OITER 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., 1960Goiter: 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: 0-597-84440-2 1. Goiter-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on goiter. 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 GOITER ...................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Goiter ............................................................................................ 5 E-Journals: PubMed Central ....................................................................................................... 19 The National Library of Medicine: PubMed ................................................................................ 20 CHAPTER 2. NUTRITION AND GOITER ............................................................................................ 47 Overview...................................................................................................................................... 47 Finding Nutrition Studies on Goiter ........................................................................................... 47 Federal Resources on Nutrition ................................................................................................... 50 Additional Web Resources ........................................................................................................... 50 CHAPTER 3. ALTERNATIVE MEDICINE AND GOITER ...................................................................... 53 Overview...................................................................................................................................... 53 National Center for Complementary and Alternative Medicine.................................................. 53 Additional Web Resources ........................................................................................................... 55 General References ....................................................................................................................... 56 CHAPTER 4. DISSERTATIONS ON GOITER ........................................................................................ 57 Overview...................................................................................................................................... 57 Dissertations on Goiter ................................................................................................................ 57 Keeping Current .......................................................................................................................... 57 CHAPTER 5. BOOKS ON GOITER ...................................................................................................... 59 Overview...................................................................................................................................... 59 Book Summaries: Online Booksellers........................................................................................... 59 Chapters on Goiter ....................................................................................................................... 60 CHAPTER 6. PERIODICALS AND NEWS ON GOITER ........................................................................ 63 Overview...................................................................................................................................... 63 News Services and Press Releases................................................................................................ 63 Academic Periodicals covering Goiter.......................................................................................... 64 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 67 Overview...................................................................................................................................... 67 U.S. Pharmacopeia....................................................................................................................... 67 Commercial Databases ................................................................................................................. 68 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 71 Overview...................................................................................................................................... 71 NIH Guidelines............................................................................................................................ 71 NIH Databases............................................................................................................................. 73 Other Commercial Databases....................................................................................................... 75 The Genome Project and Goiter ................................................................................................... 75 APPENDIX B. PATIENT RESOURCES ................................................................................................. 81 Overview...................................................................................................................................... 81 Patient Guideline Sources............................................................................................................ 81 Finding Associations.................................................................................................................... 88 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 91 Overview...................................................................................................................................... 91 Preparation................................................................................................................................... 91 Finding a Local Medical Library.................................................................................................. 91 Medical Libraries in the U.S. and Canada ................................................................................... 91 ONLINE GLOSSARIES.................................................................................................................. 97 Online Dictionary Directories ..................................................................................................... 99
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GOITER DICTIONARY ............................................................................................................... 101 INDEX .............................................................................................................................................. 141
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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 goiter is indexed in search engines, such as www.google.com or others, a nonsystematic 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 goiter, 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 goiter, 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 goiter. 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 goiter, 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 goiter. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON GOITER Overview In this chapter, we will show you how to locate peer-reviewed references and studies on goiter.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and goiter, 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 “goiter” (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: •
Screening for Thyroid Disease in Children with IDDM Source: Diabetes Care. 13(7): 801-803. July 1990. Summary: This article describes a study that evaluated the usefulness of screening for thyroid disease by performing thyroid function tests and measuring thyroid antibodies in 371 children and adolescents with insulin dependent diabetes mellitus (IDDM). Clinical data and results of serum thyroxine, triiodothyronine uptake, thyroidstimulating hormone, and antibodies to thyroid microsomal antigen and thyroglobulin were analyzed. Goiter was noted in 20 percent of subjects. Twenty-seven young people (7 percent) had thyroid dysfunction. Autoantibody testing identified persons with thyroid dysfunction with a sensitivity of 50 percent, a specificity of 84 percent, a degree of misclassification of 17 percent, a positive predictive value of 13 percent, and a negative predictive value of 97 percent. It is recommended that all children and
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adolescents be screened shortly after diagnosis of IDDM, because thyroid dysfunction may precede the onset of IDDM. A table showing the frequency of abnormalities in the 371 patients tested is included. 7 references. (AA-M). •
Hypothyroidism, Hyperthyroidism, Hyperparathyroidism Source: Patient Care. 33(14): 186-188, 191, 195-200, 202-203, 206. September 15, 1999. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: This article discusses the diagnosis and treatment of thyroid illnesses. These types of illnesses are among the most prevalent of the hormonal diseases that afflict people in the United States. Although hypothyroidism and hyperthyroidism are the most widespread, hyperparathyroidism (HPT) occurs in a large number of Americans as well. Diagnosis can be complicated because numerous patients present with nonspecific signs and symptoms that closely resemble other physical and mental conditions. Primary hypothyroidism occurs from failure of the thyroid gland itself, whereas secondary hypothyroidism results from a deficiency of pituitary thyroid-stimulating hormone. The most common cause of hypothyroidism among adult patients is Hashimoto's thyroiditis. Other causes include drug side effects, congenital hypothyroidism, iodine excess, previous thyroidectomy, neck irradiation, and pituitary or hypothalamic disorders. Women who have type 1 diabetes are at greater risk for a temporary disorder known as postpartum thyroiditis. Signs and symptoms can be overt, subtle, or nonexistent. Diagnosis involves performing a physical examination and conducting laboratory tests. The treatment of choice for managing hypothyroidism is daily oral administration of levothyroxine. Some patients may benefit from referral to an endocrinologist. Hyperthyroidism, which is not as prevalent as hypothyroidism, is caused by Graves' disease or diffuse toxic goiter. Other causes include pituitary tumors, pituitary resistance to thyroid hormones, neonatal hyperthyroidism, and malignancies. Signs and symptoms can be overt, subtle, or nonexistent. Diagnosis involves performing a physical examination and conducting laboratory tests. Patient referral to an endocrinologist is indicated following a positive diagnosis or when hyperthyroidism is suspected. Treatment options include radioactive iodine therapy, antithyroid drugs, and surgery. HPT, another fairly common endocrine disorder, is the most common cause of hypercalcemia. Although about 75 percent of patients have no signs or symptoms attributable to this disease, it may affect the skeletal system, kidneys, and gastrointestinal tract. The only successful treatment is surgical removal of one or more parathyroid glands. Patients who have primary HPT should be referred to an endocrinologist. 1 figure. 4 tables. 5 references.
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Nutrition in Brazil: Current Situation and Intervention Programs Source: IDF Bulletin. International Diabetes Federation Bulletin. 35(3): 64, 66. 1990. Summary: This article reviews the current situation on nutrition in Brazil, focusing on intervention programs. The authors note that the major nutritional deficiencies in Brazilian children are protein-energy malnutrition (PEM), anemia, and hypovitaminosis A; endemic goiter is also a problem and is briefly mentioned. The authors also report on a multicentric study on diabetes mellitus, concluded in 1988, that showed that diabetes affects about 5.5 percent of adults nationwide. Although 5 percent of the cases of diabetes may be primarily related to malnutrition, most patients are obese before the onset of the disease. 1 table. 15 references.
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Federally Funded Research on Goiter The U.S. Government supports a variety of research studies relating to goiter. 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 goiter. 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 goiter. The following is typical of the type of information found when searching the CRISP database for goiter: •
Project Title: A NOVEL IN VITRO MODEL OF THYROID OPHTHALMOPATHY Principal Investigator & Institution: Feldon, Steven E.; Professor, Chairman; Ophthalmology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2006 Summary: (provided by applicant): Thyroid-associated ophthalmopathy (TAO) is the most commonly encountered orbital disease, affecting vision and producing disfigurement. We are beginning to explore an in vitro model of TAO based upon a new methodology of reverse autologous mixed cell reaction (rAMCR), which studies the effects of autologous T-cells from TAO patients on DNA synthesis in orbital fibroblasts from the same patient. This investigation that should meet the NEI challenge to "yield insight into the initiating events leading to fibroblast activation and tissue remodeling and the cell signaling events that stimulate the trafficking of immunocompetent cells to the orbit". It should also aid in determining the immunologic and hormonal basis for the proliferation and phenotypic alteration of orbital fibroblasts (OF). The purpose of this R03 pilot study application is to further develop this model, including a rigorous evaluation of the immunologic and local environmental mechanisms involved in the enhancement of orbital fibroblast proliferation in the rAMCR. The overall hypothesis to be tested in this proposal is that peripheral blood from TAO patients contains T cells that directly activate OF to enhance fibroproliferation and to drive OF to an activated phenotype and to adipocyte-like cells characteristic of TAO. The two specific aims of the study are to determine 1) which subset(s) of peripheral blood T cells are key for stimulating OF proliferation and activation in vitro and by which means of cell-cell communication is this accomplished? and 2) what are the key functional consequences of activation by peripheral blood T cells? In preliminary studies, we have shown that an enriched T-cell results in a two-to-three fold HLA DRII and CD40/CD 40 ligand dependent increase in fibroproliferation. Understanding which OF subset is the target of the rAMCR will help narrow the avenues for therapeutic exploration and will define the cellular cross-talk between immune cells and OF. The nature of the OFs is of critical importance in TAO as they are the effector cells that cause the tissue pathology,
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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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including the accumulation of fatty tissue (especially early in disease) and the muscle fibrosis that occurs later. Exploration of the rAMCR model will help move the TAO field forward and will lead to new insights into the pathophysiology of the disease and identification of target molecules the may serve as a basis for possible therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADIPONECTIN: EFFECTS ON GRAVES' OPHTHALMOPATHY Principal Investigator & Institution: Scherer, Philipp E.; Associate Professor; Cell Biology; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): A number of different disease states, including Graves' disease, are associated with hyperproliferation of the retro-orbital adipose tissue. While we have a good understanding of the underlying causes for Graves' disease, we fail to explain some of the pathophysiological changes observed during disease progression, such as the Graves'-associated exopthalmos due to hyperproliferation of the retro-orbital adipose tissue. Progress towards identifying a molecular mechanism for this adipose hyperplasia has been hampered in the past by the lack of an appropriate mouse model that adequately mimics this particular aspect of the disease. We have recently established a novel mouse model that for the first time displays changes in retro-orbital adipose tissue reminiscent of the pathophysiologic changes associated with Graves' disease in some patients. Exposure to chronically elevated serum levels of the adipocyte-specific secretory protein adiponectin through transgenic overexpression results in massive hyperplasia of the retro-orbital fat pad. In agreement with a possible role of adiponectin in the Graves' disease associated retroorbital hyperplasia, serum adiponectin levels are elevated in a subset of Graves' patients. We propose to define the contribution of adiponectin to this hyperplasia. Our working hypothesis states that chronically elevated levels of adiponectin in association with other hormonal changes connected with Graves' disease leads to the selective hyperproliferation of this adipose tissue. We would like to: I) Further characterize this transgenic mouse line as a potential model system for Graves'-associated exophtalmos and explore possible hormonal manipulations that lead to premature or delayed onset of retro-orbital fat hyperplasia. II) Test pharmacological interventions through use of PPAR antagonists or agonists to establish a treatment modality. III) Establish a firmer correlation between increased serum adiponectin and retroorbital adipose hyperplasia in the subset of Graves patients in which adipose hyperplasia is particularly prominent. Combined, these experiments will establish whether the novel hormone adiponectin that has been shown to positively affect systemic insulin sensitivity, may at chronically high levels also be responsible for the hyperplasia of selective adipose pads in the course of Graves' disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AN ANIMAL MODEL FOR GRAVES'DISEASE/OPHTHALMOPATHY Principal Investigator & Institution: Jaume, Juan C.; Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): The ophthalmopathy of Graves' disease is a disfiguring, sight threatening condition of unclear pathogenesis and no specific or definitive therapy. Graves' disease primarily manifests with hyperthyroidism that
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results from the stimulation of the TSHR by specific autoantibodies that mimic the effect of TSH. Often the ophthalmopathy accompanies the hyperthyroidism. Rather than being considered two separate entities, hyperthyroidism and ophthalmopathy are different manifestations of the same underlying autoimmune process. No spontaneous animal model of Graves' disease exists. Recently, an animal model has been developed in which a proportion of individuals manifest immunological and endocrinological features of Graves' disease. We have generated and extended such mouse model. The overall goal of this proposal is to use this Graves'-Iike animal model to investigate critical issues of Graves' disease as is Graves' ophthalmopathy as follows: 1. Graves' ophthalmopathy in the Graves'-Iike mouse model. New observations suggest the immunizing cells used in the model behave as APC that constitutively express B7-1 molecules and bias the immune response to a Th1 type. These APC also have the capacity of presenting nonspecific antigens present in culture medium. With this information we have modified our immunization protocol to improve specific (TSHR) antigen presentation and deviate the immune response to a Th2 type characteristic of human Graves'. We propose to: a. Study the development of Graves' disease/ophthalmopathy in both, Th1 and Th2 settings. b. Examine the role of CD40 for orbital fibroblast-B/T cell cross talk. c. Study the regulation of TSHR in orbital fibroblasts/preadipocytes. 2. Characterize TSHR antibodies in their relationship to Graves' ophthalmopathy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ASSESSMENT OPHTHALMOPATHY
OF
QUALITY
OF
LIFE
IN
GRAVES'
Principal Investigator & Institution: Bradley, Elizabeth A.; Assistant Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2007 Summary: Dr. Elizabeth Bradley's long-term career goal is to study Graves' opthalmopathy as an independent clinical investigator. This application proposes a twophased career development program that will provide her with many of the tools necessary for future success. In the first two years of the award period, Dr. Bradley will complete course work through the Johns Hopkins School of Public Health's Graduate Train Program in Clinical Investigation. Johns Hopkins ophthalmic epidemiologic Dr. Sheila West will serve as primary mentor throughout the award period. Dr. Bradley will spend the final three years of the award at the Mayo Clinic, completing a study on the impact on Graves' opthalmopathy on health-related quality of life under the guidance of Mayo-based co-mentor Dr. Rebecca Bahn. Johns Hopkins offers Dr. Bradley a mentor with expertise in ophthalmic clinical investigation and the many resources of both its School of Public Health and the School of Medicine's Wilmer Eye Institute. The Mayo Clinic offers a mentor actively engaged in clinical investigation in Graves' opthalmopathy practice, and the resources of an established, NIH-funded quality of life research program. Graves'' opthalmopathy is an infiltrative orbital disease associated with autoimmune thyroid disease. Although medical and surgical interventions have been reported to improve some of the manifestations of the disease, the associated side effects of current treatments for Graves' opthalmopathy often temper their benefits. Additionally, objective indices by which to measure many of the disease manifestations are lacking. These objective measures that do exist fail to provide a comprehensive assessment of the impact of the disease and its treatment on patient health-related quality of life. Dr. Bradley plans to develop a valid, reliable Graves' opthalmopathyspecific HRQL instrument and to obtain baseline epidemiologic data on the performance of the instrument in a population of Graves' opthalmopathy patients.
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These efforts will serve as important preparatory steps toward Dr. Bradley's long-term goal of studying treatments of Graves' opthalmopathy through medical and surgical clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTS OF PHYTOESTROGENS ON PRIMATE MATERNAL FETOPLACENTAL UNIT Principal Investigator & Institution: Harrison, Richard M.; Tulane University of Louisiana New Orleans, La New Orleans, La 70112 Timing: Fiscal Year 2002 Summary: Ten female rhesus monkeys, in early stages of pregnancy, were studied to determine the effects of a dietary supplement of genistein, a phytoestrogen found in soy, on the steroidogenesis in the maternal-fetoplacental unit. The monkeys were placed in two equal groups. The experimental group received 8mg/kg body weight of genistein each Monday through Friday. Dosing continued until day 155 of gestation, at which time a Cesarean section was performed to collect the fetus and placenta. Blood was collected from the maternal peripheral circulation twice weekly during the study period. At delivery blood was collected from the maternal peripheral circulation, the uterine veins, the ovarian veins, and the fetal heart. Placental tissues were collected and frozen until assayed. Sera from the blood sample were frozen until assayed for steroid hormones. Estradiol levels in the genistein-treated monkeys were higher than in the control monkeys during gestation and at delivery all maternal and fetal blood levels from the genistein-treated monkeys were significantly higher. The estrone levels in the genistein-treated monkeys trended to be higher than the control but were not significant (p=0.057). There were no significant differences between the two groups in weight gained during pregnancy, fetal weights, or placental weights. There were trends but no significant differences in blood levels of DHEA-S, or progesterone. The placental assays found no significant differences in placental LDL and HDL levels. These data suggest that the elevated levels of estradiol in the maternal blood may be due to deconjugation of estrone in the gut and conversion to estradiol. The higher levels in the fetal blood indicate that the genistein crossed the placental barrier and stimulated the production of estradiol, since estradiol produced by the placenta is preferentially directed to the maternal circulation, as a protective measure to the fetus. This finding is significant when the use of soy-based food products used by the mother during pregnancy and soy-based infant formulas is increasing. Reports in the literature suggest that soy-based formulas may be associated with an increased incidence of goiter and thyroid disease. FUNDING Chancellor?s Grant, Tulane University School of Medicine Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EXPERIMENTAL AUTOIMMUNE GRAVES' DISEASE Principal Investigator & Institution: Prabhakar, Bellur S.; Professor and Head; Microbiology and Immunology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 01-JUN-1995; Project End 30-NOV-2003 Summary: Autoantibodies to the thyrotropin receptor can either activate thyroid gland causing hyperthyroidism or block TSH mediated activation of thyroid and cause hypothyroidism. Until several years ago, it was not possible to develop an animal mode due to the unavailability of large quantities of purified TSHR. Subsequent to cloning of human TSHR, several laboratories, including our own, have used human recombinant
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proteins to induce the disease in mice. These studies have provided new insights on the requirements for an optimal immune response to TSHR, resulting in thyroid perturbation. Earlier, we expressed the ectodomain of mouse TSHR (mTSHR) and showed that it is antigenically distinct from human TSHR. Recently, we expressed mTSHR on M12 cells (H-2D) and used them to immunize BALB/c mice. These mice showed significant TBII activity with concomitant raise in T4 levels. In the present study, we propose to use a soluble ectodomain of mTSHR and various cell lines expressing mTSHR, Class-II and Co-stimulatory molecules to define optimal conditions required to induce autoimmunity to TSHR. Sera will be tested for antibody production and hormonal perturbations, and thyroids will be evaluated for pathology and radioiodine uptake. We will carryout studies to evaluate the importance of CD4+ vs. CD8+ and Th1 vs. Th2 T cells. To do this, we will use selective depletion and adoptive transfer experiments, determine the relevance of cytokines, and test the ability of the protein to induce disease in Class-I and II, IFNgamma, and IL4 knockout mice available on BALB/c background. To define TSHR epitopes to which pathogenic antibodies bind, we will carryout epitope mapping studies. For this, we will employ recombinant fragments of TSHR, ectodomains of TSHR-LH/CGR chimeric proteins and cells expressing these chimeras. These proteins or their fragments will be tested in a number of different serological and bioassays. Together these studies are expected to allow establishment of an appropriate animal model to study autoimmunity to TSHR. Such a model would facilitate a thorough understanding of the regulation of the immune response to TSHR with implications for the development of novel therapeutics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EYE IN GRAVES DISEASE--ROLE OF ORBITAL FIBROBLASTS Principal Investigator & Institution: Bahn, Rebecca S.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-AUG-1991; Project End 31-JUL-2004 Summary: Graves' ophthalmopathy (GO) is an autoimmune eye disorder closed associated with Graves' hyperthyroidsim. There is convincing experimental evidence that the orbital fibroblast (including the preadipocyte fibroblast subpopulation) is the target cell in GO. However, the autoantigen against which the immune response is directed is unknown. The thyrotropin receptor (TSHr) is a prime candidate to be the orbital autoantigen because its involvement would help to explain the close clinical and laboratory associations between GO and hyperthyroidism. In recent studies, the PI has demonstrated the present of TSHr mRNA and protein in orbital adipose/connective tissues from patients with GO, wile TSHr expression was not apparent in normal orbital tissues. In addition, she showed that orbital preadipocyte fibroblasts, cells lacking fucntional TSHr, can be differentiated in vitro into mature TSHr-bearing adipocytes. These and other findings led to hypothesize that: 1)expression of TSHr in the orbit in GO is linked to the induction of adipogenesis in orbital preadipocyte fibroblasts, and that; 2) the adipocyte TSHr is the orbital autoantigen recognized by orbital-infiltrating lymphocytes in GO. The PI plans to examine these hypotheses using our system of cultured orbital preadipocyte fibroblasts derived from pateints with GO. In specific aim I, she will define the fibroblast-like cells present in the orbit in GO and identify factors that modulate adipogenesis in these cells. Experiments in Aim II are designed to characterize the obital TSHr and to clarify the link between TSHr expression and adipogenesis in the orbi. In Aim III, she will determine whether cloned orbitalinfiltrating lymphocytes from patients with GO recognize TSHr, or other antigens that are processed "naturally" by autologous antigen-presenting cells. The main goal of the
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research program is to increase understanding of the orbital immune response in GO in order that novel and more specific therapeutic and preventive strategies for this condition might be developed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTION AND STRUCTURE OF PENDRIN IN THYROID CELLS Principal Investigator & Institution: Kopp, Peter A.; Medicine; Northwestern University Office of Sponsored Research Chicago, Il 60611 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Pendred's syndrome is an autosomal recessive disorder defined by congenital deafness, goiter and an impaired thyroidal iodide organification. It is caused by mutations in the PDS (Pendred's syndrome) gene. Mutations in this gene may be among the most frequent genetic causes of congenital deafness since they are not only associated with Pendred's syndrome, but they also form the molecular basis of two forms of non-syndromic deafness. The PDS gene encodes pendrin, an anion transporter belonging to the Solute Carrier Family 26A (SCL26A4). Pendrin is predominantly expressed in the thyroid, the kidney and the inner ear. Functional studies in Xenopus oocytes revealed that pendrin is able to transport chloride and iodide. In thyroid follicular cells, pendrin is expressed at the apical membrane suggesting that it could be involved in the transport of iodide into the follicular lumen. In the kidney, pendrin is found in beta-intercalated cells of the cortical collecting duct and is thought to function as a chloride/base exchanger. The exact role of pendrin in the inner ear remains unknown. Our preliminary data support the concept that pendrin is an apical iodide transporter. A detailed characterization of the anion transport properties of pendrin is essential for the understanding of its role in iodide transport in thyrocytes and the synthesis of thyroid hormones. At this point, there are no data on the kinetic properties of pendrin-mediated iodide transport, and its regulation. The membrane topology and secondary modifications of pendrin are unknown, and the determinants for PDS gene expression have not been characterized. The goals of this proposal are focused on studies addressing the function and structure of pendrin. The studies in Specific Aim 1 aim at further characterizing the iodide transport properties of pendrin. The experiments outlined in Specific Aim 2 seek to characterize the membrane topology and secondary modifications of pendrin and will thus contribute to the elucidation of structure-function relationships. The experiments in Specific Aim 3 will determine the cell specificity of the pendrin promoter and study its regulation. These studies will provide fundamental insights into the (patho) physiology of this novel anion transporter that has important functions in the thyroid, the kidney and the inner ear. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FUNCTIONAL TRANSPORTERS
ANALYSIS
OF
THYROIDAL
IODIDE
Principal Investigator & Institution: Gillam, Mary P.; Medicine; Northwestern University 633 Clark Street Evanston, Il 60208 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2009 Summary: (provided by applicant): The proper transport of iodide within thyroid follicular ceils is important for synthesis of thyroid hormones. Iodide transport defects may result in hypothyroidism or goiter. Pendred's syndrome is an autosomal recessive disorder defined by the triad of congenital deafness, goiter, and an impaired iodide
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organification. It is caused by mutations in the Pendred's syndrome (PDS) gene. Mutations in this gene also explain the molecular basis of two allelic variants of Pendred's syndrome, non-syndromic autosomal recessive deafness DFNB4 and nonsyndromic familial enlarged vestibular aqueduct. The PDS gene encodes pendrin, an anion transporter belonging to the Solute Carrier Family 26A (SCL26A4). Pendrin is predominantly expressed at the apical membrane of thyrocytes, at the brush-border membrane of the renal cortical collecting duct, and in the inner ear. Although its exact roles in these tissues are not completely defined, pendrin appears to function as an iodide transporter in the thyroid and as an anion/base exchanger in the kidney. The human apical iodide transporter (hAlT) is a recently identified protein that is also expressed at the apical membrane of thyrocytes, as well as in the kidney. Despite its designated name, the function of hAlT is not established. Very preliminary functional experiments suggest that hAlT, like pendrin, may mediate iodide efflux. As of yet, it is not known whether mutations in hAlT are responsible for impaired thyroid hormonogensis or other forms of human disease. The objective of this proposal is to investigate various aspects of the function and/or regulation of pendrin and hAlT in the thyroid. The studies proposed in specific aim 1 will further characterize the iodide transport properties of pendrin. The studies proposed in specific aim 2 seek to obtain insights into the structure-function relationship of pendrin. The studies proposed in specific aim 3 will address the function of the human apical iodide transporter. Together, these studies will provide fundamental insights into the (patho)physiology of these two apical thyroid transporters and deepen our understanding of iodide transport in the thyroid. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL AND MOLECULAR CHARACTERIZATION OF PENDRIN Principal Investigator & Institution: Karniski, Lawrence P.; Associate Professor; Internal Medicine; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JAN-2005 Summary: (Adapted from applicant's abstract): Pendred syndrome, manifested by sensorineural hearing loss and goiter is the result of mutations in the PDS gene. PDS encodes a protein labeled pendrin that functions as a chloride, formate and iodide transporter and is expressed in the thyroid, inner ear and kidney. Pendrin's function is similar to a previously described chloride/formate exchanger that plays an important role in NaCl transport across epithelial cells, suggesting that pendrin might perform a similar role in the inner ear. Recent evidence suggests that some individuals with mutations in the PDS gene do not develop thyroid abnormalities but instead have nonsyndromic deafness with dilated vestibular aqueducts (DFNB4). The aims of this proposal are to characterize pendrin in terms of its function, location and regulation and determine how different PDS mutations affect pendrin. The following approach will be taken to achieve these aims: Polyclonal anti-pendrin antibodies (already generated by the Principal Investigator) will be used to identify the cell types in which pendrin is expressed. Pendrin function will be analyzed by determining substrate specificity, inhibitor profile, kinetics of transport and regulation, and chloride/bicarbonate exchange. The effect of different mutations in PDS on protein production, processing, regulation and transport properties will be examined. A knock out mouse model will be used to study the mechanisms of ion transport in cells where pendrin is normally expressed but rendered inactive. This work is a first step towards understanding the
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physiologic role of pendrin and determining how defects in pendrin lead to the clinical manifestations of Pendred syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IDENTIFYING GENES LINKED TO AUTOIMMUNE THYROID DISEASES Principal Investigator & Institution: Tomer, Yaron; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant) The autoimmune thyroid diseases (AITD) are very common with a prevalence of - 5 percent. They include Hashimoto's thyroiditis (HT), which manifests by hypothyroidism, and Graves disease (GD), which causes hyperthyroidism. The mechanisms initiating the AITD are not completely understood. Abundant data point to a genetic susceptibility to AITD, and the applicant, has identified linkages for several AITD susceptibility loci. In the past four years we have performed genome scans on two data sets of multiplex families (102 families, 540 individuals), and mapped 8 loci showing evidence for linkage with AITD. In two of the loci we identified and investigated putative AITD susceptibility genes (CTLA-4 and CD4O}. The focus of the current proposal is four of the eight loci which showed the strongest evidence for linkage with AITD. The goals of our study are to identify and characterize the AITD susceptibility genes in these four loci. The specific aims of the proposed study are: 1) To resolve the genetic heterogeneity in our families at the 4 linked loci which are the focus of our studies. At all 4 loci the linkage analysis showed evidence of heterogeneity and resolving it will facilitate identification of the AITD susceptibility genes. We will subdivide the families according to various parameters (e.g. age of onset of disease), analyze these subsets separately for linkage with the four loci, and apply the Predivided-Sample Test. Resolving heterogeneity and identifying subsets of families that are uniformly linked with these loci will amplify the power of the subsequent single nucleotide polymorphism (SNP) and fine mapping analyses (Specific Aims 2 & 3); 2) To analyze two important genes (thyroglobulin and TGFBeta3 which are located at 2 of the linked loci, and are themselves linked and associated with AITD. We will analyze the sequences of the thyroglobulin and TGF-Beta3 genes in order to identify disease-specific SNP's; 3) To fine map two additional linked loci and narrow the linked regions in order to determine appropriate candidate genes for future analyses. We have the capacity and experience to perform these studies. Our flexible relational database (lngresTM) facilitates complex linkage and association analyses. We use two ABI-310 sequencers for genotyping and sequencing, and we have experience at SNPing genes and fine mapping linked regions. We expect that these studies will lead to the identification of gene sequence variations contributing to the expression of AITD. This will allow us to understand the mechanisms initiating these diseases, and hopefully will lead to the development of new therapies targeted at the mechanisms initiating AITD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MINORITY PREDOCTORAL FELLOWSHIP Principal Investigator & Institution: Campbell, Sean; Microbiology and Immunology; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2002; Project Start 01-SEP-2002
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Summary: I have only recently begun my MD/PhD degree at the Albert Einstein College of Medicine. My experiences in research ranged from a project I performed as an undergraduate at Duke University to the 3 years I spent as a technician at the Rockefeller University. Due to those experiences, my research interest pertain to topics in the fields of biochemistry and cell biology. In particular, the topics of protein characterization and more specifically, structure/function analyses of protein complexes involved in ion transport. My initial goals are to expand our knowledge in those fields through course work in conjunction with research in relevant laboratories. This will enable me to gain the experience and tools to make an informed decision as to what my thesis project should be. To that end, I am enrolled in courses in the fields of biochemistry, genetics, immunology and physiology. Currently, I am rotating the laboratory of Dr. Nancy Carrasco in the Department of Molecular Pharmacology. DR. Carrasco'S laboratory focuses on the characterization of the thyroid sodium/iodide symporter termed NIS. This integral membrane, which has 13 membrane spanning segments, is involved in the uptake of iodide in the thyroid. Mutations in NIS have been linked to diseases that cause the development of an enlarged thyroid gland, which is termed a goiter. Furthermore, this protein is expressed in breast cancer cells. Dr. Carrasco's work on this symporter will not only provide a better understanding of thyroid disease and malignancy but also of ion transporters. It is this types of research that I intend to undertake at Einstein. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MODULATION OF AN ANIMAL MODEL OF HYPERTHYROIDISM Principal Investigator & Institution: Mclachlan, Sandra M.; Professor; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 900481804 Timing: Fiscal Year 2002; Project Start 15-FEB-1999; Project End 31-DEC-2002 Summary: Graves' hyperthyroidism, a very common autoimmune disorder affecting primarily women, is caused by TSH receptor (TSHR) autoantibodies that mimic the action of TSH. Very recently, the first animal model has been developed with the hallmarks of Graves' hyperthyroidism. We now propose to use this "Chiba" model to investigate several critical issues in Graves' disease, including exploration of approaches for immune intervention. 1. Addressing critical issues in Graves' disease:- The Chiba mouse model will be used to study the role of thyroid peroxidase (TPO) antibodies (common in Graves' disease), TSHR intramolecular cleavage, gender and iodide ingestion on development and course of hyperthyroidism 2. TSHR Antibody characterization:- TSHR antibodies arising in the Chiba mouse model will be characterized by approaches used for human TSHR autoantibodies, including:- (i) functional assays for TSH binding inhibition (TBI), thyroid stimulating immunoglobulin (TSI) and antibodies that block the biological action of TSH (TSBAb), (ii) epitopes and (iii) flow cytometry with intact cells to examine binding of non-functional TSHR antibodies. 3. TPO antibody characterization:- We will determine whether TPO antibodies in the Chiba model resemble human autoantibodies in terms of their:- (i) affinities, (ii) preferential recognition of native TPO and, (iii) preferential interaction with epitopes in the immunodominant region recognized by human TPO autoantibodies. 4. T Cell responses to TSHR antigen:- With the Chiba model of Graves' disease, we will:- (i) study the role of T cells in providing help in the generation of functional TSHR antibodies, (ii) determine the cytokines secreted by TSHR-specific T cells and, (iii) determine if the proliferative response of TSHR-specific T cell clones will vary depending on the antigen presenting cell (macrophages, B cells or syngeneic TSHRexpressing fibroblasts) 5. Intervention in the immune response in the Chiba model:- The
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Chiba model now makes feasible studies on the immunotherapy of hyperthyroidism in these animals, a long road that may ultimately provide the basis for immune intervention in human disease. We propose to examine the effect of second signal blockade (anti-CD40L) as a means to:- (i) Prevent the induction of disease and reverse the course of established disease and, (ii) Target a specific antigen (TSHR), rather than employing blanket suppression of the immune response. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MONOCLONAL THYROID STIMULATING ANTIBODIES FROM MICE WITH GRAVES' DISEASE Principal Investigator & Institution: Davies, Terry F.; Professor; Mount Sinai School of Medicine of Cuny New York, Ny 10029 Timing: Fiscal Year 2002 Summary: The TSH receptor is the primary antigen of the uniquely human, autoimmune, hyperthyroid disease named after Robert Graves (Graves Disease). An animal model resembling Graves disease has been recently developed using an immunization procedure with syngeneic fibroblasts which were engineered to constitutively express MHC class II antigen and transfected with a full length cDNA for the human TSH receptor. Such mice develop high serum levels of T4, T3 and thyroid stimulating and blocking antibodies along with markedly enlarged thyroid glands. This proposal uses this new model to derive panels of monoclonal TSH receptor antibodies with simulating, blocking or neutral activity. In particular, the aims of the proposal (1) To derive stimulating and blocking monoclonal antibodies to the TSH receptor from mice with induced hyperthyroid Graves disease, (2) to characterize the linear and nonlinear antigenic epitopes for the derived TSH receptor antibodies, (3) to examine the fine spcificity of TSH receptor monoclonal receptor antibodies with regard to their growth stimulating/inhibiting potential and their activation/inactivation of differentiated thyroid cell function and (4) to utilize selected monoclonal antibodies as TSH receptor probes. In particular we will determine the conformational changes induced by TSH receptor antibody binding and the role that TSH receptor cleavage plays in such changes. These data will provide the first characterization of murine TSH receptor antibodies with thyroid stimulating ability and allow the investigation of their antigen binding characteristics. Identification of their target epitopes will lead to new etiologic insights and treatment strategies for human Graves disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ORBITAL RADIOTHERAPY FOR GRAVES OPHTHALMOPATHY Principal Investigator & Institution: Gorman, C A.; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002 Summary: The aim is to define the role and efficacy of radiotherapy in the treatment of Graves' eye disease. Patients will be treated in one orbit and again at 6 months in the other orbit, and measurements made over a three-year period to evaluate effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PATHOGENSIS AND THERAPY OF AUTOIMMUNE THYROID DISEASE Principal Investigator & Institution: Degroot, Leslie J.; Professor; Medicine; University of Chicago 5801 S Ellis Ave Chicago, Il 60637
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Timing: Fiscal Year 2002; Project Start 01-JUL-1980; Project End 30-NOV-2003 Summary: Autoimmune thyroid disease (AITD) affects at least 6 percent of all women in their lifetime, and more than 10 percent of older women. The broad aim of our research program is to understand the causes of human autoimmune thyroid disease, the mechanisms involved in controlling the immune response, and, if possible, to develop preventive or therapeutic measures based on the immunology of the disease. Genetic factors including inheritance of MHC genes and specific CTLA4 alleles have been shown by many investigators to play a role in predisposing to Graves' disease. Responses to specific TSH receptor (TSH-R), and thyroid peroxidase (TPO) epitopes, have been demonstrated for T cells, T cell lines, and T cell clones in patients with Graves' disease. We will study the mechanism through which HLA-DRbeta1*03 and DQalpha1*05 are associated with Graves' disease, by purifying these molecules and studying the affinity of TSH-R and TPO peptides for binding. We will ask whether the binding affinity corresponds with the ability of the epitopes to stimulate T cells. We will also determine whether specific subgroups of DRbeta1*03 are primarily associated with Graves' disease, and why the DRbeta1*03 molecule found in Black Americans is not associated with Graves' disease, while the molecule found in Caucasians is associated with Graves' disease. We will also analyze the relative binding affinity of TSH-R and TPO epitopes for DRbeta1*07 and DQalpha1*02, which appear to be protective factors and, in theory, might not bind the epitopes. We will assess the function of CTLA4 in patients and control subjects in relation to inheritance of a specific allele associated with development of Graves' disease. Expression of the gene will be studied by FACs analysis and resting in stimulated cells, and function will be studied by use of antiCTLA4 antibodies during in vitro culture of lymphocytes with antigen and nonspecific T cell stimulating molecules. Secretion of IL-2 during proliferation with/without antiCTLA4, and apoptosis after withdrawal of IL-2, will also be studied as markers for CTLA4 action. CTLA4 function will be evaluated in T cell subsets. The studies planned have direct bearing on development of AITD in humans, and also apply to other autoimmune disease such as Diabetes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATHOLOGIC ALTERATIONS OF THYROID FUNCTION Principal Investigator & Institution: Foley, Thomas P.; Children's Pittsburgh/Upmc Hlth Sys of Upmc Health Systems Pittsburgh, Pa 15213
Hosp
Timing: Fiscal Year 2002 Summary: Determine etiology and pathogenesis of abnormal thyroid hormone metabolism or secretion in Grave's Disease, Hashimoto's Disease, and congenital hypothyroidism. Hormonal homeostasis is assessed during hypo and hyper- thyroidism to determine the role of altered thyroid hormone secretion in metabolic homeostasis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROTEIN KINASE C AND THYROID CELL APOPTOSIS Principal Investigator & Institution: Knauf, Jeffrey A.; Internal Medicine; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2002; Project Start 01-APR-2000; Project End 30-NOV-2002 Summary: (taken from the application) In 1997, there were an estimated 16,100 new cases of thyroid cancer in the United States. Cancer is not simply a proliferation process, but the manifestation of an imbalance between cell growth and cell death. It is likely that for a tumor clone to progress the apoptotic program must be successfully disabled. In
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support of this paradigm, we have isolated a chimeric and truncated mutant of PKCepsilon (Tr-PKC-epsilon), the gene for which was amplified and rearranged in a thyroid cancer cell line. When transfected into PCCL3 cells (a well-differentiated rat thyroid cell line) Tr-PKC-epsilon inhibits activation-induced translocation of the wild-type isozyme, resulting in protection of cells from apoptosis. This is accompanied by a marked impairment in p53 stabilization, which may be in part due to elevated levels of MDM2. These findings point to a role for PKC-epsilon in apoptosis signaling pathways in thyroid cells, and suggest that disruptions in PKC-epsilon function may be involved in thyroid tumorigenesis, possibly by altering the cellular response to DNA damage. In support of this we have found that in 75-85% of thyroid carcinomas there were dramatic changes in the level and/or subcellular distribution of PKC-epsilon compared to corresponding normal thyroid tissue. The following Specific Aims are proposed: (1) We will use an inducible expression system to achieve selective activation of either PKCepsilon or the constitutively activated mutant PKC-epsilon-A159F and to determine whether this alone can initiate an apoptotic program, that can be blocked by Tr-PKCepsilon. (2) We will explore whether PKC-epsilon activation interferes with phosphorylation, stabilization, and other post-translational modifications of p53 and MDM-2. (3) We will manipulate the function of the isozyme in thyroid follicular cells of transgenic mice, by targeting expression of either PKC-epsilon, PDK-epsilon-A159F, or the dominant negative inhibitor Tr-PKC-epsilon. Effects on thyroid cell apoptosis in vivo will then be studied in mice exposed to external radiation to the thyroid bed. (4) We will determine if the observed changes in expression and distribution of PKCepsilon in thyroid cancers are due to somatically-acquired structural defects in the PKCepsilon gene, or to epigenetic events. For tumor clones to expand, they must not only exhibit unrestrained stimulation to proliferate, but must also disable essential protection circuits that trigger apoptosis. We propose that PKC-epsilon is part of this defensive strategy, and that this can be subverted during tumorigenesis, or perhaps modulated during adaptive responses such as goiter involution, or thyroid remodeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RADIOIODINE TREATMENT AND GRAVE'S DISEASE Principal Investigator & Institution: Sisson, James C.; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RAPID FIELD TEST FOR IODINE IN URINE AND SALT Principal Investigator & Institution: Harper, Robert D.; Portascience, Inc. 337 Tom Brown Rd Moorestown, Nj 08057 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Iodine deficiency disorders (IDD) are a range of health problems, which impact over 2 billion people. IDD covers a wide spectrum of clinical conditions, Goiter is the visible "marker condition" for more severe disorders. Some disorders are the result of compensation mechanisms, such as thyroid enlargement, early abortions, still births, increased infant mortality, mental and growth retardation. Some disorders are associated with permanent brain damage that occurs during the first two trimesters of pregnancy. The resulting clinical condition, cretism is irreversible and is the single most severe and dramatic manifestation of IDD. Iodine
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supplementation through salt fortification has shown to eliminate all deficient disorders from goiter through cretism. In several countries tremendous social and economic gains have resulted from the control of IDD. The World Bank has concluded that iodine supplementation is one of the interventions "that would have the highest costeffectiveness of any health intervention available in the world today" (World Bank 1993). There is overwhelming evidence to prevent IDD by increasing iodine intake by populations at large. The need for a simple, inexpensive, semi-quantitative iodine test for urinary screen is acute and broadly based throughout the world. PortaScience has proposed the development of a disposable device for the measurement of iodide in salt solutions and urine that can be used in a clinical setting, in the field or at home. The proposed test in Phase II will have a mini column and reagent chambers all built in one piece of disposable cassette. The test weighs less than three ounces, can be stored and shipped at ambient temperature, and gives an accurate result. Phase I studies have successfully demonstrated the feasibility of the proposed method by removing interfering compounds in a single step, identifying a suitable membrane material, identifying a sensitive dye, and manually assembling test devices for testing urine that met Phase I precision and accuracy criteria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF RETROOCULAR CONNECTIVE TISSUE Principal Investigator & Institution: Smith, Terry J.; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 90502 Timing: Fiscal Year 2002; Project Start 01-DEC-1992; Project End 30-NOV-2004 Summary: (Adapted from applicant's abstract): The long-term objective of this application is to identify the unique phenotypic attributes of orbital fibroblasts that underlie their exaggerated responses to pro-inflammatory mediators. The hypothesis tested is that these attributes are responsible for the dramatic inflammation and hyaluronan accumulation seen in thyroid-associated ophthalmopathy (TAO). T lymphocytes and mast cells infiltrate the orbit in TAO and are believed to elaborate cytokines that drive the tissue remodeling. Some of these responses are mediated through intermediate induction of IL-lalpha including up-regulation of prostaglandin endoperoxidase H synthase-2 (PGHS-2) and hyaluronan synthase-2 (HAS2). TAO fibroblasts exhibit a deficient induction of IL-1 receptor antagonist (IL-1ra) which ordinarily modulates IL-1 action. The investigator hypothesizes that this underlies at least some of the exaggerated cellular responses. TAO fibroblasts unlike normal cells respond to IgG from patients with TAO to produce IL-16, a CD4+ specific chemoattractant. This induction can be blocked with the macrolide, rapamycin, implying that the FRAP/mTor pathway might be involved. The investigator now proposes to 1) identify the basis for disordered hyaluronan accumulation by determining the mechanism for HAS2 induction in orbital fibroblasts and map the human HAS2 promoter cloned recently by us; 2) determine the basis for the defective IL-1ra induction by comparing IL-1ra mRNA and protein levels, gene transcription, promoter activity and transcript stability in TAO and normal fibroblasts; 3) determine the rapamycin-sensitive signaling pathways mediating IL-16 induction by TAO lgG in affected fibroblasts and how to block them. It is believed that the insights derived from this project will allow the formulation of specific therapeutic strategies for interrupting the pathogenesis of TAO. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THYROCYTE PROTEIN TRANSPORT TO THE CELL SURFACE Principal Investigator & Institution: Arvan, Peter R.; Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 01-SEP-1988; Project End 31-AUG-2008 Summary: (provided by applicant): The successful iodination of thyroglobulin (Tg) leading to coupling of di-iodotyrosyl residues within Tg for the synthesis of thyroxine (the major form of thyroid hormone produced by the thyroid gland), requires that the thyrocyte precisely coordinate a number of distinct cell surface activities. Amongst other proteins, on the basolateral cell surface resides the thyrotropin (TSH) receptor, sodium/potassium ATPase, and sodium-iodide symporter (NIS), while the apical cell surface expresses thyroperoxidase (TPO) and pendrin activities, not to mention the production and release of hydrogen peroxide and the exocytosis of newly-synthesized Tg for hormonogenesis via a "last-come, first-served" mechanism. This grant, which serves as the sole source of thyroid-related funding for our lab, covers a spectrum of related topics pertinent to thyrocyte cell biology, with a focus on secretory pathway delivery of proteins essential for thyroid function. In earlier cycles of this grant, we defined steps in the normal folding pathway of newly-synthesized Tg; determined that the human illness described as "congenital goiter with deficient thyroglobulin" is an endoplasmic reticulum storage disease caused by the misfolding and ER retention of mutant Tg (mediated by ER-specific molecular chaperones); and identified the cog/cog mouse as a putative animal model of this illness. In papers published in the most recent five years of this grant (1997-2002), among other findings, we have pinpointed the molecular defect in the cog cog mouse as a single point mutation more than 2,000 amino acids downstream in the Tg coding sequence, and we began to concentrate on the intracellular disposal of the mutant Tg protein by ER-associated degradation (ERAD). We now present compelling evidence to support that the protein domain harboring the cog mutation -- the acetylcholinesterase-(AChE)-Iike domain, plays an essential role in normal Tg folding and homodimerization. By replacing this domain with authentic AChE (which also homodimerizes), we have created a powerful new enzymaticallyactive native reporter at the C-terminus of Tg, greatly enabling studies of Tg intracellular transport (Aim 1). We also wish to examine quality control signaling proteins and their roles in the ER retention and ERAD of mutant Tg (Aims 2 and 3). Finally we have made steady progress in our studies of the trafficking of TPO (and there are a few surprises!), and we now propose to take these studies in new directions relating to surface expression in both thyrocyte cell lines and the thyroid gland in situ (Aim 4). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THYROCYTES EXPRESS INFLAMMATORY MEDIATORS Principal Investigator & Institution: Gianoukakis, Andrew G.; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 90502 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): The understanding of autoimmune thyroid diseases, Hashimoto's thyroiditis and Graves disease (GD), remains superficial and current treatment is symptom-oriented. The mediators responsible for the lymphocytic infiltration and inflammation characteristic of autoimmune thyroid glands have not been identified. The long-term objective of this project is to investigate the role of thyroid epithelial cells in the inflammatory response. Here, we propose experiments
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designed to 1) investigate the pathogenesis of thyroid inflammation 2) identify potential therapeutic targets for interrupting these processes and 3) identify clinical markers of autoimmune thyroid disease activity. Cellular immunology, protein chemistry and molecular biology techniques will be utilized to examine thyrocyte expression of immunomodulatory molecules in vitro and in situ. We propose to measure serum levels of inflammatory mediators and attempt to correlate their serum levels with disease activity in a 48-month prospective study of patients with Graves' disease. The candidate and mentor have worked closely for over 3 years. This relationship has led to significant production and the generation of supporting preliminary data. With the support of a research career development award, continued mentoring and the availability of a General Clinical Research Center, the candidate will be able to further investigate his findings and answer the clinically relevant questions that have arisen. During the career development period, the candidate will also complete graduate level coursework in molecular biology and translational investigation. The candidate will develop the scientific knowledge base, problem solving abilities, and technical skills which will allow him to develop into a independent physician/scientiist. 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 “goiter” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for goiter in the PubMed Central database: •
A single amino acid change in the acetylcholinesterase-like domain of thyroglobulin causes congenital goiter with hypothyroidism in the cog /cog mouse: A model of human endoplasmic reticulum storage diseases. by Kim PS, Hossain SA, Park YN, Lee I, Yoo SE, Arvan P.; 1998 Aug 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=21435
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The congenital goiter mutation is linked to the thyroglobulin gene in the mouse. by Taylor BA, Rowe L.; 1987 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=304567
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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with goiter, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “goiter” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for goiter (hyperlinks lead to article summaries): •
99mTc-MIBI radio-guided minimally invasive parathyroidectomy: experience with patients with normal thyroids and nodular goiters. Author(s): Casara D, Rubello D, Cauzzo C, Pelizzo MR. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 January; 12(1): 53-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11838731&dopt=Abstract
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A case of laryngeal carcinoma appearing as a goiter. Author(s): Donangelo I, Coelho SM, Buescu A, Vaisman M. Source: Ear, Nose, & Throat Journal. 2001 December; 80(12): 876-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775521&dopt=Abstract
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A giant goiter in the 21st century. Author(s): Nobre EL, Aragues JM, Galvao-Telles A. Source: Thyroid : Official Journal of the American Thyroid Association. 2003 April; 13(4): 405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804110&dopt=Abstract
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A giant retrosternal goiter with severe tracheal compression and superior vena cava syndrome: an operative experience. Author(s): Irabor DO. Source: Ethiop Med J. 2003 January; 41(1): 63-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765001&dopt=Abstract
6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A new locus for a dominant form of multinodular goiter on 3q26.1-q26.3. Author(s): Takahashi T, Nozaki J, Komatsu M, Wada Y, Utsunomiya M, Inoue K, Takada G, Koizumi A. Source: Biochemical and Biophysical Research Communications. 2001 June 15; 284(3): 650-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11396950&dopt=Abstract
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A newborn with a goiter and thyroid dyshormonogenesis. Author(s): Felner EI. Source: J Matern Fetal Neonatal Med. 2002 September;12(3):207-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530620&dopt=Abstract
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A randomized trial comparing levothyroxine with radioactive iodine in the treatment of sporadic nontoxic goiter. Author(s): Wesche MF, Tiel-V Buul MM, Lips P, Smits NJ, Wiersinga WM. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 March; 86(3): 9981005. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11238476&dopt=Abstract
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A rare coexistence of primary hyperparathyroidism and hyperthyroidism due to toxic nodular goiter--a case report. Author(s): Bolko P, Jaskula M, Wasko R, Bednarek J, Sowinski J. Source: Pol Arch Med Wewn. 2003 February; 109(2): 165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12879780&dopt=Abstract
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Aberrant apoptosis in thyroid epithelial cells from goiter nodules. Author(s): Mezosi E, Yamazaki H, Bretz JD, Wang SH, Arscott PL, Utsugi S, Gauger PG, Thompson NW, Baker JR Jr. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 September; 87(9): 4264-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213883&dopt=Abstract
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Activin betaB expression in rat experimental goiter and human thyroid tumors. Author(s): Matsuo SE, Ebina KN, Kulcsar MA, Friguglietti CU, Kimura ET. Source: Thyroid : Official Journal of the American Thyroid Association. 2003 March; 13(3): 239-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729472&dopt=Abstract
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Adenomatous goiter with recurrent thyrotoxicosis. Author(s): Nagai Y, Sugimoto N, Nagasato A, Hashizume Y, Abe T, Nomura G. Source: Intern Med. 2002 July; 41(7): 595-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132533&dopt=Abstract
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Aggressive metastatic follicular thyroid carcinoma with anaplastic transformation arising from a long-standing goiter in a patient with Pendred's syndrome. Author(s): Camargo R, Limbert E, Gillam M, Henriques MM, Fernandes C, Catarino AL, Soares J, Alves VA, Kopp P, Medeiros-Neto G. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 October; 11(10): 981-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11716048&dopt=Abstract
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Amyloid goiter as the initial manifestation of systemic amyloidosis due to familial mediterranean fever with homozygous MEFV mutation. Author(s): Sbai A, Wechsler B, Leenhardt L, Beaufils H, Hoang C, Menegaux F, Piette JC. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 April; 11(4): 397-400. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11349841&dopt=Abstract
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Amyloid goiter in Familial Mediterranean Fever (FMF): a clinicopathologic study of 10 cases. Author(s): Ozdemir BH, Akman B, Ozdemir FN. Source: Renal Failure. 2001 September; 23(5): 659-67. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11725912&dopt=Abstract
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Amyloid goiter in juvenile onset rheumatoid arthritis. Author(s): Duzgun N, Morris Y, Yildiz HI, Ozturk S, Ayva SK, Ensari A, Erekul S, Kuzu I, Erdogan N, Duman M. Source: Scandinavian Journal of Rheumatology. 2003; 32(4): 253-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14626634&dopt=Abstract
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Amyloid goiter: report of two cases and review of the literature. Author(s): Goldsmith JD, Lai ML, Daniele GM, Tomaszewski JE, LiVolsi VA. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2000 July-August; 6(4): 31823. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11242609&dopt=Abstract
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Amyloid goiter--a case report. Author(s): Kapadia HC, Desai RI, Desai IM, Parikh NR. Source: Indian J Pathol Microbiol. 2001 April; 44(2): 147-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11883132&dopt=Abstract
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Anaplastic thyroid carcinoma in a 49 year-old woman with a long-standing goiter. A case report. Author(s): Vescini F, Di Gaetano P, Vigna E, Pascoli A, Cacciari M. Source: Minerva Endocrinol. 2000 September-December; 25(3-4): 81-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11338400&dopt=Abstract
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Application of staging systems for differentiated thyroid carcinoma in an endemic goiter region with iodine substitution. Author(s): Passler C, Prager G, Scheuba C, Kaserer K, Zettinig G, Niederle B. Source: Annals of Surgery. 2003 February; 237(2): 227-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12560781&dopt=Abstract
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Association of anion gap with thyroid dysfunction and nodular goiter in CAPD patients. Author(s): Lin CC, Yang WC, Ng YY, Chou YH, Tarng DC, Chen TW. Source: Perit Dial Int. 2002 May-June; 22(3): 394-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12227399&dopt=Abstract
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Association of tobacco smoking with goiter in a low-iodine-intake area. Author(s): Knudsen N, Bulow I, Laurberg P, Ovesen L, Perrild H, Jorgensen T. Source: Archives of Internal Medicine. 2002 February 25; 162(4): 439-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11863477&dopt=Abstract
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Bilateral chylothorax due to retrosternal goiter in a patient with non-Hodgkin's lymphoma. Author(s): Simmgen M, Newlands ES, Southcott BM, Vigushin DM. Source: Medical Oncology (Northwood, London, England). 2001; 18(2): 153-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11778762&dopt=Abstract
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Castleman's disease presenting as a goiter in a child. Author(s): Kukuvitis A, Gompakis N, Zafeiriou D, Katzos G. Source: Hormone Research. 2003; 59(1): 42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566734&dopt=Abstract
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Clinical value of calcifications in thyroid carcinoma and multinodular goiter. Author(s): Consorti F, Anello A, Benvenuti C, Boncompagni A, Giovannone G, Moles N, Scardella L, Antonaci A. Source: Anticancer Res. 2003 May-June; 23(3C): 3089-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926167&dopt=Abstract
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Comparative efficacy and side effects of the treatment of euthyroid goiter with levothyroxine or triiodothyroacetic acid. Author(s): Brenta G, Schnitman M, Fretes O, Facco E, Gurfinkel M, Damilano S, Pacenza N, Blanco A, Gonzalez E, Pisarev MA. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 November; 88(11): 5287-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14602763&dopt=Abstract
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Comparison of two different doses of iodide in the prevention of gestational goiter in marginal iodine deficiency: a longitudinal study. Author(s): Antonangeli L, Maccherini D, Cavaliere R, Di Giulio C, Reinhardt B, Pinchera A, Aghini-Lombardi F. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 July; 147(1): 29-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12088916&dopt=Abstract
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Comparison of urinary iodine excretion and goiter survey to determine the prevalence of iodine deficiency. Author(s): Bhasin SK, Kumar P, Dubey KK. Source: Indian Pediatrics. 2001 August; 38(8): 901-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11521003&dopt=Abstract
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Congenital goiter with hypothyroidism caused by a 5' splice site mutation in the thyroglobulin gene. Author(s): Targovnik HM, Rivolta CM, Mendive FM, Moya CM, Vono J, Medeiros-Neto G. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 July; 11(7): 685-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11484898&dopt=Abstract
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Congenital retropharyngeal goiter in a newborn as a magnetic resonance imaging finding. Author(s): Dalgic N, Ergenekon E, Bideci A, Erbas G, Koc E, Tali T, Atalay Y. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2001 August; 43(4): 431-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11472595&dopt=Abstract
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Cost-effective management of thyroid nodules and nodular thyroid goiters. Author(s): Supit E, Peiris AN. Source: Southern Medical Journal. 2002 May; 95(5): 514-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12005008&dopt=Abstract
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Current treatment of nodular goiter with hyperthyroidism (Plummer's disease): surgery versus radioiodine. Author(s): Kang AS, Grant CS, Thompson GB, van Heerden JA. Source: Surgery. 2002 December; 132(6): 916-23; Discussion 923. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490836&dopt=Abstract
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Cytologic appearance of toxic nodular goiter after thyrostatic treatment. A karyometric study. Author(s): Slowinska-Klencka D, Klencki M, Sporny S, Popowicz B, Lewinski A. Source: Anal Quant Cytol Histol. 2003 February; 25(1): 39-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630081&dopt=Abstract
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Cytologic characterization of postiodization residual goiter in schoolchildren by fine needle biopsy. Author(s): Karak AK, Marwaha RK, Tandon N, Gupta N, Kochupillai N, Verma K. Source: Acta Cytol. 2003 March-April; 47(2): 227-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685194&dopt=Abstract
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Cytologic distinction of goiterous nodules from morphologically normal thyroid: analyses of cytomorphologic features. Author(s): Layfield LJ, Wax T, Jones C. Source: Cancer. 2003 August 25; 99(4): 217-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12925983&dopt=Abstract
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Detection of a large substernal goiter during Tc-99m tetrofosmin cardiac SPECT imaging. Author(s): Ravizzini GC, Farnsworth SE, Pagnanelli RA, Borges-Neto S. Source: Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology. 2001 May-June; 8(3): 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11391314&dopt=Abstract
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Development of the parafollicular cells in recurrent goiter. Author(s): Rink T, Fitz H, Schroth HJ, Braun S. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 May; 144(5): 485-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331214&dopt=Abstract
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Diagnostic approach to thyroid goiter. Author(s): Garg MK, Dhall A. Source: J Assoc Physicians India. 2001 July; 49: 742-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11573562&dopt=Abstract
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Diagnostic utility of cytokeratin 19 expression in multinodular goiter with papillary areas and papillary carcinoma of thyroid. Author(s): Erkilic S, Aydin A, Kocer NE. Source: Endocrine Pathology. 2002 Fall; 13(3): 207-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12446919&dopt=Abstract
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Dietary supplies of iodine and thiocyanate in the etiology of endemic goiter in Tripura. Author(s): Chandra AK, Ray I. Source: Indian J Pediatr. 2001 May; 68(5): 399-404. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11407152&dopt=Abstract
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Difference in goiter rates between regular and occasional users of iodized salt in Mongolia. Author(s): Yamada C, Oyunchimeg D. Source: Food Nutr Bull. 2002 March; 23(1): 89-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975374&dopt=Abstract
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Difference in goiter rates between two areas in Mae Hong Son Province despite an equally sufficient iodine supply. Author(s): Aramrattana A, Limpijarnkit L, Leelapat P, Sriphrapradang A, Mangklabruks A, Pruenglampoo S, Vachiranakorn J, Rajatanavin R. Source: J Med Assoc Thai. 2002 July; 85(7): 831-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296417&dopt=Abstract
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Differential diagnosis of hyperthyroidism: Doppler sonographic quantification of thyroid blood flow distinguishes between Graves' disease and diffuse toxic goiter. Author(s): Saleh A, Cohnen M, Furst G, Godehardt E, Modder U, Feldkamp J. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 2002 January; 110(1): 32-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835123&dopt=Abstract
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Differential expression of IGFBP-5 and two human ESTs in thyroid glands with goiter, adenoma and papillary or follicular carcinomas. Author(s): Stolf BS, Carvalho AF, Martins WK, Runza FB, Brun M, Hirata R Jr, Jordao Neves E, Soares FA, Postigo-Dias J, Kowalski LP, Reis LF. Source: Cancer Letters. 2003 March 10; 191(2): 193-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618333&dopt=Abstract
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Distinction between autoimmune and non-autoimmune hyperthyroidism by determination of TSH-receptor antibodies in patients with the initial diagnosis of toxic multinodular goiter. Author(s): Wallaschofski H, Orda C, Georgi P, Miehle K, Paschke R. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 2001 August; 33(8): 504-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11544566&dopt=Abstract
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Does radioiodine therapy have an equal effect on substernal and cervical goiter volumes? Evaluation by magnetic resonance imaging. Author(s): Bonnema SJ, Knudsen DU, Bertelsen H, Mortensen J, Andersen PB, Bastholt L, Hegedus L. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 April; 12(4): 313-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034056&dopt=Abstract
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Dyspnea due to giant goiter. Author(s): Alper F, Kantarci M, Kurkcuoglu IC, Balik AA. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2003 August; 24(2): 302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12895627&dopt=Abstract
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Ectopic goiter masquerading as submandibular gland swelling: a case report and review of the literature. Author(s): Kumar R, Sharma S, Marwah A, Moorthy D, Dhanwal D, Malhotra A. Source: Clinical Nuclear Medicine. 2001 April; 26(4): 306-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11290889&dopt=Abstract
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Effect of different drugs on the level of DNA-hydrolyzing polyclonal IgG antibodies in sera of patients with Hashimoto's thyroiditis and nontoxic nodal goiter. Author(s): Nevinsky GA, Breusov AA, Baranovskii AG, Prints AV, Kanyshkova TG, Galvita AV, Naumov VA, Buneva VN. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 March-April; 7(2): 201-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11257722&dopt=Abstract
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Effect of iodine or iopanoic acid on thyroid Ca2+/NADPH-dependent H2O2generating activity and thyroperoxidase in toxic diffuse goiters. Author(s): Cardoso LC, Martins DC, Campos DV, Santos LM, Correa da Costa VM, Rosenthal D, Vaisman M, Violante AH, Carvalho DP. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 September; 147(3): 293-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213665&dopt=Abstract
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Effects of iodized salt consumption on goiter prevalence in Isfahan: the possible role of goitrogens. Author(s): Aminorroaya A, Amini M, Rezvanian H, Kachoie A, Sadri G, Mirdamadi M, Fard MA, Sanaat Z, Naghdi H, Ahmadi N. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 March-April; 7(2): 95-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11421552&dopt=Abstract
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Electromyographic nerve identification during resection of an intrathoracic goiter via a right anterolateral thoracotomy using a novel method. Author(s): Kastl S, Hemmerling TM, Schmidt J, Kat S, Hohenberger W, Klein P. Source: Surgery. 2001 July; 130(1): 93-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11436020&dopt=Abstract
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Endemic goiter and cretinism: an update on iodine status. Author(s): Dunn JT. Source: J Pediatr Endocrinol Metab. 2001; 14 Suppl 6: 1469-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837501&dopt=Abstract
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Endemic goiter in pregnant women: utility of the simplified classification of thyroid size by palpation and urinary iodine as screening tests. Author(s): Castaneda R, Lechuga D, Ramos RI, Magos C, Orozco M, Martinez H. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 December; 109(12): 1366-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504972&dopt=Abstract
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Endemic goiter, thiocyanate overload, and selenium status in school-age children. Author(s): Erdogan MF, Erdogan G, Sav H, Gullu S, Kamel N. Source: Biological Trace Element Research. 2001 February; 79(2): 121-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11330518&dopt=Abstract
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Endocrinology and art. “A ferocious cretin with voluminous goiter”. Morazzone, circa 1600. Author(s): Pozzilli P. Source: J Endocrinol Invest. 2001 February; 24(2): 137. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11263472&dopt=Abstract
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Endocrinology and art. “The Judas goiter”. Unknown painter, XV century. Author(s): Aghini-Lombardi F. Source: J Endocrinol Invest. 2001 January; 24(1): 62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11227735&dopt=Abstract
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Erythrocyte, plasma, and serum antioxidant activities in untreated toxic multinodular goiter patients. Author(s): Aliciguzel Y, Ozdem SN, Ozdem SS, Karayalcin U, Siedlak SL, Perry G, Smith MA. Source: Free Radical Biology & Medicine. 2001 March 15; 30(6): 665-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295364&dopt=Abstract
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Evaluation and treatment of sporadic nontoxic goiter--some answers and more questions. Author(s): Samuels MH. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 March; 86(3): 994-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11238475&dopt=Abstract
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Evaluation of substernal goiters using computed tomography and MR imaging. Author(s): Jennings A. Source: Endocrinology and Metabolism Clinics of North America. 2001 June; 30(2): 40114, Ix. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11444168&dopt=Abstract
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Extensive squamous metaplasia in nodular goiter--a diagnostic dilemma in the fine needle aspiration (FNA) cytology--a case report. Author(s): Nayak SK, Pai PK, Naik R, Rao VS. Source: Indian J Pathol Microbiol. 2002 January; 45(1): 111-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593577&dopt=Abstract
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False-positive suspicion of a thyroid metastatic lesion by In-111 pentetreotide uptake in a toxic nodular goiter. Author(s): Gaci M, Morel O, Sultan AM, Giraud P, Muratet JP, Gamelin E, Jallet P. Source: Clinical Nuclear Medicine. 2001 June; 26(6): 579-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11353323&dopt=Abstract
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Fas and Bcl-2 protein expression in thyrocytes of patients with nodular goiter. Author(s): Andrikoula M, Vartholomatos G, Tsangaris GT, Bafa M, TzortzatouStathopoulou F, Tsatsoulis A. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 October; 145(4): 403-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11580996&dopt=Abstract
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Five novel inactivating mutations in the thyroid peroxidase gene responsible for congenital goiter and iodide organification defect. Author(s): Rivolta CM, Esperante SA, Gruneiro-Papendieck L, Chiesa A, Moya CM, Domene S, Varela V, Targovnik HM. Source: Human Mutation. 2003 September; 22(3): 259. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12938097&dopt=Abstract
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Fluorine-18-fluorodeoxyglucose positron emission tomography in the preoperative assessment of thyroid nodules in an endemic goiter area. Author(s): Kresnik E, Gallowitsch HJ, Mikosch P, Stettner H, Igerc I, Gomez I, Kumnig G, Lind P. Source: Surgery. 2003 March; 133(3): 294-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660642&dopt=Abstract
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Follicular adenoma of thyroid associated with mediastinal malignant hemangioendothelioma, masquerading as malignant retrosternal goiter. Author(s): Mishra A, Mishra SK. Source: J Assoc Physicians India. 2001 July; 49: 730. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11573559&dopt=Abstract
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Ganglioneuroma of the neck, masquerading as a goiter. Author(s): Leonardis M, Sperb D, Alster C, Campisi C, Herter NT. Source: European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2003 December; 29(10): 929-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14624790&dopt=Abstract
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Giant substernal goiter with chylothorax. Author(s): Darwish BK, Kabbani SS. Source: Asian Cardiovascular & Thoracic Annals. 2003 June; 11(2): 165-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12878569&dopt=Abstract
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Goiter and hypothyroidism in two siblings due to impaired Ca(+2)/NAD(P)Hdependent H(2)O(2)-generating activity. Author(s): Figueiredo MD, Cardoso LC, Ferreira AC, Campos DV, da Cruz Domingos M, Corbo R, Nasciutti LE, Vaisman M, Carvalho DP. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 October; 86(10): 4843-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11600551&dopt=Abstract
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Goiter assessment: help or hindrance in tracking progress in iodine deficiency disorders control program? Author(s): Gorstein J. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 December; 11(12): 1201-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186511&dopt=Abstract
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Goiter in a newborn exposed to lithium in utero. Author(s): Frassetto F, Tourneur Martel F, Barjhoux CE, Villier C, Bot BL, Vincent F. Source: The Annals of Pharmacotherapy. 2002 November; 36(11): 1745-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12398572&dopt=Abstract
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Goiter in rural area of Aligarh district. Author(s): Singh PN, Ahmad J. Source: Indian J Physiol Pharmacol. 2002 January; 46(1): 102-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12024947&dopt=Abstract
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Goiter prevalence and urinary iodide excretion in a formerly iodine-deficient region after introduction of statutory lodization of common salt. Author(s): Heinisch M, Kumnig G, Asbock D, Mikosch P, Gallowitsch HJ, Kresnik E, Gomez I, Unterweger O, Lind P. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 September; 12(9): 809-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481947&dopt=Abstract
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Goiter prevalence, urinary iodine excretion, thyroid function and anti-thyroid function and anti-thyroid antibodies after 12 years of salt iodization in Shahriar, Iran. Author(s): Azizi F, Navai L, Fattahi F. Source: Int J Vitam Nutr Res. 2002 October; 72(5): 291-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463103&dopt=Abstract
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Goiters in the Renaissance. Author(s): Vescia FG, Basso L. Source: Vesalius. 1997 June; 3(1): 23-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11619418&dopt=Abstract
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Graves' disease presented as painful goiter. Author(s): Chao CS, Lin SY, Sheu WH. Source: Hormone Research. 2002; 57(1-2): 53-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12006721&dopt=Abstract
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Horseshoe kidney with mesangioproliferative glomerulonephritis and goiter. Author(s): Kavukcu S, Sahin B, Turkmen M, Soylu A, Lebe B, Buyukgebiz A. Source: Turk J Pediatr. 2003 October-December; 45(4): 350-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14768805&dopt=Abstract
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Huge mediastinal goiter. Author(s): Margaritora S, Cesario A, Porziella V, Granone P. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2003 May; 23(5): 840. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12754043&dopt=Abstract
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I-123 uptake by mediastinal goiter after recombinant human thyroid-stimulating hormone administration. Author(s): Achong DM, Tenorio LE. Source: Clinical Nuclear Medicine. 2001 October; 26(10): 817-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11564915&dopt=Abstract
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Impact of localization studies on feasibility of minimally invasive parathyroidectomy in an endemic goiter region. Author(s): Prager G, Czerny C, Ofluoglu S, Kurtaran A, Passler C, Kaczirek K, Scheuba C, Niederle B. Source: Journal of the American College of Surgeons. 2003 April; 196(4): 541-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691928&dopt=Abstract
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Impact of protein energy malnutrition on thyroid size in an iodine deficient population of Gujarat (India): Is it an aetiological factor for goiter? Author(s): Brahmbhatt SR, Brahmbhatt RM, Boyages SC. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 July; 145(1): 11-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11415847&dopt=Abstract
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Indications, risks, and acceptance of total thyroidectomy for multinodular benign goiter. Author(s): Muller PE, Kabus S, Robens E, Spelsberg F. Source: Surgery Today. 2001; 31(11): 958-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766081&dopt=Abstract
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Influence of iodine deficiency and iodine prophylaxis on thyroid cancer histotypes and incidence in endemic goiter area. Author(s): Huszno B, Szybinski Z, Przybylik-Mazurek E, Stachura J, Trofimiuk M, Buziak-Bereza M, Golkowski F, Pantoflinski J. Source: J Endocrinol Invest. 2003; 26(2 Suppl): 71-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762644&dopt=Abstract
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Insulin-like growth factor-I and insulin-like growth factor binding protein-3 levels of children living in an iodine- and selenium-deficient endemic goiter area. Author(s): Aydin K, Bideci A, Kendirci M, Cinaz P, Kurtoglu S. Source: Biological Trace Element Research. 2002 Winter; 90(1-3): 25-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666822&dopt=Abstract
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Intraoperative neuromonitoring of surgery for benign goiter. Author(s): Thomusch O, Sekulla C, Walls G, Machens A, Dralle H. Source: American Journal of Surgery. 2002 June; 183(6): 673-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12095600&dopt=Abstract
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Intrathoracic goiter: analysis of 21 cases. Author(s): Ignjatovic M, Stanic V, Cuk V, Kostic Z. Source: Acta Chir Iugosl. 2002; 49(1): 15-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587479&dopt=Abstract
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Iodine and selenium deficiency in school-children in an endemic goiter area in Turkey. Author(s): Aydin K, Kendirci M, Kurtoglu S, Karakucuk EI, Kiris A. Source: J Pediatr Endocrinol Metab. 2002 July-August; 15(7): 1027-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12199330&dopt=Abstract
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Iodine deficiency and goiter prevalence in a population living at sea level in Campania (Italy). Author(s): Valentino R. Source: J Endocrinol Invest. 2003 January; 26(1): 100-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602545&dopt=Abstract
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Iodine deficiency in Azerbaijan after the discontinuation of an iodine prophylaxis program: reassessment of iodine intake and goiter prevalence in schoolchildren. Author(s): Markou KB, Georgopoulos NA, Makri M, Anastasiou E, Vlasopoulou B, Lazarou N, Deville L, Megreli C, Vagenakis GA, Sakellaropoulos GC, Jabbarov R, Kerimova MG, Mamedgasanov RM, Vagenakis AG. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 December; 11(12): 1141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186501&dopt=Abstract
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Iodine deficiency in Calabria: characterization of endemic goiter and analysis of different indicators of iodine status region-wide. Author(s): Costante G, Grasso L, Schifino E, Marasco MF, Crocetti U, Capula C, Chiarella R, Ludovico O, Nocera M, Parlato G, Filetti S. Source: J Endocrinol Invest. 2002 March; 25(3): 201-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936460&dopt=Abstract
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Iodine status and goiter prevalence in Turkey before mandatory iodization. Author(s): Erdogan G, Erdogan MF, Emral R, Bastemir M, Sav H, Haznedaroglu D, Ustundag M, Kose R, Kamel N, Genc Y. Source: J Endocrinol Invest. 2002 March; 25(3): 224-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936463&dopt=Abstract
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Iodized oil as a complement to iodized salt in schoolchildren in endemic goiter in Romania. Author(s): Simescu M, Varciu M, Nicolaescu E, Gnat D, Podoba J, Mihaescu M, Delange F. Source: Hormone Research. 2002; 58(2): 78-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207166&dopt=Abstract
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Is thyroid carcinoma more common in single nodules or multinodular goiters? Author(s): Goldberg LD. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2000 January-February; 6(1): 110-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11419931&dopt=Abstract
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Juvenile rheumatoid arthritis with amyloid goiter: report of a case with review of the literature. Author(s): Srivastava A, Baxi M, Yadav S, Agarwal A, Gupta RK, Misra SK, Mithal A. Source: Endocrine Pathology. 2001 Winter; 12(4): 437-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11914477&dopt=Abstract
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Lack of reported mutations in a Japanese case of toxic multinodular goiter. Author(s): Hanamitsu M, Takeuchi E, Kitanishi T, Sakurai H, Tanaka H, Kitano H. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2002 JulyAugust; 64(4): 275-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12232474&dopt=Abstract
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Levels of soluble human leukocyte antigen class 1 are increased in Graves' disease and toxic multinodular goiter and correlate with the levels of triiodothyronine. Author(s): Yaturu S, McDonald J. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 August; 12(8): 679-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225636&dopt=Abstract
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Life-threatening giant mediastinal goiter: a surgical challenge. Author(s): Veronesi G, Leo F, Solli PG, D'Aiuto M, D'Ovidio F, Mazzarol G, Spaggiari L, Pastorino U. Source: The Journal of Cardiovascular Surgery. 2001 June; 42(3): 429-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11501515&dopt=Abstract
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Limited sensitivity of parathyroid imaging with (99m)Tc-sestamibi/(123)I subtraction in an endemic goiter area. Author(s): Rink T, Schroth HJ, Holle LH, Garth H. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 2002 September; 43(9): 1175-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215555&dopt=Abstract
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Liposarcoma of the thyroid gland mimicking retrosternal goiter. Author(s): Awad WI, Rhys Evans PH, Nicholson AG, Goldstraw P. Source: The Annals of Thoracic Surgery. 2003 February; 75(2): 566-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607674&dopt=Abstract
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Low TSH requirement and goiter in transgenic mice overexpressing IGF-I and IGF-Ir receptor in the thyroid gland. Author(s): Clement S, Refetoff S, Robaye B, Dumont JE, Schurmans S. Source: Endocrinology. 2001 December; 142(12): 5131-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11713206&dopt=Abstract
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Management of simple nodular goiter: current status and future perspectives. Author(s): Hegedus L, Bonnema SJ, Bennedbaek FN. Source: Endocrine Reviews. 2003 February; 24(1): 102-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12588812&dopt=Abstract
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Management of the nontoxic multinodular goiter: a North American survey. Author(s): Bonnema SJ, Bennedbaek FN, Ladenson PW, Hegedus L. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 January; 87(1): 1127. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11788632&dopt=Abstract
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Massive intrathoracic toxic multinodular goiter treated with radioiodine. Author(s): Drivas I, Mansberg R, Roberts JM, Kean AM. Source: Clinical Nuclear Medicine. 2003 February; 28(2): 138-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544137&dopt=Abstract
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Minimally invasive open parathyroidectomy in an endemic goiter area: a prospective study. Author(s): Prager G, Czerny C, Kurtaran A, Passler C, Scheuba C, Bieglmayer C, Niederle B. Source: Archives of Surgery (Chicago, Ill. : 1960). 2001 July; 136(7): 810-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11448396&dopt=Abstract
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Monoallelic deletion in the 5' region of the thyroglobulin gene as a cause of sporadic nonendemic simple goiter. Author(s): Gonzalez-Sarmiento R, Corral J, Mories MT, Corrales JJ, Miguel-Velado E, Miralles-Garcia JM. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 August; 11(8): 789-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525274&dopt=Abstract
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MR imaging findings in fetal goiter caused by maternal graves disease. Author(s): Karabulut N, Martin DR, Yang M, Boyd BK. Source: Journal of Computer Assisted Tomography. 2002 July-August; 26(4): 538-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218817&dopt=Abstract
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MR imaging of large multinodular goiters: observer agreement on volume versus observer disagreement on dimensions of the involved trachea. Author(s): Bonnema SJ, Andersen PB, Knudsen DU, Hegedus L. Source: Ajr. American Journal of Roentgenology. 2002 July; 179(1): 259-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12076947&dopt=Abstract
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Multinodular goiter in children. Author(s): Al-Fifi S, Rodd C. Source: J Pediatr Endocrinol Metab. 2001 June; 14(6): 749-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11453525&dopt=Abstract
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Multinodular goiter. Author(s): Day TA, Chu A, Hoang KG. Source: Otolaryngologic Clinics of North America. 2003 February; 36(1): 35-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12803008&dopt=Abstract
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Multinodular goiter: surgical management and histopathological findings. Author(s): Prades JM, Dumollard JM, Timoshenko A, Chelikh L, Michel F, Estour B, Martin C. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2002 April; 259(4): 217-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064511&dopt=Abstract
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Multinucleated giant cells in fine needle aspirates. Can they help differentiate papillary thyroid cancer from benign nodular goiter? Author(s): Tsou PL, Hsiao YL, Chang TC. Source: Acta Cytol. 2002 September-October; 46(5): 823-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365214&dopt=Abstract
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Neonatal goiter caused by expectorant usage. Author(s): Bostanci I, Sarioglu A, Ergin H, Aksit A, Cinbis M, Akalin N. Source: J Pediatr Endocrinol Metab. 2001 September-October; 14(8): 1161-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11592576&dopt=Abstract
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Nodular goiter and goiter nodules: Where iodine deficiency falls short of explaining the facts. Author(s): Derwahl M, Studer H. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 2001; 109(5): 250-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11507648&dopt=Abstract
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Nodular toxic goiter (Plummer's disease) in a child. Author(s): Rosenbloom AL, Pierson KK. Source: The Journal of Pediatrics. 1974 January; 84(1): 104-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12119925&dopt=Abstract
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Non-hyperfunctioning nodules from multinodular goiters: a minor role in pathogenesis for somatic activating mutations in the TSH-receptor and Gsalpha subunit genes. Author(s): Derrien C, Sonnet E, Gicquel I, Le Gall JY, Poirier JY, David V, Maugendre D. Source: J Endocrinol Invest. 2001 May; 24(5): 321-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11407651&dopt=Abstract
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Novel technique for control of mediastinal bleeding during thyroidectomy for substernal goiter. Author(s): Clark OH, Lal G. Source: Journal of the American College of Surgeons. 2003 May; 196(5): 818-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742217&dopt=Abstract
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Operative management of substernal goiter: analysis of 52 patients. Author(s): Arici C, Dertsiz L, Altunbas H, Demircan A, Emek K. Source: Int Surg. 2001 October-December; 86(4): 220-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12056465&dopt=Abstract
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Orthopnea and tidal expiratory flow limitation in patients with euthyroid goiter. Author(s): Torchio R, Gulotta C, Perboni A, Ciacco C, Guglielmo M, Orlandi F, MilicEmili J. Source: Chest. 2003 July; 124(1): 133-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12853515&dopt=Abstract
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Overexpression of epidermal growth factor and epidermal growth factor-receptor mRNAs in dyshormonogenetic goiters. Author(s): Pedrinola F, Rubio I, Santos CL, Medeiros-Neto G. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 January; 11(1): 15-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11272091&dopt=Abstract
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Painless thyroiditis associated with severe inflammatory reactions in amyloid goiter: a case report. Author(s): Bando Y, Ushiogi Y, Toya D, Tanaka N, Fujisawa M. Source: Endocrine Journal. 2001 June; 48(3): 323-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11523903&dopt=Abstract
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Papillary carcinoma occurring within an adenomatous goiter of the thyroid gland in Cowden's disease. Author(s): Kameyama K, Takami H, Miyajima K, Mimura T, Hosoda Y, Ito K, Ito K. Source: Endocrine Pathology. 2001 Spring; 12(1): 73-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11478271&dopt=Abstract
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Parathyroid adenoma after radioactive iodine therapy for multinodular goiter. Author(s): Cundiff JG, Portugal L, Sarne DH. Source: American Journal of Otolaryngology. 2001 September-October; 22(5): 374-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11562893&dopt=Abstract
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Pattern of intrathoracic goiter in Ibadan, Nigeria. Author(s): Adegboye VO, Ogunseinde OA, Obajimi MO, Ladipo JK, Brimmo AI. Source: Niger Postgrad Med J. 2002 December; 9(4): 226-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690684&dopt=Abstract
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Pemberton's sign associated with a large multinodular goiter. Author(s): O'Brien KE, Gopal V, Mazzaferri E. Source: Thyroid : Official Journal of the American Thyroid Association. 2003 April; 13(4): 407-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804111&dopt=Abstract
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Pendred's syndrome with goiter and enlarged vestibular aqueducts diagnosed by PDS gene mutation. Author(s): Ishinaga H, Shimizu T, Yuta A, Tsukamoto K, Usami S, Majima Y. Source: Head & Neck. 2002 July; 24(7): 710-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112546&dopt=Abstract
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Pregnancy and multinodular goiter. Author(s): Papi G, Carapazzi C. Source: J Endocrinol Invest. 2002 July-August; 25(7): 665. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150346&dopt=Abstract
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Pretreatment with a single, low dose of recombinant human thyrotropin allows dose reduction of radioiodine therapy in patients with nodular goiter. Author(s): Bonnema SJ, Nielsen VE, Hegedus L. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 December; 88(12): 6113-4; Author Reply 6114-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14671219&dopt=Abstract
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Pretreatment with a single, low dose of recombinant human thyrotropin allows dose reduction of radioiodine therapy in patients with nodular goiter. Author(s): Nieuwlaat WA, Huysmans DA, van den Bosch HC, Sweep CG, Ross HA, Corstens FH, Hermus AR. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 July; 88(7): 3121-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843153&dopt=Abstract
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Pretreatment with recombinant human TSH changes the regional distribution of radioiodine on thyroid scintigrams of nodular goiters. Author(s): Nieuwlaat WA, Hermus AR, Sivro-Prndelj F, Corstens FH, Huysmans DA. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 November; 86(11): 5330-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11701700&dopt=Abstract
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Prevalence of goiter among primary school students, aged 8-10 years, in the West Bank and Gaza, 1997. Author(s): Ramlawi A. Source: Public Health Rev. 2000; 28(1-4): 67-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11411279&dopt=Abstract
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Prevalence of goiter in schoolchildren--a study on the influence of adequate iodine prophylaxis in Poland. Author(s): Golkowski F, Huszno B, Trofimiuk M, Sowinski J, Bandurska-Stankiewicz E, Dorant B, Szybinski Z. Source: J Endocrinol Invest. 2003; 26(2 Suppl): 11-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762634&dopt=Abstract
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Puppet with a voluminous goiter. Author(s): Pozzilli P, Marchini F. Source: J Endocrinol Invest. 2003 June; 26(6): 595. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12952377&dopt=Abstract
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Radiology quiz case. Thyroid goiter presenting as a retropharyngeal mass. Author(s): Govindaraj S, Rezaee R, Pearl A, Som PM, Urken ML. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 September; 129(9): 1013-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12975279&dopt=Abstract
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Relapses of hyperthyroidism in patients treated with radioiodine for nodular toxic goiter: relation to thyroid autoimmunity. Author(s): Custro N, Ganci A, Scafidi V. Source: J Endocrinol Invest. 2003 February; 26(2): 106-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12739735&dopt=Abstract
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Retrospective analysis of the association of nodular goiter with primary and secondary hyperparathyroidism. Author(s): dell'Erba L, Baldari S, Borsato N, Bruno G, Calo-Gabrieli G, Carletto M, Ciampolillo A, Dondi M, Erba P, Gerundini P, Lastoria S, Marinelli P, Santoro M, Scarano B, Zagni P, Bagnasco M, Mariani G. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 October; 145(4): 429-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11581000&dopt=Abstract
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Risk factors for goiter and thyroid nodules. Author(s): Knudsen N, Laurberg P, Perrild H, Bulow I, Ovesen L, Jorgensen T. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 October; 12(10): 879-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487770&dopt=Abstract
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Schwannoma of the left brachial plexus mimicking a cervicomediastinal goiter in a young Nigerian lady. Author(s): Irabor DO, Ladipol JK, Nwachokor FN, Thomas JO. Source: West Afr J Med. 2002 July-September; 21(3): 195-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744565&dopt=Abstract
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Serum levels of cytokines in children and adolescents with Graves' disease and nontoxic nodular goiter. Author(s): Bossowski A, Urban M. Source: J Pediatr Endocrinol Metab. 2001 June; 14(6): 741-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11453524&dopt=Abstract
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Side-effects of iodized oil administration in patients with simple goiter. Author(s): Azizi F, Daftarian N. Source: J Endocrinol Invest. 2001 February; 24(2): 72-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11263474&dopt=Abstract
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Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism. Author(s): Vestergaard P, Rejnmark L, Weeke J, Hoeck HC, Nielsen HK, Rungby J, Laurberg P, Mosekilde L. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 January; 12(1): 69-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11838733&dopt=Abstract
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Sodium/iodide symporter (NIS) and pendrin are expressed differently in hot and cold nodules of thyroid toxic multinodular goiter. Author(s): Russo D, Bulotta S, Bruno R, Arturi F, Giannasio P, Derwahl M, Bidart JM, Schlumberger M, Filetti S. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2001 November; 145(5): 591-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11720877&dopt=Abstract
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Solid cell nest in fine-needle aspiration of goiter. Author(s): Moldavsky M, Szvalb S, Stayerman C. Source: Diagnostic Cytopathology. 2002 July; 27(1): 66-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112820&dopt=Abstract
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Spread of goiters outside the thyroid bed: a review of 190 cases and an analysis of the incidence of the various extensions. Author(s): Chin SC, Rice H, Som PM. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 November; 129(11): 1198-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14623750&dopt=Abstract
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Surgical treatment of multinodular goiter: incidence of lesions of the recurrent nerves after total thyroidectomy. Author(s): Bononi M, de Cesare A, Atella F, Angelini M, Fierro A, Fiori E, Camgemi V, Piat G. Source: Int Surg. 2000 July-September; 85(3): 190-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11324993&dopt=Abstract
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Surgical treatment of substernal goiter. Author(s): Ozdemir A, Hasbahceci M, Hamaloglu E, Ozenc A. Source: Int Surg. 2000 July-September; 85(3): 194-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11324994&dopt=Abstract
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The advantage of total thyroidectomy to avoid reoperation for incidental thyroid cancer in multinodular goiter. Author(s): Giles Y, Boztepe H, Terzioglu T, Tezelman S. Source: Archives of Surgery (Chicago, Ill. : 1960). 2004 February; 139(2): 179-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14769577&dopt=Abstract
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The influence of parity on multinodular goiter prevalence in areas with moderate iodine deficiency. Author(s): Rotondi M, Sorvillo F, Mazziotti G, Balzano S, Iorio S, Savoia A, Piscopo M, Biondi B, Amato G, Carella C. Source: J Endocrinol Invest. 2002 May; 25(5): 442-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12035941&dopt=Abstract
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The relation between serum ferritin and goiter, urinary iodine and thyroid hormone concentration. Author(s): Azizi F, Mirmiran P, Sheikholeslam R, Hedayati M, Rastmanesh R. Source: Int J Vitam Nutr Res. 2002 October; 72(5): 296-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463104&dopt=Abstract
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The Sardinian Autoimmunity Study: 3. Studies on circulating antithyroid antibodies in Sardinian schoolchildren: relationship to goiter prevalence and thyroid function. Author(s): Loviselli A, Velluzzi F, Mossa P, Cambosu MA, Secci G, Atzeni F, Taberlet A, Balestrieri A, Martino E, Grasso L, Songini M, Bottazzo GF, Mariotti S; Sardinian Schoolchildren Study Group. Source: Thyroid : Official Journal of the American Thyroid Association. 2001 September; 11(9): 849-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11575854&dopt=Abstract
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Thoracic intrathymic thyroid and cervical goiter: single-stage resection. Author(s): Tang AT, Johnson MJ, Addis B, Weeden DF. Source: The Annals of Thoracic Surgery. 2002 August; 74(2): 578-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173852&dopt=Abstract
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Thoracoscopic resection of an ectopic intrathoracic goiter. Author(s): Grondin SC, Buenaventura P, Luketich JD. Source: The Annals of Thoracic Surgery. 2001 May; 71(5): 1697-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11383834&dopt=Abstract
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Thyroid abscess associated with a substernal goiter. Case report. Author(s): Lavini C, Natali P, Magni G, Valli R, Morandi U. Source: The Journal of Cardiovascular Surgery. 2003 April; 44(2): 271-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813398&dopt=Abstract
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Thyroid carcinoma in single cold nodules and in cold nodules of multinodular goiters. Author(s): Sachmechi I, Miller E, Varatharajah R, Chernys A, Carroll Z, Kissin E, Rosner F. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2000 January-February; 6(1): 5-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11419919&dopt=Abstract
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Thyroid function and goiter recurrence after thyroid lobectomy in elderly subjects. Author(s): Guberti A, Sianesi M, Del Rio P, Bertocchi A, Dazzi D, Guareschi C, Robuschi G. Source: J Endocrinol Invest. 2002; 25(10 Suppl): 71-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508924&dopt=Abstract
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Thyroid function tests in pregnant women with and without goiter in the eastern Black Sea region. Author(s): Erem C, Kavgaci H, Karahan C, Mocan MZ, Telatar M. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2001 August; 15(4): 293-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560103&dopt=Abstract
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Thyroid hormone profile in children with goiter in an endemic goiter area. Author(s): Semiz S, Senol U, Bircan O, Gumuslu S, Korgun DK, Akcurin S, Bircan I. Source: J Pediatr Endocrinol Metab. 2001 February; 14(2): 171-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11305795&dopt=Abstract
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Thyroid size and goiter prevalence after introduction of iodized salt: a 5-y prospective study in schoolchildren in Cote d'Ivoire. Author(s): Zimmermann MB, Hess SY, Adou P, Toresanni T, Wegmuller R, Hurrell RF. Source: The American Journal of Clinical Nutrition. 2003 March; 77(3): 663-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12600858&dopt=Abstract
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Thyroid status and leptin in Basedow-Graves and multinodular goiter patients. Author(s): Seven R. Source: Journal of Toxicology and Environmental Health. Part A. 2001 August 24; 63(8): 575-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549117&dopt=Abstract
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Thyroid ultrasonography consistently identifies goiter in adults over the age of 30 years despite a diminished response with aging of the thyroid gland to the effects of goitrogenesis. Author(s): Brahmbhatt SR, Brahmbhatt RM, Eastman CJ, Boyages SC. Source: Scientificworldjournal. 2001 July 17; 1: 243-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806080&dopt=Abstract
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Tie-2 is expressed on thyroid follicular cells, is increased in goiter, and is regulated by thyrotropin through cyclic adenosine 3',5'-monophosphate. Author(s): Ramsden JD, Cocks HC, Shams M, Nijjar S, Watkinson JC, Sheppard MC, Ahmed A, Eggo MC. Source: The Journal of Clinical Endocrinology and Metabolism. 2001 June; 86(6): 2709-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11397875&dopt=Abstract
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To treat or not to treat? The unusual story of two unmarried sisters with goiter. Author(s): Fueger BJ, Zettinig G, Dudczak R. Source: Thyroid : Official Journal of the American Thyroid Association. 2002 August; 12(8): 740-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225647&dopt=Abstract
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Toxic intrathoracic goiter and mediastinal lymphadenopathy: an unusual presentation of systemic primary AL amyloidosis. Author(s): de Saedeleer B, Poppe K, Lacor P, de Mey J, Vincken W, Bourgain C, Velkeniers B. Source: Acta Clin Belg. 2003 January-February; 58(1): 46-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12723261&dopt=Abstract
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Toxic multinodular goiter in the elderly. Author(s): Vitti P, Rago T, Tonacchera M, Pinchera A. Source: J Endocrinol Invest. 2002; 25(10 Suppl): 16-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508907&dopt=Abstract
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Toxic thyroid adenoma and toxic multinodular goiter. Author(s): Luft FC. Source: Journal of Molecular Medicine (Berlin, Germany). 2001; 78(12): 657-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11434717&dopt=Abstract
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Treatment of multinodular goiter by surgery. Author(s): DeGroot LJ. Source: J Endocrinol Invest. 2001 November; 24(10): 820-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765054&dopt=Abstract
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Treatment of recurrent nodular goiters with percutaneous ethanol injection: a clinical study of twelve patients. Author(s): Solymosi T, Gal I. Source: Thyroid : Official Journal of the American Thyroid Association. 2003 March; 13(3): 273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729476&dopt=Abstract
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Two unusual sites of colon cancer metastases and a rare thyroid lymphoma. Case 1. Metastatic colon cancer to a multinodular goiter. Author(s): De Ridder M, Sermeus AB, Van de Steene J, Storme GA. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 August 1; 19(15): 3572-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11481365&dopt=Abstract
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Ultrasonographic determination of goiter prevalence in southern Brazilian schoolchildren. Author(s): Lisboa HR, Gross JL. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2002 October; 35(10): 1147-52. Epub 2002 October 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12424486&dopt=Abstract
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Ultrasonography in the diagnosis of cancer in multinodular goiter. Author(s): Barbaro D, Lapi P, Orsini P, Pasquini C, Piazza F. Source: J Endocrinol Invest. 2002 September; 25(8): 748. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240909&dopt=Abstract
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Use of fine-needle aspiration cytology and frozen section in the management of nodular goiters. Author(s): Abboud B, Allam S, Chacra LA, Ingea H, Tohme C, Farah P. Source: Head & Neck. 2003 January; 25(1): 32-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478541&dopt=Abstract
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Use of iodized salt and the prevalence of goiters in an endemic area of Bangladesh. Author(s): Sarker FH, Taufiqun-Nessa UK, Chowdhury SA. Source: Mymensingh Med J. 2002 January; 11(1): 22-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148391&dopt=Abstract
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Visual vignette. Mediastinal mass due to substernal goiter. Author(s): Hussein WI. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2002 May-June; 8(3): 244. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12134778&dopt=Abstract
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CHAPTER 2. NUTRITION AND GOITER Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and goiter.
Finding Nutrition Studies on Goiter 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 “goiter” (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 “goiter” (or a synonym): •
A newborn with a goiter and thyroid dyshormonogenesis. Author(s): Department of Pediatrics, Division of Endocrinology, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699, USA. Source: Felner, E I J-Matern-Fetal-Neonatal-Med. 2002 September; 12(3): 207-8 1476-7058
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Assessment of goiter in an area of endemic iodine deficiency. Author(s): Endocrine Laboratory, Department of Medicine and Therapeutics, University College Dublin, Ireland.
[email protected] Source: Smyth, P P Darke, C Parkes, A B Smith, D F John, R Hetherton, A M Lazarus, J H Thyroid. 1999 September; 9(9): 895-901 1050-7256
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Difference in goiter rates between two areas in Mae Hong Son Province despite an equally sufficient iodine supply. Author(s): Faculty of Medicine, Chiang Mai University, Thailand. Source: Aramrattana, A Limpijarnkit, L Leelapat, P Sriphrapradang, A Mangklabruks, A Pruenglampoo, S Vachiranakorn, J Rajatanavin, R J-Med-Assoc-Thai. 2002 July; 85(7): 831-8 0125-2208
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Endemic goiter and cretinism: an update on iodine status. Author(s): University of Virginia Health System, Charlottesville 22908, USA.
[email protected] Source: Dunn, J T J-Pediatr-Endocrinol-Metab. 2001; 14 Suppl 6: 1469-73
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Endemic goiter and iodine deficiency in Turkey. Source: Hatemi, H. Urgancioglu, I. NATO-ASI-Ser-Ser-A-Life-Sci. New York, N.Y. : Plenum Press. 1993. volume 241 page 427-430.
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Endemic goiter in Croatia. Source: Kusic, Z. Dakovic, N. Delange, F. Mesaros Simuncic, E. Kaic Rak, A. Roncevic, S. Stanicic, A. Karner, I. Smoje, J. Juresa, V. NATO-ASI-Ser-Ser-A-Life-Sci. New York, N.Y. : Plenum Press. 1993. volume 241 page 409-413.
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Endemic goiter in Portugal. Source: Sobrinho, L. Oliveira, A.L. NATO-ASI-Ser-Ser-A-Life-Sci. New York, N.Y. : Plenum Press. 1993. volume 241 page 389-393.
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Goiter in a newborn exposed to lithium in utero. Author(s): Unite Fonctionnelle, Centre de pharmacovigilance, CHU de Grenoble, Grenoble, France.
[email protected] Source: Frassetto, F Tourneur Martel, F Barjhoux, C E Villier, C Bot, B L Vincent, F AnnPharmacother. 2002 November; 36(11): 1745-8 1060-0280
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Iodine and selenium deficiency in school-children in an endemic goiter area in Turkey. Author(s): Selcuk University Medical Faculty, Konya, Turkey.
[email protected] Source: Aydin, K Kendirci, M Kurtoglu, S Karakucuk, E I Kiris, A J-Pediatr-EndocrinolMetab. 2002 Jul-August; 15(7): 1027-31
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Iodine deficiency disorders and endemic goiter in the Commonwealth of Independent States (CIS). Source: Gerasimov, G. Judenitch, O. Dedov, I. NATO-ASI-Ser-Ser-A-Life-Sci. New York, N.Y. : Plenum Press. 1993. volume 241 page 347-351.
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Iodine deficiency in Azerbaijan after the discontinuation of an iodine prophylaxis program: reassessment of iodine intake and goiter prevalence in schoolchildren. Author(s): Department of Medicine, University of Patras Medical School, University Hospital, Greece. Source: Markou, K B Georgopoulos, N A Makri, M Anastasiou, E Vlasopoulou, B Lazarou, N Deville, L Megreli, C Vagenakis, G A Sakellaropoulos, G C Jabbarov, R Kerimova, M G MamedgasaNovember, R M Vagenakis, A G Thyroid. 2001 December; 11(12): 1141-6 1050-7256
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Iodine status and goiter prevalence in Turkey before mandatory iodization. Author(s): Ankara University Medical School, Department of Endocrinology and Metabolic Diseases, Turkey. Source: Erdogan, G Erdogan, M F Emral, R Bastemir, M Sav, H Haznedaroglu, D Ustundag, M Kose, R Kamel, N Genc, Y J-Endocrinol-Invest. 2002 March; 25(3): 224-8 0391-4097
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Lack of reported mutations in a Japanese case of toxic multinodular goiter. Author(s): Department of Otolaryngology, Division of Head and Neck Surgery, Shiga University of Medical Science, Otsu, Japan.
[email protected] Source: Hanamitsu, M Takeuchi, E Kitanishi, T Sakurai, H Tanaka, H Kitano, H ORL-JOtorhinolaryngol-Relat-Spec. 2002 Jul-August; 64(4): 275-7 0301-1569
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Medical-geographic aspects of agroenvironments: endemic goiter in central Java [Essential nutrients to the human diet, iodine deficient soils]. Source: Chapman, B. Res-Ext-Ser-Coll-Trop-Agric-Hum-Resour-Univ-Hawaii. Honolulu, Hawaii : The College. March 1984. (026) page 80-93. maps. 0271-9916
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Neonatal goiter caused by expectorant usage. Author(s): Department of Pediatrics, Pamukkale University, Denizli, Turkey.
[email protected] Source: Bostanci, I Sarioglu, A Ergin, H Aksit, A Cinbis, M Akalin, N J-PediatrEndocrinol-Metab. 2001 Sep-October; 14(8): 1161-2
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Serum levels of cytokines in children and adolescents with Graves' disease and nontoxic nodular goiter. Author(s): 2nd Department of Children's Diseases, Medical Academy of Bialystok, Poland.
[email protected] Source: Bossowski, A Urban, M J-Pediatr-Endocrinol-Metab. 2001 June; 14(6): 741-7
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Smoking as a risk factor for Graves' disease, toxic nodular goiter, and autoimmune hypothyroidism. Author(s): The Osteoporosis Clinic, Aarhus Amtssygehus, Aarhus University Hospital, Denmark.
[email protected] Source: Vestergaard, Peter Rejnmark, Lars Weeke, Jorgen Hoeck, Hans Christian Nielsen, Henning K Rungby, Jorgen Laurberg, Peter Mosekilde, Leif Thyroid. 2002 January; 12(1): 69-75 1050-7256
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Some problems of endemic goiter in Czecho-Slovakia yesterday, today and tomorrow. Source: Langer, P. Tajtakova, M. Podoba, J. Zamrazil, V. Pohunkova, D. Bednar, J. Gutekunst, R. NATO-ASI-Ser-Ser-A-Life-Sci. New York, N.Y. : Plenum Press. 1993. volume 241 page 353-357.
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The influence of parity on multinodular goiter prevalence in areas with moderate iodine deficiency. Author(s): Institute of Endocrinology, Second University of Naples, Italy.
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Source: Rotondi, M Sorvillo, F Mazziotti, G Balzano, S Iorio, S Savoia, A Piscopo, M Biondi, B Amato, G Carella, C J-Endocrinol-Invest. 2002 May; 25(5): 442-6 0391-4097 •
Toxic thyroid adenoma and toxic multinodular goiter. Author(s): Franz-Volhard-Klinik, Humboldt University of Berlin, Berlin-Buch, Germany.
[email protected] Source: Luft, F C J-Mol-Med. 2001; 78(12): 657-60 0946-2716
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Treatment of multinodular goiter by surgery. Author(s): Department of Medicine, University of Chicago, IL 60637, USA. Source: DeGroot, L J J-Endocrinol-Invest. 2001 November; 24(10): 820-2 0391-4097
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Use of iodized salt and the prevalence of goiters in an endemic area of Bangladesh. Author(s): Department of Community Medicine, Mymensingh Medical College. Source: Sarker, F H Taufiqun Nessa, U K Chowdhury, S A Mymensingh-Med-J. 2002 January; 11(1): 22-5 1022-4742
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
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
Nutrition
•
Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to goiter; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Minerals Iodine Source: Healthnotes, Inc.; www.healthnotes.com Iodine Source: Integrative Medicine Communications; www.drkoop.com Iodine Source: Prima Communications, Inc.www.personalhealthzone.com Iodine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,888,00.html Selenium Source: Healthnotes, Inc.; www.healthnotes.com
•
Food and Diet Broccoli Source: Healthnotes, Inc.; www.healthnotes.com Brussels Sprouts Source: Healthnotes, Inc.; www.healthnotes.com Cabbage Source: Healthnotes, Inc.; www.healthnotes.com Cauliflower Source: Healthnotes, Inc.; www.healthnotes.com Lima Beans Source: Healthnotes, Inc.; www.healthnotes.com
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Low-Salt Diet Source: Healthnotes, Inc.; www.healthnotes.com Soy Source: Healthnotes, Inc.; www.healthnotes.com Sweet Potatoes Source: Healthnotes, Inc.; www.healthnotes.com Water Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND GOITER Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to goiter. 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 goiter 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 “goiter” (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 goiter: •
Diagnosis and management of large toxic multinodular goiters. Author(s): Hamburger JI, Hamburger SW. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1985 August; 26(8): 888-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2411889&dopt=Abstract
•
Earliest prevention of endemic goiter by iodine supplementation during pregnancy. Author(s): Liesenkotter KP, Gopel W, Bogner U, Stach B, Gruters A. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 1996 April; 134(4): 443-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8640295&dopt=Abstract
•
Effect of iodine supplementation on goiter prevalence among the pediatric population in a severely iodine deficient area. Author(s): Demirel F, Ozer T, Gurel A, Acun C, Ozdemir H, Tomac N, Unalacak M.
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Source: J Pediatr Endocrinol Metab. 2004 January; 17(1): 73-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14960024&dopt=Abstract •
Erythrocyte, plasma, and serum antioxidant activities in untreated toxic multinodular goiter patients. Author(s): Aliciguzel Y, Ozdem SN, Ozdem SS, Karayalcin U, Siedlak SL, Perry G, Smith MA. Source: Free Radical Biology & Medicine. 2001 March 15; 30(6): 665-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295364&dopt=Abstract
•
Euthyroidism via iodide supplementation in hereditary congenital goiter with thyroglobulin deficiency. Author(s): van Voorthuizen WF, de Vijlder JJ, van Dijk JE, Tegelaers WH. Source: Endocrinology. 1978 December; 103(6): 2105-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=748035&dopt=Abstract
•
Goiter in Tibetan medicine. Author(s): Burrow GN, Hopkins J, Dhonden Y, Dolma L. Source: Yale J Biol Med. 1978 July-August; 51(4): 441-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=751325&dopt=Abstract
•
Persistence of goiter despite oral iodine supplementation in goitrous children with iron deficiency anemia in Cote d'Ivoire. Author(s): Zimmermann M, Adou P, Torresani T, Zeder C, Hurrell R. Source: The American Journal of Clinical Nutrition. 2000 January; 71(1): 88-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10617951&dopt=Abstract
•
Postural changes of the cervical spine in patients with nontoxic goiter. Author(s): Gokpinar E, Nilsson N, Anderson PB, Beyer J, Hegedus L. Source: Journal of Manipulative and Physiological Therapeutics. 1998 NovemberDecember; 21(9): 600-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9868630&dopt=Abstract
•
Studies on soybean factors which produced goiter in rats. Author(s): Suwa J, Koyanagi T, Kimura S. Source: J Nutr Sci Vitaminol (Tokyo). 1979; 25(4): 309-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=574898&dopt=Abstract
•
The feasibility of high dose iodine 131 treatment as an alternative to surgery in patients with a very large goiter: effect on thyroid function and size and pulmonary function. Author(s): Bonnema SJ, Bertelsen H, Mortensen J, Andersen PB, Knudsen DU, Bastholt L, Hegedus L.
Alternative Medicine 55
Source: The Journal of Clinical Endocrinology and Metabolism. 1999 October; 84(10): 3636-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10523007&dopt=Abstract •
The medical treatment of non-toxic goiter: several questions remain. Author(s): Koutras DA. Source: Thyroidology. 1993 August; 5(2): 49-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7522531&dopt=Abstract
•
Traditional Chinese medicine action on experimental rat goiter and normal rat thyroids. Author(s): Chen BX, Jiang RG, Hu JK. Source: Chinese Medical Journal. 1983 March; 96(3): 235-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6409535&dopt=Abstract
•
Treatment of toxic adenomatous goiter by large doses of radioactive iodine. Author(s): COOK JR, JONES RW, MCCULLAGH EP. Source: The Journal of Clinical Endocrinology and Metabolism. 1955 December; 15(12): 1512-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13271533&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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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/
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The following is a specific Web list relating to goiter; 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 Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Hyperthyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Integrative Medicine Communications; www.drkoop.com
•
Alternative Therapy Chinese System of Food Cures Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html
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Chinese Medicine Haizao Alternative names: Seaweed; Sargassum Source: Chinese Materia Medica Kunbu Alternative names: Kelp or Tangle; Thallus Laminariae Source: Chinese Materia Medica
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Herbs and Supplements Kelp Source: Healthnotes, Inc.; www.healthnotes.com Thyroid Hormones Source: Healthnotes, Inc.; www.healthnotes.com
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 GOITER Overview In this chapter, we will give you a bibliography on recent dissertations relating to goiter. 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 “goiter” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on goiter, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Goiter 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 goiter. 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: •
Ethnography of Nutritional Deficiency in a Spanish Mountain Village: Analysis of Public Health's Delay in Preventing Iodine Deficiency Disorders (IDD) (Goiter, Asturias, Cretinism, Medical History, Disrepute) by Fernandez, Renate Lellep, PhD from Rutgers the State University of New Jersey - New Brunswick, 1986, 491 pages http://wwwlib.umi.com/dissertations/fullcit/8612114
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. BOOKS ON GOITER Overview This chapter provides bibliographic book references relating to goiter. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on goiter 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 “goiter” at online booksellers’ Web sites, you may discover nonmedical books that use the generic term “goiter” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “goiter” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Endemic Goiter and Endemic Cretinism: Iodine Nutrition in Health and Disease by John B. Stanbury (Editor), Basil S. Hetzel (Editor); ISBN: 047105819X; http://www.amazon.com/exec/obidos/ASIN/047105819X/icongroupinterna
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Nontoxic goiter: concept and controversy by Joel I. Hamburger; ISBN: 0398027234; http://www.amazon.com/exec/obidos/ASIN/0398027234/icongroupinterna
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Total diet survey in goiter endemic areas in Indonesia; ISBN: 3893361545; http://www.amazon.com/exec/obidos/ASIN/3893361545/icongroupinterna
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Towards the Eradication of Endemic Goiter, Cretinism and Iodine Deficiency (Scientific Pub No 502) by John T Dunn, et al; ISBN: 9275115028; http://www.amazon.com/exec/obidos/ASIN/9275115028/icongroupinterna
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Chapters on Goiter In order to find chapters that specifically relate to goiter, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and goiter 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 “goiter” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on goiter: •
Pendred Syndrome Source: in Martini, A.; Read, A.; Stephens, D., eds. Genetics and Hearing Impairment. San Diego, CA: Singular Publishing Group, Inc. 1996. p. 146-156. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $54.00 plus shipping and handling. ISBN: 1565937929. Summary: Pendred syndrome is a genetic condition characterized by sporadic goiter and hearing loss. This chapter on Pendred syndrome is from a book that offers an overview of genetic hearing loss for audiologists, otolaryngologists, and clinical geneticists. The authors begin with a brief review of the history and classification of Pendred syndrome, then discuss audiovestibular studies in the syndrome, thyroid dysfunction in Pendred syndrome, the perchlorate discharge test, radiological studies in Pendred syndrome, the inherited basis of Pendred syndrome, and related genetic studies. The authors conclude that the clinical, genetic, and radiological evidence in support of a distinct autosomal recessive entity conforming to the condition described by Pendred is overwhelming. No single test is diagnostic but, taken in combination, the audiovestibular, radiological, and perchlorate studies appear robust enough to identify most cases. 2 figures.
•
Endocrine Conditions Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 263-297. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail:
[email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: The endocrine system is a widespread system consisting of glands that exert their effects, usually at some distance, by means of chemicals (hormones) secreted into the circulation. Endocrine and nervous system mechanisms thus normally maintain homeostasis. This chapter on endocrine conditions is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. Topics include the hypothalamus and pituitary, posterior pituitary hypofunction, anterior pituitary hypo and hyperfunction, adrenocortical hypofunction, systemic corticosteroid therapy, acute adrenal insufficiency, adrenocortical hyperfunction (including Cushing's syndrome), hyperaldosteronism, pheochromocytoma, the thyroid, goiter, lingual thyroid, hypo and hyperthyroidism, the parathyroids, hypo and hyperparathyroidism, the pancreas, diabetes mellitus, hormone-secreting pancreatic tumors, the gonads, oral
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contraceptives, pregnancy, lactation, prematurity, menopause, hormone replacement therapy, multiple endocrine adenoma (MEA), and endocrine and metabolic manifestations of cancer and other diseases. For each condition, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. 1 appendix. 5 figures. 23 tables. 53 references. •
Endocrine Disease Source: in Miller, R.L., et al. General and Oral Pathology for the Dental Hygienist. St. Louis, MO: Mosby-Year Book, Inc. 1995. p. 309-320. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-9934. (800) 426-4545 or (314) 872-8370; Fax (800) 535-9935 or (314) 4321380; E-mail:
[email protected]; http://www.mosby.com. PRICE: $43.00 plus shipping and handling. ISBN: 0801670241. Stock Number 07024. Summary: This chapter, from a textbook on pathology for dental hygiene students, covers endocrine disease. Topics include the clinical aspects of hyper-and hypopituitarism; diabetes insipidus; the development of the thyroid gland, and the physiology and function of the thyroglossal duct cyst and the lingual thyroid gland; common causes of myxedema; the etiology of Hashimoto's disease; the etiology and clinical symptoms of Graves' disease; thyroid cancer and its relationship to radiation or genetic etiology; goiter; the etiology, pathogenesis, and clinical features of FriderichsenWaterhouse syndrome, Addison's disease, and Cushing's syndrome; diseases caused by hypersecretion of aldosterone and adrenal sex hormones; the clinical and radiographic changes indicative of hyperparathyroidism; diabetes mellitus (types I and II); and common dental problems associated with diabetes mellitus. The chapter includes a list of learning objectives; illustrative case studies; and recommended readings. 4 figures. 2 tables.
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CHAPTER 6. PERIODICALS AND NEWS ON GOITER Overview In this chapter, we suggest a number of news sources and present various periodicals that cover goiter.
News Services and Press Releases One of the simplest ways of tracking press releases on goiter 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 “goiter” (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 goiter. 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 “goiter” (or synonyms). The following was recently listed in this archive for goiter: •
Japan pledges $5 million to fight goiter in Nepal Source: Reuters Health eLine Date: November 15, 2000
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “goiter” (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 “goiter” (or synonyms). If you know the name of a company that is relevant to goiter, 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 “goiter” (or synonyms).
Academic Periodicals covering Goiter Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to goiter. In addition to these
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sources, you can search for articles covering goiter 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 7. 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 goiter. 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 goiter. 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 goiter: Sodium Iodide •
Systemic - U.S. Brands: Iodopen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202621.html
Thyroid Hormones •
Systemic - U.S. Brands: Armour Thyroid; Cytomel; Levo-T; Levothroid; Levoxyl; Synthroid; Thyrar; Thyroid Strong; Thyrolar; Triostat; Westhroid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202566.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. 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 Institute8: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
8
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
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 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:10 •
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
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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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
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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/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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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
9
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). 10 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
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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 Gateway11 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.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “goiter” (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 24697 430 908 5 140 26180
HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 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.15 Simply search by “goiter” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
11
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
12
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). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15
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 Biologists16 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.17 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.18 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/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Goiter In the following section, we will discuss databases and references which relate to the Genome Project and goiter. 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).19 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. 16 Adapted 17
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. 18 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. 19 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 “goiter” (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 goiter: •
Bird-headed Dwarfism with Progressive Ataxia, Insulin-resistant Diabetes, Goiter, and Primary Gonadal Insufficiency Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=210740
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Goiter, Multinodular 1 Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=138800
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Goiter, Multinodular 2 Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=300273
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Goiter, Multinodular 3 Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=606082
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Goiter, Multinodular, Cystic Renal Disease and Digital Anomalies Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=138790 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
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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
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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
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Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan
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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
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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
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “goiter” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database20 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 Database21 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.
20
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 21 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “goiter” (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).
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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 goiter 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 goiter. 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 goiter. 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 “goiter”:
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Other guides Autoimmune Diseases http://www.nlm.nih.gov/medlineplus/autoimmunediseases.html Hormones http://www.nlm.nih.gov/medlineplus/hormones.html Laboratory Tests http://www.nlm.nih.gov/medlineplus/laboratorytests.html Thyroid Cancer http://www.nlm.nih.gov/medlineplus/thyroidcancer.html Thyroid Diseases http://www.nlm.nih.gov/medlineplus/thyroiddiseases.html Traveler's Health http://www.nlm.nih.gov/medlineplus/travelershealth.html
Within the health topic page dedicated to goiter, the following was listed: •
General/Overviews Thyroid Disease Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZDMMPX77C &sub_cat=501 Thyroid Disorders Source: National Women's Health Information Center http://www.4woman.gov/faq/thyroid_disease.htm Your Thyroid Gland Source: American Academy of Otolaryngology--Head and Neck Surgery http://www.entnet.org/healthinfo/thyroid/thyroid_gland.cfm
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Diagnosis/Symptoms Calcium Pentagastrin Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/calciumpentagastri.pdf Neck Swelling Source: American Academy of Family Physicians http://familydoctor.org/514.xml T3 (Triiodothyronine): The Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/t3/test.html T4 (Thyroxine): The Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/t4/test.html Thyroid Scan/Thyroid Uptake Study Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/thyroidupt.pdf
Patient Resources
TRH Stimulation Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/trh.pdf TSH (Thyroid-Stimulating Hormone) Test Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/tsh/test.html •
Treatment Antithyroid Drugs Source: UpToDate http://patients.uptodate.com/frames.asp?page=topic.asp&file=endo_hor/5036 Thyroid Hormone Treatment Source: American Thyroid Association http://www.thyroid.org/patients/brochures/HormoneTreatment_brochure.pdf Thyroid Surgery http://www.nlm.nih.gov/medlineplus/tutorials/thyroidsurgeryloader.html Thyroidectomy Source: InteliHealth http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20758.html What Is an Endocrinologist? Source: Hormone Foundation http://www.hormone.org/publications/what_is_endocr.html
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Nutrition Preparing to Receive I-131: The Low-Iodine Diet Source: National Institutes of Health http://www.cc.nih.gov/ccc/patient_education/pepubs/lowio.pdf
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Specific Conditions/Aspects Goiter Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00217 Graves' Dermopathy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00605 Graves' Disease http://www.thyroid.org/patients/brochures/Graves_brochure.pdf Hashimoto's Disease and the Flu Shot Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00676 Hashimoto's Disease: What It Is and How It's Treated Source: American Academy of Family Physicians http://familydoctor.org/548.xml
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Hormonal Causes of Ovulatory Disorders Source: Resolve http://www.resolve.org/main/national/treatment/diagnosis/thyroid.jsp?name=t reatment&tag=diagnosis Hyperthyroidism Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00344 Hyperthyroidism: Can It Cause Bone Thinning? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00764 Hypothyroidism Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00353 Hypothyroidism: Can It Cause Joint Pain? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00069 Soy: Does It Adversely Affect the Thyroid? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00454 Subacute (Viral) Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00331 Thyroid Disease and the Eye Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/thyroid.html Thyroid Nodules Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00491 Thyrotoxic Myopathy Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/thyrotoxic_myopathy. htm •
Children Clinical Hypothyroidism Source: MAGIC Foundation http://www.magicfoundation.org/clinhypo.html Congenital Hypothyroidism Source: MAGIC Foundation http://www.magicfoundation.org/congthyr.html Thyroid Disorders Source: Nemours Foundation http://kidshealth.org/kid/health_problems/gland/thyroid.html
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Thyroid through the Ages: Birth and Early Childhood (Growth) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-birth.php •
Latest News Thyroid Radiation May Be Cancer Risk Source: 03/03/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16384 .html
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Organizations American Thyroid Association http://www.thyroid.org/ Hormone Foundation http://www.hormone.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/
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Pictures/Diagrams Atlas of the Body: The Endocrine System Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZW5TZ46JC &sub_cat=514
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Prevention/Screening How to Take the Thyroid “Neck Check” http://www.aace.com/pub/tam2001/neckcheck3.pdf
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Research Are Thyroid Nodules That Grow Cancerous? Source: American College of Physicians http://www.annals.org/cgi/content/full/138/4/I-60 Effects of Removing Thyroid Antigens in Patients with Autoimmune Thyroid Disease Source: American College of Physicians http://www.annals.org/cgi/content/full/139/5_Part_1/I-75
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Teenagers Thyroid Disease and Teens Source: Nemours Foundation http://kidshealth.org/teen/diseases_conditions/growth/thyroid.html
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Women Postpartum Thyroiditis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00153 Thyroid Disease and Pregnancy Source: American Thyroid Association http://www.thyroid.org/patients/brochures/Thyroid_Dis_Pregnancy_broch.pdf Thyroid through the Ages: Midlife (Menopause) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-midlife.php Thyroid through the Ages: The Reproductive Years (Pregnancy) Source: American Association of Clinical Endocrinologists http://www.aace.com/pub/tam2001/tam-reproyrs.php
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “goiter” (or synonyms). The following was recently posted: •
ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guide Source: American College of Cardiology Foundation - Medical Specialty Society; 2001 October; 70 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2968&nbr=2194&a mp;string=goiter
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American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1996 (revised 2002); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3525&nbr=2751&a mp;string=goiter
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American Gastroenterological Association management of oropharyngeal dysphagia
medical
position
statement
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Source: American Gastroenterological Association - Medical Specialty Society; 1998 July 24 (reviewed 2001); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3067&nbr=2293&a mp;string=goiter •
Guidelines for detection of thyroid dysfunction Source: American Thyroid Association - Professional Association; 2000 June 12; 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2361&nbr=1587&a mp;string=goiter
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Laboratory support for the diagnosis and monitoring of thyroid disease Source: National Academy of Clinical Biochemistry - Professional Association; 2002; 125 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3522&nbr=2748&a mp;string=goiter
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Potassium iodide as a thyroid blocking agent in radiation emergencies Source: Food and Drug Administration (U.S.) - Federal Government Agency [U.S.]; 2001 November; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3089&nbr=2315&a mp;string=goiter
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Procedure guideline for thyroid scintigraphy Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1364&nbr=622&am p;string=goiter
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Procedure guideline for thyroid uptake measurement Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1342&nbr=623&am p;string=goiter
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Radiation disasters and children Source: American Academy of Pediatrics - Medical Specialty Society; 2003 June; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3842&nbr=3058&a mp;string=goiter
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Society of Nuclear Medicine procedure guideline for therapy of thyroid disease with iodine-131 (sodium iodide) Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 2002 February 10; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3191&nbr=2417&a mp;string=goiter 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 goiter. 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
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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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 goiter. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with goiter. 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 goiter. For more information, see the
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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 “goiter” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “goiter”. 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 “goiter” (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 “goiter” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
22
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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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
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
23
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 93 •
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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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
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 95 •
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on goiter: •
Basic Guidelines for Goiter Goiter Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001178.htm
•
Signs & Symptoms for Goiter Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Breathing difficulties Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm
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Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Neck lump Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003098.htm Palpitations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Shortness of breath Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Swallowing difficulties Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003115.htm Sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Wheezing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003070.htm •
Diagnostics and Tests for Goiter Antithyroid microsomal antibody Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm Microsomal antibody Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm Radioactive iodine uptake Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003689.htm T4 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003517.htm Thyroid scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003829.htm Thyroid stimulating hormone Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm Ultrasound of thyroid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003776.htm
Online Glossaries 99 •
Surgery and Procedures for Goiter Thyroidectomy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002933.htm
•
Background Topics for Goiter Cobalt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002495.htm Endemic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002362.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Malignancy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002253.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
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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GOITER 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] Abscess: A localized, circumscribed collection of pus. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcholinesterase: An enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. In the CNS, this enzyme plays a role in the function of peripheral neuromuscular junctions. EC 3.1.1.7. [NIH] 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] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adoptive Transfer: Form of passive immunization where previously sensitized immunologic agents (cells or serum) are transferred to non-immune recipients. When transfer of cells is used as a therapy for the treatment of neoplasms, it is called adoptive immunotherapy (immunotherapy, adoptive). [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal insufficiency: The reduced secretion of adrenal glands. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent
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chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonists: Drugs that trigger an action from a cell or another drug. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile
Dictionary 103
sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]
Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] 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] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the
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antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspiration: The act of inhaling. [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] ATP: ATP an abbreviation for adenosine triphosphate, a compound which serves as a carrier of energy for cells. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a
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variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Axilla: The underarm or armpit. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] 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] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Beta-pleated: Particular three-dimensional pattern of amyloidoses. [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] Bioassays: Determination of the relative effective strength of a substance (as a vitamin, hormone, or drug) by comparing its effect on a test organism with that of a standard preparation. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] 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]
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Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] 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] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachiocephalic Veins: Large veins on either side of the root of the neck formed by the junction of the internal jugular and subclavian veins. They drain blood from the head, neck, and upper extremities, and unite to form the superior vena cava. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It 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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [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] 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
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for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] 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 Communication: Any of several ways in which living cells of an organism communicate with one another, whether by direct contact between cells or by means of chemical signals carried by neurotransmitter substances, hormones, and cyclic AMP. [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] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chaperonins: A class of sequence-related molecular chaperones found in bacteria, mitochondria, and plastids. Chaperonins are abundant constitutive proteins that increase in
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amount after stresses such as heat shock, bacterial infection of macrophages, and an increase in the cellular content of unfolded proteins. Bacterial chaperonins are major immunogens in human bacterial infections because of their accumulation during the stress of infection. Two members of this class of chaperones are chaperonin 10 and chaperonin 60. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chimeras: Organism that contains a mixture of genetically different cells. [NIH] Chimeric Proteins: Proteins in individuals that are derived from genetically different zygotes. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [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] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] 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 study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [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] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior
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part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
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] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray
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machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] 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] 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] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an
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increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [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] Cyst: A sac or capsule filled with fluid. [NIH] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] 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] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] 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] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate
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objects. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] DNA Topoisomerase: An enzyme catalyzing ATP-independent breakage of single-stranded DNA, followed by passage and rejoining of another single-stranded DNA. This enzyme class brings about the conversion of one topological isomer of DNA into another, e.g., the relaxation of superhelical turns in DNA, the interconversion of simple and knotted rings of single-stranded DNA, and the intertwisting of single-stranded rings of complementary sequences. (From Enzyme Nomenclature, 1992) EC 5.99.1.2. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysphagia: Difficulty in swallowing. [EU] 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] Ectopic: Pertaining to or characterized by ectopia. [EU] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] 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
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latter being a high-energy biproduct of nuclear decay. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinologist: A doctor that specializes in diagnosing and treating hormone disorders. [NIH]
Endolymphatic Duct: Duct connecting the endolymphatic sac with the membranous labyrinth. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] 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] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH]
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Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]
Epitope Mapping: Methods used for studying the interactions of antibodies with specific regions of protein antigens. Important applications of epitope mapping are found within the area of immunochemistry. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [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] Estrone: 3-Hydroxyestra-1,3,5(10)-trien-17-one. A metabolite of estradiol but possessing less biological activity. It is found in the urine of pregnant women and mares, in the human placenta, and in the urine of bulls and stallions. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), estrone may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]
Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] External radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external-beam radiation. [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] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU]
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Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fetal Blood: Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the placenta. The cord blood is blood contained in the umbilical vessels at the time of delivery. [NIH] Fetal Heart: The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (heart/embryology) only on the basis of time. [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] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually
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between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genistein: An isoflavonoid derived from soy products. It inhibits protein-tyrosine kinase and topoisomerase-ii (dna topoisomerase (atp-hydrolysing)) activity and is used as an antineoplastic and antitumor agent. Experimentally, it has been shown to induce G2 phase arrest in human and murine cell lines. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] 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] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin
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secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonads: The gamete-producing glands, ovary or testis. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Heat-Shock Proteins: Proteins which are synthesized in eukaryotic organisms and bacteria in response to hyperthermia and other environmental stresses. They increase thermal tolerance and perform functions essential to cell survival under these conditions. [NIH] Heat-Shock Proteins 90: A class of molecular chaperones whose members act in the mechanism of signal transduction by steroid receptors. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH]
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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] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperaldosteronism: Aldosteronism. [EU] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersecretion: Excessive secretion. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH]
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Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypovitaminosis: A condition due to a deficiency of one or more essential vitamins. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] 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]
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Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [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]
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] Ingestion: Taking into the body by mouth [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH]
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Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Involution: 1. A rolling or turning inward. 2. One of the movements involved in the gastrulation of many animals. 3. A retrograde change of the entire body or in a particular organ, as the retrograde changes in the female genital organs that result in normal size after delivery. 4. The progressive degeneration occurring naturally with advancing age, resulting in shrivelling of organs or tissues. [EU] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Iodine-131: Radioactive isotope of iodine. [NIH] Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iopanoic Acid: Radiopaque medium used as diagnostic aid. [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] 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] Kinetic: Pertaining to or producing motion. [EU]
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Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lactation: The period of the secretion of milk. [EU] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] 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] Levothyroxine: Levo isomer of the thyroid hormone thyroxine. It is used for replacement therapy in reduced or absent thyroid function. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Lobectomy: The removal of a lobe. [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
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site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] 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]
Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU]
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Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] 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] 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] Microsomal: Of or pertaining to microsomes : vesicular fragments of endoplasmic reticulum formed after disruption and centrifugation of cells. [EU] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH]
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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] 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] Molecular Chaperones: A family of cellular proteins that mediate the correct assembly or disassembly of other polypeptides, and in some cases their assembly into oligomeric structures, but which are not components of those final structures. It is believed that chaperone proteins assist polypeptides to self-assemble by inhibiting alternative assembly pathways that produce nonfunctional structures. Some classes of molecular chaperones are the nucleoplasmins, the chaperonins, the heat-shock proteins 70, and the heat-shock proteins 90. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [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] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Myxedema: A condition characterized by a dry, waxy type of swelling with abnormal deposits of mucin in the skin and other tissues. It is produced by a functional insufficiency of the thyroid gland, resulting in deficiency of thyroid hormone. The skin becomes puffy around the eyes and on the cheeks and the face is dull and expressionless with thickened nose and lips. The congenital form of the disease is cretinism. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes
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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] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [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] Oocytes: Female germ cells in stages between the prophase of the first maturation division and the completion of the second maturation division. [NIH] Ophthalmic: Pertaining to the eye. [EU] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At
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the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] 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] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parathyroidectomy: Excision of one or both of the parathyroid glands. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
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Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Pelvic: Pertaining to the pelvis. [EU] 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] Peripheral blood: Blood circulating throughout the body. [NIH] Peroxidase: A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC 1.11.1.7. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] 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
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day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [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] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] 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] Post-translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] 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] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body,
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secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH]
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Protein-Energy Malnutrition: The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses. [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] Protein-Tyrosine Kinase: An enzyme that catalyzes the phosphorylation of tyrosine residues in proteins with ATP or other nucleotides as phosphate donors. EC 2.7.1.112. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] 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] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and
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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] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] 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] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombinant Proteins: Proteins prepared by recombinant DNA technology. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] 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] 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] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] 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] Resection: Removal of tissue or part or all of an organ by surgery. [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] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH]
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Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrosternal: Situated or occurring behind the sternum. [EU] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] 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
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as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [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] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [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 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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] 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 Iodide: Sodium iodide (NaI). A compound forming white, odorless deliquescent crystals and used as iodine supplement, expectorant or in its radioactive (I-131) form as an diagnostic aid, particularly for thyroid function determinants. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the
Dictionary 135
axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] 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] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Sterile: Unable to produce children. [NIH] Sternum: Breast bone. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] 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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subcutaneous: Beneath the skin. [NIH] Submandibular: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the
136
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submandibular salivary gland. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substernal Goiter: A goiter which lies behind the sternum. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Substrate Specificity: A characteristic feature of enzyme activity in relation to the kind of substrate on which the enzyme or catalytic molecule reacts. [NIH] Superior vena cava: Vein which returns blood from the head and neck, upper limbs, and thorax. It is formed by the union of the two brachiocephalic veins. [NIH] Superior Vena Cava Syndrome: Obstruction of the superior vena cava caused by neoplasm, thrombosis, aneurysm, or external compression and causing suffusion and/or cyanosis of the face, neck, and upper arms. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Syncytium: A living nucleated tissue without apparent cellular structure; a tissue composed of a mass of nucleated protoplasm without cell boundaries. [NIH] Systemic: Affecting the entire body. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] 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] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH]
Dictionary 137
Thoracic: Having to do with the chest. [NIH] Thoracotomy: Surgical incision into the chest wall. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroid Nodule: A small circumscribed mass of differentiated tissue associated with the thyroid gland. It can be pathogenic or non-pathogenic. The growth of nodules can lead to a condition of nodular goiter. Most nodules appear between the ages of 30 and 50 years and most are benign. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrostatic: Antithyroid agent. [EU] Thyrotoxicosis: The clinical syndrome that reflects the response of the peripheral tissues to an excess of thyroid hormone. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH]
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Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Triad: Trivalent. [NIH] Tsh: A glycoprotein secreted by the pars distalis of the pituitary gland in vertebrates that has hormonal activity. It stimulates the growth of the thyroid gland, as well as the secretion of thyroid hormone. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] 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 kidneys. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] 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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Veins: The vessels carrying blood toward the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU]
Dictionary 139
Vestibular Aqueduct: A small bony canal linking the vestibule of the inner ear to the posterior part of the internal surface of the petrous temporal bone. It surrounds the endolymphatic duct. [NIH] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
141
INDEX A Abdomen, 101, 108, 113, 122, 127, 135, 137, 139 Abdominal, 101, 127 Abscess, 43, 101 Acetylcholine, 101, 108 Acetylcholinesterase, 18, 19, 101 Adaptability, 101, 107 Adenine, 101 Adenoma, 26, 30, 38, 45, 50, 61, 101 Adenosine, 44, 101, 104, 128 Adipocytes, 9, 101, 110, 122 Adipose Tissue, 6, 101 Adoptive Transfer, 9, 101 Adrenal Cortex, 101, 102, 110, 114, 130 Adrenal Glands, 101, 102 Adrenal insufficiency, 60, 101 Adverse Effect, 101, 134 Afferent, 101, 122 Affinity, 15, 101, 134 Age of Onset, 12, 102 Agonists, 6, 102 Aldosterone, 61, 102 Algorithms, 102, 105 Alleles, 15, 102 Alpha Particles, 102, 131 Alternative medicine, 64, 102 Amino Acid Sequence, 102, 103 Amino Acids, 18, 102, 128, 129, 131 Amyloid, 22, 34, 38, 102 Amyloidosis, 22, 45, 102 Anaesthesia, 102, 120 Anal, 25, 103, 123 Analgesic, 103, 122 Analytes, 82, 83, 103 Anaphylatoxins, 103, 109 Anaplastic, 22, 23, 103 Anatomical, 103, 104, 119, 133 Androgens, 101, 103, 110 Anemia, 4, 54, 77, 103 Aneurysm, 103, 136 Animal model, 7, 9, 13, 14, 18, 103 Antiallergic, 103, 110 Antibacterial, 103, 135 Antibiotic, 103, 135 Antibodies, 3, 7, 9, 11, 13, 14, 15, 27, 31, 43, 103, 105, 114, 117, 119, 123, 125, 129, 131
Antibody, 9, 13, 14, 98, 102, 103, 104, 109, 111, 114, 117, 118, 119, 120, 121, 125, 131, 132, 135, 139 Anticoagulant, 103, 130 Antigen, 3, 7, 9, 13, 14, 15, 35, 102, 103, 104, 109, 116, 118, 119, 120 Antigen-Antibody Complex, 104, 109 Antigen-presenting cell, 9, 104 Anti-infective, 104, 118, 121 Anti-inflammatory, 104, 110, 117 Anti-Inflammatory Agents, 104, 110 Antineoplastic, 104, 110, 116 Antioxidant, 29, 54, 104 Apoptosis, 15, 16, 21, 104 Aqueous, 104, 105, 111, 118, 122 Arachidonic Acid, 104, 130 Arterial, 104, 117, 130 Arteries, 104, 106, 110, 124 Aspiration, 29, 104 Ataxia, 76, 77, 104, 136 ATP, 104, 112, 116, 121, 128, 131 Atrial, 86, 104 Atrial Fibrillation, 86, 104 Atrium, 104 Atrophy, 76, 77, 104 Autoantibodies, 7, 8, 13, 105 Autoantigens, 105 Autoimmune disease, 15, 105 Autoimmunity, 9, 40, 43, 105 Autologous, 5, 9, 105 Axilla, 105, 106 B Bacteria, 103, 105, 107, 117, 124, 135, 138 Bactericidal, 105, 114 Basal Ganglia, 104, 105 Basal Ganglia Diseases, 104, 105 Base, 10, 11, 19, 101, 105, 111, 121, 129, 136 Benign, 32, 33, 37, 101, 105, 126, 132, 137 Beta-pleated, 102, 105 Bile, 105, 122, 135 Bioassays, 9, 105 Biochemical, 21, 102, 105, 115 Biopsy, 105, 128 Biotechnology, 19, 20, 64, 73, 75, 76, 77, 78, 105 Bladder, 106, 130, 138 Blastocyst, 106, 110, 129 Blood pressure, 106, 117, 134
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Blood vessel, 106, 108, 115, 121, 122, 123, 124, 136, 137, 138 Body Fluids, 106, 112, 134 Bone Marrow, 106, 119, 123 Bone scan, 106, 133 Brachial, 41, 106 Brachial Plexus, 41, 106 Brachiocephalic Veins, 106, 136 Brachytherapy, 106, 120, 121, 131, 139 Branch, 95, 106, 123, 128, 135, 136 Bronchi, 106, 114, 138 C Calcium, 82, 106, 109, 118, 127, 136 Carbohydrate, 106, 110, 116, 129 Carbon Dioxide, 106, 128 Carcinogen, 107, 114 Carcinogenic, 107, 130, 135 Carcinoma, 20, 22, 23, 26, 34, 38, 43, 107 Cardiac, 25, 104, 107, 125, 135 Case report, 21, 22, 23, 27, 29, 38, 43, 107, 108 Case series, 107, 108 Caudal, 107, 111, 118, 129 Cell, 5, 6, 7, 9, 10, 11, 13, 14, 15, 18, 41, 76, 77, 102, 103, 104, 105, 106, 107, 108, 109, 111, 112, 113, 114, 115, 116, 117, 119, 121, 124, 125, 126, 127, 128, 129, 130, 132, 136, 137, 138, 139 Cell Communication, 5, 107 Cell Death, 15, 104, 107, 116, 126 Cell Division, 76, 105, 107, 125, 129, 130 Cell membrane, 107, 114, 121, 128 Cell Size, 107, 115 Centrifugation, 107, 124 Cerebellar, 104, 107, 132 Cerebral, 104, 105, 107, 136 Cerebrum, 107, 138 Cervical, 27, 43, 54, 106, 107 Cervix, 107 Chaperonins, 107, 125 Chemotactic Factors, 108, 109 Chest wall, 108, 137 Chimeras, 9, 108 Chimeric Proteins, 9, 108 Cholesterol, 105, 108, 135 Choline, 101, 108 Chromaffin System, 108, 113 Chromatin, 104, 108 Chromosome, 108, 122 Chronic, 76, 108, 111, 113, 120, 121, 123, 129 Chronic renal, 108, 129
Circulatory system, 108, 113 Clinical study, 45, 108 Clinical trial, 5, 8, 73, 108, 131, 132 Clone, 15, 108 Cloning, 8, 105, 108 Cochlea, 108, 120 Cofactor, 109, 130, 137 Collagen, 109, 115 Complement, 34, 103, 109, 116 Complementary and alternative medicine, 53, 56, 109 Complementary medicine, 53, 109 Computational Biology, 73, 75, 109 Computed tomography, 29, 109, 110, 133 Computerized axial tomography, 110, 133 Computerized tomography, 110 Conception, 110, 115 Concomitant, 9, 110 Connective Tissue, 9, 106, 109, 110, 115, 116, 117, 123, 124, 133 Connective Tissue Cells, 110 Consumption, 28, 110 Contraindications, ii, 110 Coronary, 110, 124 Coronary Thrombosis, 110, 124 Corpus, 110, 130, 136 Corpus Luteum, 110, 130 Cortex, 104, 110, 132 Cortical, 10, 11, 110, 133, 136 Corticosteroid, 60, 110 Curative, 110, 136 Cyanosis, 110, 136 Cyclic, 44, 107, 111, 130 Cyst, 61, 111 Cytokines, 9, 13, 17, 41, 49, 111 Cytoplasm, 104, 107, 111, 113 Cytotoxic, 111, 131, 132 D Databases, Bibliographic, 73, 111 Decidua, 111, 129 Deletion, 36, 104, 111 Density, 107, 111, 115 Depressive Disorder, 111, 122 Deuterium, 111, 118 Diabetes Insipidus, 61, 111 Diabetes Mellitus, 3, 4, 60, 61, 111, 117 Diagnostic procedure, 64, 111 Diencephalon, 111, 118, 136 Diffusion, 111, 120, 121 Direct, iii, 15, 67, 107, 111, 132 Disease Progression, 6, 111, 132 Disinfectant, 111, 114
Index 143
Dissociation, 102, 112 DNA Topoisomerase, 112, 116 Dorsal, 112, 129 Drive, ii, vi, 4, 5, 17, 47, 61, 112, 121 Drug Interactions, 68, 112 Duct, 10, 11, 61, 112, 113, 114, 133 Dyes, 102, 112, 115 Dysphagia, 87, 112 Dysplasia, 77, 112 Dystrophy, 76, 112 E Ectopic, 27, 43, 112 Effector, 5, 101, 109, 112, 126 Effector cell, 5, 112, 126 Efficacy, 14, 24, 112 Electrolyte, 102, 110, 112, 124, 129, 134 Electrons, 104, 105, 112, 121, 127, 131, 132 Embryo, 106, 113, 120 Embryology, 113, 115 Endemic, 4, 23, 26, 28, 30, 32, 33, 34, 35, 36, 44, 46, 48, 49, 50, 53, 59, 99, 113, 135 Endocrine Glands, 113, 127 Endocrine System, 60, 85, 113 Endocrinologist, 4, 83, 113 Endolymphatic Duct, 113, 139 Endotoxins, 109, 113 End-stage renal, 108, 113, 129 Energy balance, 113, 122 Environmental Exposure, 113, 126 Environmental Health, 44, 72, 74, 113 Enzymatic, 106, 109, 113 Enzyme, 101, 112, 113, 117, 124, 128, 131, 136, 137, 139 Epidemic, 113, 135 Epidermal, 38, 113, 124 Epidermal Growth Factor, 38, 113 Epidermis, 113 Epigastric, 113, 127 Epithelial, 11, 18, 21, 101, 111, 113, 114 Epithelial Cells, 11, 18, 21, 113, 114 Epitope, 9, 114 Epitope Mapping, 9, 114 Erythrocytes, 103, 106, 114 Essential Tremor, 77, 114 Estradiol, 8, 114 Estrone, 8, 114 Ethanol, 45, 114 Excitation, 114, 115 Exocrine, 114, 127 Exocytosis, 18, 114 Expectorant, 37, 49, 114, 134 Expiration, 114
Expiratory, 38, 114 External radiation, 16, 114 External-beam radiation, 114, 121, 131, 139 Extracellular, 102, 110, 114, 115, 134, 136 Extracellular Matrix, 110, 114, 115 Extremity, 106, 114 Exudate, 114, 115 F Family Planning, 73, 115 Fat, 6, 101, 104, 106, 110, 115, 117, 122, 133 Fatty acids, 115, 130 Ferritin, 42, 115 Fetal Blood, 8, 115 Fetal Heart, 8, 115 Fetal Weight, 8, 115 Fetus, 8, 115, 128, 129, 138 Fibroblasts, 5, 7, 9, 13, 14, 17, 110, 115 Fibrosis, 6, 77, 115, 133 Fine-needle aspiration, 41, 46, 115, 126 Flow Cytometry, 13, 115 Fluorescence, 115 Fluorescent Dyes, 115 Fold, 5, 115 G Gamma Rays, 115, 131, 132 Ganglia, 101, 105, 116, 126 Gas, 106, 111, 116, 118 Gastric, 113, 116 Gastrin, 116, 118 Gastrointestinal, 4, 114, 116, 136 Gastrointestinal tract, 4, 114, 116 Gene, 10, 11, 12, 15, 16, 17, 19, 24, 30, 36, 39, 77, 78, 102, 105, 116, 126 Gene Expression, 10, 77, 116 Genetic Engineering, 105, 108, 116 Genetics, 13, 60, 116 Genistein, 8, 116 Genital, 116, 121 Genotype, 116, 128 Germ Cells, 116, 126, 127, 134, 136 Gestation, 8, 116, 129 Gestational, 24, 116 Giant Cells, 37, 116 Gland, 18, 27, 61, 82, 84, 101, 108, 116, 123, 127, 128, 130, 133, 135, 136, 137 Glomerular, 116 Glomeruli, 116 Glomerulonephritis, 32, 116 Glucocorticoids, 101, 110, 116 Glucose, 76, 111, 117, 120, 133 Glucose Intolerance, 111, 117
144
Goiter
Glutathione Peroxidase, 117, 134 Glycoprotein, 116, 117, 137, 138 Gonadal, 76, 117, 135 Gonads, 60, 117 Governing Board, 117, 129 Graft, 117, 118, 119 Graft Rejection, 117, 119 Gravidity, 117, 127 Growth, 14, 15, 16, 33, 38, 76, 85, 103, 104, 107, 113, 117, 120, 123, 126, 129, 137, 138 H Haptens, 102, 117 Heat-Shock Proteins, 117, 125 Heat-Shock Proteins 90, 117, 125 Hemoglobin, 103, 111, 114, 117 Hemoglobinuria, 76, 117 Hereditary, 54, 118, 128, 132 Heredity, 116, 118 Heterogeneity, 12, 102, 118 Homeostasis, 15, 60, 118 Homologous, 102, 118 Hormonal, 4, 5, 6, 9, 15, 84, 105, 110, 118, 138 Hormone Replacement Therapy, 61, 118 Host, 118, 119 Hybrid, 108, 118 Hydrogen, 18, 105, 106, 111, 117, 118, 125, 126, 127, 131 Hydrogen Peroxide, 18, 117, 118 Hydrolysis, 101, 118, 121, 129, 131 Hyperaldosteronism, 60, 118 Hypercalcemia, 4, 118 Hyperplasia, 6, 118 Hypersecretion, 61, 118 Hypersensitivity, 118, 133 Hyperthyroidism, 4, 6, 8, 9, 12, 13, 21, 25, 26, 27, 40, 56, 60, 84, 86, 118 Hypertrophy, 118 Hypothalamic, 4, 118 Hypothalamus, 60, 111, 118, 128, 136 Hypothyroidism, 4, 8, 10, 12, 19, 24, 30, 41, 49, 56, 84, 86, 119 Hypovitaminosis, 4, 119 I Id, 50, 55, 76, 83, 84, 86, 87, 88, 94, 96, 119 Immune response, 7, 9, 13, 15, 103, 104, 105, 110, 117, 119, 136, 139 Immune Sera, 119 Immune system, 104, 105, 112, 119, 123, 138, 139 Immunization, 7, 14, 101, 119 Immunochemistry, 114, 119
Immunodeficiency, 76, 119 Immunoglobulin, 13, 103, 119, 125 Immunologic, 5, 101, 108, 119, 132 Immunology, 8, 12, 13, 15, 19, 102, 115, 119 Immunosuppressive, 119 Immunosuppressive therapy, 119 Immunotherapy, 14, 101, 119 Impairment, 16, 60, 104, 119 Implant radiation, 119, 120, 121, 131, 139 In situ, 18, 19, 119 In vitro, 5, 9, 15, 19, 119 In vivo, 16, 119 Incision, 120, 121, 137 Indicative, 59, 61, 120, 128, 138 Induction, 9, 14, 17, 103, 120 Infant Mortality, 16, 120 Infarction, 110, 120, 124 Infection, 108, 119, 120, 123, 133, 139 Infiltration, 18, 116, 120 Inflammation, 17, 18, 104, 115, 120, 133, 137 Ingestion, 13, 120, 136 Inner ear, 10, 11, 120, 139 Innervation, 106, 120 Insight, 5, 120 Insulin, 3, 6, 33, 76, 120 Insulin-dependent diabetes mellitus, 120 Insulin-like, 33, 120 Intermittent, 120, 123 Internal radiation, 120, 121, 131, 139 Interstitial, 106, 120, 121, 139 Intestinal, 120, 123 Intestines, 101, 116, 120 Intoxication, 121, 139 Intracellular, 18, 120, 121, 129, 130, 134 Intrinsic, 102, 121 Invasive, 20, 32, 36, 121, 123 Involuntary, 105, 114, 121, 125 Involution, 16, 121 Iodine-131, 88, 121 Ion Transport, 11, 13, 121, 124 Ionizing, 102, 113, 121, 132 Ions, 105, 112, 118, 121 Iopanoic Acid, 27, 121 Irradiation, 4, 121, 139 Ischemia, 105, 121 K Kb, 72, 121 Kidney Disease, 72, 77, 85, 121 Kinetic, 10, 121
Index 145
L Labile, 109, 122 Labyrinth, 109, 113, 120, 122, 134, 139 Lactation, 61, 122 Laryngeal, 20, 122 Larynx, 122, 138 Lens, 122, 132 Leptin, 44, 122 Lesion, 29, 122 Lethargy, 119, 122 Leukemia, 76, 122 Leukocytes, 106, 108, 111, 122, 128 Levo, 24, 68, 122 Levothyroxine, 4, 21, 122 Library Services, 94, 122 Ligament, 122, 130 Linkage, 12, 122 Lipid, 108, 120, 122 Lithium, 31, 48, 122 Liver, 101, 102, 104, 105, 116, 122, 133 Liver scan, 122, 133 Lobe, 122 Lobectomy, 43, 122 Localization, 32, 122 Localized, 101, 102, 120, 123, 129 Longitudinal study, 24, 123 Long-Term Care, 7, 123 Lumen, 10, 123 Lymph, 45, 107, 108, 123, 135 Lymph node, 107, 123 Lymphadenopathy, 45, 123 Lymphatic, 120, 123, 124, 129, 135, 137 Lymphatic system, 123, 135, 137 Lymphocyte, 104, 123 Lymphocytic, 18, 123 Lymphoid, 103, 123 Lymphoma, 23, 45, 76, 123 M Magnetic Resonance Imaging, 24, 27, 123, 133 Malabsorption, 76, 123 Malignancy, 13, 99, 123 Malignant, 30, 76, 104, 123, 126, 132 Malnutrition, 4, 32, 105, 123, 125 Manic, 122, 123 Manifest, 7, 123 Mediate, 11, 124, 125 MEDLINE, 73, 75, 77, 124 Melanocytes, 124 Melanoma, 76, 124 Membrane, 10, 11, 13, 17, 107, 109, 114, 122, 124, 128, 129, 138
Menopause, 61, 86, 124 Menstrual Cycle, 124, 130 Menstruation, 111, 124 Mercury, 115, 124 Mesenchymal, 113, 124 Metabolic disorder, 111, 124 Metabolite, 114, 124 Metaplasia, 29, 124 Metastasis, 124 Metastatic, 22, 29, 45, 124 MI, 20, 99, 124 Microorganism, 109, 124, 139 Microsomal, 3, 98, 124 Mineralocorticoids, 101, 110, 124 Mitosis, 104, 125 Modification, 116, 125, 131 Molecular, 6, 10, 11, 13, 18, 19, 45, 73, 75, 105, 107, 109, 117, 125 Molecular Chaperones, 18, 107, 117, 125 Molecule, 15, 103, 105, 109, 111, 112, 114, 118, 125, 127, 129, 132, 136 Monoclonal, 14, 121, 125, 131, 139 Monoclonal antibodies, 14, 125 Monophosphate, 44, 125 Mucus, 114, 125 Muscle Fibers, 125 Muscular Atrophy, 77, 125 Muscular Dystrophies, 112, 125 Myocardium, 124, 125 Myopathy, 84, 125 Myotonic Dystrophy, 77, 125 Myxedema, 61, 125 N Necrosis, 104, 120, 124, 125 Need, 3, 17, 60, 89, 108, 126 Needle biopsy, 25, 115, 126 Neonatal, 4, 21, 37, 48, 49, 120, 126 Neoplasia, 76, 126 Neoplasm, 126, 136 Neoplastic, 123, 126 Nephropathy, 121, 126 Nerve, 28, 104, 106, 120, 126, 133, 135 Nerve Fibers, 106, 126 Nervous System, 60, 77, 101, 116, 117, 126, 136 Neuromuscular, 101, 126 Neuromuscular Junction, 101, 126 Neurosecretory Systems, 113, 126 Neurotransmitters, 125, 126 Neutrons, 102, 121, 126, 131 Nuclei, 102, 112, 116, 123, 125, 126, 131
146
Goiter
Nucleus, 104, 105, 108, 111, 115, 126, 130, 131, 136 O Oncogene, 76, 126 Oocytes, 10, 126 Ophthalmic, 7, 84, 126 Optic Chiasm, 118, 126 Oral Health, 60, 127 Orbit, 5, 9, 14, 17, 127 Orbital, 5, 6, 7, 9, 17, 127 Ovary, 110, 114, 117, 127 Ovum, 110, 111, 116, 127, 130 Oxidation, 104, 117, 127 P Palliative, 127, 136 Palpation, 28, 127 Pancreas, 60, 101, 120, 127 Pancreatic, 60, 76, 127 Pancreatic cancer, 76, 127 Papilla, 127 Papillary, 26, 37, 38, 127 Parathyroid, 4, 35, 38, 127, 136 Parathyroid Glands, 4, 127 Parathyroid hormone, 127 Parathyroidectomy, 20, 32, 36, 127 Parity, 42, 49, 127 Paroxysmal, 76, 127 Pathogenesis, 6, 15, 17, 19, 37, 61, 127 Pathologic, 104, 105, 110, 118, 128 Pathologic Processes, 104, 128 Pathophysiology, 6, 128 Pelvic, 128, 130 Peptide, 122, 128, 129, 131, 137 Percutaneous, 45, 128 Peripheral blood, 5, 128 Peroxidase, 13, 15, 30, 128 Peroxide, 128 Pharmacologic, 128, 137 Phenotype, 5, 128 Phospholipids, 115, 128 Phosphorus, 106, 127, 128 Phosphorylation, 16, 128, 131 Physical Examination, 4, 128 Physiologic, 12, 124, 128, 130, 132 Physiology, 10, 11, 13, 61, 128 Pigment, 124, 128 Pilot study, 5, 128 Pituitary Gland, 110, 128, 138 Placenta, 8, 114, 115, 128, 130 Plants, 107, 108, 117, 129, 133, 137 Plasma, 29, 54, 103, 107, 117, 124, 129, 134 Plasma cells, 103, 129
Plexus, 106, 129 Point Mutation, 18, 129 Polycystic, 77, 129 Polymorphism, 12, 129 Polypeptide, 102, 109, 113, 129, 139 Polysaccharide, 103, 129 Posterior, 60, 103, 104, 112, 127, 129, 139 Post-translational, 16, 129 Potassium, 18, 87, 102, 124, 129 Practice Guidelines, 74, 86, 129 Precursor, 104, 108, 112, 113, 129 Prenatal, 113, 115, 129 Prevalence, 12, 24, 28, 31, 33, 34, 40, 42, 43, 44, 46, 49, 50, 53, 129 Problem Solving, 19, 129 Progesterone, 8, 129, 135 Progression, 103, 130 Progressive, 76, 108, 117, 121, 125, 130 Promoter, 10, 17, 130 Prophase, 126, 130 Prophylaxis, 32, 33, 40, 49, 130 Prospective study, 19, 36, 44, 123, 130 Prostaglandin, 17, 130 Prostaglandins A, 130 Prostate, 76, 130 Protein C, 13, 19, 102, 115, 130 Protein S, 77, 105, 130 Protein-Energy Malnutrition, 4, 131 Proteins, 9, 18, 102, 103, 107, 108, 109, 111, 117, 125, 128, 129, 131, 132, 134, 137 Protein-Tyrosine Kinase, 116, 131 Proteolytic, 109, 131 Protocol, 7, 131 Protons, 102, 118, 121, 131 Public Policy, 73, 131 Publishing, 19, 60, 131 Pulmonary, 54, 106, 110, 131 Purifying, 15, 131 Q Quality of Life, 7, 131 R Radiation, 61, 85, 87, 113, 114, 115, 120, 121, 131, 132, 133, 139 Radiation therapy, 114, 120, 121, 131, 139 Radioactive, 4, 21, 38, 55, 98, 106, 118, 119, 120, 121, 122, 125, 131, 133, 134, 139 Radioimmunotherapy, 131, 132 Radiolabeled, 121, 131, 139 Radiological, 60, 128, 131 Radiology, 40, 132 Radiotherapy, 14, 106, 121, 131, 132, 139 Randomized, 21, 112, 132
Index 147
Reagent, 17, 132 Receptor, 8, 9, 13, 14, 15, 17, 18, 27, 35, 37, 38, 104, 132 Recombinant, 8, 32, 39, 132 Recombinant Proteins, 9, 132 Rectum, 116, 130, 132 Recurrence, 43, 132 Red Nucleus, 104, 132 Refer, 1, 109, 122, 126, 131, 132, 138 Refraction, 132, 135 Regimen, 112, 132 Remission, 132 Reoperation, 42, 132 Resection, 28, 43, 132 Resolving, 12, 132 Retinoblastoma, 76, 132 Retreatment, 39, 132 Retrograde, 121, 133 Retrosternal, 20, 23, 30, 35, 133 Rheumatism, 133 Rheumatoid, 22, 34, 133 Rheumatoid arthritis, 22, 34, 133 Ribose, 101, 133 Risk factor, 40, 41, 49, 130, 133 S Salivary, 127, 133, 135, 136 Saponins, 133, 135 Scans, 12, 133 Schizoid, 133, 139 Schizophrenia, 133, 139 Schizotypal Personality Disorder, 133, 139 Sclerosis, 77, 133 Screening, 3, 28, 85, 108, 133 Secretion, 15, 101, 110, 113, 117, 118, 119, 120, 122, 124, 125, 133, 134, 138 Secretory, 6, 18, 133 Seizures, 127, 133 Selenium, 28, 33, 48, 51, 134 Semen, 130, 134 Semicircular canal, 120, 134 Sequencing, 12, 134 Serum, 3, 6, 14, 19, 29, 41, 42, 49, 54, 101, 103, 109, 119, 124, 134 Sex Determination, 77, 134 Shock, 108, 134 Side effect, 4, 7, 24, 67, 101, 134, 137 Signs and Symptoms, 4, 132, 134 Skeletal, 4, 103, 125, 134 Skeleton, 130, 134 Skull, 127, 134, 136 Small intestine, 118, 120, 134 Social Environment, 131, 134
Sodium, 13, 18, 41, 68, 88, 102, 124, 134 Sodium Iodide, 68, 88, 134 Solvent, 114, 134 Soma, 134, 135 Somatic, 37, 125, 135 Specialist, 89, 135 Species, 118, 125, 135, 138, 139 Specificity, 3, 10, 102, 135 Spectrum, 16, 18, 135 Spinal cord, 106, 108, 126, 135 Spleen, 102, 123, 135 Sporadic, 21, 29, 36, 60, 132, 135 Squamous, 29, 135 Stabilization, 16, 135 Staging, 23, 133, 135 Sterile, 127, 135 Sternum, 133, 135, 136 Steroid, 8, 117, 133, 135 Stimulus, 112, 114, 120, 135 Stomach, 101, 116, 118, 120, 134, 135 Stress, 108, 133, 135 Subcutaneous, 101, 135 Submandibular, 27, 135, 136 Submaxillary, 113, 135 Substance P, 124, 133, 136 Substernal Goiter, 25, 29, 30, 38, 42, 43, 46, 136 Substrate, 11, 136 Substrate Specificity, 11, 136 Superior vena cava, 20, 106, 136 Superior Vena Cava Syndrome, 20, 136 Supplementation, 17, 53, 54, 136 Suppression, 14, 110, 136 Symphysis, 130, 136 Syncytium, 116, 136 Systemic, 6, 22, 45, 60, 68, 102, 106, 120, 121, 131, 136, 138, 139 T Telangiectasia, 77, 136 Temporal, 136, 139 Testis, 114, 117, 136 Tetany, 127, 136 Thalamic, 104, 136 Thalamic Diseases, 104, 136 Therapeutics, 9, 48, 54, 68, 136 Third Ventricle, 118, 136 Thoracic, 27, 30, 32, 35, 43, 106, 137, 139 Thoracotomy, 28, 137 Thorax, 101, 136, 137 Thrombin, 130, 137 Thrombomodulin, 130, 137 Thrombosis, 130, 136, 137
148
Goiter
Thymus, 119, 123, 137 Thyroid Gland, 4, 8, 13, 14, 18, 26, 35, 38, 44, 61, 82, 117, 118, 125, 127, 137, 138 Thyroid Hormones, 4, 10, 56, 68, 137 Thyroid Nodule, 24, 30, 40, 84, 85, 137 Thyroiditis, 4, 12, 18, 27, 38, 84, 86, 137 Thyrostatic, 25, 137 Thyrotoxicosis, 21, 137 Thyrotropin, 8, 9, 18, 39, 44, 119, 137 Thyroxine, 3, 18, 24, 82, 122, 137 Tomography, 30, 36, 137 Topical, 114, 118, 137 Toxic, iv, 4, 21, 25, 26, 27, 29, 34, 35, 36, 37, 40, 41, 45, 49, 50, 53, 54, 55, 113, 134, 137 Toxicity, 112, 124, 137 Toxicology, 44, 74, 137 Toxins, 103, 113, 120, 125, 131, 137 Trachea, 36, 106, 114, 122, 137, 138 Transfection, 105, 138 Transfer Factor, 119, 138 Translational, 19, 138 Translocation, 16, 138 Transplantation, 108, 119, 138 Triad, 10, 138 Tsh, 83, 138 Tuberculosis, 110, 138 Tuberous Sclerosis, 77, 138 U Ultrasonography, 44, 46, 115, 138 Unconscious, 119, 138 Urethra, 130, 138 Urinary, 17, 24, 28, 31, 42, 138
Urine, 17, 106, 111, 113, 114, 117, 138 Uterus, 107, 110, 111, 124, 130, 138 V Vaccine, 131, 138 Vascular, 120, 128, 137, 138 Veins, 8, 106, 129, 138 Vena, 138 Venous, 130, 138 Vesicular, 124, 138 Vestibular, 11, 39, 138, 139 Vestibular Aqueduct, 11, 39, 139 Vestibule, 109, 120, 134, 138, 139 Veterinary Medicine, 73, 139 Viral, 84, 116, 139 Virus, 116, 139 Viscera, 135, 139 Vitro, 5, 139 Vivo, 139 W Weight Gain, 8, 139 White blood cell, 103, 122, 123, 125, 129, 139 Windpipe, 137, 139 Withdrawal, 15, 139 X Xenograft, 103, 139 X-ray, 109, 110, 115, 121, 131, 132, 133, 139 X-ray therapy, 121, 139 Y Yeasts, 128, 139 Z Zymogen, 130, 139
