Coroneos JC. Source: Vascular and Endovascular Surgery. 2002 May-June; 36(3): 179-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075383&dopt=Abstract

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The use of biocompound-grafts together with varicose veins. First clinical experience. Author(s): Zurbrugg HR, Hetzer R. Source: The Journal of Cardiovascular Surgery. 1996 December; 37(6 Suppl 1): 143-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10064367&dopt=Abstract

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The use of routine duplex scanning in the assessment of varicose veins. Author(s): Wills V, Moylan D, Chambers J. Source: The Australian and New Zealand Journal of Surgery. 1998 January; 68(1): 41-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9440455&dopt=Abstract

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Thrombomodulin promoter mutations, venous thrombosis, and varicose veins. Author(s): Le Flem L, Mennen L, Aubry ML, Aiach M, Scarabin PY, Emmerich J, AlhencGelas M. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2001 March; 21(3): 445-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231927&dopt=Abstract

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Thrombosis, phlebitis, and varicose veins. Author(s): Campbell B. Source: Bmj (Clinical Research Ed.). 1996 January 27; 312(7025): 198-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8563576&dopt=Abstract

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Thrombotic complications of varicose veins. A literature review of the role of superficial venous thrombosis. Author(s): Guex JJ. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1996 April; 22(4): 378-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8624665&dopt=Abstract

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Treating varicose veins with transilluminated powered phlebectomy. Author(s): Zotto LM. Source: Aorn Journal. 2002 December; 76(6): 981-90; Quiz 991-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528487&dopt=Abstract

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Treatment and prevention of varicose veins. Author(s): Johnson MT. Source: Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing. 1997 September; 15(3): 97-103. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9362840&dopt=Abstract

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Treatment of primary varicose veins: an assessment of the combination of high saphenous ligation and sclerotherapy. Author(s): Ishikawa M, Morimoto N, Sasajima T, Kubo Y, Nozaka T. Source: Surgery Today. 1998; 28(7): 732-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9697267&dopt=Abstract

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Treatment of small bleeding varicose veins with injection sclerotherapy. Bleeding blue blebs. Author(s): Tretbar LL. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1996 January; 22(1): 78-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8556262&dopt=Abstract

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Treatment of varicose veins: an assessment of intraoperative and postoperative compression sclerotherapy. Author(s): Iwamoto S, Ikeda M, Kawasaki T, Monden M. Source: Annals of Vascular Surgery. 2003 May; 17(3): 290-5. Epub 2003 April 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704548&dopt=Abstract

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Treatment of varicose veins: proximal saphenofemoral ligation comparing adjunctive varicose phlebectomy with sclerotherapy at a military medical center. Author(s): Brethauer SA, Murray JD, Hatter DG, Reeves TR, Hemp JR, Bergan JJ. Source: Vascular Surgery. 2001 January-February; 35(1): 51-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11668369&dopt=Abstract

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Ultrasonic treatment of varicose veins. Author(s): Schultz-Haakh H, Li JK, Welkowitz W, Rosenberg N. Source: Angiology. 1989 February; 40(2): 129-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2916761&dopt=Abstract

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Ultrastructural demonstration of mast cells in varicose veins of lower limbs: presence of mast cell-mediated mechanism. Author(s): Yamada T, Yamamoto H, Ogawa A, Miyazaki K, Tokunaga O, Itoh T. Source: The Journal of Cardiovascular Surgery. 1997 October; 38(5): 443-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9358800&dopt=Abstract

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Ultrastructural evidence for collagen degradation in the walls of varicose veins. Author(s): Jurukova Z, Milenkov C. Source: Experimental and Molecular Pathology. 1982 August; 37(1): 37-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7117497&dopt=Abstract

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Understanding the basis of treatment choices for varicose veins: a model for decision making with the repertory grid technique. Author(s): Baker D. Source: Quality in Health Care : Qhc. 1996 September; 5(3): 128-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10161526&dopt=Abstract

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Unilateral pulsatile varicose veins from tricuspid regurgitation. Author(s): Klein HO, Shachor D, Schneider N, David D. Source: The American Journal of Cardiology. 1993 March 1; 71(7): 622-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8438758&dopt=Abstract

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Unilateral pulsating varicose veins in tricuspid regurgitation resembling arteriovenous fistula. Report of a case. Author(s): Falicov RE, Barrocas M. Source: Vasc Dis. 1967 April; 4(2): 95-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6027153&dopt=Abstract

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Unusual imaging of varicose veins after radiolabeling of autologous low-density lipoproteins. Author(s): Rodrigues M, Granegger S, Kritz H, Sinzinger H. Source: Revista Espanola De Medicina Nuclear. 1998; 17(6): 442-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9873132&dopt=Abstract

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Unusually prolonged pooling of Tc-99m MDP in varicose veins. Author(s): Roman MR, Angelides S, Gibson MG. Source: Clinical Nuclear Medicine. 2001 December; 26(12): 1034. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11711709&dopt=Abstract

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Use of varicose veins as arterial bypass grafts. Author(s): Moritz A, Grabenwoger F, Raderer F, Ptakovsky H, Magometschnigg H, Ullrich R, Staudacher M. Source: Cardiovascular Surgery (London, England). 1993 October; 1(5): 508-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8076087&dopt=Abstract

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Vanquishing varicose veins. Less invasive techniques work well and slash recovery time. Author(s): Weiss R. Source: Health News. 2002 June; 8(6): 4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12085782&dopt=Abstract

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Varicose symptoms without varicose veins: the hypotonic phlebopathy, epidemiology and pathophysiology. The Acireale project. Author(s): Andreozzi GM, Signorelli S, Di Pino L, Garozzo S, Cacciaguerra G, Leone A, Martini R. Source: Minerva Cardioangiol. 2000 October; 48(10): 277-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11195857&dopt=Abstract

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Varicose veins and pregnancy. Author(s): de Cossart L. Source: The British Journal of Surgery. 2001 March; 88(3): 323-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11260095&dopt=Abstract

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Varicose veins combined with mucoid degeneration of the venous wall. Author(s): Fischer R, Leu HJ, Schneider J, Liechti PM. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1996; 25(1): 76-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8851270&dopt=Abstract

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Varicose veins demonstrated on sestamibi tumor imaging. Author(s): Spieth ME, Kasner DL. Source: Clinical Nuclear Medicine. 2002 October; 27(10): 737-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352122&dopt=Abstract

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Varicose veins made easy! Author(s): Tsavellas G, Ranaboldo CJ. Source: Annals of the Royal College of Surgeons of England. 2000 March; 82(2): 120-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10743433&dopt=Abstract

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Varicose veins of the lower limbs and venous capacitance in postmenopausal women: relationship with obesity. Author(s): Iannuzzi A, Panico S, Ciardullo AV, Bellati C, Cioffi V, Iannuzzo G, Celentano E, Berrino F, Rubba P. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2002 November; 36(5): 965-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422106&dopt=Abstract

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Varicose veins on the internet. Author(s): Libertiny G, Perkins JM, Magee TR, Galland RB. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2000 October; 20(4): 386-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11035972&dopt=Abstract

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Varicose veins possess greater quantities of MMP-1 than normal veins and demonstrate regional variation in MMP-1 and MMP-13. Author(s): Gillespie DL, Patel A, Fileta B, Chang A, Barnes S, Flagg A, Kidwell M, Villavicencio JL, Rich NM. Source: The Journal of Surgical Research. 2002 August; 106(2): 233-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12175972&dopt=Abstract

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Varicose veins. Author(s): Yao JS. Source: Asian J Surg. 2003 April; 26(2): 59-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732486&dopt=Abstract

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Varicose veins. Author(s): Anast RP. Source: Midwifery Today Int Midwife. 2001 Spring; (57): 6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596393&dopt=Abstract

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Varicose veins. Treatment warranted for medical as well as cosmetic reasons. Author(s): Zurat KM. Source: Adv Nurse Pract. 2003 June; 11(6): 28-33; Quiz 33-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807052&dopt=Abstract

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Varicose veins: hooks, clamps, and suction. Application of new techniques to enhance varicose vein surgery. Author(s): Bergan JJ. Source: Semin Vasc Surg. 2002 March; 15(1): 21-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840422&dopt=Abstract

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Varicose veins: loss of release of vascular endothelial growth factor and reduced plasma nitric oxide. Author(s): Hollingsworth SJ, Tang CB, Dialynas M, Barker SG. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2001 December; 22(6): 551-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11735206&dopt=Abstract

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Venous hemodynamic changes after external banding valvuloplasty with varicosectomy in the treatment of primary varicose veins. Author(s): Ik Kim D, Boong Lee B, Bergan JJ. Source: The Journal of Cardiovascular Surgery. 1999 August; 40(4): 567-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10532220&dopt=Abstract

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Venous physiology in the different patterns of recurrent varicose veins and the relationship to clinical severity. Author(s): Jiang P, van Rij AM, Christie RA, Hill GB, Thomson IA. Source: Cardiovascular Surgery (London, England). 2000 March; 8(2): 130-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10737349&dopt=Abstract

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What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. Author(s): Bradbury A, Evans C, Allan P, Lee A, Ruckley CV, Fowkes FG. Source: Bmj (Clinical Research Ed.). 1999 February 6; 318(7180): 353-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9933194&dopt=Abstract

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What treatments are effective for varicose veins? Author(s): Hagen MD, Johnson ED. Source: The Journal of Family Practice. 2003 April; 52(4): 329-31; Discussion 330. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681095&dopt=Abstract

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Which treatment would patients prefer for their varicose veins. Author(s): Rosenberg IL. Source: Annals of the Royal College of Surgeons of England. 1998 November; 80(6): 447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10209420&dopt=Abstract

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Which treatment would patients prefer for their varicose veins? Author(s): Campbell B, Dimson S, Bickerton D. Source: Annals of the Royal College of Surgeons of England. 1998 May; 80(3): 212-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9682648&dopt=Abstract

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Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation. Author(s): Wong JK, Duncan JL, Nichols DM. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 March; 25(3): 267-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623340&dopt=Abstract

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Women, pregnancy, and varicose veins. Author(s): Stansby G. Source: Lancet. 2000 April 1; 355(9210): 1117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10791371&dopt=Abstract

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Work conditions as risk factors for varicose veins of the lower extremities in certain professions of the working population of Rijeka. Author(s): Kontosic I, Vukelic M, Drescik I, Mesaros-Kanjski E, Materljan E, Jonjic A. Source: Acta Medica Okayama. 2000 February; 54(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10709620&dopt=Abstract

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CHAPTER 2. NUTRITION AND VARICOSE VEINS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and varicose veins.

Finding Nutrition Studies on Varicose Veins 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 “varicose veins” (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 “varicose veins” (or a synonym): •

Effects of Centella asiatica extract on mucopolysaccharide metabolism in subjects with varicose veins. Author(s): Institute of General Medicine and Clinical Methodology, Department and Service of Medical Angiology, Faculty of Medicine and Surgery, University of Naples, Italy. Source: Arpaia, M R Ferrone, R Amitrano, M Nappo, C Leonardo, G del Guercio, R Int-JClin-Pharmacol-Res. 1990; 10(4): 229-33 0251-1649

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Fiber intake, constipation, and risk of varicose veins in the general population: Edinburgh Vein Study. Author(s): Wolfson Unit for Prevention of Peripheral Vascular Diseases, Public Health Sciences, Teviot Place, EH8 9AG, Edinburgh, UK. [email protected] Source: Lee, A J Evans, C J Hau, C M Fowkes, F G J-Clin-Epidemiol. 2001 April; 54(4): 423-9 0895-4356

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Hemorrhoids and varicose veins: a review of treatment options. Author(s): Thorne Research, 4616 SE 30th, Portland, OR 97202, [email protected] Source: MacKay, D Altern-Med-Revolume 2001 April; 6(2): 126-40 1089-5159

USA.

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I have a number of spider veins on my legs and have had unsuccessful treatments for them--both injection and laser therapy. I recently read an ad for a cream called Dermal-K, which is supposed to alleviate the condition. How effective is this cream? Source: Robb Nicholson, C Harv-Womens-Health-Watch. 1998 November; 6(3): 8 1070910X

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Influence of pentoxifylline administered in vivo on the synthesis of PGI2 in human varicose veins. Author(s): Department of Pharmacology and Toxicology, Martin Luther University Halle-Wittenberg, GDR. Source: Fahr, A Langer, R Sziegoleit, W Albert, H Liebal, H Mest, H J Biomed-BiochimActa. 1988; 47(10-11): S238-40 0232-766X

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Microvascular changes in venous hypertension due to varicose veins after standardized application of Essaven gel--a placebo-controlled, randomized study. Author(s): Irvine2 Vascular Laboratory, Department of Biomedical Sciences, Chieti University and San Valentino Vascular Screening Project, Italy. Source: Cesarone, M R De Sanctis, M T Incandela, L Belcaro, G Griffin, M Angiology. 2001 December; 52 Suppl 3: S11-6 0003-3197

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Pharmacological assessment of adrenergic receptors in human varicose veins. Author(s): Department of Surgery, Mayo Clinic and Foundation, Rochester, MN 55905, USA. [email protected] Source: Miller, V M Rud, K S Gloviczki, P Int-Angiol. 2000 June; 19(2): 176-83 0392-9590

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Plethysmographic confirmation of the beneficial effect of calcium dobesilate in primary varicose veins. Author(s): Second Surgical Clinic, University of Athens, Greece. Source: Androulakis, G Panoysis, P A Angiology. 1989 January; 40(1): 1-4 0003-3197

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Preoperative diclofenac is a useful adjunct to spinal anesthesia for day-case varicose vein repair. Author(s): Department of Anesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. [email protected]

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Source: Rautoma, P Santanen, U Luurila, H Perhoniemi, V Erkola, O Can-J-Anaesth. 2001 Jul-August; 48(7): 661-4 0832-610X •

Studies on the effect of short-term oral dihydroergotamine and troxerutin in patients with varicose veins. Author(s): Department of Clinical Pharmacology, University of Vienna, Austria. Source: Schuller Petrovic, S Wolzt, M Bohler, K Jilma, B Eichler, H G Clin-PharmacolTher. 1994 October; 56(4): 452-9 0009-9236

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The out-patient therapy of trunk varicosis of the greater saphenous vein by means of ligation and sclerotherapy. A contribution from a German phlebology practice. Source: Hubner, K J-Dermatol-Surg-Oncol. 1991 October; 17(10): 818-23 0148-0812

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Varicose veins of the lower limbs and venous capacitance in postmenopausal women: relationship with obesity. Author(s): Division of Internal Medicine, Cava de' Tirreni and Amalphitan Coast Hospital, Salerno, Italy. [email protected] Source: Iannuzzi, A Panico, S Ciardullo, A V Bellati, C Cioffi, V Iannuzzo, G Celentano, E Berrino, F Rubba, P J-Vasc-Surg. 2002 November; 36(5): 965-8 0741-5214

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Varicose veins: a reappraisal from a global perspective. Author(s): Department of Surgery, George Washington University Medical Center, Washington, DC. Source: Geelhoed, G W Burkitt, D P South-Med-J. 1991 September; 84(9): 1131-4 00384348

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Varicose veins--primary treatment with sclerotherapy. A personal appraisal. Author(s): Department of Surgery, Tufts Medical School, Medford, Massachusetts. Source: Gallagher, P G J-Dermatol-Surg-Oncol. 1992 January; 18(1): 39-42 0148-0812

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

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

Vitamins Vitamin C and Flavonoids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,935,00.html Vitamin E Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,906,00.html

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

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

A single blind randomized, controlled trial of hydrotherapy for varicose veins. Author(s): Ernst E, Saradeth T, Resch KL. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1991; 20(2): 147-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1877335&dopt=Abstract

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Case report: successful treatment of varicose veins with acupuncture. Author(s): Bodenheim R. Source: Am J Acupunct. 1999; 27(1-2): 23-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10513095&dopt=Abstract

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Clinical study on the efficacy of O-(beta-hydroxyethyl)rutoside (HR) in varicosis of pregnancy. Author(s): Bergstein NA. Source: J Int Med Res. 1975; 3(3): 189-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=162674&dopt=Abstract

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Clinical, functional and quality of life changes after balneokinesis with sulphurous water in patients with varicose veins. Author(s): Mancini S Jr, Piccinetti A, Nappi G, Mancini S, Caniato A, Coccheri S. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 2003 February; 32(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677762&dopt=Abstract

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Controversies and realities of therapy for varicosis. Author(s): Orbach EJ. Source: Int Surg. 1977 March; 62(3): 149-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=856751&dopt=Abstract

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Effect of hydroxyethylrutosides on blood oxygen levels and venous insufficiency symptoms in varicose veins. Author(s): McEwan AJ, McArdle CS. Source: British Medical Journal. 1971 April 17; 2(754): 138-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5581491&dopt=Abstract

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Hemorrhoids and varicose veins: a review of treatment options. Author(s): MacKay D. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2001 April; 6(2): 126-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11302778&dopt=Abstract

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Hemorrhoids, varicose veins and deep vein thrombosis: epidemiologic features and suggested causative factors. Author(s): Burkitt DP. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1975 September; 18(5): 483-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1175115&dopt=Abstract

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Influence of O-(beta-hydroxyethyl)-rutoside or venoruton on lactate dehydrogenase of human cultured varicose veins. Author(s): Matagne D, Hamoir G. Source: Biochemical Pharmacology. 1975 August 15; 24(16): 1491-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1191306&dopt=Abstract

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Leech therapy for complicated varicose veins. Author(s): Bapat RD, Acharya BS, Juvekar S, Dahanukar SA. Source: The Indian Journal of Medical Research. 1998 June; 107: 281-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9701897&dopt=Abstract

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Studies on the effect of short-term oral dihydroergotamine and troxerutin in patients with varicose veins. Author(s): Schuller-Petrovic S, Wolzt M, Bohler K, Jilma B, Eichler HG. Source: Clinical Pharmacology and Therapeutics. 1994 October; 56(4): 452-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7955807&dopt=Abstract

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Symptomatic relief of the pre-varicose syndrome and the symptomatology associated with varicose veins using ergot compounds. Author(s): Gordon JA. Source: Cent Afr J Med. 1972 November; 18(11): 219-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4205180&dopt=Abstract

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The effect of paroven (HR) on the clearance of sodium-24 from the subcutaneous tissues of the foot in patients with varicose veins. Author(s): Chant AD. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1973; 2(3): 288-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4745138&dopt=Abstract

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The modern treatment of varicose vein disease. Author(s): Heslop JH. Source: N Z Med J. 1973 November 14; 78(502): 389-94. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4520459&dopt=Abstract

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Varicose veins. Author(s): Anast RP. Source: Midwifery Today Int Midwife. 2001 Spring; (57): 6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596393&dopt=Abstract

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What treatments are effective for varicose veins? Author(s): Hagen MD, Johnson ED. Source: The Journal of Family Practice. 2003 April; 52(4): 329-31; Discussion 330. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681095&dopt=Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Chronic Venous Insufficiency Source: Healthnotes, Inc.; www.healthnotes.com Hemorrhoids Source: Integrative Medicine Communications; www.drkoop.com Hemorrhoids Source: Prima Communications, Inc.www.personalhealthzone.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Peripheral Vascular Disease Source: Healthnotes, Inc.; www.healthnotes.com Restless Legs Syndrome Source: Healthnotes, Inc.; www.healthnotes.com

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Varicose Veins Source: Healthnotes, Inc.; www.healthnotes.com Varicose Veins Source: Integrative Medicine Communications; www.drkoop.com Varicose Veins Source: Prima Communications, Inc.www.personalhealthzone.com Water Retention Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Acupressure Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,662,00.html Aston-patterning Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10118,00.html Shiatsu Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,733,00.html

•

Homeopathy Arnica Source: Healthnotes, Inc.; www.healthnotes.com Calcarea Carbonica Source: Healthnotes, Inc.; www.healthnotes.com Carbo Vegetabilis Source: Healthnotes, Inc.; www.healthnotes.com Hamamelis Source: Healthnotes, Inc.; www.healthnotes.com Lycopodium Source: Healthnotes, Inc.; www.healthnotes.com Pulsatilla Source: Healthnotes, Inc.; www.healthnotes.com Zincum Metallicum Source: Healthnotes, Inc.; www.healthnotes.com

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Herbs and Supplements Aesculus Alternative names: Horse Chestnut; Aesculus hippocastanum L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Agrimony Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,833,00.html Ananas Comosus Source: Integrative Medicine Communications; www.drkoop.com Aortic Glycosaminoglycans Source: Prima Communications, Inc.www.personalhealthzone.com Bilberry Alternative names: Vaccinium myrtillus, European Blueberry, Huckleberry Source: Integrative Medicine Communications; www.drkoop.com Bilberry Source: Prima Communications, Inc.www.personalhealthzone.com Bilberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10007,00.html Blackberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,837,00.html Brahmi Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Bromelain Alternative names: Ananas comosus, Bromelainum Source: Integrative Medicine Communications; www.drkoop.com Bromelainum Source: Integrative Medicine Communications; www.drkoop.com Butcher’s Broom Alternative names: Ruscus aculeatus Source: Healthnotes, Inc.; www.healthnotes.com

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Butcher's Broom Source: Prima Communications, Inc.www.personalhealthzone.com Butcher's Broom Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Butcher's Broom Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10010,00.html Calendula Source: Prima Communications, Inc.www.personalhealthzone.com Centella Alternative names: Gotu Kola; Centella asiatica (Linn.) Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Centella Source: Integrative Medicine Communications; www.drkoop.com Centella Asiatica Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Cherry Fruit Extract Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10015,00.html Collinsonia Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca European Blueberry Source: Integrative Medicine Communications; www.drkoop.com Flavonoids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,782,00.html Ginkgo Alternative names: Ginkgo biloba Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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Gotu Kola Alternative names: Centella asiatica Source: Healthnotes, Inc.; www.healthnotes.com Gotu Kola Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Gotu Kola Source: Prima Communications, Inc.www.personalhealthzone.com Gotu Kola Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10031,00.html Grape Seed Extract Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,793,00.html Horse Chestnut Alternative names: Aesculus hippocastanum Source: Healthnotes, Inc.; www.healthnotes.com Horse Chestnut Source: Prima Communications, Inc.www.personalhealthzone.com Horse Chestnut Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Horse Chestnut Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10037,00.html Huckleberry Source: Integrative Medicine Communications; www.drkoop.com Hydrocotyle Source: Integrative Medicine Communications; www.drkoop.com Indian Pennywort Source: Integrative Medicine Communications; www.drkoop.com Ivy Leaf Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10112,00.html

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Marsh Pennywort Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Oak Alternative names: Quercus spp. Source: Healthnotes, Inc.; www.healthnotes.com Opcs (oligomeric Proanthocyanidins) Source: Prima Communications, Inc.www.personalhealthzone.com Prickly Ash Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Sitosterol Source: Prima Communications, Inc.www.personalhealthzone.com St. John's Wort Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Vaccinium Myrtillus Source: Integrative Medicine Communications; www.drkoop.com Witch Hazel Alternative names: Hamamelis virginiana Source: Healthnotes, Inc.; www.healthnotes.com Witch Hazel Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca

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

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CHAPTER 4. DISSERTATIONS ON VARICOSE VEINS Overview In this chapter, we will give you a bibliography on recent dissertations relating to varicose veins. 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 “varicose veins” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on varicose veins, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Varicose Veins 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 varicose veins. 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: •

Risk Factors for Varicose Veins in Postmenopausal Women by Williams, Deanna Perez; PhD from University of Arkansas, 2002, 85 pages http://wwwlib.umi.com/dissertations/fullcit/3079092

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

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

Patents on Varicose Veins By performing a patent search focusing on varicose veins, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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

5-HT.sub.2 receptor antagonist compositions useful in treating venous conditions Inventor(s): Amer; Moh S. (Santa Barbara, CA) Assignee(s): Sam Amer & Co. (Monecito, CA) Patent Number: 5,605,902 Date filed: August 7, 1995 Abstract: Methods of employing compositions containing 5-hydroxytryptamine-2 (5HT.sub.2) receptor antagonists for the treatment of such venous conditions as varicose veins, venous insufficiency and wounds are disclosed. Excerpt(s): This invention relates to the treatment of and to compositions containing 5HT.sub.2 receptor antagonists useful in treating such venous conditions as hemorrhoids, varicose veins, venous insufficiency and wounds. In particular it comprises use of a 5hydroxytryptamine-2 receptor antagonist (5-HT.sub.2) at an effective therapeutic dose to treat a human or animal suffering from such a condition. The 5-HT.sub.2 receptor antagonist can also be administered prophylactically. Serotonin or 5-hydroxytryptamine or 5-HT is a vasoconstrictor and a powerful stimulant of a variety of smooth muscles and nerves. A derivative of the amino acid tryptophan, 5-HT is formed predominantly in enterochromaffin or argentaffin cells of the intestinal tract. It is transported in the blood by platelets and is present in the brain and other tissues. Its pharmacological actions result in a variety of responses involving, inter alia, the cardiovascular, respiratory, and gastrointestinal systems, smooth muscles, exocrine glands, carbohydrate metabolism, sensory nerve endings, autonomic ganglia, the adrenal medulla, and the central nervous system. Cellular reaction is determined by the type and number of receptors on the outer membrane of the cells. Consequently, one hormone can trigger different responses in different cells because it may have different receptors. Thus, the same hormone that can contract one smooth muscle cell, can also relax a skeletal muscle cell having a different receptor to the same hormone. This is true for 5-HT. Web site: http://www.delphion.com/details?pn=US05605902__

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Apparatus and methods for removing blood vessels Inventor(s): Anderson; Richard Rox (Lexington, MA), Dierickx; Christine C. (TieltWinge, BE) Assignee(s): The General Hospital Corporation (Boston, MA) Patent Number: 6,306,130 Date filed: April 7, 1999 Abstract: Methods and apparatus for inducing necrosis and degradation of blood vessels are described. The invention is suitable to treat various conditions such as varicose veins and telangiectasia. The apparatus for inducing degradation of a blood vessel in a tissue, e.g., skin, includes an external energy source that non-invasively delivers to the blood vessel energy that is preferentially absorbed by the blood vessel to heat the blood vessel walls to a temperature of at least about 60 degrees centigrade, and a pressure source connected to the energy source to collapse the blood vessel once the

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blood vessel walls have been heated to at least about 60 degrees centigrade for a period of time and with a force sufficient to permanently weld the apposed walls of the blood vessel together, whereby the blood vessel undergoes necrosis and degradation. Excerpt(s): This invention relates to methods and apparatus for inducing blood vessel necrosis of unwanted or diseased, e.g., dilated, blood vessels. A blood vessel can be any vascular structure, e.g., an artery, a vein, or a capillary. A dilated blood vessel is usually associated with any one or more of a variety of disease conditions, e.g., telangiectasias and varicose veins. Telangiectasias are skin manifestations of primary cutaneous disorders and systemic diseases. For example, linear telangiectasias are seen on the faces of patients with actinically damaged skin and acne rosacea and are found on the legs of patients with venous hypertension and essential telangiectasia. Mat telangiectasias are lesions of broad macules and are commonly found on the face, oral mucosa, and hands of patients. Web site: http://www.delphion.com/details?pn=US06306130__ •

Apparatus for in situ saphenous vein bypass and less-invasive varicose vein treatment Inventor(s): Acosta; George M. (Long Beach, CA), Brustad; John R. (Dana Point, CA), Daw; Derek J. (Costa Mesa, CA) Assignee(s): Endovascular, Inc. (Costa Mesa, CA) Patent Number: 5,658,282 Date filed: June 7, 1995 Abstract: An apparatus for in situ saphenous vein bypass includes an operating catheter which includes an optical fiber and an electrode, and a control catheter which includes a valvulotome. The operating catheter and control catheter are locked together and advanced through an incision in the leg. The catheters are closely spaced from each other, on opposite sides of a valve to be disrupted. Then, the valvulotome is manipulated to disrupt the valve, the electrode is manipulated to stanch blood flow from the valve and to close off side branches, and both procedures are viewed by means of the optical fiber. The valves of the saphenous vein are thusly disrupted in sequence, and the side branches to the saphenous vein closed off, to thereby modify the saphenous vein in situ for arterial use. In alternate embodiments, the electrode is used with delivery catheters to stop blood flow through a side branch or varicose vein. The electrode includes an embedded temperature sensor for sensing electrode temperature. Excerpt(s): The present invention relates generally to endoscopic surgical tools, and more particularly to endoscopic apparatus and methods for in situ saphenous vein bypass surgery and less invasive treatment of varicose veins. Many hundreds of thousands of people each year experience partial or complete blockage of the femoral artery attributable to plaque build-up in the artery. When this occurs, the supply of oxygen-rich arterial blood to the leg is reduced, causing pain and, if it is left untreated, eventually leads to amputation of the leg. For some blockages, it is possible to remove the blocking tissue by angioplasty or atherectomy, thereby preserving the functionality of the femoral artery. For more complex blockages, however, it is sometimes necessary to altogether bypass the blocked femoral artery. In other words, it is sometimes necessary to attach a substitute conduit to the femoral artery at a location that is upstream (proximal) to the blockage and a location that is downstream (distal) to the blockage, with the substitute conduit assuming the function of the femoral artery in

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delivering arterial blood to the leg. Such a bypass procedure may be required when the femoral artery has become too occluded or otherwise impaired between the upstream and downstream locations to transport the flow of blood required of it. Web site: http://www.delphion.com/details?pn=US05658282__ •

Article of wearing apparel providing an undergarment Inventor(s): Lowth; Leonard Cecil (London, GB2) Assignee(s): Scholl Inc. (Chicago, IL) Patent Number: 4,106,514 Date filed: January 10, 1977 Abstract: A leg portion has at its upper end a first upper thigh, hip and abdomen covering section to the upper portion of which is connected a second upper thigh, abdomen and hip covering section for the opposite side of the wearer's body. A waistband is attached to the upper ends of the sections. An elastic crotch gusset is connected to and between the remaining lower portions of the sections and coacts with the sections to effect substantially uniformly tensioned engagement of the sections and the crotch gusset entirely about the wearer's upper thighs and groin areas. The crotch gusset and the second section define between them a downward leg opening through which the remaining leg of a wearer extends, and the crotch gusset and the second section each provide part of an edge for the leg opening and which edge snuggly engages about the upper thigh of the remaining leg of the wearer to restrain upward creeping of the second section. The garment is especially suitable for persons afflicted with varicose veins in the groin and upper thigh areas of the body, and possibly abdominal area. Excerpt(s): This invention relates to articles of wearing apparel providing undergarments and is more particularly concerned with such garments having surgical value in providing support for a wearer's abdomen, thighs, groin or legs, particularly where afflicted with varicose veins. Sufferers from varicose veins in the legs above or below the knee have for many years been provided with stretch stockings incorporating elastic or elastomeric threads which cause the stockings to apply pressure around the leg, which eases the discomfort of varicose veins. Abdominal varicose veins, usually in the frontal region above the crotch, can be similarly supported by bands of such stretch material applied round the abdominal part of the torso, but varicose veins in the groin, and particularly the inner part of the groin, and upper thigh are difficult to support due to the shape of that part of the human body. Hitherto such support as was possible for varicose veins in all these regions of the body has been provided by separate garments or bandages. An important object of the present invention is to provide a new and improved article of wearing apparel providing an undergarment which will in and of itself provide for support in the abdominal, thigh, groin and leg areas of the wearer's body. Web site: http://www.delphion.com/details?pn=US04106514__

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•

Combined syringe and electrosurgical electrode for sclerotherapy Inventor(s): Ellman; Alan G. (1135 Railroad Ave., Hewlett, NY 11557), Garito; Jon C. (1135 Railroad Ave., Hewlett, NY 11557) Assignee(s): none reported Patent Number: 6,293,944 Date filed: September 10, 1999 Abstract: A hypodermic needle syringe with means connected to the needle for selectively applying to the needle radio-frequency (RF) electrosurgical currents. For treating varicose veins, the hypodermic needle is inserted into the vein to be treated and the syringe plunger withdrawn to see whether blood is back drawn into the syringe barrel. If blood is detected, then the electrosurgical apparatus is activated and the resultant application of the RF electrosurgical currents quickly collapses the vein. An advantage is that the needle need not be withdrawn after the blood is detected, with the result that no problem arises of trying to locate a pin hole previously produced by a needle. Excerpt(s): This invention relates to an electrosurgical electrode for electrosurgical scierotherapy, i.e., the treatment of varicose veins of a patient. Reference is made to our U.S. Pat. No. 5,695,495, whose contents are herein incorporated by reference, which describes an electrosurgical electrode for scierotherapy. The latter replaces an earlier form of sclerotherapy which involves introducing a sclerosing agent, be it physical, chemical or mechanical, into a vessel to produce sclerosis. The advantage of our patented electrosurgical electrode is that it enables physicians to offer to patients a treatment that is virtually non-invasive and non-surgical, efficiently performed, easily learned by the physician and thus performed at a significantly reduced price, and requiring less patient follow-up with superior results compared to non-electrosurgical procedures. The common manner to implement this new procedure and in a sense a possible disadvantage is that the precise vein to be treated is first identified by placing the hollow needle of a hypodermic syringe into the skin/vein interface, and withdrawing the plunger. If blood is back drained into the syringe barrel, then the practitioner by viewing the blood knows the syringe needle is in the vein to be treated. Once the vein is thus identified, the needle is removed and the patented insulated needle electrode is placed carefully trying to locate the same needle or hole site formed by the syringe needle as well as depth location of where the vein was. This can be a difficult and tedious task and often results in losing the previously identified vein. The procedure then has to be repeated. The time necessary to find the correct vein can be consuming. Web site: http://www.delphion.com/details?pn=US06293944__

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Device and method for underskin laser treatments Inventor(s): Del Giglio; Antonio (Verona, IT) Assignee(s): CeramOptec Industries, Inc. (East Longmeadow, MA) Patent Number: 6,200,332 Date filed: July 9, 1999 Abstract: A device and method for underskin laser treatment that is minimally invasive, versatile and precise, that allows for underskin laser treatment with only minimal

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insertions into the area of treatment. For example, an entire area may be treated with one insertion. The device and method incorporates a standard insertion component making the system inexpensive and easy for doctors to use. In addition, the the invention allows users to get in direct contact with the treatment site, eliminating deleterious side effects encountered when treatment is administered to the skin surface. The device and method has applications in several areas of treatment. First, underskin treatment of aesthetic skin blemishes such as sagging and wrinkles can be performed with minimal external effects. Laser power is delivered directly beneath the skin, bypassing harmful exposure of the skin surface to the radiation. Second, common vascular abnormalities such as capillary disorders, spider nevus, hemangioma, and varicose veins can be selectively eliminated. The device allows a simple, single insertion per treated structure and specific laser delivery. The needle is inserted into the vascular structure and any abnormalities are eradicated starting from the source and continuing through the entire structure. Third, when coupled with x-ray imaging, the present invention may be used to treat various internal body structures for example during surgery. X-ray imaging allows the user to orient the device within the body structures. Laser delivery treatment can then be administered as described above. Excerpt(s): Underskin laser treatment is an effective way to eliminate many abnormalities. A below the skin application provides a more proximal access to the area of treatment enabling the use of a less powerful and less harmful laser. Straight form surface treatments require laser energy to be focused on the skin surface, commonly leading to undesired side effects such as external discoloration or scarring. The present invention describes an underskin laser treatment system that can be utilized for correcting skin irregularities, eradicating vascular abnormalities, and operating in various parts of the body. Radiation administered below the surface of the skin provides a more proximal application with reduced risks of accidentally exposing surrounding tissue to the laser radiation. The present invention describes an improved method of wrinkle removal. By allowing laser energy to be delivered subcutaneously, the present invention substantially prevents against surface epidermal injury. Further, the closer proximity of the application of the radiation to the underskin site allows a lower power application reducing the amount of deleterious side effects in general. Laser treatment below the surface of the skin has also been described in U.S. Pat. No. 5,531,739 to Trelles. There a method is described whereby an optical probe is inserted into the skin adjacent to a vascular abnormality. Introducing laser pulses will serve to collapse and close off the vein. This method requires multiple insertions of the device along the desired vein to treat the abnormality. The procedure has limitations. First, the described method is specific for treatment of veins, primarily in the leg, and is therefore limited to that specific treatment. Second, the procedure requires a low power beam to illuminate and direct the probe to the treatment site under the skin. Treatment is then limited to underskin sites at a depth that the illumination beam can penetrate. Third, the method describes delivery of the laser power to the vicinity of, and outside the vein requiring treatment. Such laser treatment closes off the vein by collapsing its wall, an indirect solution. Web site: http://www.delphion.com/details?pn=US06200332__

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•

Device for treatment of spider veins Inventor(s): Gordon; Dennis P. (1244 Rancho Cir., Las Vegas, NV 89107) Assignee(s): none reported Patent Number: 6,224,618 Date filed: October 20, 1999 Abstract: A device is set forth for treatment of spider veins. The device includes a needle having at its tip a slot defining tines. The needle is inserted through the skin to locate the spider vein in the slot. The needle is rotated to sever the vein from connecting veins. Excerpt(s): The present invention relates to medical devices and more particularly to devices for treatment of spider veins. Spider veins, are a common cosmetic problem. They occur in approximately eighty million people, mostly Caucasian females. When severe they may be so unsightly as to deter the wearing of clothing such as shorts or skirts and may show through hosiery. The cause is thought to be related to estrogen and/or venous insufficiency. Current treatment consists of sclerotherapy or laser treatment by cauterizing the veins. In Suval, U.S. Pat. No. 5,792,168 there is shown a device for treating varicose veins which includes a needle having a hook to capture the vein for removal from the incision. However, destroying the veins in situ does not work because veins will recannulize. Therefore, physically removing veins or interrupting their continuity appears to be the best hope for treatment. Web site: http://www.delphion.com/details?pn=US06224618__

•

Endothelium stripper and method of using the same Inventor(s): Salem; Mohamed E. M. (Moharem Bake, EG) Assignee(s): University of South Florida (Tampa, FL) Patent Number: 5,011,489 Date filed: October 5, 1989 Abstract: A surgical tool for stripping the endothelium from varicose veins. A smooth probe member surmounts an elongate flexible wire and is inserted into the vein and withdrawn therefrom as a preparatory step. The smooth probe member is then removed from the wire member, and a smooth head member of frusto conical configuration is then mounted to the distal end of the wire. A plurality of barbed head members are then secured to the smooth head member, in longitudinal alignment with one another, distal to the smooth head member. The head members can be rigidly or flexibly interconnected to one another. The barbs on the barbed head members are swept back to facilitate their insertion into the vein and such barb members engage and strip the endothelium when the head members are withdrawn from the vein. The smooth head member is the leading head member during such withdrawal. Excerpt(s): This invention relates, generally, to surgical tools. More particularly, it relates to a tool that removes the inner lining of varicose veins without removing the veins from the patient's body. Varicose veins are usually found in the limbs of the lower body; they are veins that are abnormally dilated and elongated. Various surgical treatments have been developed to treat the condition; these treatments include removal of the affected veins from the body.

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Web site: http://www.delphion.com/details?pn=US05011489__ •

Endovascular laser device and treatment of varicose veins Inventor(s): Gomez; Joaquina Fructuoso (Santa Lavinea, No. 7, Costa d'en Blane Calvia, Mallorca, ES), Min; Robert J. (2000 Broadway #8C, New York, NY 10023), Navarro; Luis (164 E. 71st St., New York, NY 10021), Navarro; Nestor (Manuel Girona 74, Barcelona, ES), Salat; Carlos Bone (Santa Lavinea, No. 7, Costa d'en Blane Calvia, Mallorca, ES) Assignee(s): none reported Patent Number: 6,398,777 Date filed: August 13, 1999 Abstract: A method is disclosed for treating blood vessels using endovascular techniques to deliver laser energy. Percutaneous access into the vein lumen will be obtained using an angiocatheter through which a fiber optic line will be introduced. The vein will be emptied of blood using elevation of the limb, patient positioning, compression, or other means. Laser energy will be delivered into the vein lumen using wavelengths from about 532 nanometers to about 1064 nanometers. Sufficient power and duration will be used to damage the entire thickness of the vein wall, ultimately causing fibrosis of the treated blood vessel. Fibrosis of the treated blood vessel causes the blood vessel to decrease in diameter or collapse. Excerpt(s): The present invention relates to a method for treating varicose veins. More particularly, the present invention relates to a method of utilizing laser energy delivered into the vessel lumen via endovascular techniques to treat varicose veins. The use of lasers in the treatment of vascular disease has been gaining rapid interest. Lesions such as port wine stains, facial telangiectasias, and some lower extremity veins have been treated externally by lasers with some success. Most of these laser procedures irradiate the surface of the skin with laser energy that penetrates the skin, is absorbed by the blood, and coagulates and collapses the blood vessel. Larger varicose veins are located deeper in the soft tissues. Such veins have not been successfully treated with laser techniques. It is believed that treating such larger veins with laser energy delivered from the surface would require higher powers that could lead to increased side effects including scarring and skin hyper- or hypopigmentation. Web site: http://www.delphion.com/details?pn=US06398777__

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Laser apparatus for subsurface cutaneous treatment Inventor(s): O'Donnell, Jr.; Francis E. (St. Louis, MO) Assignee(s): Sublase, Inc. (Rydal, PA) Patent Number: 6,197,020 Date filed: October 23, 1998 Abstract: A laser apparatus for selective photocoagulation of subsurface skin (dermis) for the purpose of increasing skin tone, reducing wrinkles, removing hair, removing tattoos or treating varicose veins without damaging the skin surface (epidermis). A diffuser lens in the laser apparatus is employed to focus the laser energy to the dermis. The laser apparatus includes a highly transmissive contact tip and cooling means to reduce heat build-up in the contact tip, as monitored by a thermocouple mechanism.

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The device can be used alone or in conjunction with superficial laser resurfacing or chemical peels to increase skin tone. Excerpt(s): Not applicable. The present invention relates to an apparatus and method of laser treatment of subsurface cutaneous tissue for the purpose of effecting a tightening of the skin and reducing wrinkles without significantly altering the epidermis. Pulsed CO.sub.2 lasers, erbium lasers, holmium lasers, and other infrared lasers are being used clinically to remove the epidermis and superficial reticular dermis for the purpose of laser resurfacing. Besides removing the superficial layers, there is often a significant contraction of the skin associated with these laser resurfacing technologies. This skin tightening is due to sufficient, but not excessive dermal collagen heating by the laser, and it is as important to patient satisfaction as the more youthful epidermis (skin surface) appearance achieved by laser resurfacing. Web site: http://www.delphion.com/details?pn=US06197020__ •

Leg exercising apparatus Inventor(s): Lowth; Leonard C. (London, GB2) Assignee(s): Scholl, Inc. (Chicago, IL) Patent Number: 4,159,111 Date filed: June 21, 1977 Abstract: A leg exerciser for medical purposes, comprising a treadle apparatus including a base with a pair of foot pedals mounted thereon, one for each foot, arranged so that when one is pushed downwardly the other must move upwardly with dorsal and plantar flexion, imitating the muscular actions involved in normal walking. The apparatus is light in weight and can be used by patients to exercise the legs either in a prone or sitting position to reduce pressure in a vein which could lead to varicose veins or worse to thrombosis. Excerpt(s): Heretofore, extremely expensive apparatus has been built for massaging a bedridden patient's legs to avoid varicose veins or the development of a thrombus. Due to the expense of such a machine and which is extremely large and could not be carried around by hand from one patient to another, few were used in hospitals, and most of the hospitals relied upon manual manipulation in keep the blood flowing uniformly to a vein back to the heart but muscles in the legs must be exercised for the purposes of aiding in pumping the blood to the heart and keeping low pressure in the veins. In healthy people, continuous high pressure in the legs can lead to leg fatigue and eventually varicose veins. In medical and surgical patients, and particularly in postoperative patients, the problem can be more serious, because bedridden patients are generally unable to exercise their legs, and this leads to an increased risk of thrombophlebitis or ultimately to a possible coronary thrombosis. The instant invention provides a leg exercising apparatus which enables the patient to exercise his leg muscles from a prone or seated position by dorsal and plantar flexion, thus imitating the muscular actions involved in normal walking. Furthermore, the device is so light in weight that it is easily carried by a nurse and often times may be carried by a mobile patient. The apparatus includes a plastic base portion to each side of which a foot pedal is pivoted at the heel end, each pedal being made so that the foot will not slip off it. Web site: http://www.delphion.com/details?pn=US04159111__

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Maternity brace Inventor(s): Alberts; Gina (5 North Villas, London NW1 9BJ, GB) Assignee(s): none reported Patent Number: 6,537,132 Date filed: October 26, 2000 Abstract: A maternity brace for providing support to the vulval and abdominal regions of a pregnant woman. The maternity brace has a central vulval panel and a pair of front and rear straps attached thereto. A body-encircling adjusting belt is in communication with the front and rear straps. An abdominal panel positioned between the two front straps applies a supporting force to the abdomen. A back panel along the back of the adjusting belt imparts stability to the lower back. The front and rear straps may be nonlinear to add comfort and support. Wearing the maternity brace improves the overall well-being of an expectant mother and helps to prevent varicose veins, stretch marks, back pain, cystocele, rectocele, hemorrhoids, increased wear on knee and hip joints, reduced blood circulation, and overall fatigue. Excerpt(s): The present invention relates to a support brace for providing support to the vulval and abdominal regions of a pregnant woman and for reducing or eliminating the deleterious effects of the increased body weight of pregnancy. The additional size and weight of the fetus in a pregnancy often impact negatively on several body parts and the overall well-being of an expectant mother. Varicose veins may develop. Hemorrhoids may form. Conditions such as cystocele and rectocele may occur. The additional weight of the fetus places a strain on the lower back and may cause poor posture and back pain. Knee and hip joints may fatigue from the extra stress. Stretch marks may appear in the abdominal region. Thus there is a need for therapies and other means to alleviate or prevent these conditions. Various types of supportive garments and girdles have been proposed to help reduce the deleterious effects of both fetal weight and additional body weight of the expectant mother. For example, Alberts U.S. Pat. No. 3,116,736 discloses a body support having both a vulval support for supporting the vulval region of the wearer and a girdle for providing beneficial support to the abdominal region. Castiglia U.S. Pat. No. 4,195,640 discloses a lower torso support appliance having both an inelastic front panel for engaging the abdominal region of the wearer and a rigid sheet-like member for engaging the lower back. Web site: http://www.delphion.com/details?pn=US06537132__

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Method and apparatus for improving the appearance of spider veins Inventor(s): Sickler, Jr.; Ernest H. (Elizabeth, NJ) Assignee(s): none reported Patent Number: 5,597,580 Date filed: May 3, 1994 Abstract: A method and article are disclosed for topical application of tea, such as orange pekoe or black, to improve the appearance of spider veins and varicose veins. A method and article are also disclosed for topical application of tea to improve circulation in the extremities. Excerpt(s): This invention relates to the non-invasive treatment of spider veins and varicose veins. Varicose veins are weakened veins in which blood collects leading to a

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swollen and bluish appearance of the veins. They occur most commonly in the legs. Primary varicose veins are believed to be hereditary, whereas secondary varicose veins may occur as a result of an injury. Spider veins are small venules in the skin usually having a reddish appearance, most commonly found in women, and believed to be hormonal. They too occur most commonly in the legs. Traditionally, varicose veins have been treated by surgery or injection treatments. Preventive tips include keeping one's weight down, raising the legs, wearing support hose, and not smoking. D. Tkac, ed., The Doctors Book of Home Remedies, Rodale Press: Emmaus, Pa., 1990, pp. 616-20. Other recommendations include ingesting B complex, C, and E vitamins and herbs such as butchers broom, hawthorn, horsechestnut, marigold, misletoe, witch hazel, white oak bark and yarrow. The Vitamin & Herb Guide, Global Health Ltd.: Tofield, Alberta, Canada, 1992, pp. 34-35. More recently, it has been suggested that a substance called anthocyanosides in bilberries can be ingested to erase varicose veins. Examiner, Nov. 30, 1993, p. 4. Spider veins have also been treated by injection treatments, heat, and electrolysis. H. Ellis, Varicose Veins, Arco Publishing, Inc.: New York, 1983, p. 94. In the case of spider veins, such treatment may result in dicoloration of the skin. H. Ellis, Varicose Veins, at p. 94; H. C. Baron, Varicose Veins, William Morrow and Company, Inc.: New York, 1979, p. 126. Some authorities recommend not treating spider veins but rather covering them cosmetically. H. Ellis, Varicose Veins, at p. 94; H.C. Baron, Varicose Veins, at p. 126. Web site: http://www.delphion.com/details?pn=US05597580__ •

Method and apparatus for treating varicose veins Inventor(s): Suval; William D. (15201 Eleventh St., Suite 300, Victorville, CA 92392) Assignee(s): none reported Patent Number: 5,611,357 Date filed: February 9, 1995 Abstract: A minimally invasive method for treating a varicose vein is provided. Generally, the method includes the opening of at least one small incision through a skin layer of the patient adjacent to the varicose vein. The varicose vein is then at least partially obstructed through the small incision. Thereafter, the incision is closed by conventional techniques. More specifically, the vein is at least partially obstructed by threading a suture through the small incision that extends through at least a portion of the vein. A plurality of small incisions in close proximity with the vein are opened with at least one of the plurality of small incisions being substantially centered over the vein. The suture is threaded through the substantially centered incision so that the suture penetrates through at least a portion of the vein. The suture is then withdrawn through another one of the plurality of small incisions. Next, the suture is re-threaded through the other one of the plurality of small incisions so that the suture penetrates through at least a portion of the vein in close proximity with the portion of the vein previously penetrated by the suture. Finally, the suture is re-withdrawn through the substantially centered incision. The threading, withdrawing, re-threading, and re-withdrawing steps are repeated with respect to each other one of the plurality of small incisions. Excerpt(s): The present invention relates to medical treatment of varicose veins, and more particularly, to a minimally invasive method and apparatus for treating varicose veins that allows for complete obliteration of the affected veins without scarring or any of the other undesirable complications of conventional treatments. Varicose veins is a medical condition present in up to twenty-five percent of the adult population, and is

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especially prevalent among middle-aged women. The term "varicose" is derived from the Greek word for "grapelike" and refers to the torturous appearance of the afflicted veins. Patients suffering from varicose veins often experience various symptoms, including aching, itching, heaviness, swelling or cramping of the legs, while more serious complications of varicose veins can include thrombophlebitis, dermatitis, hemorrhage and ulcers. Even absent such complications, many patients seek medical treatment of varicose veins for primarily cosmetic reasons due to the generally unsightly appearance that characterizes the condition. Specifically, varicose veins are a condition of the superficial saphenous veins of the legs in which the veins have become abnormally twisted, lengthened, or dilated. The condition is usually caused by inefficient or defective one-way valves within the veins. These one-way valves provide an important function in controlling blood pressure within the venous system of the legs. During walking, the leg muscles provide a musculovenous pump that compresses the veins and propels blood to the heart. Efficiency of the musculovenous pump is enhanced by the one-way valves within the veins that protect the venous system at the lower extremities from excess pressure generated by coughing, straining, lifting, standing or other such exertion. The superficial veins normally carry only ten to fifteen percent of the blood, with the remainder carried by the deep veins; however, the percentage of blood carried by the superficial veins can exceed these normal levels due to dilation of the superficial veins or thrombosis of the deep veins. As a result, the oneway valves can become incompetent which further increases retrograde pressure within the superficial veins. Since the superficial veins lie close to the skin layer and are poorly supported by the subcutaneous tissue, the increased retrograde pressure causes the varicose veins to be formed. Web site: http://www.delphion.com/details?pn=US05611357__ •

Method and device for treatment of varicose veins Inventor(s): Fratarcangelo; Peter A. (14 Fireside Ct., Norwalk, CT 06850), Kottler; Thomas (180 Merwins La., Fairfield, CT 06430), Starkey; Paul (104 S. Powdermill Rd., Morris Plains, NJ 07950) Assignee(s): none reported Patent Number: 6,074,356 Date filed: March 6, 1998 Abstract: A method and device for treatment of a varicose vein is provided which includes the step of applying to the skin of a subject superficial to the vein to be treated a device including: (a) an element for securing the device to the leg of a subject superficial to the vein to be treated such as a carrier tape; and (b) a one-way valve element such as a cantilever element biased by a spring for applying a selected amount of pressure to the skin superficial to the vein to be treated in a manner such that bloodflow toward the heart is permitted during peripheral venous pumping but wherein backflow away from the heart as a result of gravity is substantially reduced; and applying sufficient pressure to the skin superficial to the vein to be treated in a manner such that blood-flow toward the heart is permitted during peripheral venous pumping but wherein backflow away from the heart as a result of gravity is substantially reduced. Excerpt(s): The present invention relates to the medical treatment of varicose veins, and more specifically to a non-invasive, topical treatment for varicose veins utilizing the device described herein to act as an external one-way valve to replace the function of the defective internal valves contained within the varicose veins to be treated. This non-

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invasive treatment improves blood flow in the varicose veins and diminishes the vein varicosities without the necessity for an invasive and costly surgical procedure, the scarring which often results post-operatively from such procedures, the recurrence of varicosities which often follows such procedures, or the other undesirable effects of presently available treatments for varicose veins. This non-invasive treatment differs from other available treatments in that unlike such treatments, it restores rather than obliterates venous function. Varicose veins is a medical condition which involves the abnormal twisting, lengthening or dilation of the superficial veins of the leg. It has been estimated that between 20% to 30% of the adult population suffers from some form and degree of varicose veins. Significant varicosities, those which are large enough for treatment, have been estimated to occur in about 12% of the adult population. Patients suffering from varicose veins often suffer from a variety of symptoms including aching, swelling, burning, throbbing and cramping in and around the areas in which the varicosities exist. These symptoms are felt much more intensely by women during pregnancy or during or just before menstruation. One survey showed that 50% of persons with varicose veins were bothered by their symptoms occasionally, and that 18% noted frequent to continuous symptoms. More serious complications may also result from the presence of varicose veins including phlebitis, ulceration, eczema, dermatitis and two-fold to four-fold increased risk of deep vein thrombosis. Even in the absence of such symptoms or more serious complications relating to the varicosities, many varicose vein sufferers seek medical treatment for the condition due to unsightliness of the varicosities. The venous system of the legs consists of two channels: one deep within the muscular system and one superficial to it. The deep veins and the superficial veins are connected through a series of communicating veins, also called perforating veins. The superficial veins function mainly to collect blood from the subcutaneous tissue and to carry it to the closest communicating vein for rapid transit through the deep veins back to the heart. Approximately 15% of the venous blood volume in the legs is contained in the superficial veins, with 85% in the deep vein system. Web site: http://www.delphion.com/details?pn=US06074356__ •

Method for removing veins Inventor(s): Spitz; Gregory (Batavia, IL) Assignee(s): Smith & Nephew, Inc. (Memphis, TN) Patent Number: 5,893,858 Date filed: October 6, 1997 Abstract: The present invention relates to devices and methods for removing veins in a venous system of a patient. One device includes an elongated shaft having a first end and a second end, the second end of the first elongated shaft sized for insertion into an incision of a patient and a cutting head associated with the second end of the elongated shaft and being movable in response to electrical energy, the cutting head being constructed to cut veins into small pieces of a patient that are exposed to the cutting head. A method of removing varicose veins is also provided. The method includes the steps of making at least one incision through the skin layer of a patient in close proximity the undesired veins, inserting a distal end of a surgical instrument having a cutting element, and advancing the cutting element end of the surgical instrument to a position adjacent to a selected vein. The method function includes the steps of energizing surgical instrument to cause the cutting element to move at a desired speed,

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contacting the cutting element against the undesired vein while the cutting element is moving to break up the vein into particles, and withdrawing the distal end of the surgical instrument and closing the at least one small incision. Excerpt(s): The present invention relates generally to surgical apparatus and procedures. More particularly, it relates to methods and apparatus for removing veins, such as, varicose veins and spider veins, in a venous system of a patient. Over twenty-five percent of the population is plagued with varicose veins and spider veins. These veins have usually lost their ability to carry blood back to the heart and blood often accumulates in these veins. As a result, the veins may become swollen, distorted, and prominent. This condition is usually caused by inefficient or defective one-way valves which prevent blood from draining back through the vein. A number of factors can contribute to the development of varicose veins and spider veins, including heredity, obesity, posture, standing or sitting for a long periods of time, hormonal shifts, and excessive heat. Varicose veins may cause patients to experience various symptoms, such as, for example, aching, burning, swelling, cramping, and itching, while more serious complications of varicose veins can include thrombophlebitis, dermatitis, hemorrhage and ulcers. If these varicose veins are not treated, blood clots may form in the vein, and phlebitis or inflammation of the inside lining of the vein may occur. Even absent such symptoms, many patients seek medical treatment of varicose and spider veins for cosmetic reasons. Web site: http://www.delphion.com/details?pn=US05893858__ •

Method for testing for readiness for harvesting of tribulus terrestris l. having high steroidal saponin content Inventor(s): Alexis; Brian (1250 Chelsea Ave, #D, Santa Monica, CA 90404) Assignee(s): none reported Patent Number: 6,343,258 Date filed: August 13, 1999 Abstract: A cream made from the herb Tribulus Terrestris L. The cream preparation is made by low temperature water/alcohol extraction of Tribulus Terrestris L. After water/alcohol extraction of the herb Tribulus Terrestris L the extract is concentrated with a vacuum evaporator and mixed with a cream to concentrations of about 5, 10, 15% based on raw starting material. A number of factors are critical in preparation of the Tribulus Terrestris L raw material. These include: time of harvesting, part of the herb used, specific geographic area in Bulgaria where the herb is gathered, method of harvesting, and low temperature drying. Adherence to these factors guarantees high steroidal saponin, sapogenin and sterol content of the raw material used for making the cream. The finished cream has very strong anti-bacterial, anti-inflammation, anti-virus, anti-herpes effect and has been found to be highly useful in treating vulvo-vaginitis, vulvo-hemorrhoids, varicose veins and acne with. In some cases it blocks cancer cells from growing. This product was also found to be very successful in suppository form for the treatment of vulvo-vaginal, vulvo-hemorrhoidal and colonic conditions. Excerpt(s): The present invention relates to the field of therapeutic compounds for the treatment of diseases of the skin. In particular the present invention relates to creams made from the herb Tribulus Terrestris which are useful in the treatment of vulvovaginitis, vulvohemorrhoids, varicose veins and acne. Tribulus Terrestris, commonly known as "Puncture Vine" or Caltrop fruit, is an herb that has been used for centuries in

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Europe for hormone insufficiency in men and women. It has also been used in the treatment of liver, kidney and urinary tract disease, and all types of skin disorders by Chinese herbalists for over 400 years. In recent years Tribulus Terrestris has been touted as a dietary supplement for improving athletic performance. It has been discovered that ingestion of Tribulus Terrestris significantly elevates the level of several hormones: Testosterone; Luteinizing Hormone; Follicle Stimulating Hormone; and Estradiol. Clinical studies on Tribulus, conducted at the Chemical Pharmaceutical Institute in Sofia, Bulgaria, showed improved reproductive functions, including increased sperm production and Testosterone levels in men. Among women, Tribulus Terrestris increased the concentration of hormones including Estradiol, with Testosterone being very slightly influenced, thereby improving reproductive function, libido and ovulation. The active components of Tribulus Terrestris have a stimulating effect on the immune, sexual and reproductive systems, leading to improved muscle building, stamina and endurance. Other positive changes observed in a number of cases were a reduction in cholesterol, enhanced mood and well-being. No adverse effects to the central nervous or cardiovascular systems were noted in any of the clinical studies. Web site: http://www.delphion.com/details?pn=US06343258__ •

Method for the treatment of varicose veins using xanthoxylum from a prickly ash tree Inventor(s): Rathmann; Richard R. (800 S. Habor City Blvd., Melbourne, FL 32901), Terry; James M. (221 Espanola Way, Melbourne, FL 32901) Assignee(s): none reported Patent Number: 5,955,085 Date filed: November 17, 1997 Abstract: Bark, berries or tablets of the species Xanthoxylum clava-herculis L and Xanthoxylum americanum Hill, both of the yellow wood tree family, both containing the compound xanthoxylum, are employed for the treatment of varicose veins and other membrane and vascular disorders. Improved strength, flexibility, comfort, and blood flow of the veins, arteries and their constituent structures is obtained. Excerpt(s): The instant invention relates to a new use of the bark of the prickly ash tree which, more particularly, constitutes a method for the treatment of vascular disorders, including, without limitation, varicose veins and heart disease. This invention is an improvement of our U.S. Pat. No. 5,562,906 (1996) entitled Method of Treatment of Vascular Disorders. Varicose veins comprise elongated, protrusive, inoperative, and often spider-like veins, usually occurring in the legs, and frequently occurring after pregnancy. It has, in the prior art, been known that various plants, herbs, bushes, and the like, will yield certain beneficial medicinal effects. More particularly, and in the context of the instant invention, two types of prickly ash trees have been identified as useful. These, in scientific nomenclature, have been termed Xanthoixylum americanum Hill and the Xanthoxylum clava-herculis L. These plant species are, in the American vernacular, known as the northern prickly ash tree and the southern prickly ash tree. The southern prickly ash is also known as the hercules club prickly ash. The Merck index of pharmacological agents states that the compound known as xanthoxylum is found in the bark of both the northern and southern prickly ash. The book "A Guide to Medicinal Plants", by Krochmal, published by Quadrangle Books, indicates that the northern prickly ash (Xanthoxylum americanum Hill) is a shrub or small tree growing from five to ten feet in height. The leaves are alternate and compound, with five to eleven leaflets. The sterns are petioles and are often prickly. The greenish white flower

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thereof is small and inconspicuous, and its fruit is reddish, globe-shaped, and aromatic. Krochmal also states that alternate names for the northern prickly ash are american prickly ash, common prickly ash, pellitory bark, toothache bush, toothache tree, and yellow wood. Said reference further states that the northern prickly ash is found on river banks and in rich moist woods from New England southward to Alabama, Mississippi, Florida, Georgia, Kentucky, West Virginia and Virginia and westward to North Dakota and Oklahoma. Web site: http://www.delphion.com/details?pn=US05955085__ •

Method for treatment of unwanted veins and device therefor Inventor(s): Cho; George (Hopkinton, MA), Furumoto; Horace W. (Wellesley, MA), McDaniel; David H. (Virginia Beach, VA) Assignee(s): Cynosure, Inc. (Chelmsford, MA) Patent Number: 5,843,072 Date filed: November 7, 1996 Abstract: A combined sclerotherapy and light treatment method is described for the treatment of unwanted veins such as varicose and telangiectatic leg veins. Substantially increased success, in the range of 90-100%, has been achieved by implementing a dwell time of between 12 hours and 6 months between the light-based therapy and the sclerotherapy. Near infra-red wavelength light is preferably used in the light therapy due to its better depths of penetration through the skin to deeper lying, larger vessels such as varicose veins. Excerpt(s): This application is related to U.S. Pat. application Ser. No. 08/744,344, filed Nov. 7, 1996, entitled "Alexandrite Laser System For Hair Removal And Method Therefor", by Horace W. Furumoto, et al., the teachings of which are incorporated herein by this reference in their entirety. Varicose and telangiectatic leg veins are common forms of ectatic vascularization. Varicose veins have been classified into three groups: dilated saphenous veins, dilated superficial branches and dilated venules. More encompassing classification for the conditions is simply unwanted leg veins. Light therapy, sclerotherapy, and vein stripping are typical modes of treating these conditions. Each therapy has its advantages and disadvantages. Photocoagulation based on the principle of selective photothermolysis underlies most light therapies to treat leg veins. The dermal and epidermal layers containing the veins are irradiated with light, usually from lasers or flashlamps. The wavelength or color of this light is chosen so that its energy will be preferentially absorbed in the targeted veins. This leads to the localized heating of the veins with the intent of raising the temperature of the veins to a point at which the constituent proteins will denature. The pulse duration of the irradiating light is also important for selectivity. If the pulse duration is too long, heat absorbed by the veins will diffuse out into the surrounding tissues so that the veins will not be selectively heated to the degree necessary to selectively destroy only the veins. If the pulse durations are too short, however, the light absorbing chemical species such as blood hemoglobin will be heated too quickly causing vaporization. This effect can cause purpura. Theory dictates that the proper pulse width should match the thermal diffusion time of the targeted structures. For smaller vessels contained in portwine stain birthmarks, for example, these thermal diffusion times can be on the order of hundreds of microseconds (.mu.sec) to several milliseconds (msec). Larger leg veins, however, can have thermal diffusion times in the 5 to 100 msec range.

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Web site: http://www.delphion.com/details?pn=US05843072__ •

Photomatrix device Inventor(s): Zharov; Vladimir Pavlovich (Moscow, RU) Assignee(s): Board of Trustees of the University of Arkansas (Little Rock, AR) Patent Number: 6,443,978 Date filed: September 22, 2000 Abstract: A device for the physiotherapeutic irradiation of spatially extensive pathologies by light with the help of a matrix of the sources of optical radiation such as lasers or light diodes placed on the surface of a substrate whose shape is adequate to the shape of the zone of pathology is disclosed. In addition, the device contains stops and a holder to fix the substrate against the bioobject. Additional modules are provided to adjust the temperature, pressure, gas composition over the pathological area. As a source of radiation, chemical reactions accompanied by the luminescence of the products of reaction are suggested. The power supply unit can be autonomous with remote feeding through pulse magnetic field. A supplementary hood optically transparent is provided to localize the pathology as well as the strips that scatter the radiation to get a more uniform bioobject's exposure. Application: light-therapy to treat various extensive pathologies on the bioobject's surface including dermatology, cosmetology; the treatment of traumas, bruises, oedemas, varicose veins, blood therapy, treatment of infectious processes. Excerpt(s): This invention concerns medicine and biology, in particular, it concerns physiotherapy and photobiology and it deals with the therapeutic influence of light on various human being's organs, micro-organisms and plants in combination with other kinds of energy, including magnetic field, electrostimulation, mechanical therapy, vacuum-therapy, etc. A device for light-therapeutic influence on different human being's areas is known; it consists of the sources of optical radiation, for example, such as lasers or light diodes coupled with a power supply unit and a timer [Illarionov V.E. Fundamentals of laser therapy, Moscow, Respect, 1992, pp. 26, 31, 71-80]. Sources of radiation are placed separately or installed into anglepoised heads or connected with light fibers, through which the radiation is directed onto the bioobject. The disadvantage of such devices is the difficulty in creating the uniform light exposure over extensive pathological zones on the human being's body, especially when these zones have complex spatial geometry. The closest device, in technical terms, is a combined therapeutic device, which consists of several narrow-band sources in form of light diodes with the radiation wavelengths varying in the spectrum range from 0.25.mu.m to 2.mu.m [1]. The sources of radiation can operate either in a continuous mode or in a pulse one with a wide range of frequencies and pulse profiles. The sources of radiation are usually placed at the butt-end parts of anglepoised hands, which can be fixed against the shell of a power supply unit with the help of special holders. Web site: http://www.delphion.com/details?pn=US06443978__

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Portable bed adjusting device for patients and the like Inventor(s): Webb; Norma M. (1532 Alison Dr., West Chester, PA 19380) Assignee(s): none reported Patent Number: 4,312,088 Date filed: April 28, 1980 Abstract: A portable device for raising one end of a bed a selected height, to incline the mattress longitudinally without consequent displacement, to provide comfort for a sleeper suffering from ailments such as a hiatal hernia, cardiac failure, varicose veins or phlebitis. The device includes bed elevating blocks adapted to be inserted under one end of the bed and longitudinally extending mattress retainers adapted to be inserted between the mattress and the mattress support, such as a box spring, to secure the mattress against longitudinal movement when the bed is inclined. The bed elevating blocks may be constituted of two separate, connectable components which are adjustable relative to each other to provide selectivity in the elevation of one end of the bed. The mattress retainers are constituted of two separate, longitudinally aligned, detachably connectable, L-shaped elements, each of the elements having a short perpendicular leg, the two legs extending in opposite directions. The oppositely disposed short legs function as grips for engaging, respectively, the mattress and the mattress support, thereby preventing the mattress from moving relative to its support. Excerpt(s): This invention relates to a device in the nature of accessory implements for a standard or conventional bed to elevate the bed at one end to incline its mattress longitudinally without displacing the mattress relative to the bed. A great many people-and not all of them hospital patients--suffer from physical ailments which require, or are relieved by, sleeping in a longitudinally inclined position. Such physical ailments include hiatal hernias, cardiac failure and respiratory difficulties, in respect to which it is desirable, and often necessary, to sleep with the head elevated. Other physical conditions, such as phlebitis or varicose veins, often require sleeping with the feet and legs elevated. The therapeutic value and comfort realized by hospital patients and other persons who suffer from physical ailments such as those described above, by sleeping in beds in which the mattresses are disposed in an inclined longitudinal plane, are well known. Many devices, accessories and arrangements have been suggested for modifying a bed to achieve the desired angular adjustment. But most solutions provide either for the special construction of an entire bed incorporating such adjustment means-which is costly, but satisfactory for hospital use--or for accessories or attachments which, because of their size and weight, must be stored in the vicinity of the bed or beds for which they are to be used. Examples of known arrangements for raising one end of the bed, to incline its mattress longitudinally, may be seen from U.S. Pat. Nos. 3,110,039, 3,259,921 and 3,795,925. Further, examples of known devices for retaining a mattress against slippage or displacement, when one end of the bed is elevated, are shown in the following U.S. Pat. Nos.: 1,683,795, 2,067,515, 2,082,131, 2,147,538 and 4,017,919. Web site: http://www.delphion.com/details?pn=US04312088__

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S-2'-›2-(1-methyl-2-piperidyl) ethyl! cinnamanilide Inventor(s): Amer; Moh. Samir (877 Sandpoint Rd., Carpinteria, CA 93013) Assignee(s): none reported Patent Number: 5,780,487 Date filed: February 28, 1997 Abstract: The 5HT.sub.2 receptor antagonizing effect of 2'-›2-(1-methyl-2-piperidyl) ethyl! cinnamanilide, a racemic mixture (R S-MPEC) of S-MPEC and R-MPEC isomers is found to be provided practically entirely by the S-MPEC isomer, the R-MPEC being effectively an impurity. Disclosed are pure S-MPEC, mixtures thereof with up to about 10% of R-MPEC, a novel method of resolving the S-MPEC involving a novel intermediate compound, therapeutic compositions containing S-MPEC, and uses thereof for administration to animals, especially humans, in need of 5HT.sub.2 receptor blockage, as for hemorrhoids, varicose veins, venous and coronary insufficiencies, wound healing, and as analgesic or local anesthetic agents. Excerpt(s): This invention relates to a specific isomer, namely a specific S (or(-)or 1 or levo) isomer, in particular die compound S-2'- ›2-(1-methyl-2-piperidyl) ethyl! cinnamanilide or its acid salt, its preparation and its use in therapeutic treatments and compositions as a 5-HT.sub.2 receptor antagonist (blocker) for treating or preventing hemorrhoids, varicose veins, or venous or coronary insufficiency, treating wounds or as analgesic or local anesthetic agents in animals including mammals, especially humans. In my U.S. Pat. No. 5,266,571 dated Nov. 30, 1993, the entire disclosure of which is incorporated herein by reference thereto, I have disclosed and claimed a method for treating or preventing hemorrhoids in animals by administration of a 5-HT.sub.2 receptor antagonist based on the discovery that 5-HT (5-hydroxytryptamine or serotonin) plays an important role in mediating both the increase in venous pressure and/or platelet clumping that lead to the congestion of the veins in the hemorrhoidal plexus, that 5-HT.sub.2 receptors rather than 5-HT.sub.1 receptors are involved, and that 5-HT.sub.2 receptor antagonists thus inhibit hemorrhoids. As such preferred antagonists are mentioned 2'- ›2-(1-methyl-2-piperidyl) ethyl! cinnamanilide hydrochloride (MPEC) and two other compounds. In my U.S. patent application Ser. No. 08/512,235 filed Aug. 7, 1995, now U.S. Pat. No. 5,605,902, the entire disclosure of which is herein incorporated by reference thereto, which prior U.S. application corresponds to PCT WO94/18958 published Sep. 1, 1994, I further disclose and claim the use of the same 5-HT.sub.2 receptor antagonists for treating or preventing varicose veins or venous insufficiency or for treating wounds. Web site: http://www.delphion.com/details?pn=US05780487__

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Self-powered compression devices and methods for promoting circulation and therapeutic compression Inventor(s): Arye; Assaf Ben (Zichron Yakov, IL), Calderon; Noam A. (Haifa, IL) Assignee(s): C-Boot Ltd (Haifa, IL) Patent Number: 6,589,194 Date filed: June 23, 2000 Abstract: A self-powered compression device for use in promoting circulation, said device embodying a plurality of inflatable sleeves arranged sequentially for applying

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compression to a body or limb and which further comprises a pump, a piping system and a bandage or boot to enclose the device in its entirety. A method for using selfgenerated pressure in promoting circulation in conditions including but not limited to, lymphatic and traumatic edemas, venous disorders, limb ulcers, varicose veins, muscle fatigue, sports medicine, cellulite treatment, diabetic feet, feet massage for recreation or cosmetic enhancements. Excerpt(s): The present invention relates to self-powered compression devices and methods for promoting circulation and therapeutic compression in mammals in general or an individual in need thereof. More particularly, the invention is in the class of medical devices, comprising a shoe, a plurality of sleeves or limb massager, which utilizes sequential, cyclical pressure, energy or vector forces, to aid circulation in a body part such as the limbs of a mammal. The inflatable sleeves or pockets are filled with air by a pumping means. The inflatable sleeves transmit massaging movement to the vessel walls whenever the individual wearing the device moves. The pressure generated is a function of the user's body weight and gravitational force. The present invention further provides methods to harness energy generated during movement and weight transfer and uses the energy for compressing to create a massaging effect on the circulation and the muscular-skeletal system. There are many patented devices that apply cyclic pressure to a mammal's limbs-legs, arms and/or feet. Many have used pulsating pads or plunges for improving circulation. Elastic and non-elastic stockings are widely employed in support and compression therapy of the foot and ankle. Others have used hydraulic and pneumatic bladders for the same and for many other purposes. The shapes, sizes and composition of such bladders and pads are widely varied, depending largely on their particular application. Most suffer varying degrees of shortcomings, including ineffectiveness, difficulties in application and removal, lack of controlled adjustability, loss of compression, excessive sweating, foul odor and discomfort. U.S. Pat. Nos. 5,120,300 and 5,254,122 relate to therapeutic devices capable of applying therapeutic compression to the body, particularly the limbs, arms and/or feet, in which the user applies non-elastic therapeutic compression band by band, and the user can tighten the compression bands to control the non-elastic pressure. The cyclical or sequential compression of limbs improves blood fluid returns for reducing edema and improving healing. U.S. Pat. No. 5,897,518 describes a foot and ankle-therapeutic compression device in which a pair of foot and ankle compression bands are tightened and anchored in tightened condition by VELCRO hook and loop surfaces. Web site: http://www.delphion.com/details?pn=US06589194__ •

Topical composition for the treatment of spider veins Inventor(s): Becker; Philip E. (Jupiter, FL), Doepker; Mary Lou (Miami, FL) Assignee(s): Swedish Herbal Systems, Inc. (Jupiter, FL) Patent Number: 5,698,206 Date filed: December 5, 1996 Abstract: A composition for topical application to the skin having an effective amount of natural herbs placed in a carrier oil for use in combination with an individual having ingested a moderate amount of Vitamin C. The composition provides for treatment of surface vein disorders, namely spider and varicose veins, by rejuvenating the veins and associated vein valves providing normal blood transfer.

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Excerpt(s): This invention relates to the treatment of vein disorders, and more particularly to a topically applied lotion for the treatment of spider veins. Varicose and spider veins are terms used to describe two problematic vein disorders. The veins appear in the legs, particularly around the ankles, calves, thighs and inside the knees. The disorder is a result of blood collecting in the veins which results in swelling. In many instances the blood flows backwards, a condition that may cause the vein to further expand, causing an unsightly situation. There are two principal vein types in the legs. Deep veins carry about 90 percent of the blood, the remainder carried in veins which are often visible just under the skin. Once circulating blood has oxygenated tissues, the blood is collected by the veins and pumped to veins in the abdomen, which returns the blood to the heart. Valves prevent blood from draining back down the leg under the force of gravity. As the vein must support a column of blood, if the valve fails a pooling of blood occurs. This is most noticeable in superficial veins which become swollen and distorted. If the backflow of blood is severe or prolonged, the tissues may lack nourishment causing the skin to become thin, hard, dry, scaly, and discolored. Web site: http://www.delphion.com/details?pn=US05698206__ •

Tubular device for the treatment of hollow organs with electric current Inventor(s): Denck; Helmuth (Kirchmayergasse 5-7, Haus C, A-1130 Wien, AT), Kovac; Werner (Mariahilferstrasse 127, A-1060 Wien, AT), Nashef; Basem (Geylinggasse 30, A1130 Wien, AT), Urban; Gerald (Rembrandstrasse 19, A-1020 Wien, AT) Assignee(s): none reported Patent Number: 4,776,349 Date filed: October 3, 1986 Abstract: A tubular device for the treatment of hollow organs is flexibly arranged and comprises a coating of silver. This coating is connected to a current source via connecting wires. Particularly, the tubular device is used for the treatment of the esophagus, and by the irritation caused by the electric current it is to effect an inflammation of the esophagus wall and thus a thickening of the latter so as to reduce the danger of hemorraghes of varicose veins within the esophagus or to prevent the hemorraghes. The tubular device is expansible in order to secure a close abutment of the silver coating against the mucous membrane of the esophagus. Excerpt(s): It is especially in the gullet (oesophagus) that varicose veins occur sometimes, which varicose veins lead to hemorrhages. Such hemorrhages are often difficult to staunch and therefore represent an acute danger to life. The invention refers to a tubular device for the treatment of hollow organs including mucous membranes, in particular of the esophagus, with electric current, and especially for the treatment of varicose veins. There are known, for example, stiff probes of silver sheet for the treatment of the esophagus. These probes are introduced into the esophagus, and under the influence of electric current a thrombosing of the varicose veins is caused. By this thickening of the mucous membrane, the varicose veins are protected, and thus hemorrhages are prevented. To this purpose, however, the tubular member must closely abut against the mucous membrane, because otherwise a current transmitting is not possible and furthermore, there is the danger of injuries. Such a close abutment is not secured by using a stiff tubular member. It is the object of the invention to provide a tubular device that renders possible an unobjectionable treatment of the inner surfaces of cavities, namely of the esophagus. By the invention, an inflammation of the mucous membrane of the esophagus is to be effected, which, particularly by repeated treatment,

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results in a thickening of the esophagus. To fulfill this object, the invention generally consists in that the device is formed as a tube, is made of flexible, elastic material, especially rubber, and at least on a part of its surface comprises a conductive flexible coating of a biologically safe (inert) material connectable to a source of current via an electric line that is guided within the tubular member under isolation. By the fact that the tubular member consists of a fexible, elastic material, e.g. rubber, an abutment of the tubular member at all areas of the mucous membrance is substantially favorized, and by the surface of the tubular member comprising a flexible coating of conductive, biologically safe material, the flexibility and elasticity of the tubular member itself is not impaired. Thus, the supply of current is largely enhanced at all areas of the mucous membrane. According to the invention, a conductive coating can be deposited by evaporation onto the tubular member as a metallic coating or be brushed onto the tubular member as a matrix containing finely distributed metal, so that a thin coating is obtained in case of vaporizing and a fexible coating in case of embedding the metallic particles into the matrix, which coating does not encroach upon the fexibility of the tubular member. According to the invention, the conductive coating is preferably made of silver which has proved good as a biologically safe material. In accordance with a preferred embodiment of the invention, a layer of silver chloride is arranged on the silver coating. This layer of silver chloride, that, for example, can be produced out of the silver by an electrolytic or a chemical process, effects that polarization phenomena are prevented and that the electric transfer resistance from the silver layer to the mucous membrane is reduced irrespective of the direction of current. Preferably, direct current is used, and in this case, the silver chloride layer has a particularly advantageous result. Web site: http://www.delphion.com/details?pn=US04776349__ •

Varicose vein probe with hollow curved spiral tip Inventor(s): Rossdeutscher; Sonja (Dortmund, DE) Assignee(s): Astra Meditec AB (Molndal, DE) Patent Number: 5,047,013 Date filed: September 8, 1989 Abstract: The invention relates to a probe for treating varicose veins, comprising a flexible plastic tube with a tip portion which can be guided through varicose veins at its front end, the tube being at least as long as the veins to be treated. To enable a sclerosing agent to be injected at desired points along the varicose vein, the invention proposes that the probe should have at least one lateral opening in the region of the tip portion, and that the inner cavity of the tube should form a flow connection from a joining piece at the rear end of the tube to the lateral opening, for injection of sclerosing agent. Excerpt(s): The invention relates to a probe for treating varicose veins. It comprises a flexible plastic tube with a tip portion which can be guided through varicose veins at its front end, the tube being at least as long as the vein to be treated. A probe of this type is known, for example, from De-PS 20 62 204. The probes described in this specification and other known ones are generally used to strip affected veins. For this purpose the tip of the probe is inserted at one end of the vein to be removed, and the probe is guided through the whole length of the vein and brought out through a surgical incision at the other end. The end of the probe becomes hooked onto the vein at the insertion opening, so the whole vein is drawn out by pulling the tip portion. This surgical operation is generally carried out under complete narcosis. Some of the known vein probes are also tubular, but instead of the internal tube cavity being open to carry liquids it is generally

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filled by a wire. The wire dictates the flexibility or rigidity of the probe but also serves to take up the tensile forces when the vein is pulled out. Although other probes which can be inserted in veins or arteries are known under the designation of catheters, these either comprise a very soft, flexible plastic tube which is more or less floated into the vein or artery with the blood stream, or they have a guide wire and a more or less sharp edged tip which can only be inserted in the blood vessel under radiological control. Web site: http://www.delphion.com/details?pn=US05047013__ •

Venoscope Inventor(s): Biegeleisen; Ken P. (91 Hudson Ave., Irvington, NY 10533) Assignee(s): none reported Patent Number: 5,022,399 Date filed: May 10, 1989 Abstract: A method and apparatus for the non-surgical treatment of venous disorders and varicose veins wherein a flexible catheter is inserted into a varicose vein of a patient to be treated, guiding the catheter to the initial branch of the vein while viewing and monitoring blood flow therein to assure proper position and directing a treatment through the catheter to treat the varicose vein. The catheter of the invention includes first and second passages for directing a fluid and treatment to the distal end of the catheter, first and second fiber bundles to illuminate and view the vein, at least one piezoelectric crystal located on the distal end of the catheter for monitoring areas adjacent thereto and a guide wire for guiding the distal end of the catheter through the veins of the patient. Excerpt(s): Venous disorders, especially varicose veins, are extremely common, afflicting tens of millions of Americans. The treatment of varicose veins has always been controversial, because no perfect treatment exists. There is substantial data indicating that the differences between the veins of varicose people and "normal" (i.e., nonvaricose) people are not limited to the diseased veins, but bear as well on the apparently normal ones. In other words, whatever forces are responsible for the conversion of a normal vein to a varicose vein are present and acting upon the apparently normal veins adjacent to the varicose veins on the same leg. It is now universally accepted that no existing treatment will prevent veins which are normal now from becoming varicose in the future. Above and beyond the fact that the varicose predisposition cannot be permanently cured, the recognizably abnormal varicose veins currently present, toward which all therapeutic modalities are directed, are not easily removed. In certain respects, removal of a varicose vein is like removal of a malignant tumor. Any part of the venous network which is contributing to the varicosity, and which is left behind by the surgeon, can and will give rise to a total treatment failure. Web site: http://www.delphion.com/details?pn=US05022399__

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Venous gradient support device Inventor(s): Salley; Frank (1002 Chastain Park Ct., Atlanta, GA 30342) Assignee(s): none reported Patent Number: 6,142,961 Date filed: August 27, 1998 Abstract: A venous pressure gradient support device to be worn over a surface portion of the human body to prevent or remedy varicose veins. The device includes a container configured for receiving and retaining a plurality of beads. Preferably, the beads are glass spherical beads and the container is an envelope having a flap which may be folded over to retain the beads in the envelope. The envelope of beads may be worn underneath a support garment such as support hose so that the envelope filled with beads is pressed to the surface portion of the human body. The envelope of beads conforms to the irregular shape of the human body and the beads take on a pressure gradient to balance the blood pressure at the surface portion of the human body. Excerpt(s): This invention relates generally to venous return and particularly to a wearing article for treating chronic venous insufficiency of lower human extremities. Veins are blood vessels which return blood to the heart in the circulatory system. Veins are flexible tubes which are divided into compartments by one-way valves. Blood is pumped back to the heart when a skeletal muscle contracts and compresses a compartment, forcing its blood to flow through the valve close to the heart toward the heart and forcing the other valve, the one farther from the heart, to close, allowing no blood to flow away from the heart. A varicose vein is a vein in which at least one valve is destroyed, allowing blood to flow away from the heart. The pressure on a valve farther from the heart but next to a destroyed valve is greater than the pressure on a valve next to a good valve. The next farther valve fails more quickly. Thus a series of valves can fail, each valve failing more quickly than its predecessor, because the pressure increases on each succeeding valve farther from the heart with the failure of each preceding, closer valve. This pressure that increases as the distance from the heart increases is called a pressure or gravity gradient. Web site: http://www.delphion.com/details?pn=US06142961__

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

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

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Endoscopic arterial pumps for treatment of cardiac insufficiency and venous pumps for right-sided cardiac support Inventor(s): Barbut, Denise R.; (New York, NY), Heinemann, Murk-Hein; (New York, NY), Patterson, Russel H.; (New York, NY) Correspondence: O'melveny & Myers Llp; Suite 100; 114 Pacifica; Irvine; CA; 926183315; US Patent Application Number: 20030105383 Date filed: October 28, 2002 Abstract: Methods for using blood pumps to treat heart failure are disclosed. The pump is mounted on an interior of a stent, and the stent is releasably mounted on a distal end of a catheter. The distal end of the catheter is inserted into a peripheral artery and advanced to position at a region of interest within the descending aorta, the ascending aorta, or the left ventricle. The stent and the pump are released from the catheter, and the pump is activated to increase blood flow downstream of the pump. The pump can also be positioned in the vena cava or used to treat right-sided heart failure following the insertion of an LVAD, or to improve venous return in patients with varicose veins. Non-stent pumps are described for insertion between the pulmonary vein and aorta, and between the vena cava and pulmonary artery designed for use during cardiac surgery. Excerpt(s): This is a continuation of U.S. patent application Ser. No. 09/691,611, filed Oct. 17, 2000, which is a continuation of U.S. application Ser. No. 09/362,992, filed Jul. 27, 1999, now U.S. Pat. No. 6,136,025, both of which are incorporated herein by reference in their entirety. The present invention relates generally to methods useful for treating patients with heart failure and cardiogenic shock. More specifically, the invention provides means for implanting a blood pump endoscopically in arteries, such as the descending aorta, the ascending aorta, the left ventricle, or the pulmonary vein to assist the failing left ventricle and improve perfusion to vital organs. The pump may provide continuous or intermittent flow. The device can also be implanted endoscopically in veins, such as the inferior vena cava, the right atrium or pulmonary artery for treatment of right heart failure or venous insufficiency. Heart failure has a prevalence in the United States of more than 2 million patients with at least 400,000 new cases diagnosed each year. Mean life expectancy following a diagnosis of cardiac failure is less than 2 years. Heart failure is responsible for at least 200,000 deaths each year, with annual costs estimated to exceed 10 billion dollars. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Fixed-circumference medical support appliance Inventor(s): Coleman, Richard A.; (Berkeley, CA) Correspondence: Richard A. Coleman; 1415 Allston Way; Berkeley; CA; 94702; US Patent Application Number: 20030195449 Date filed: April 12, 2002 Abstract: A medical support appliance custom made to fit the patient's limb exactly. Since the appliance fits exactly, it restricts the engorgement of varicose veins and swelling of the limb by retaining its exact shape and dimension, thereby resisting any outward expansion of the limb, and not by pressing in on the limb. The appliance

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employs an assembly of materials which resists the outward pressure exerted by the veins by retaining its circumference dimensions, and which at the same time stretches longitudinally for comfort and mobility. The assembly is a composite of latex, formed around a replica of the patient's limb, wrapped with non-stretch fiberglass thread, and finished with trim material and a zipper. Excerpt(s): Varicose veins have vexed humanity throughout recorded history. There are references to varicose veins and the attendant risks of surgery in the Ebers papyrus of 1550 BC. For the working man or woman who must be on their feet much of the day, painful varicose veins can be debilitating. For the athlete, varicose veins can put an early stop to sports activities. Invasive medical treatments are available and can be effective in some cases. To provide a non-exhaustive summary here, these include stripping (surgical removal of veins), sclerosis (blocking veins via injection of chemical agent or other means), and more recently, venous valve cuffing (implanting devices which reduce circumference of major venous valves). But for the many cases where these treatments are not appropriate or are ineffective, the primary non-invasive medical approach is the application of bandages or elastic hosiery to compress the limb. In the material that follows we will show that this compression approach also has its problems, and that patients who live with this type of treatment will welcome a better solution. Prior art for non-invasive varicose vein relief falls into three major categories: Elastic compression, non-elastic compression, and resistance wrapping. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Kit for endovascular venous surgery Inventor(s): Branco, Antonio Carlos; (Sao Paul, BR) Correspondence: Mark G. Lappin, P.C.; Mcdermott, Will & Emery; 28 State Street; Boston; MA; 02109; US Patent Application Number: 20010047170 Date filed: July 5, 2001 Abstract: The instant invention provides endoluminal methods and devices for the removal of anatomical structures such as vascular structures under endoscopic visualization of the process from within the anatomical structure or surgical region of interest. The present invention allows a surgeon to perform these procedures using a small number of small incisions.The present invention provides an elongated flexible endoscopic guide which may be passed through the lumen of an elongate vessel or structure, such as for example, the saphenous vein from an entry veinotomy to an exit veinotomy. The guide provides passageways for a variety of surgical devices: an endoscope for viewing the surgical regions of interest, a cautery device and other surgical tools for performing ligation and other surgical procedures, and phleboextractor for removing elongate structures. A porous flexible drain can be deployed to provide pharmacological agents or collecting fluid at the surgical site. In the preferred embodiment, the device is used to care for chronic venous insufficiency, varicose saphenous vein segments, venous insufficiency, and varicose veins, by removal of those veins or segments. Excerpt(s): This application claims priority from PCT Application No. PCT/IB00/00378 filed Feb. 2, 2000, which claims priority to Brazilian Patent Application No. PI 9900481-0 filed Feb. 4, 1999, and claims the benefit of U.S. Provisional Application Ser. No. 60/144,800 filed Jul. 21, 1999, U.S. Provisional Application Ser. No. 60/148,242 filed

Patents 95

Aug. 11, 1999, and U.S. Provisional Application Ser. No. 60/163,684 filed Nov. 5, 1999. This invention pertains to methods and devices for endovascular surgery, in particular to methods and devices for treating, repairing and removing blood vessels. Varicose veins are swollen, tortuous veins with abnormally functioning valves. It is a common, progressive condition that usually affects the veins of the leg, and results in pain, muscle cramps and a feeling of heaviness in the legs. For mild cases, elevation of the legs or elastic stockings can help relieve the symptoms. For more severe cases, particularly where there is significant impairment and disruption of quality of life, surgical intervention can be warranted. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Medical instrument working end and method for endoluminal treatments Inventor(s): Shadduck, John H.; (Tiburon, CA) Correspondence: John H. Shadduck; 1490 Vistazo West; Tiburon; CA; 94920; US Patent Application Number: 20030109869 Date filed: January 18, 2003 Abstract: A medical instrument that utilizes electrical energy delivery between first and second opposing polarity electrodes in an interior bore of a working end to cause vaporization of an inflowing fluid media. The vaporization and expansion of the fluid media creates pressure gradients in the working end that causes heated vapor to propagate distally from the working end. The propagation or jetting of the vapor media is used to controllably cause thermal effects in endoluminal environments. The instrument and method can be used to shrink and occlude blood vessels in a treatment for varicose veins. Excerpt(s): This application is a continuation-in-part of U.S. patent applications Ser. No. 09/782,649 filed Feb. 12, 2001, titled "Medical Instrument Working End Creating Very High Pressure Gradients", which is a continuation-in-part of Ser. No. 09/181,906 filed Oct. 28, 1998, both of which are incorporated herein by this reference. The invention relates to the working end of a micro-catheter or other device for endoluminal introduction that utilizes a thermal energy emitter to apply energy to a fluid media within at least one interior bore of the working end to vaporize and/or cavitate the fluid and to eject the fluid media from the working end to apply energy to endoluminal structure in the form of therapeutic heat and/or acoustic energy. Varicose and spider veins are enlarged, dilated, and tortuous veins that are caused by weakness in the vein walls and incompetent vein valves. When the valves cease to function, the blood does not flow as effectively to the heart as it should but, rather, allowed to pool in the veins. This increases pressure in the vein and eventually causes the vessel walls stretch and distend. The vein increases in diameter and cannot return to normal size or shape. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and apparatus for avulsion of varicose veins Inventor(s): Mirizzi, Michael S.; (San Jose, CA), Parker, Mark P.; (San Jose, CA), Rodriguez, John; (San Jose, CA), Tantisira, Radit; (Ann Arbor, MI) Correspondence: Townsend And Townsend And Crew, Llp; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20030125759 Date filed: December 3, 2002 Abstract: Apparatuses and methods for removing veins, usually varicose veins, rely on endoluminal capture of a distal end of the vein segment to be removed. In the illustrated embodiments, a shaft having reciprocatable penetrating elements is used to engage and capture the distal end of the vein. After rotating the shaft to pull the distal segment of the vein away from the connecting tissue, the shaft is withdrawn proximally, invaginating the segment back to the point of insertion. Excerpt(s): The present application claims the benefit of U.S. Provisional Patent Application Serial No. 60/342,719 (Attorney Docket No. 019738-000200), filed Dec. 21, 2001, 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 relates to methods and apparatus for removing veins from surrounding connective tissue. Various techniques have been developed to treat varicose veins. In simple cases, elevation of the legs and compression stockings may be sufficient therapy to mitigate the progression of the varicose veins. An alternative therapy includes "sclerotherapy." In the procedure, the diseased veins are injected with a sclerosing solution, such as sodium tetradecyl sulfate, along the tract of the varicose vein. Typically, multiple injections are administered during a treatment session. The sclerosing solution causes subsequent inflammation and damage to the endothelial cell lining of the vein. This damage and contraction in conjunction with post-procedural external compression results in localized occlusion or contraction of the vessel which forces rerouting of the blood through other conduits and in ideal circumstances causes the vein to become a fibrin cord which is resorbed over time. With this therapy, patients typically require two or more treatment sessions in order to satisfactorily alleviate the varicose veins. However, typically the technique does not provide a permanent or complete solution with varicose veins reoccurring over time. Consequently, sclerotherapy is often combined with a more invasive operation such as ligation and/or stripping of the saphenous vein. In additionally, sclerotherapy is not without the potential for complication. These can include the potential for browning splotches or bruising of the skin, formation of blood clots in the veins, inflammation, adverse allergic reactions, ulceration, phlebitis, anaphylactic overdose, ischemia, skin or fat necrosis, and peripheral neuropathy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 97

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Method and apparatus for treating venous insufficiency Inventor(s): Farley, Brian E.; (Los Altos, CA), Laufer, Michael D.; (Menlo Park, CA), Parker, Mark P.; (San Jose, CA), Schulz, Grace Y.; (San Carlos, CA), Zikorus, Arthur W.; (San Jose, CA) Correspondence: Fulwider Patton Lee & Utecht, Llp; Howard Hughes Center; 6060 Center Drive; Tenth Floor; Los Angeles; CA; 90045; US Patent Application Number: 20030191512 Date filed: March 25, 2003 Abstract: A catheter delivers an electrode within a vein for a minimally invasive treatment of varicose veins and venous insufficiency using RF energy. The catheter is introduced into a patient and positioned within the section of the vein to be treated. The electrode radiates high frequency energy towards the vein, and the surrounding venous tissue becomes heated and begins to shrink. The catheter includes a controllable member for limiting the amount of shrinkage of the vein to the diameter of the member. The electrode remains active until there has been sufficient shrinkage of the vein. The extent of shrinkage of the vein may be detected by fluoroscopy. After treating one section of the vein, the catheter and the electrode can be repositioned intraluminally within the vein to treat different sections of the vein until all desired venous sections and valves are repaired and rendered functionally competent. Excerpt(s): This invention relates to the treatment and correction of venous insufficiency or varicose veins, and more particularly to a minimally invasive procedure using a catheter-based system to deploy an electrode for providing radio frequency (RF) energy, microwave energy, or thermal energy to shrink a vein intraluminally to change the fluid flow dynamics and to restore the competency of the venous valve and the proper function of the vein. The human venous system of the lower limb consists essentially of the superficial venous system and the deep venous system with perforating veins connecting the two systems. The superficial system includes the long or great saphenous vein and the short saphenous vein. The deep venous system includes the anterior and posterior tibial veins which unite to form the popliteal vein, which in turn becomes the femoral vein when joined by the short saphenous vein. The venous systems contain numerous one-way valves for directing blood flow back to the heart. Venous valves are usually bicuspid valves, with each cusp forming a sack or reservoir for blood which, under pressure, forces the free surfaces of the cusps together to prevent retrograde flow of the blood and allow antegrade flow to the heart. When an incompetent valve is in the flow path of retrograde flow toward the foot, the valve is unable to close because the cusps do not form a proper seal and retrograde flow of blood cannot be stopped. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method for the prevention and treatment of chronic venous insufficiency Inventor(s): Farrow, Thomas M.; (Denver, CO), Jia, Qi; (Arvada, CO), Mahiou, Belaid; (Westminster, CO), Nissanka, Ajith; (Boulder, CO), Qiu, Zhihua; (Westminster, CO) Correspondence: Swanson & Bratschun, L.L.C.; Suite 330; 1745 Shea Center Drive; Highlands Ranch; CO; 80129; US Patent Application Number: 20010000731 Date filed: December 19, 2000

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Abstract: The present invention provides a method for the prevention and treatment of chronic venous insufficiency. Specifically, the present invention provides a method for the prevention and treatment of varicose veins, particularly hemorrhoids by application of an effective amount of an isoquinoline alkaloid. Included in this invention is an improved method for isolating and purifying alkaloids, particularly isoquinoline alkaloids from plants. Excerpt(s): 1. The present invention relates generally to a method for the prevention and treatment of chronic venous insufficiency. Specifically, the present invention relates generally to a method for the prevention and treatment of varicose veins, particularly hemorrhoids by administration of an isoquinoline alkaloid. Included in this invention is an improved method for isolating and purifying alkaloids, particularly isoquinoline alkaloids from plant sources. 2. Varicose veins are swollen and knotted veins that are both unsightly and uncomfortable. Up to 20% of the adult population have varicose veins and experience discomfort as a result. They can cause swelling of the legs and feet and the skin to itch. Factors such as prolonged standing or sitting, obesity and pregnancy play a large part in the development of varicosity. Varicose veins can occur in almost any part of the body, however they most often occur in the calf or on the inside of the leg between the groin and the ankle. 3. Hemorrhoids are a varicose dilation of the veins around the anus. Hemorrhoids are similar to varicose veins in the legs, in that the supporting walls of the veins weaken. According to the National Institutes of Health, about half of the United States population over age 50 suffer from hemorrhoids. While most hemorrhoids are not serious, they can have a major effect on one's quality of life. Prevention and treatment of hemorrhoids can include dietary changes, stool softeners, sitz baths and application of conventional topical anti-inflammatory ointments, such as Hemorid, Hemcure, Hemorr-X, Delicare, Preparation H and Ultroid. In more extreme cases, destroying the hemorrhoid by freezing or heating, ligation of the hemorrhoid or even laser surgery may be warranted. There are also a variety of traditional remedies available in India, China and other countries. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method of selective photothermolysis Inventor(s): Azar, Zion; (Schoham, IL) Correspondence: William Dippert; C/o Cowan, Liebowitz & Latman; 1133 Avenue OF The Americas; New York; NY; 10036-6799; US Patent Application Number: 20020019625 Date filed: April 9, 2001 Abstract: A method and apparatus for selective photothermolysis of a target tissue within surrounding tissue. The target and the surrounding tissue are heated to a predetermined temperature of about 60.degree. C. by a pulsed heat source such as a flash lamp which creates a temperature gradient in the air included in a cavity formed between the housing of the apparatus and the surrounding tissue. The surface temperature of the tissue is monitored by a sensor unit. When the tissue surface reaches the predetermined temperature the target tissue is heated to the point of coagulation, preferably by narrow band electromagnetic radiation. The temperature difference between the coagulating target and the surrounding tissue is sufficiently mild that heat diffusing out of the target does not damage the surrounding tissue, even in the case of a relatively large target such as varicose veins. The heating action may be terminated by automatically pumping air or another suitable coolant into the cavity when the surface

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of the tissue reaches a preset value or by lifting the apparatus off the tissue. The apparatus may include a programmable controller which may be programmed locally or remotely with the treatment parameters. Excerpt(s): This Application is a continuation-in-part of U.S. patent application Ser. No. 08/707,562, filed Sep. 4, 1996. The present invention relates to dermatological surgery and, more specifically, to a method of selective photothermolysis that allows the destruction of targets, such as varicose veins, that are too large to be destroyed by presently known methods without damaging the surrounding healthy tissue, and targets such as plaque psoriasis. Selective photothermolysis is a surgical method, introduced by Anderson and Parrish in 1983 ("Selective Photothermolysis: Precise Microsurgery by Selective Absorption of Pulsed Radiation", Science, Vol. 220, pp. 524527), for destroying certain diseased or unsightly tissue, on or near the skin, with minimal damage to the surrounding healthy tissue. The tissue to be destroyed must be characterized by significantly greater optical absorption at some wavelength of electromagnetic radiation than the surrounding tissue. The method consists of irradiating the target and the surrounding tissue with pulsed electromagnetic radiation, usually visible radiation, that is preferentially absorbed by the target. The energy and duration of the pulses is such that the target is heated to between about 70.degree. C. and about 80.degree. C., at which temperature the proteins of the target coagulate. Because the target absorbs the incident radiation much more strongly than the surrounding tissue, the surrounding tissue is heated negligibly. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods and devices for sclerotherapy Inventor(s): Abergel, R. Patrick; (Santa Monica, CA) Correspondence: Perkins Coie Llp; Post Office Box 1208; Seattle; WA; 98111-1208; US Patent Application Number: 20030120201 Date filed: December 21, 2001 Abstract: In a method for sclerotherapy for treating varicose veins, a flushing solution, such as sterile saline solution, is initially injected into the vein or vessel being treated. The flushing solution displaces or flushes out blood from the treatment site of the vessel. A sclerosing agent is then injected into the treatment site. The displacement of blood before introduction of the sclerosing agent reduces complications. A syringe assembly useful for performing the method has first and second reservoirs sealed off from each by an end cap. The end cap is removed just before use. A needle is attached and is connected to both reservoirs. Flushing solution is delivered from the first reservoir followed by sclerosing solution delivered from the second reservoir, without removing the needle from the vessel. Excerpt(s): The field of the invention is sclerotherapy. More specifically, the invention relates to the treatment of spider and varicose veins via sclerotherapy. The invention further relates to a novel syringe assembly useful in sclerotherapy, as well as in other medical applications. Spider veins or telangiectasias of the legs are common conditions, especially among women. With this condition, small dark-colored veins form on the legs, just underneath the skin surface. These types of veins can form anywhere on the legs between the thigh and ankle. They often have a web or sunburst pattern, but may also be formed as short, somewhat random line segments. In many cases, spider veins are largely unnoticeable, when localized in a small area. However, when larger areas of

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skin are affected, spider veins can be perceived as having a detrimental appearance on the skin. Varicose veins are larger veins, in comparison to spider veins. Varicose veins may protrude or be raised above the skin surface. They typically have a blue or purple color. A varicose vein generally contains stagnant or refluxing blood, which is out of circulation. Consequently, a varicose vein no longer functions to channel blood flow back to the circulatory system or the heart. Larger veins have valves which maintain blood flow in the forward direction. If the valves fail, blood accumulates under pressure, causing the veins of the leg to engorge. These varicose veins often appear as bulging, and have a rope-like or thread-like appearance. In more severe cases, these vascular disorders can result in aching, throbbing, swelling, or other conditions requiring medical treatment. Moreover, many patients having varicose veins, even without these symptoms, become distressed by the appearance of the varicose veins. Consequently, various treatments have been developed for both medical and cosmetic reasons. These treatments include surgery for severe cases, as well as sclerotherapy, typically used for smaller varicose veins closer to the skin surface. In the past, sclerotherapy has been performed by injecting a sclerosing agent into the vein. This non-surgical procedure destroys the varicose vein by irritating the vein wall, and causing the vein to close up. Procedures using ultrasound, or an electrosurgical electrode in combination with sclerotherapy have also been proposed. In general, sclerotherapy is a proven, safe, and effective technique. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods for minimally invasive, localized delivery of sclerotherapeutic agents Inventor(s): Leu, Anders J.; (Baden, CH) Correspondence: Shinjyu Global IP Counselors, Llp; 1233 20th Street, Nw, Suite 700; Washington; DC; 20036-2680; US Patent Application Number: 20030045860 Date filed: September 4, 2001 Abstract: Apparatus and methods are provided for localized, minimally invasive administration of sclerotherapy in the treatment of varicose veins. A treatment site within a vein is isolated from blood flow through the vain. Sclerotherapeutic agents are delivered to the isolated vessel segment. A-substantial portion of the agents are then removed from the vein, and isolation is removed from the treatment site. Inflammation, clotting, scarring, and closure of the varicose vein ensues at the treatment site. In a preferred embodiment, this technique is accomplished with a catheter having an inflatable member. The inflatable member is expandable to a deployed configuration in which its central region is of reduced cross-section as compared to its proximal and distal regions. The central region comprises one or more perforations extending through the inflatable member so that sclerotherapeutic agents may be delivered through the perforations. Excerpt(s): The present invention relates to delivery of therapeutic agents. More particularly, the present invention provides apparatus and methods for minimally invasive, localized delivery of sclerotherapeutic agents within a body lumen. Varicose veins are bulged sections of blue, twisted veins, normally found on a person's calf or thigh. In the United States alone, approximately 25 million people suffer from varicose veins. The condition is often hereditary and is most common in women. Onset may first occur during pregnancy, due to hormonal changes and increased pressure in the veins during uterus expansion. Obesity, menopause, aging, and repeated abdominal strain

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may also be contributing factors. Veins carry oxygen-depleted blood back toward a person's heart. In a healthy persons one-way valves within the veins prevent backward flow of the blood away from the heart. In people with varicose veins, the valves may leak or may be absent, causing blood to accumulate and stretch the veins. Alternatively, weakness in the vein walls may cause pooling of the blood. Less commonly, congenital abnormalities or vascular diseases, such as phlebitis, may lead to accumulation. Regardless of the cause, the accumulated blood creates-unsightly lumps and kinks just under the skin. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Topical cream for alleviating spider veins Inventor(s): Brown, Beverly Ann; (Dallas, TX), Osborn, Gary; (Dallas, TX) Correspondence: Robert C. Klinger; Jackson Walker L.L.P.; Suite 600; 2435 North Central Expressway; Richardson; TX; 75080; US Patent Application Number: 20030104043 Date filed: December 3, 2001 Abstract: A basic therapeutic unit comprises an aqueous solution of copper associated with a skin- and tissue-penetration enabler. Topical application of the unit to the skin penetrates therethrough and through subjacent tissue so that the copper resides at the sites of spider veins for the alleviation or elimination thereof. The copper solution may be copper gluconate and the enabler may be a liposome. A quantity of these therapeutic units may be suspended in a cream or emollient. Additional substances, such as vasodilators, thickeners, preservatives and dispersants may be encapsulated by or contained in the bilayer of the liposome or may be added to the cream. Excerpt(s): The present invention relates to therapeutic substances and methods of making and using same, and, more particularly, to a therapeutic unit which serves as the basis for topical copper-delivery systems that are more effective than other delivery systems in marshalling copper at the site of spider veins, and to methods for making and using these copper-delivery systems. Copper in a variety of forms has, for some time, been used medically and as a dietary supplement. Copper is present in many foods and in multivitamins and has been cited as a key factor in enzyme activity and production, as well as in the utilization of iron within the human body. Copper is also said to be a component of superoxide dismutase. Copper has been included as an ingredient in various skin creams and ointments. Copper peptides are said to alleviate skin dryness, wrinkles and fine lines and to be otherwise essential for good skin health. Introducing some forms of copper into the body, such as by ingestion, is said to result in the alleviation or elimination of varicose and spider veins. Lastly, an significantly to the present invention, copper has also been cited as a cofactor in several enzymatic reactions related to metabolism, the cross-linking of collagen and elastin, antioxidant formation and skin pigmentation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Keeping Current In order to stay informed about patents and patent applications dealing with varicose veins, 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 “varicose veins” (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 varicose veins. You can also use this procedure to view pending patent applications concerning varicose veins. 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 VARICOSE VEINS Overview This chapter provides bibliographic book references relating to varicose veins. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on varicose veins include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “varicose veins” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “varicose veins” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “varicose veins” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

A Colour Atlas of Surgery for Varicose Veins (Single Surgical Procedures) by C. V. Ruckley; ISBN: 0723410011; http://www.amazon.com/exec/obidos/ASIN/0723410011/icongroupinterna

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Ambulatory Phlebectomy: A Practical Guide for Treating Varicose Veins by Stefano Ricci, et al; ISBN: 0815170459; http://www.amazon.com/exec/obidos/ASIN/0815170459/icongroupinterna

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Color Atlas of Surgery for Varicose Veins by C. Vaughan Ruckley; ISBN: 0874895081; http://www.amazon.com/exec/obidos/ASIN/0874895081/icongroupinterna

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Early discharge from hospital for patients with hernia or varicose veins : report of a randomised controlled trial; ISBN: 0113202431; http://www.amazon.com/exec/obidos/ASIN/0113202431/icongroupinterna

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Encyclopedia of Natural Medicine, Revised 2nd Edition : Your comprehensive, userfriendly A-to-Z guide to treating more than 70 medicalcontions--from arthritis to

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varicose veins, from cancer to heart disease. by N.D. Michael T. Murray (Author), N.D. Joseph Pizzorno (Author); ISBN: 0761511571; http://www.amazon.com/exec/obidos/ASIN/0761511571/icongroupinterna •

Fegan's Compression Sclerotherapy for Varicose Veins by Shukri K. Shami (Editor), Timothy R. Cheatle (Editor) (2003); ISBN: 1852337125; http://www.amazon.com/exec/obidos/ASIN/1852337125/icongroupinterna

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NO/VARICOSE VEINS by Luis Navarro (Author); ISBN: 0553272241; http://www.amazon.com/exec/obidos/ASIN/0553272241/icongroupinterna

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Sclerotherapy of Spider Veins by Victoria, M.D. Vital-Lewis, Victoria Vitale-Lewis; ISBN: 0750694599; http://www.amazon.com/exec/obidos/ASIN/0750694599/icongroupinterna

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The Natural Pharmacist: Everything You Need to Know About Varicose Veins by N.D. Lise Meserole, Richard M. Conant (2004); ISBN: 0761516174; http://www.amazon.com/exec/obidos/ASIN/0761516174/icongroupinterna

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The Treatment of venous disorders : a comprehensive review of current practice in the management of varicose veins and the postthrombotic syndrome; ISBN: 0852000847; http://www.amazon.com/exec/obidos/ASIN/0852000847/icongroupinterna

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Understanding Varicose Veins (Family Doctor Books) by B. Campbell; ISBN: 1898205566; http://www.amazon.com/exec/obidos/ASIN/1898205566/icongroupinterna

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Vanish Varicose Veins with Horse Chestnut Seed Extract by B.Sc., Phm. Sherry Torkos; ISBN: 1890694169; http://www.amazon.com/exec/obidos/ASIN/1890694169/icongroupinterna

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Varicose Veins by Janet DiGiambittista (2000); ISBN: 0741404664; http://www.amazon.com/exec/obidos/ASIN/0741404664/icongroupinterna

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Varicose Veins; ISBN: 0668053348; http://www.amazon.com/exec/obidos/ASIN/0668053348/icongroupinterna

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Varicose Veins (New Self Help Series) by Leon Chaitow; ISBN: 0722513046; http://www.amazon.com/exec/obidos/ASIN/0722513046/icongroupinterna

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Varicose Veins (Your Operation) by Jane Smith, David Leaper; ISBN: 0340643757; http://www.amazon.com/exec/obidos/ASIN/0340643757/icongroupinterna

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Varicose Veins : A Guide for Patients by Peterson (Illustrator), et al; ISBN: 188527422X; http://www.amazon.com/exec/obidos/ASIN/188527422X/icongroupinterna

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Varicose Veins 3E by Harold Ellis, Peter Taylor; ISBN: 1900151677; http://www.amazon.com/exec/obidos/ASIN/1900151677/icongroupinterna

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Varicose Veins and Related Disorders by David J. Tibbs; ISBN: 0750610328; http://www.amazon.com/exec/obidos/ASIN/0750610328/icongroupinterna

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Varicose Veins and Spider Veins Evolution in Treatment by Dr. H. Majlessi; ISBN: 077950027X; http://www.amazon.com/exec/obidos/ASIN/077950027X/icongroupinterna

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Varicose Veins and Spider Veins: Myths and Realities by Robert A. Musson, Robert A. Musson; ISBN: 096689541X; http://www.amazon.com/exec/obidos/ASIN/096689541X/icongroupinterna

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•

Varicose Veins and Telangiectasias: Diagnosis and Treatment by John J. Bergan (Editor), et al; ISBN: 0942219449; http://www.amazon.com/exec/obidos/ASIN/0942219449/icongroupinterna

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Varicose veins, related diseases, and sclerotherapy : a guide for practitioners by H. I. Biegeleisen; ISBN: 0920792189; http://www.amazon.com/exec/obidos/ASIN/0920792189/icongroupinterna

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Varicose Veins, Venous Disorders, and Lymphatic Problems in the Lower Limbs by David J. Tibbs (Editor), et al; ISBN: 0192627627; http://www.amazon.com/exec/obidos/ASIN/0192627627/icongroupinterna

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Varicose Veins: A Commonsense Approach to Their Management by Howard Baron; ISBN: 0688084591; http://www.amazon.com/exec/obidos/ASIN/0688084591/icongroupinterna

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Varicose Veins: A Guide to Prevention and Treatment by Howard C. Baron, Barbara A. Ross (1995); ISBN: 0816029865; http://www.amazon.com/exec/obidos/ASIN/0816029865/icongroupinterna

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You and Your Varicose Veins (Overcoming Common Problems) by Patricia Gilbert; ISBN: 0859695360; http://www.amazon.com/exec/obidos/ASIN/0859695360/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “varicose veins” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •

A pathological study of the saphenous valves of varicose veins. Author: Gilpin, Charles A.,; Year: 1966; [Minneapolis] 1958

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A rational treatment for the radical cure of varicose veins and ulcers Author: Koehn, John W.; Year: 1972; Chicago: Huron Press, c1925

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Anaesthesia for out-patient varicose vein surgery with special reference to recovery. Author: Aromaa, Ulla.; Year: 1969; Helsinki, 1974

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Haemodynamics; the mechanism of venous capillary and lymphatic flow, oedema, and injection treatment of varicose veins. Author: Kittel, P. B.; Year: 1964; London, H. K. Lewis, 1929

10

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

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•

On the causation of varicose veins and their prevention and arrest by natural means; an evolutionary approach. Author: Cleave, T. L. (Thomas Latimer); Year: 1963; Bristol, Wright, 1960

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The anatomy of varicose veins. Author: Mullarky, Robert Emmett,; Year: 1967; Springield, Ill., Thomas [c1965]

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The clinical management of varicose veins. Author: Barrow, David Woolfolk,; Year: 1955; [New York] Hoeber-Harper [1957]

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The nature cure treatment of varicose veins & ulcers; also haemorrhoids and phlebitis. Author: Sneddon, James Russell.; Year: 1939; London, Health for All Pub. Co. [1950]

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The prevalence of varicose veins in the lower extremities. Author: Borschberg, Edwin.; Year: 1968; Basel, New York, Karger, 1967

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The Treatment of venous disorders: a comprehensive review of current practice in the management of varicose veins and the post-thrombotic syndrome Author: Hobbs, John T.; Year: 1971; Lancaster, Eng.: MTP, c1977

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Varicose veins: a commonsense approach to their management Author: Baron, Howard C.; Year: 1971; New York: Morrow, 1979; ISBN: 0688034594 http://www.amazon.com/exec/obidos/ASIN/0688034594/icongroupinterna

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Varicose veins and the care of the feet. Author: Carman, John A. (John Ambrose); Year: 1967; London, Foyle [1964]

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Varicose veins and venous thrombosis of the lower extremity. Author: Barone, Anthony Martin,; Year: 1954; [Chicago? c1948]

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Varicose veins, by Alton Ochsner. and Howard Mahorner. with fifty text illustrations, two color plates. Author: Ochsner, Alton,; Year: 1943; St. Louis, The C. V. Mosby company, 1939

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Varicose veins, venous thrombosis and arterial diseases of the lower extremity. Author: Barone, Anthony Martin,; Year: 1958; [Chicago? c1951]

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Varicose veins. Author: Foote, Robert Rowden.; Year: 1960; London, Butterworth, 1954

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Varicose veins; a practical manual, by R. Rowden Foote, with the assistance of A. Gordon Dingley. Author: Foote, Robert Rowden.; Year: 1965; Bristol, Wright, 1960

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Varicose veins; compression sclerotherapy. Author: Fegan, George.; Year: 1960; London, Heinemann [c1967]

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Varicose veins; phlebitis, leg ulcers, dropsy, eczema, haemorrhoids. Author: Foote, Robert Rowden.; Year: 1964; London, Duckworth [1954]

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Why do varicosities recur: clinical studies in patients with varicose veins Author: Schalin, Lars.; Year: 1972; Stockholm: [s.n.], 1981

Chapters on Varicose Veins In order to find chapters that specifically relate to varicose veins, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and varicose veins 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 “varicose veins” (or

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synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on varicose veins: •

Week Two: Nutrition Basics Source: in Green, W.F. First Year: Hepatitis B. New York, NY: Marlowe and Company. 2002. p. 87-98. Contact: Available from Marlowe and Company. 161 William Street, 16th Floor, New York, NY 10038. PRICE: $15.95 plus shipping and handling. ISBN: 1569245339. Summary: Viral hepatitis B (liver infection) is one of the most preventable medical conditions due to the availability of a hepatitis B vaccine, yet an estimated 100,000 people in the United States are infected each year, and 6,000 die from complications. When the author of this book was diagnosed in 1993, he decided to be proactive in his quest to understand and manage his illness. In this chapter, the author focuses on what readers can expect to experience during the second week after they receive their diagnosis of hepatitis B virus HBV) infection, discussing the issue of nutrition. The chapter is in two parts: first, a focus on the psychosocial aspects that the reader might experience, followed by a section of instructional material. In nontechnical language, the author reviews the basic building blocks of nutrition (including proteins, fats, carbohydrates, vitamins, minerals, antioxidants, supplements), and the role of the liver in processing those nutrients. The second section outlines other symptoms that may be due to HBV (beyond fatigue, which was discussed in a previous chapter). These can include liver pain or discomfort, joint pain, gastrointestinal symptoms, varicose veins, night sweats, rashes, and itching.

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

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

Varicose veins [motion picture] Source: Wiley F. Barker; produced by Davis & Geck; Year: 1969; Format: Motion picture; Danbury, Conn.: Davis & Geck, 1969

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CHAPTER 8. PERIODICALS AND NEWS ON VARICOSE VEINS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover varicose veins.

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

U.S. delay for varicose veins treatment Source: Reuters Industry Breifing Date: December 01, 2003

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BTG's varicose vein drug trial put on ice, shares slump Source: Reuters Industry Breifing Date: November 14, 2003

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UK's BTG gets boost from varicose veins treatment Source: Reuters Industry Breifing Date: August 29, 2003

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BTG identifies marketing partners for varicose vein treatment Source: Reuters Industry Breifing Date: August 29, 2003

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Height, family history ups varicose vein risk Source: Reuters Health eLine Date: April 04, 2003

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BTG to launch US trials of alternative treatment for varicose veins Source: Reuters Industry Breifing Date: July 23, 2002

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UK officials approve phase III trial of Provensis' varicose vein treatment Source: Reuters Industry Breifing Date: February 28, 2001

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New treatment zaps varicose veins with radiowaves Source: Reuters Health eLine Date: March 28, 2000

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Scientific basis for varicose vein surgery lacking Source: Reuters Medical News Date: February 05, 1999

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Leg symptoms may not be due to varicose veins Source: Reuters Health eLine Date: February 05, 1999 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

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Market Wire’s home page at http://www.marketwire.com/mw/home, type “varicose veins” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “varicose veins” (or synonyms). If you know the name of a company that is relevant to varicose veins, 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 “varicose veins” (or synonyms).

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

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for varicose veins. 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 varicose veins. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to varicose veins: Corticosteroids •

Dental - U.S. Brands: Kenalog in Orabase; Orabase-HCA; Oracort; Oralone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202010.html

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Inhalation - U.S. Brands: AeroBid; AeroBid-M; Azmacort; Beclovent; Decadron Respihaler; Pulmicort Respules; Pulmicort Turbuhaler; Vanceril; Vanceril 84 mcg Double Strength http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202011.html

•

Nasal - U.S. Brands: Beconase; Beconase AQ; Dexacort Turbinaire; Flonase; Nasacort; Nasacort AQ; Nasalide; Nasarel; Nasonex; Rhinocort; Vancenase; Vancenase AQ 84 mcg; Vancenase pockethaler http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202012.html

•

Ophthalmic - U.S. Brands: AK-Dex; AK-Pred; AK-Tate; Baldex; Decadron; Dexair; Dexotic; Econopred; Econopred Plus; Eflone; Flarex; Fluor-Op; FML Forte; FML Liquifilm; FML S.O.P.; HMS Liquifilm; Inflamase Forte; Inflamase Mild; I-Pred; Lite Pred; Maxidex; Ocu-Dex; Ocu-Pred; Ocu-Pr http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202013.html

•

Otic - U.S. Brands: Decadron http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202014.html

•

Rectal - U.S. Brands: Anucort-HC; Anu-Med HC; Anuprep HC; Anusol-HC; Anutone-HC; Anuzone-HC; Cort-Dome; Cortenema; Cortifoam; Hemorrhoidal HC; Hemril-HC Uniserts; Proctocort; Proctosol-HC; Rectosol-HC http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203366.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/

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

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

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

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

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

•

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

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

•

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

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.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 “varicose veins” (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 11208 315 460 1 0 11984

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 “varicose veins” (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/.

The Genome Project and Varicose Veins In the following section, we will discuss databases and references which relate to the Genome Project and varicose veins. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 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. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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

Varicose Veins Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?192200 Genes and Disease (NCBI - Map)

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

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

•

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

•

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

•

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

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

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•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “varicose veins” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “varicose veins” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

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

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

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

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•

Guides on varicose veins Varicose Veins http://www.nlm.nih.gov/medlineplus/varicoseveins.html

•

Other guides Circulatory Disorders http://www.nlm.nih.gov/medlineplus/circulatorydisorders.html Pulmonary Embolism http://www.nlm.nih.gov/medlineplus/pulmonaryembolism.html Thrombophlebitis http://www.nlm.nih.gov/medlineplus/thrombophlebitis.html

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

General/Overviews Varicose Veins and Spider Veins Source: National Women's Health Information Center http://www.4woman.gov/faq/varicose.htm What Are Varicose Veins? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00256

•

Diagnosis/Symptoms Leg Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/541.xml Vascular Diseases Diagnosis Source: Society of Interventional Radiology http://www.sirweb.org/patPub/vascularDiagnosis.shtml

•

Treatment Phlebology: The Treatment of Leg Veins Source: American College of Phlebology http://www.phlebology.org/brochure.htm Sclerotherapy Source: American Society of Plastic Surgeons http://www.plasticsurgery.org/public_education/procedures/Sclerotherapy.cfm Varicose Veins - Sclerotherapy http://www.nlm.nih.gov/medlineplus/tutorials/varicoseveinsloader.html

Patient Resources

•

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Children What Are Varicose Veins? Source: Nemours Foundation http://www.kidshealth.org/kid/grownup/getting_older/varicose_veins.html

•

Organizations American College of Phlebology http://www.phlebology.org/ American Society for Dermatologic Surgery http://www.asds-net.org/ National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/

•

Research Study Finds Sclerotherapy Effective in Removing Facial Veins Source: American Academy of Dermatology http://www.skincarephysicians.com/agingskinnet/SpiderVeins.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 Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on varicose veins. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Spider Vein, Varicose Vein Therapy Source: Schaumberg, IL: American Academy of Dermatology. 2001. 8 p. Contact: Available from American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumberg, IL 60168. (888)462-DERM ext. 22. Website: www.aad.org. PRICE: Single copy free. Summary: This brochure for the general public discusses spider and varicose veins. Spider veins are small superficial blood vessels that occur mainly on the legs and become enlarged. Varicose veins are larger dilated blood vessels that may be raised above the skin surface. In addition to discoloring the skin, patients may experience pain or a burning sensation. Spider veins are more common in women and may be

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hereditary, caused by injury, or caused by wearing tight girdles and hosiery. In some cases, wearing support hose may prevent spider veins from developing. Sclerotherapy (a procedure in which veins are injected with a sclerosing solution causing them to collapse and fade) is the main treatment for spider veins. It usually takes several treatments but is successful in most patients. Side effects of sclerotherapy include stinging or pain at the injection site, allergic reactions to the sclerosing solution, muscle cramps, and swelling. Radiofrequency and surgery are used to treat larger varicose veins. Laser and intense pulsed light are used to treat facial spider veins. 4 figures. •

Treatment for Spider and Varicose Veins Source: Schaumburg, IL: American Society for Dermatologic Surgery (ASDS). 1998. 6 p. Contact: Available from American Society for Dermatologic Surgery. ATTN: Pamphlets, 930 North Meacham Road, Schaumburg, IL 60173-6016. (800) 441-2737 or (847) 330-9830. Fax (847) 330-1135. Website: www.asds-net.org. PRICE: Package of 50 for members, $25.00; for nonmembers, $40.00; bulk orders sold to physicians only. Call '800' number or access website for single free copy. Summary: This brochure uses a question and answer format to provide the general public with information on the treatment of spider and varicose veins. The fact sheet describes these veins and the factors contributing to them, identifies the health hazards posed by varicose veins, presents treatment methods, and notes possible complications. One method of treating spider or varicose veins is sclerotherapy. This relatively inexpensive procedure involves injecting a saline or specially developed chemical solution into the vein; this causes it to close up or collapse and become scar tissue that is eventually absorbed. Other methods include laser surgery, electrodesiccation, surgical ligation and stripping, and ambulatory phlebectomy. The fact sheet provides information on the American Society for Dermatologic Surgery and presents a source for further information.

•

Varicose Veins: A Guide for Patients Source: San Ramon, CA: Health Information Network (HIN), Inc. 1995. 28 p. Contact: Available from Health Information Network (HIN), Inc. 231 Market Place, No. 331, San Ramon, CA 94583. (800) HIN-1947. Website: HINbooks.com. PRICE: $2.95 plus shipping and handling. ISBN 188527422X. Order Number: 0202. Summary: This illustrated booklet provides people who have varicose veins with an overview of this condition. Varicose veins occur when the valves between the deep and superficial veins fail and blood flows the wrong way. Valves may fail because of a defect in the valve, an inherited susceptibility to valve defects, or a defective vein. The booklet outlines the symptoms and discusses the complications that may occur with more severe varicose veins, including phlebitis, bleeding, and leg ulcers. Other topics include ways to treat varicose veins, such as making adjustments to daily routine and lifestyle, wearing elastic support stockings, having surgery to remove the veins, and undergoing sclerotherapy. The booklet explains the standard regimen of care, focusing on being evaluated before surgery and recovering, and also describes sclerotherapy. In addition, the booklet discusses the occurrence of varicose veins during pregnancy and their reappearance following surgery and injections. The booklet concludes with a glossary of terms.

Patient Resources

•

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Spider and Varicose Veins Source: Postgraduate Medicine. 106(3): 181-182. September 1999. Summary: This information sheet uses a question and answer format to provide people who have spider and varicose veins with information on their causes and treatment. Spider and varicose veins occur when tiny valves in the veins leak, so blood cannot move forward as it should and the veins begin to stretch to accommodate the pooled blood. Varicose veins are more common in women than in men, and they tend to be hereditary. Obesity, menopause, aging, and abdominal straining can also contribute to the development of varicose veins. Spider veins are usually a cosmetic problem and do not need to be treated. Sclerotherapy may be recommended for treating spider or varicose veins in some patients. Laser therapy using pulse-dye or argon lasers is another treatment for spider veins. A stripping procedure is sometimes used for more extensive varicose vein problems. Blocking or removing veins does not impede circulation because the legs have many channels for the blood to take. 3 figures. Healthfinder™

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

Spider and Varicose Veins Summary: Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Source: American Society For Dermatologic Surgery http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6750 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 varicose veins. 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

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•

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

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your search to “Organizations” and “varicose veins”. 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 “varicose veins” (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 “varicose veins” (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.25

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

25

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)26: •

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/

26

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

142 Varicose Veins

•

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

•

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

•

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

•

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

143

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Varicose Veins Varicose vein surgery Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002952.htm Varicose vein treatment Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002143.htm Varicose veins Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001109.htm

•

Signs & Symptoms for Varicose Veins Eczema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003259.htm Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm

144 Varicose Veins

Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Muscle cramps Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Pain in the legs Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003182.htm Problems breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Swelling of ankles Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003104.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm •

Diagnostics and Tests for Varicose Veins ANA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003535.htm Angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003327.htm Duplex Doppler/ultrasound exam of extremity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003433.htm MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003335.htm Plethysmography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003771.htm Ulcers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003228.htm Ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003336.htm

•

Surgery and Procedures for Varicose Veins Sclerotherapy of veins Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002952.htm

Online Glossaries 145

Skin graft Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002982.htm Varicose vein surgery Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002952.htm Vein stripping Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002952.htm •

Background Topics for Varicose Veins Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Blood clots Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Embolism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Peripheral Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002273.htm

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

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

•

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

•

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

•

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

147

VARICOSE VEINS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Ablation: The removal of an organ by surgery. [NIH] 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] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Rosacea: An acneiform eruption occurring mostly in middle-aged adults and appearing generally on the forehead, cheeks, nose, and chin. Three types are recognized: granulomatous, glandular hyperplastic with rhinophyma, and ocular. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] 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

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complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

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] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anaphylactic: Pertaining to anaphylaxis. [EU] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory

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distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] 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] Anionic: Pertaining to or containing an anion. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [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] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [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] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU]

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Aorta: The main trunk of the systemic arteries. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Argon: A noble gas with the atomic symbol Ar, atomic number 18, and atomic weight 39.948. It is used in fluorescent tubes and wherever an inert atmosphere is desired and nitrogen cannot be used. [NIH] Aromatic: Having a spicy odour. [EU] 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] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]

Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called endarterectomy. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH]

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Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Avulsion: The forcible separation, or tearing away, of a part of an organ. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [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] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] 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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basilar Artery: The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Bioluminescence: The emission of light by living organisms such as the firefly, certain

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mollusks, beetles, fish, bacteria, fungi and protozoa. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning 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] Blebs: Cysts on or near the surface of the lungs. [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 network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] 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] 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] Bronchospasm: Spasmodic contraction of the smooth muscle of the bronchi, as occurs in

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asthma. [EU] 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] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [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 Dobesilate: A drug used to reduce hemorrhage in diabetic retinopathy. [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] 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] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiogenic: Originating in the heart; caused by abnormal function of the heart. [EU] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It

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differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] 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 Division: The fission of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [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] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] 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] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clinical trial: A research study that tests how well new medical treatments or other

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

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addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Compression bandage: A bandage designed to provide pressure to a particular area. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] 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

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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 heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] 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] Cystocele: Fallen bladder. When the bladder falls or sags from its normal position down to the pelvic floor, it can cause either urinary leakage or urinary retention. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH]

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Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [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] Diastolic: Of or pertaining to the diastole. [EU] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH] Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydroergotamine: A derivative of ergotamine prepared by the catalytic hydrogenation of ergotamine. It is used as a vasoconstrictor, specifically for the therapy of migraine. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Diploid: Having two sets of chromosomes. [NIH] Dipyridamole: A drug that prevents blood cell clumping and enhances the effectiveness of fluorouracil and other chemotherapeutic agents. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] 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] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] 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

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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] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dwell time: In peritoneal dialysis, the amount of time a bag of dialysate remains in the patient's abdominal cavity during an exchange. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] 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] 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] Elasticity: Resistance and recovery from distortion of shape. [NIH] 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] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrodesiccation: The drying of tissue by a high-frequency electric current applied with a needle-shaped electrode. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] 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] Emollient: Softening or soothing; called also malactic. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [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] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH]

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Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] 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] Enhancers: Transcriptional element in the virus genome. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 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] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which

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covers the inner or outer surfaces of the body. [NIH] Erbium: Erbium. An element of the rare earth family of metals. It has the atomic symbol Er, atomic number 68, and atomic weight 167.26. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Ergotamine: A vasoconstrictor found in ergot of Central Europe. It is an alpha-1 selective adrenergic agonist and is commonly used in the treatment of migraine headaches. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by radioisotope dilution technique. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] 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]

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Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Fallopian Tubes: Two long muscular tubes that transport ova from the ovaries to the uterus. They extend from the horn of the uterus to the ovaries and consist of an ampulla, an infundibulum, an isthmus, two ostia, and a pars uterina. The walls of the tubes are composed of three layers: mucosal, muscular, and serosal. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fat Necrosis: A condition in which the death of adipose tissue results in neutral fats being split into fatty acids and glycerol. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Femoral Vein: The vein accompanying the femoral artery in the same sheath; it is a continuation of the popliteal vein and becomes the external iliac vein. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetal Weight: The weight of the fetus in utero, which is usually estimated by various formulas based on measurements made during prenatal ultrasonography. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectins: Glycoproteins found on the surfaces of cells, particularly in fibrillar structures. The proteins are lost or reduced when these cells undergo viral or chemical transformation. They are highly susceptible to proteolysis and are substrates for activated blood coagulation factor VIII. The forms present in plasma are called cold-insoluble globulins. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ,

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usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Fluoroscopy: Production of an image when X-rays strike a fluorescent screen. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [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] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] 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]

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Genotype: The genetic constitution of the individual; the characterization of the genes. [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] 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] 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]

Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [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

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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] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoid: An enlarged or swollen blood vessel, usually located near the anus or the rectum. [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] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heptaminol: An amino alcohol that has been used as a myocardial stimulant and vasodilator and to relieve bronchospasm. Its most common therapeutic use is in orthostatic hypotension. The mechanism of heptaminol's therapeutic actions is not well understood although it has been suggested to affect catecholamine release or calcium metabolism. [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] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Holmium: An element of the rare earth family of metals. It has the atomic symbol Ho, atomic number 67, and atomic weight 164.93. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH]

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Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] 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] 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] 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] Hypnotic: A drug that acts to induce sleep. [EU] Hypodermic: Applied or administered beneath the skin. [EU] Hypopigmentation: A condition caused by a deficiency in melanin formation or a loss of pre-existing melanin or melanocytes. It can be complete or partial and may result from trauma, inflammation, and certain infections. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs. [NIH] Iliac Vein: A vein on either side of the body which is formed by the union of the external and internal iliac veins and passes upward to join with its fellow of the opposite side to form the inferior vena cava. [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] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of

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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] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [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] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] 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]

Inferior vena cava: A large vein that empties into the heart. It carries blood from the legs and feet, and from organs in the abdomen and pelvis. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH]

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Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrahepatic: Within the liver. [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]

Invertebrates: Animals that have no spinal column. [NIH] 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] Isometric Contraction: Muscular contractions characterized by increase in tension without change in length. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney 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] Lactate Dehydrogenase: A tetrameric enzyme that, along with the coenzyme NAD+, catalyzes the interconversion of lactate and pyruvate. In vertebrates, genes for three different subunits (LDH-A, LDH-B and LDH-C) exist. [NIH] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Leg Ulcer: Ulceration of the skin and underlying structures of the lower extremity. About

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90% of the cases are due to venous insufficiency (varicose ulcer), 5% to arterial disease, and the remaining 5% to other causes. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [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] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligation: Application of a ligature to tie a vessel or strangulate a part. [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 independent assortment. [NIH] Lipid: Fat. [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] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [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 Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [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] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH]

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Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] 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] Luminescence: The property of giving off light without emitting a corresponding degree of heat. It includes the luminescence of inorganic matter or the bioluminescence of human matter, invertebrates and other living organisms. For the luminescence of bacteria, bacterial luminescence is available. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphedema: Edema due to obstruction of lymph vessels or disorders of the lymph nodes. [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] Malabsorption: Impaired intestinal absorption of nutrients. [EU] 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] 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] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger

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cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] 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] 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] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]

Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the

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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] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]

Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Fatigue: A state arrived at through prolonged and strong contraction of a muscle. Studies in athletes during prolonged submaximal exercise have shown that muscle fatigue increases in almost direct proportion to the rate of muscle glycogen depletion. Muscle fatigue in short-term maximal exercise is associated with oxygen lack and an increased level of blood and muscle lactic acid, and an accompanying increase in hydrogen-ion concentration in the exercised muscle. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU]

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Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] 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] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] 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] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal

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transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oedema: The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Edema may be localized, due to venous or lymphatic obstruction or to increased vascular permeability, or it may be systemic due to heart failure or renal disease. Collections of edema fluid are designated according to the site, e.g. ascites (peritoneal cavity), hydrothorax (pleural cavity), and hydropericardium (pericardial sac). Massive generalized edema is called anasarca. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [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]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU]

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Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptic Ulcer Hemorrhage: Bleeding from a peptic ulcer. [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] Perennial: Lasting through the year of for several years. [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] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores

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that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [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] Phlebitis: Inflammation of a vein. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photobiology: The branch of biology dealing with the effect of light on organisms. [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 Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase

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"physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] 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]

Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [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]

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Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polytetrafluoroethylene: Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Popliteal: Compression of the nerve at the neck of the fibula. [NIH] Popliteal Vein: The vein formed by the union of the anterior and posterior tibial veins; it courses through the popliteal space and becomes the femoral vein. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [NIH] Portosystemic Shunt: An operation to create an opening between the portal vein and other veins around the liver. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postural: Pertaining to posture or position. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU]

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Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] 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] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [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] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prosthesis: An artificial replacement of a part of the body. [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] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia.

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[NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

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 Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] 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.

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Also called radiotherapy. [NIH] Radicular: Having the character of or relating to a radicle or root. [NIH] Radiculopathy: Disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. [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] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [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] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] 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] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial

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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] Reoperation: A repeat operation for the same condition in the same patient. It includes reoperation for reexamination, reoperation for disease progression or recurrence, or reoperation following operative failure. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Reticular: Coarse-fibered, netlike dermis layer. [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] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Rheology: The study of the deformation and flow of matter, usually liquids or fluids, and of the plastic flow of solids. The concept covers consistency, dilatancy, liquefaction, resistance to flow, shearing, thixotrophy, and viscosity. [NIH] Rhinophyma: A manifestation of severe Acne rosacea resulting in significant enlargement of the nose and occurring primarily in men. It is caused by hypertrophy of the sebaceous glands and surrounding connective tissue. The nose is reddened and marked with numerous telangiectasias. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]

Saline: A solution of salt and water. [NIH] Salivary: The duct that convey saliva to the mouth. [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]

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Saponin: A substance found in soybeans and many other plants. Saponins may help lower cholesterol and may have anticancer effects. [NIH] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Sclerotherapy: Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [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

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circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sitz Bath: A special plastic tub. A person sits in a few inches of warm water to help relieve discomfort of hemorrhoids or anal fissures. [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 Manifestations: Dermatologic disorders attendant upon non-dermatologic disease or injury. [NIH] Skin Pigmentation: Coloration of the skin. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol 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] Sodium Tetradecyl Sulfate: An anionic surface-active agent used for its wetting properties in industry and used in medicine as an irritant and sclerosing agent for hemorrhoids and varicose veins. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] 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]

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Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord 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] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sports Medicine: The field of medicine concerned with physical fitness and the diagnosis and treatment of injuries sustained in sports activities. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Sterile: Unable to produce children. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU]

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Subcutaneous: Beneath the skin. [NIH] 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] Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] 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] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH]

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Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombophlebitis: Inflammation of a vein associated with thrombus formation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] 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] Toothache: Pain in the adjacent areas of the teeth. [NIH] Topical: On the surface of the body. [NIH] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [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] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or

188 Varicose Veins

kidneys. [NIH] Tunica Intima: The innermost coat of blood vessels, consisting of a thin lining of endothelial cells longitudinally oriented and continuous with the endothelium of capillaries on the one hand and the endocardium of the heart on the other. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urokinase: A drug that dissolves blood clots or prevents them from forming. [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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Varices: Stretched veins such as those that form in the esophagus from cirrhosis. [NIH] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in

Dictionary 189

nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Insufficiency: Inadequacy of the venous valves and impairment of venous return (venous stasis) usually from the legs, often with edema and sometimes with stasis ulcers at the ankle. [NIH] Venous Pressure: The blood pressure in a vein. It is usually measured to assess the filling pressure to the ventricle. [NIH] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] 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] 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] Waiting Lists: Prospective patient listings for appointments. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] 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

190 Varicose Veins

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]

191

INDEX A Abdomen, 5, 72, 78, 89, 147, 152, 164, 167, 169, 174, 176, 185, 186 Abdominal, 5, 72, 78, 100, 133, 147, 158, 159, 166, 174, 176 Ablation, 39, 147 Acetylcholine, 147, 173 Acne, 71, 82, 147, 182 Acne Rosacea, 71, 147 Acoustic, 95, 147 Acrylonitrile, 147, 182 Adaptability, 147, 154 Adenine, 147 Adenosine, 17, 147, 176 Adipose Tissue, 147, 162 Adjustment, 86, 147 Adrenal Medulla, 70, 147, 153, 160, 173 Adrenergic, 37, 54, 147, 160, 161 Adverse Effect, 83, 147, 184 Aetiology, 12, 19, 34, 147 Affinity, 147, 148, 184 Agar, 148, 177 Agonist, 7, 148, 161 Agoraphobia, 148, 176 Algorithms, 148, 152 Alkaline, 148, 153 Alkaloid, 98, 148 Allergen, 148, 157 Alpha Particles, 148, 180 Alternative medicine, 57, 65, 112, 148, 155 Amino Acids, 148, 175, 178, 179, 186 Amnestic, 148, 171 Ampulla, 148, 160, 162 Amputation, 71, 148 Anal, 148, 184 Anal Fissure, 148, 184 Analgesic, 87, 148, 158, 169 Anaphylactic, 96, 148 Anaphylaxis, 148 Anatomical, 94, 149, 150, 154, 167, 183 Anemia, 127, 149 Anesthesia, 54, 149, 150, 159, 171 Aneurysm, 15, 149 Angiogenesis, 5, 149, 170 Angioplasty, 71, 149, 150 Anionic, 149, 184 Anions, 149, 168, 186 Ankle, 88, 98, 99, 149, 188, 189

Antibacterial, 149, 184 Antibiotic, 149, 184 Antibodies, 149, 166 Antibody, 148, 149, 155, 166, 167, 168, 170, 172, 180, 181, 190 Antigen, 148, 149, 155, 166, 167, 170 Anti-inflammatory, 98, 149, 158, 167 Antioxidant, 43, 101, 149 Antipyretic, 149, 158 Anus, 98, 148, 149, 152, 165 Anxiolytic, 149, 171 Aorta, 93, 150, 157, 166, 189 Apoptosis, 21, 38, 150 Aqueous, 101, 150, 151, 157, 166, 169 Arginine, 150, 173 Argon, 133, 150 Aromatic, 84, 150, 185 Arterial, 7, 10, 32, 49, 71, 93, 106, 150, 166, 169, 179, 186 Arteries, 7, 83, 91, 93, 150, 151, 152, 154, 156, 157, 166, 170, 171, 172 Arterioles, 150, 152, 153, 171 Arteriosus, 150, 180 Arteriovenous, 25, 48, 150, 171 Arteriovenous Fistula, 48, 150 Ascites, 5, 150, 174 Ataxia, 126, 127, 150, 186 Atherectomy, 71, 150, 159 Atrium, 93, 150, 189 Atrophy, 126, 150, 172 Attenuated, 150, 158 Autacoids, 150, 167 Autologous, 49, 151 Autonomic, 70, 147, 151, 173, 185 Avulsion, 33, 45, 96, 151 B Back Pain, 78, 151 Bacteria, 149, 151, 152, 162, 170, 171, 184, 188 Bacteriophage, 151, 177 Bacterium, 151, 155 Basal Ganglia, 150, 151 Basal Ganglia Diseases, 150, 151 Base, 77, 147, 151, 157, 168 Basement Membrane, 151, 161, 168 Basilar Artery, 15, 151 Basophils, 151, 169 Benign, 151, 173, 181

192 Varicose Veins

Bilateral, 12, 39, 151 Bile, 151, 163, 169 Biochemical, 12, 58, 151, 183 Biological Transport, 151, 158 Bioluminescence, 151, 170 Biopsy, 152, 175 Biotechnology, 8, 105, 112, 123, 125, 126, 127, 152 Bladder, 152, 157, 163, 179, 188 Blebs, 47, 152 Blood Coagulation, 23, 152, 153, 162 Blood Glucose, 152, 164 Blood Platelets, 152, 183 Blood pressure, 7, 80, 92, 152, 153, 166, 176, 184, 189 Blood Volume, 29, 81, 152 Body Fluids, 152, 153, 159, 184 Bone Marrow, 152, 166, 170, 172, 184 Bowel, 148, 152, 167, 185 Bowel Movement, 152, 185 Brachytherapy, 152, 167, 168, 180, 190 Bradykinin, 152, 173 Branch, 71, 91, 141, 152, 159, 175, 176, 184, 186 Breakdown, 152, 158, 163 Bronchospasm, 152, 165 Burns, 4, 153 Burns, Electric, 153 Bypass, 21, 32, 49, 71, 153, 156 C Calcium, 17, 54, 153, 155, 165, 170, 179 Calcium Dobesilate, 17, 54, 153 Capillary, 5, 71, 74, 105, 152, 153, 189 Carbohydrate, 70, 153, 164 Carbon Dioxide, 153, 163, 177, 189 Carcinogenic, 153, 179 Carcinogens, 153, 174 Cardiac, 86, 93, 153, 159, 160, 161, 171, 172 Cardiogenic, 93, 153 Cardiorespiratory, 153, 171 Cardiovascular disease, 6, 153 Cardiovascular System, 5, 83, 153 Case report, 3, 13, 15, 34, 57, 153 Catecholamine, 153, 165 Catheterization, 149, 153 Catheters, 71, 91, 154, 167 Caudal, 154, 178 Cell Death, 38, 150, 154, 172 Cell Division, 126, 151, 154, 171, 177 Cellulose, 154, 163, 177 Central Nervous System, 70, 147, 154, 163, 178, 183

Cerebellar, 150, 154, 181 Cerebral, 150, 151, 154, 160 Cerebral Arteries, 151, 154 Cerebrovascular, 151, 153, 154, 186 Cerebrum, 154, 187 Cervix, 154, 163, 182 Chin, 147, 154 Cholesterol, 83, 151, 154, 157, 169, 170, 183 Chromatin, 150, 154, 160, 173 Chronic Disease, 6, 154 Chronic renal, 154, 178 Circulatory system, 6, 92, 100, 154 Clinical trial, 4, 123, 154, 156, 181 Cloning, 152, 155 Coagulation, 23, 98, 152, 153, 155, 162, 165, 168, 187 Coenzyme, 155, 168 Cofactor, 101, 155, 179 Collagen, 11, 13, 25, 45, 48, 77, 101, 151, 155, 161, 162, 170, 177, 179 Collapse, 70, 74, 76, 132, 149, 152, 155 Competency, 97, 155 Complement, 155, 156 Complementary and alternative medicine, 57, 65, 155 Complementary medicine, 57, 156 Compress, 94, 156, 187 Compression bandage, 25, 156 Computational Biology, 123, 125, 156 Conception, 156, 162 Congestion, 87, 156 Connective Tissue, 12, 96, 152, 155, 156, 162, 163, 170, 182 Connective Tissue Cells, 156 Consciousness, 148, 156 Constipation, 22, 54, 156 Constriction, 7, 156, 168 Consumption, 156, 157 Contraindications, ii, 4, 156 Controlled study, 15, 156 Conus, 156, 180 Conventional therapy, 156 Conventional treatment, 79, 156 Corneum, 156, 160 Coronary, 15, 32, 77, 87, 153, 156, 157, 171, 172 Coronary Artery Bypass, 32, 156 Coronary heart disease, 153, 157 Coronary Thrombosis, 77, 157, 171, 172 Cortex, 150, 154, 157, 161, 181 Curative, 157, 173, 186 Cutaneous, 71, 76, 77, 157

Index 193

Cyclic, 15, 88, 157, 164, 173, 176 Cystocele, 78, 157 Cytokine, 43, 157, 175 Cytoplasm, 150, 151, 157, 160, 172, 173 D Databases, Bibliographic, 123, 157 Decision Making, 48, 157 Degenerative, 156, 157, 165 Deletion, 150, 157 Density, 49, 157, 169, 170 Dermal, 12, 54, 77, 84, 157 Dermatitis, 80, 81, 82, 157, 159 Dermatology, 10, 16, 36, 42, 44, 85, 131, 157 Desensitization, 8, 157 Developing Countries, 29, 157 Diabetes Mellitus, 158, 164 Diabetic Retinopathy, 153, 158, 176 Diagnostic procedure, 69, 113, 158 Dialysate, 158, 159 Diaphragm, 158, 165, 177 Diastolic, 158, 166 Diclofenac, 54, 158 Diclofenac Sodium, 158 Diffusion, 84, 151, 158, 167 Digestion, 151, 152, 158, 167, 169, 175, 185 Dihydroergotamine, 55, 59, 158 Dilatation, 149, 158, 179 Dilation, 80, 81, 98, 133, 150, 152, 158 Dilution, 12, 158, 161, 177 Diploid, 158, 177 Dipyridamole, 26, 158 Direct, iii, 74, 90, 115, 158, 172, 181 Disease Progression, 158, 182 Distal, 71, 75, 81, 91, 93, 96, 100, 157, 158, 159, 175, 179, 180 Dorsal, 77, 158, 178, 185 Dorsum, 158 Drive, ii, vi, 53, 158, 169 Drug Interactions, 116, 159 Duct, 148, 153, 159, 161, 182 Duodenum, 151, 159, 160, 185 Dwell time, 84, 159 Dysplasia, 127, 159 Dystrophy, 126, 159, 172 E Eczema, 81, 106, 143, 159 Edema, 88, 143, 158, 159, 170, 174, 189 Efficacy, 58, 159 Elasticity, 90, 159 Elastin, 11, 101, 155, 159, 161 Electrocoagulation, 155, 159

Electrode, 71, 73, 97, 100, 159 Electrodesiccation, 132, 159 Electrolysis, 79, 149, 159 Electrolyte, 159, 184 Electrons, 149, 151, 159, 168, 174, 180, 181 Electrophysiological, 159, 189 Emollient, 101, 159, 164, 174 Encapsulated, 101, 159 Endarterectomy, 149, 150, 159 Endocardium, 159, 188 Endoscope, 19, 94, 160 Endoscopic, 23, 71, 93, 94, 160, 171 Endothelial cell, 96, 159, 160, 188 Endothelium, 42, 75, 160, 173, 177, 188 Endothelium, Lymphatic, 160 Endothelium, Vascular, 160 Endothelium-derived, 160, 173 End-stage renal, 154, 160, 178 Enhancers, 30, 160 Environmental Exposure, 160, 174 Environmental Health, 122, 124, 160 Enzymatic, 101, 153, 155, 160 Enzyme, 7, 44, 101, 155, 160, 164, 167, 168, 176, 177, 186, 189 Eosinophils, 160, 169 Epidemiological, 6, 160 Epidermal, 74, 84, 160, 170 Epidermis, 76, 77, 156, 160, 165, 180 Epidural, 13, 34, 160 Epinephrine, 147, 160, 173 Epithelium, 151, 160 Erbium, 77, 161 Ergot, 59, 161, 182 Ergotamine, 158, 161 Erythrocyte Volume, 152, 161 Erythrocytes, 149, 152, 161 Esophageal, 5, 161, 183 Esophageal Varices, 5, 161, 183 Esophagus, 5, 89, 161, 164, 181, 185, 188 Essential Tremor, 126, 161 Estradiol, 24, 40, 83, 161 Estrogen, 75, 161 Evacuation, 156, 161 Excitability, 161, 172 Exocrine, 70, 161, 174 Exogenous, 159, 161 Extensor, 161, 180 External-beam radiation, 161, 168, 180, 189 Extracellular, 7, 10, 27, 156, 161, 162, 170, 184

194 Varicose Veins

Extracellular Matrix, 10, 27, 156, 161, 162, 170 Extracellular Matrix Proteins, 10, 161, 170 Extracellular Space, 161, 162 Extraction, 82, 162 Extremity, 21, 38, 76, 106, 144, 162, 168 F Facial, 3, 76, 131, 132, 162 Fallopian Tubes, 162, 182 Family Planning, 123, 162 Fat, 96, 147, 152, 157, 162, 169, 184 Fat Necrosis, 96, 162 Fatigue, 77, 78, 88, 107, 144, 162, 164, 172 Fatty acids, 162, 179 Feces, 156, 162, 185 Femoral, 10, 13, 18, 21, 38, 71, 97, 162, 178 Femoral Artery, 71, 162 Femoral Vein, 21, 97, 162, 178 Femur, 162 Fetal Weight, 78, 162 Fetus, 78, 162, 177, 179, 188 Fibrin, 96, 152, 162, 177, 186, 187 Fibrinogen, 162, 177, 186 Fibroblasts, 45, 156, 162 Fibronectins, 161, 162 Fibrosis, 76, 127, 162, 183 Fibula, 163, 178 Flatus, 163 Flexion, 77, 163 Fluoroscopy, 97, 163 Fluorouracil, 158, 163 Flushing, 99, 163 Fold, 81, 163 Forearm, 152, 163 Fossa, 19, 163 Fundus, 163 Fungi, 152, 163, 171, 190 Fungus, 161, 163, 182 G Gallbladder, 147, 163 Ganglia, 70, 147, 150, 151, 163, 173, 185 Gas, 85, 150, 153, 158, 163, 165, 173, 186, 188, 189 Gas exchange, 163, 189 Gastric, 163, 164, 175, 183 Gastrin, 163, 165 Gastrointestinal, 70, 107, 152, 160, 163, 183, 185 Gastrointestinal tract, 163, 183, 185 Gene, 5, 105, 127, 128, 152, 163, 174 Genotype, 5, 164, 176 Gland, 147, 164, 170, 174, 179, 185

Glucose, 126, 152, 154, 158, 164 Glycerol, 162, 164, 176 Glycogen, 164, 172 Glycoprotein, 7, 162, 164, 168 Glycosaminoglycans, 23, 62, 161, 164 Governing Board, 164, 178 Graft, 145, 164, 166 Grafting, 32, 157, 164 Groin, 15, 34, 72, 98, 164 Growth, 51, 126, 149, 150, 154, 157, 164, 170, 172, 173, 174, 177, 187, 188 Guanylate Cyclase, 164, 173 H Haematoma, 9, 164 Haemorrhage, 31, 164 Haploid, 164, 177 Heart attack, 153, 164 Heart failure, 34, 93, 164, 174 Heartburn, 164, 165 Hemoglobin, 84, 149, 161, 164, 165 Hemoglobinuria, 126, 165 Hemorrhage, 3, 21, 80, 82, 153, 158, 159, 165, 175, 180, 183, 185 Hemorrhoid, 98, 165 Hemostasis, 165, 183 Hepatic, 165, 169 Hepatitis, 107, 165 Hepatocytes, 165 Heptaminol, 17, 165 Hereditary, 79, 100, 132, 133, 165, 182 Heredity, 22, 82, 163, 165 Hernia, 15, 22, 35, 86, 103, 165 Herpes, 82, 165 Herpes Zoster, 165 Hiatal Hernia, 86, 165 Holmium, 77, 165 Hormonal, 79, 82, 100, 150, 165 Hormone, 70, 83, 160, 161, 163, 165 Horny layer, 160, 165 Hydrogen, 151, 153, 161, 165, 166, 172, 173, 174, 180, 186 Hydrogen Peroxide, 166, 186 Hydroxylysine, 155, 166 Hydroxyproline, 155, 166 Hypersensitivity, 148, 157, 166 Hypertension, 5, 6, 7, 32, 43, 54, 71, 153, 166 Hypertrophy, 3, 5, 36, 166, 182 Hypnotic, 166, 171 Hypodermic, 73, 166 Hypopigmentation, 76, 166 Hypotension, 165, 166

Index 195

I Id, 56, 60, 130, 133, 140, 142, 166 Iliac Artery, 162, 166 Iliac Vein, 162, 166 Immune response, 149, 166, 189 Immune system, 166, 188 Immunization, 166, 179 Immunodeficiency, 126, 166 Immunohistochemistry, 7, 166 Immunologic, 166, 175, 181 Immunotherapy, 157, 166 Impairment, 95, 150, 166, 171, 189 Implant radiation, 167, 168, 180, 190 In situ, 43, 71, 75, 167 In vitro, 26, 167 In vivo, 26, 27, 54, 167 Incision, 71, 75, 79, 81, 90, 167, 168 Incompetence, 18, 34, 37, 38, 39, 167 Indicative, 103, 167, 175, 188 Indomethacin, 36, 167 Infarction, 6, 157, 167, 171, 172 Infection, 4, 107, 166, 167, 170, 173, 185 Inferior vena cava, 93, 166, 167 Infiltration, 26, 27, 32, 167 Inflammation, 4, 82, 89, 96, 100, 147, 149, 157, 163, 165, 166, 167, 176, 187, 188 Infusion, 167, 183 Ingestion, 83, 101, 167, 178 Inorganic, 167, 170 Intermittent, 6, 93, 167, 176 Internal radiation, 167, 168, 180, 190 Interstitial, 152, 162, 167, 168, 190 Intervertebral, 167, 181 Intestinal, 70, 167, 170 Intestine, 5, 152, 159, 165, 167, 168, 181, 184 Intoxication, 168, 189 Intracellular, 167, 168, 173, 181 Intrahepatic, 5, 168 Invasive, 18, 19, 33, 49, 71, 73, 78, 79, 80, 94, 96, 97, 100, 168 Invertebrates, 168, 170 Involuntary, 151, 161, 168, 172 Ions, 151, 159, 165, 168, 179 Irradiation, 85, 168, 190 Ischemia, 96, 150, 168 Isometric Contraction, 7, 168 J Joint, 107, 168, 186 K Kb, 122, 168 Kidney Disease, 122, 127, 168

L Lactate Dehydrogenase, 58, 168 Laminin, 151, 161, 168 Large Intestine, 167, 168, 181, 184 Laser Surgery, 98, 132, 168 Laser therapy, 54, 85, 133, 168 Latent, 168, 178 Leg Ulcer, 106, 132, 168 Lens, 76, 169, 182 Lesion, 157, 169, 188 Leukemia, 126, 169 Leukocytes, 31, 151, 152, 160, 167, 169, 172, 173 Levo, 87, 169 Libido, 83, 169 Library Services, 140, 169 Life Expectancy, 93, 169 Ligament, 4, 169, 179 Ligation, 10, 12, 13, 20, 30, 35, 39, 47, 48, 55, 94, 96, 98, 132, 169 Linkages, 164, 169 Lipid, 164, 169, 171 Lipoprotein, 169, 170 Liposome, 101, 169 Liver, 5, 31, 83, 107, 147, 151, 161, 162, 163, 164, 165, 168, 169, 178 Liver Cirrhosis, 31, 169 Localization, 166, 169 Localized, 10, 84, 96, 99, 100, 159, 164, 167, 168, 169, 174, 177, 183, 188 Locomotion, 169, 177 Loop, 88, 165, 169 Low-density lipoprotein, 49, 169, 170 Lumbar, 151, 170 Lumen, 76, 94, 100, 160, 170 Luminescence, 85, 170 Lymph, 154, 160, 170 Lymph node, 170 Lymphatic, 5, 88, 105, 160, 167, 170, 174, 178, 184, 185, 187 Lymphedema, 6, 46, 170 Lymphoid, 149, 170 Lymphoma, 126, 170 M Malabsorption, 126, 170 Malignant, 91, 126, 170, 181 Malignant tumor, 91, 170 Malnutrition, 150, 170, 172 Mammary, 157, 170 Matrix metalloproteinase, 32, 37, 170 Mediator, 170, 183 MEDLINE, 123, 125, 127, 170

196 Varicose Veins

Melanin, 166, 170 Melanocytes, 166, 170, 171, 173 Melanoma, 126, 171 Membrane, 70, 83, 89, 151, 155, 161, 168, 171, 172, 176, 182 Meninges, 154, 171 Menopause, 100, 133, 171, 178 Menstruation, 81, 171 Mental Disorders, 171, 179 Mental Health, iv, 4, 122, 124, 171, 179 Metastasis, 170, 171 MI, 36, 41, 96, 145, 171 Microcirculation, 17, 169, 171, 177 Microorganism, 155, 171, 189 Micro-organism, 85, 171 Microscopy, 7, 151, 171 Midazolam, 7, 171 Mitochondrial Swelling, 171, 172 Mitosis, 150, 171 Mobility, 94, 171 Modification, 171, 180 Molecular, 5, 21, 48, 123, 125, 152, 156, 162, 171, 177, 181, 182, 186 Molecule, 149, 151, 155, 160, 171, 174, 181, 188 Monoclonal, 168, 172, 180, 190 Monocytes, 169, 172 Morphogenesis, 5, 172 Morphological, 33, 46, 163, 170, 172 Motility, 167, 172, 183 Mucosa, 71, 172 Muscle Fatigue, 88, 172 Muscle Fibers, 172 Muscular Atrophy, 126, 172 Muscular Dystrophies, 159, 172 Mydriatic, 158, 172 Myocardial infarction, 6, 157, 171, 172 Myocardium, 171, 172 Myotonic Dystrophy, 126, 172 N Narcosis, 90, 172 Necrosis, 21, 41, 70, 71, 96, 150, 162, 167, 171, 172 Need, 3, 73, 78, 87, 88, 104, 106, 133, 134, 154, 164, 170, 172 Neoplasia, 126, 172 Neoplastic, 170, 172 Nephropathy, 168, 173 Nerve, 70, 147, 149, 150, 154, 170, 173, 175, 178, 181, 182, 183, 185 Nerve Endings, 70, 173

Nervous System, 70, 126, 147, 154, 163, 170, 173, 178, 179, 183 Neuroeffector Junction, 173 Neuronal, 172, 173 Neurons, 163, 173, 185 Neuropathy, 96, 173, 175 Neurosis, 173, 176 Neutrons, 148, 168, 173, 180 Neutrophils, 169, 173 Nevus, 3, 74, 173 Niacin, 173, 187 Nitric Oxide, 51, 173 Nitrogen, 148, 150, 161, 173, 187 Norepinephrine, 147, 173 Nuclear, 49, 50, 151, 159, 172, 174 Nucleus, 150, 151, 154, 157, 160, 172, 173, 174, 180, 181, 186 O Ocular, 147, 174 Odour, 150, 174 Oedema, 105, 174 Ointments, 98, 101, 174 Oncogene, 126, 174 Orofacial, 3, 174 Orthostatic, 165, 174 Ovaries, 162, 174, 182 Ovary, 161, 174 Overdose, 96, 174 Ovulation, 83, 174 Oxidation, 149, 174 P Palliative, 174, 186 Pancreas, 147, 174 Pancreatic, 126, 174 Pancreatic cancer, 126, 174 Paroxysmal, 126, 174 Particle, 169, 175 Patch, 13, 156, 175, 187 Pathogenesis, 5, 21, 33, 36, 38, 175 Pathologic, 150, 152, 156, 166, 175, 180 Pathologic Processes, 150, 175 Pathologies, 85, 175 Pathophysiology, 19, 36, 49, 175 Patient Education, 131, 138, 140, 145, 175 Patient Satisfaction, 77, 175 Pelvic, 157, 175, 179 Penis, 175, 182 Pentoxifylline, 27, 54, 175 Peptic, 175, 183 Peptic Ulcer, 175, 183 Peptic Ulcer Hemorrhage, 175, 183 Peptide, 175, 178, 179

Index 197

Percutaneous, 35, 76, 175 Perennial, 175, 187 Perfusion, 93, 175 Peripheral Neuropathy, 96, 175 Peripheral Vascular Disease, 6, 54, 60, 175 Peritoneal, 150, 158, 159, 174, 176 Peritoneal Cavity, 150, 174, 176 Peritoneal Dialysis, 158, 159, 176 Petechiae, 164, 176 Pharmacologic, 7, 149, 150, 176, 187, 188 Phenotype, 5, 176 Phlebitis, 47, 81, 82, 86, 96, 101, 106, 132, 176 Phobia, 4, 176 Phobic Disorders, 176 Phosphodiesterase, 175, 176 Phospholipids, 162, 169, 176 Phosphorus, 153, 176 Photobiology, 85, 176 Photocoagulation, 19, 76, 84, 155, 176 Physical Fitness, 176, 185 Physical Therapy, 4, 7, 176 Physiologic, 148, 171, 176, 181 Physiology, 51, 159, 177 Pigment, 170, 171, 177 Placenta, 161, 177 Plants, 83, 85, 98, 148, 153, 164, 174, 177, 183, 187 Plaque, 71, 99, 149, 150, 177 Plasma, 16, 37, 51, 149, 152, 160, 162, 164, 165, 177, 179, 183 Plasma Volume, 152, 177 Plasmin, 177 Plasminogen, 32, 177 Plasminogen Activators, 177 Platelet Aggregation, 173, 175, 177 Platelets, 70, 152, 173, 177, 183, 187 Platinum, 169, 177 Plethysmography, 16, 18, 144, 177 Pleural, 174, 177, 178 Pleural cavity, 174, 178 Plexus, 87, 178 Poisoning, 161, 168, 178 Polycystic, 127, 178 Polypeptide, 155, 162, 177, 178 Polytetrafluoroethylene, 13, 178 Pons, 151, 178 Popliteal, 19, 97, 162, 178 Popliteal Vein, 97, 162, 178 Port, 76, 178 Port-a-cath, 178 Portal Vein, 178

Portosystemic Shunt, 5, 178 Posterior, 19, 97, 148, 150, 151, 158, 174, 178 Postmenopausal, 12, 50, 55, 67, 178 Postoperative, 9, 47, 77, 178 Postural, 8, 178 Practice Guidelines, 124, 178 Precursor, 160, 173, 177, 178, 179, 187 Predisposition, 91, 178 Prenatal, 162, 179 Presynaptic, 173, 179 Presynaptic Terminals, 173, 179 Prevalence, 38, 93, 106, 179 Primary Prevention, 6, 179 Probe, 74, 75, 90, 179 Progression, 6, 96, 158, 179, 182 Progressive, 95, 154, 164, 172, 179 Proline, 155, 166, 179 Promoter, 46, 179 Prone, 77, 179 Prophylaxis, 15, 179 Prostaglandins, 167, 179 Prostaglandins A, 167, 179 Prostate, 126, 179, 182 Prosthesis, 21, 179 Protein S, 105, 127, 152, 179 Proteoglycans, 151, 161, 179 Prothrombin, 179, 186 Protons, 148, 165, 180 Proximal, 48, 71, 74, 100, 158, 179, 180 Pruritic, 159, 180 Psoriasis, 99, 180 Psychic, 169, 173, 180, 183 Public Policy, 123, 180 Publishing, 8, 79, 180 Pulmonary, 6, 10, 22, 93, 130, 152, 156, 180, 189 Pulmonary Artery, 93, 152, 180, 189 Pulmonary Embolism, 6, 10, 22, 130, 180 Pulse, 84, 85, 133, 180 Pupil, 158, 172, 180 Purifying, 98, 180 Purpura, 84, 164, 180 Purulent, 180, 188 Q Quality of Life, 14, 17, 20, 41, 58, 95, 98, 180 R Race, 87, 180 Radiation, 74, 85, 98, 99, 160, 161, 167, 168, 180, 181, 189 Radiation therapy, 161, 167, 168, 180, 190

198 Varicose Veins

Radicular, 181 Radiculopathy, 13, 181 Radioactive, 165, 167, 168, 174, 180, 181, 190 Radiolabeled, 168, 180, 181, 190 Radiological, 91, 175, 181 Radiology, 9, 14, 18, 28, 130, 181 Radiotherapy, 152, 168, 181, 190 Randomized, 20, 22, 32, 44, 54, 57, 159, 181 Receptor, 7, 70, 87, 149, 181, 183 Receptors, Serotonin, 181, 183 Recombinant, 181, 189 Rectum, 149, 152, 163, 165, 168, 179, 181 Recur, 106, 181 Recurrence, 13, 28, 81, 181, 182 Red Nucleus, 150, 181 Refer, 1, 155, 163, 165, 169, 173, 181 Reflux, 16, 18, 24, 34, 36, 40, 41, 43, 46, 52, 181 Refraction, 181, 184 Regimen, 132, 159, 181 Regurgitation, 48, 164, 181 Remission, 181 Reoperation, 44, 182 Reproductive system, 83, 182 Resolving, 87, 182 Restoration, 176, 182, 189 Reticular, 77, 182 Retina, 156, 158, 169, 182 Retinoblastoma, 126, 182 Retrograde, 41, 80, 97, 182 Rheology, 175, 182 Rhinophyma, 147, 182 Ribose, 147, 182 Rigidity, 91, 177, 182 Risk factor, 6, 38, 52, 182 Rubber, 90, 147, 182 Rye, 161, 182 S Saline, 99, 132, 182 Salivary, 174, 182 Saphenous, 11, 12, 15, 19, 25, 30, 39, 43, 44, 47, 55, 71, 80, 84, 94, 96, 97, 105, 157, 182 Saphenous Vein, 11, 12, 30, 39, 43, 44, 55, 71, 80, 84, 94, 96, 97, 157, 182 Saponin, 82, 183 Scatter, 85, 183 Schizoid, 183, 189 Schizophrenia, 183, 189 Schizotypal Personality Disorder, 183, 189 Sclerosis, 30, 73, 94, 126, 127, 183, 187 Screening, 23, 24, 54, 155, 183

Sedative, 171, 183 Seizures, 174, 183 Semen, 179, 183 Sensor, 71, 98, 183 Sensory loss, 181, 183, 186 Serotonin, 70, 87, 181, 183, 187 Serous, 160, 183 Serum, 155, 170, 183 Sex Determination, 127, 183 Shock, 93, 149, 183, 187 Side effect, 74, 76, 115, 132, 147, 184, 187 Sitz Bath, 98, 184 Skeletal, 70, 88, 92, 172, 184 Skeleton, 162, 168, 184 Skin Manifestations, 71, 184 Skin Pigmentation, 101, 184 Small intestine, 159, 165, 167, 184 Smooth muscle, 10, 11, 25, 26, 43, 45, 70, 150, 152, 156, 184 Social Environment, 180, 184 Sodium, 59, 96, 158, 184 Sodium Tetradecyl Sulfate, 96, 184 Soft tissue, 5, 76, 152, 184 Solid tumor, 149, 184 Somatic, 171, 175, 184 Specialist, 134, 158, 184 Species, 83, 84, 160, 171, 172, 180, 184, 186 Spectrum, 85, 184 Sperm, 83, 184 Spinal cord, 154, 160, 171, 173, 181, 185 Spinal Cord Injuries, 181, 185 Spinal Nerve Roots, 181, 185 Spinous, 160, 185 Spleen, 170, 185 Sporadic, 182, 185 Sports Medicine, 88, 138, 185 Stasis, 37, 42, 185, 189 Stent, 93, 185 Sterile, 99, 185 Stimulant, 70, 165, 185 Stimulus, 158, 159, 176, 185, 186 Stomach, 5, 147, 161, 163, 165, 176, 181, 184, 185 Stool, 98, 168, 185 Stress, 43, 78, 153, 163, 178, 182, 185 Stroke, 6, 122, 153, 185 Stupor, 172, 185 Styrene, 182, 185 Subacute, 167, 185 Subclinical, 167, 183, 185 Subcutaneous, 59, 80, 81, 159, 174, 186 Subspecies, 184, 186

Index 199

Substrate, 85, 186 Suction, 51, 186 Sulfur, 161, 186 Superoxide, 7, 31, 44, 101, 186 Superoxide Dismutase, 44, 101, 186 Symphysis, 154, 179, 186 Symptomatology, 59, 186 Systemic, 7, 71, 149, 150, 152, 160, 167, 168, 174, 180, 186, 190 Systemic disease, 71, 186 Systolic, 166, 186 T Telangiectasia, 70, 71, 127, 186 Testis, 161, 186 Thalamic, 150, 186 Thalamic Diseases, 150, 186 Therapeutics, 59, 117, 186 Thermal, 84, 95, 97, 173, 186 Thigh, 19, 28, 72, 99, 100, 162, 164, 186 Thoracic, 21, 32, 151, 158, 186 Thorax, 147, 170, 186 Threshold, 161, 166, 186 Thrombin, 16, 162, 177, 179, 186 Thrombocytes, 177, 187 Thrombolytic, 177, 187 Thrombophlebitis, 6, 23, 30, 44, 77, 80, 82, 130, 187 Thrombosis, 16, 23, 24, 29, 46, 47, 58, 77, 80, 81, 106, 157, 171, 172, 179, 183, 185, 187, 189 Thrombus, 77, 157, 167, 177, 187, 189 Thymus, 166, 170, 187 Tin, 175, 177, 187 Tissue, 5, 7, 12, 21, 41, 70, 71, 74, 77, 80, 81, 96, 97, 98, 99, 101, 132, 147, 149, 150, 151, 152, 153, 155, 156, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 182, 184, 185, 187, 189 Toothache, 84, 187 Topical, 78, 80, 88, 98, 101, 166, 187 Tourniquet, 44, 187 Toxic, iv, 160, 173, 182, 185, 187 Toxicity, 159, 187 Toxicology, 54, 124, 187 Toxins, 149, 167, 187 Transdermal, 30, 187 Transfection, 152, 187 Translocation, 5, 187 Trauma, 151, 166, 172, 186, 187 Treatment Failure, 91, 187 Trees, 83, 182, 187

Tryptophan, 70, 155, 183, 187 Tuberous Sclerosis, 127, 187 Tunica Intima, 44, 159, 188 U Ulcer, 169, 175, 183, 188 Ulceration, 81, 96, 168, 188 Ultrasonography, 18, 162, 188 Unconscious, 166, 188 Ureters, 188 Urethra, 175, 179, 188 Urinary, 83, 157, 188 Urinary Retention, 157, 188 Urinary tract, 83, 188 Urine, 7, 152, 165, 188 Urokinase, 32, 188 Uterus, 100, 154, 162, 163, 171, 174, 182, 188 V Vaccine, 107, 188 Vagina, 154, 171, 182, 188 Vaginal, 31, 82, 188 Vaginitis, 82, 188 Valves, 71, 80, 82, 88, 89, 92, 94, 95, 97, 100, 101, 105, 132, 133, 188, 189 Varices, 5, 27, 161, 183, 188 Vascular endothelial growth factor, 51, 188 Vasodilator, 152, 165, 188 VE, 9, 188 Vector, 88, 188 Vena, 93, 166, 167, 189 Venous blood, 43, 81, 189 Venous Insufficiency, 9, 19, 23, 38, 44, 58, 60, 70, 75, 87, 92, 93, 94, 97, 98, 169, 189 Venous Pressure, 87, 92, 189 Venous Thrombosis, 46, 47, 106, 189 Ventricle, 93, 180, 186, 189 Ventricular, 28, 189 Ventricular Function, 28, 189 Venules, 79, 84, 152, 153, 160, 171, 189 Vertebral, 151, 189 Veterinary Medicine, 123, 189 Virus, 82, 107, 151, 160, 177, 189 Vitro, 26, 167, 189 Vivo, 26, 27, 54, 167, 189 W Waiting Lists, 22, 189 Withdrawal, 75, 189 Womb, 182, 188, 189 Wound Healing, 87, 170, 189 X X-ray, 74, 163, 168, 174, 180, 181, 189

200 Varicose Veins

X-ray therapy, 168, 189

Y Yeasts, 163, 176, 190

Index 201

202 Varicose Veins

Index 203

204 Varicose Veins

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