HAND TREMOR 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., 1960Hand Tremor: 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: 0-497-00509-3 1. Hand Tremor-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 hand tremor. 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 HAND TREMOR ......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Hand Tremor................................................................................. 4 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. ALTERNATIVE MEDICINE AND HAND TREMOR ......................................................... 11 Overview...................................................................................................................................... 11 National Center for Complementary and Alternative Medicine.................................................. 11 Additional Web Resources ........................................................................................................... 14 General References ....................................................................................................................... 15 CHAPTER 3. PATENTS ON HAND TREMOR ..................................................................................... 17 Overview...................................................................................................................................... 17 Patents on Hand Tremor ............................................................................................................. 17 Patent Applications on Hand Tremor.......................................................................................... 21 Keeping Current .......................................................................................................................... 22 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 27 Overview...................................................................................................................................... 27 NIH Guidelines............................................................................................................................ 27 NIH Databases............................................................................................................................. 29 Other Commercial Databases....................................................................................................... 31 APPENDIX B. PATIENT RESOURCES ................................................................................................. 33 Overview...................................................................................................................................... 33 Patient Guideline Sources............................................................................................................ 33 Finding Associations.................................................................................................................... 35 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 37 Overview...................................................................................................................................... 37 Preparation................................................................................................................................... 37 Finding a Local Medical Library.................................................................................................. 37 Medical Libraries in the U.S. and Canada ................................................................................... 37 ONLINE GLOSSARIES.................................................................................................................. 43 Online Dictionary Directories ..................................................................................................... 45 HAND TREMOR DICTIONARY ................................................................................................. 47 INDEX ................................................................................................................................................ 61
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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 hand tremor is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about hand tremor, 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 hand tremor, 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 hand tremor. 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 hand tremor, 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 hand tremor. 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 HAND TREMOR Overview In this chapter, we will show you how to locate peer-reviewed references and studies on hand tremor.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and hand tremor, 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 “hand tremor” (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: •
Teens Give Advice on Handling Medication Side Effects Source: Stadtlanders Lifetimes. Issue 1: p. 17. 1998. Contact: Available from Stadtlanders Lifetimes. Stadtlanders Pharmacy, 600 Penn Center Boulevard, Pittsburgh, PA 15235-5810. E-mail:
[email protected]. Summary: This brief newsletter article offers advice from teenagers to other teenagers about handling medication side effects, particularly those required of people who have received a transplanted organ (such as a kidney). The author notes that acne, puffy cheeks, and weight gain are common problems among adolescent transplant recipients taking prednisone (a steroid). Other medications can cause abnormal hair growth, hand tremors, and bruising. The author shares the advice of several teens, eliciting surprising attitudes of acceptance and maturity in dealing with the changes that may accompany
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medication use. The teens underscored the importance of having a good support system and sharing some of their concerns with their friends. Also, communicating with the health care providers about side effects due to medications can also be helpful. The physician may be able to make alterations in dosage or type of medication. In addition, doctors and pharmacists can advise about diet and exercise to deal with weight gain and recommend products to use for facial hair and acne. The article concludes with a brief section of strategies for parents who are trying to help their teens through their health problems.
Federally Funded Research on Hand Tremor The U.S. Government supports a variety of research studies relating to hand tremor. 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 hand tremor. 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 hand tremor. The following is typical of the type of information found when searching the CRISP database for hand tremor: •
Project Title: AN ACTIVE HAND-HELD MICROMANIPULATOR Principal Investigator & Institution: Riviere, Cameron N.; Robotics Institute; CarnegieMellon University 5000 Forbes Ave Pittsburgh, Pa 15213 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2005 Summary: (provided by applicant): This project aims to create a hand-held active instrument for manual micromanipulation that compensates physiological hand tremor and other unintended motion by generating an equal but opposite deflection of its own tip, enabling positioning accuracy of approximately 10 l_m. This hand-held instrument, which we have named "Micron," will thus be able to replace automated micromanipulators for many tasks. The instrument will implement filtering algorithms for both tremor and non-tremulous movement errors. The device is designed both for microinjection and micromanipulation in the cell biology laboratory, and for clinical microsurgery (especially vitreoretinal), and is therefore relevant to both basic science and clinical applications. An exploratory research (R21) phase, now nearing completion, has resulted in a fully operational prototype and a demonstration of effective error canceling to the level of roughly 28 _m p-p (12 _m rms). The exploratory phase has also revealed that the stringent accuracy requirement of this application places unusual demands on the research, particularly in sensing of the instrument tip motion. If the goal of 10 l_m p-p noise is to be reached, the types of kinematic approximations that are
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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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typical in robotic applications cannot be used. The research proposed herein will involve advanced design developments, kinematic computations, and development of zerophase filtering concepts to enable sufficient sensing accuracy. The tip micromanipulator design will also be modified to incorporate a new minimal-hysteres is actuation scheme, as well as closed-loop control using strain gauge sensing. Initial tests will be conducted using a motorized testbed. The instrument will then be field tested in realistic settings. Experimental trials will be conducted with human users in the cell biology laboratory. Preclinical microsurgical evaluation will be conducted in the surgical practice suite. This will include tests in vitro with cadaveric porcine eyes, as well as animal experiments in vivo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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.3 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 hand tremor, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “hand tremor” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for hand tremor (hyperlinks lead to article summaries): •
A case of Sandifer's syndrome with hand tremor. Author(s): Demir E, Saka E, Aysun S. Source: Turk J Pediatr. 2001 October-December; 43(4): 348-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11765169
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A mechanical-reflex oscillator hypothesis for parkinsonian hand tremor. Author(s): Stiles RN, Pozos RS. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1976 June; 40(6): 990-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=931943
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A randomized controlled trial of the effects of weights on amplitude and frequency of postural hand tremor in people with Parkinson's disease. Author(s): Meshack RP, Norman KE. Source: Clinical Rehabilitation. 2002 August; 16(5): 481-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12194619
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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 randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. Author(s): Brin MF, Lyons KE, Doucette J, Adler CH, Caviness JN, Comella CL, Dubinsky RM, Friedman JH, Manyam BV, Matsumoto JY, Pullman SL, Rajput AH, Sethi KD, Tanner C, Koller WC. Source: Neurology. 2001 June 12; 56(11): 1523-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11402109
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A randomized, double-blind, placebo-controlled study to evaluate botulinum toxin type A in essential hand tremor. Author(s): Jankovic J, Schwartz K, Clemence W, Aswad A, Mordaunt J. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1996 May; 11(3): 250-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8723140
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A stochastic time series model for hand tremor. Author(s): Randall JE. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1973 March; 34(3): 390-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4688133
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Abduction-adduction hand tremor of myokymia. Author(s): Brick JF, Gutmann L. Source: Neurology. 1988 June; 38(6): 995. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3368084
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Alcohol drinking reduces hand tremor. Author(s): Landauer AA. Source: British Journal of Addiction. 1981 December; 76(4): 429-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6947818
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Analyzing the dynamics of hand tremor time series. Author(s): Gantert C, Honerkamp J, Timmer J. Source: Biological Cybernetics. 1992; 66(6): 479-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1586672
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Botulinum toxin A injections for the treatment of hand tremors. Author(s): Trosch RM, Pullman SL. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1994 November; 9(6): 601-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7845399
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Characteristics of hand tremor time series. Author(s): Timmer J, Gantert C, Deuschl G, Honerkamp J. Source: Biological Cybernetics. 1993; 70(1): 75-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8312399
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Data compression, and a dynamic display system for the differential diagnosis of hand tremor in the clinical neurological examination. Author(s): Pau LF. Source: Medical & Biological Engineering & Computing. 1977 May; 15(3): 292-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=195158
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Delayed onset hand tremor caused by cerebral infarction. Author(s): Kim JS. Source: Stroke; a Journal of Cerebral Circulation. 1992 February; 23(2): 292-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1561662
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Delayed onset of hand tremor related to cerebellar hemorrhage. Author(s): Lin JJ, Chang DC. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1999 January; 14(1): 189-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9918376
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Detection of hand tremor in workers exposed to mercury vapor: a comparative study of three methods. Author(s): Roels H, Abdeladim S, Braun M, Malchaire J, Lauwerys R. Source: Environmental Research. 1989 August; 49(2): 152-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2753003
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Development of a quantitative test for hand tremor measurement. Study of factors influencing the response in a control population. Author(s): Roels H, Malchaire J, Van Wambeke JP, Buchet JP, Lauwerys R. Source: J Occup Med. 1983 June; 25(6): 481-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6886851
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Effect of electrical stimulation of the thalamic Vim nucleus on hand tremor during stereotactic thalamotomy. Author(s): Takahashi A, Watanabe K, Satake K, Hirato M, Ohye C. Source: Electroencephalography and Clinical Neurophysiology. 1998 August; 109(4): 376-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9751302
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Effect of exercise on microsurgical hand tremor. Author(s): Hsu PA, Cooley BC. Source: Microsurgery. 2003; 23(4): 323-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12942522
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Effect of Timolol vs. a postural orthotic on hand tremor during microsurgery. Author(s): Lubahn JD, Dickson BG, Cooney TE. Source: Microsurgery. 2002; 22(6): 273-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12375295
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Effects of cigarette smoking and oral nicotine on hand tremor. Author(s): Shiffman SM, Gritz ER, Maltese J, Lee MA, Schneider NG, Jarvik ME. Source: Clinical Pharmacology and Therapeutics. 1983 June; 33(6): 800-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6851411
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Exercise-induced hand tremor: a possible test for beta 2-adrenoceptor selectivity in man? Author(s): Abila B, Wilson JF, Marshall RW, Richens A. Source: British Journal of Clinical Pharmacology. 1986 July; 22(1): 104-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2874824
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Frequency and displacement amplitude relations for normal hand tremor. Author(s): Stiles RN. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1976 January; 40(1): 44-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1248981
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Hand tremor in patients with spasmodic torticollis. Author(s): Deuschl G, Heinen F, Guschlbauer B, Schneider S, Glocker FX, Lucking CH. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1997 July; 12(4): 547-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9251073
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Hand tremor induced by industrial exposure to inorganic mercury. Author(s): Wood RW, Weiss AB, Weiss B. Source: Archives of Environmental Health. 1973 May; 26(5): 249-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4696382
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Measurement of hand tremor induced by industrial exposure to metallic mercury. Author(s): Fawer RF, de Ribaupierre Y, Guillemin MP, Berode M, Lob M. Source: Br J Ind Med. 1983 May; 40(2): 204-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6830719
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Mechanical and neural feedback factors in postural hand tremor of normal subjects. Author(s): Stiles RN. Source: Journal of Neurophysiology. 1980 July; 44(1): 40-59. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7420138
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Mechanistic components of normal hand tremor. Author(s): Elble RJ, Randall JE. Source: Electroencephalography and Clinical Neurophysiology. 1978 January; 44(1): 7282. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=74327
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Physiologic hand tremor. Author(s): Elble RJ. Source: Archives of Neurology. 1982 November; 39(11): 737-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7126005
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Quantification of hand tremor in the clinical neurological examination. Author(s): Albers JW, Potvin AR, Tourtellotte WW, Pew RW, Stribley RF. Source: Ieee Transactions on Bio-Medical Engineering. 1973 January; 20(1): 27-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4681807
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Quantitative measurement of the effects of caffeine and propranolol on surgeon hand tremor. Author(s): Humayun MU, Rader RS, Pieramici DJ, Awh CC, de Juan E Jr. Source: Archives of Ophthalmology. 1997 March; 115(3): 371-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9076210
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Resting hand tremor in abstinent cocaine-dependent, alcohol-dependent, and polydrug-dependent patients. Author(s): Bauer LO. Source: Alcoholism, Clinical and Experimental Research. 1996 October; 20(7): 1196-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8904970
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Shooting performance is related to forearm temperature and hand tremor size. Author(s): Lakie M, Villagra F, Bowman I, Wilby R. Source: Journal of Sports Sciences. 1995 August; 13(4): 313-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7474045
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Stability of frequency during long-term recordings of hand tremor. Author(s): Hefter H, Homberg V, Reiners K, Freund HJ. Source: Electroencephalography and Clinical Neurophysiology. 1987 November; 67(5): 439-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2444412
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The phase of postural hand tremor is not influenced by repetitive photic brain stimulation. Author(s): Lakie M, Combes N. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 1999 December; 110(12): 2020-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10616106
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The variation of hand tremor with force in healthy subjects. Author(s): Sutton GG, Sykes K. Source: The Journal of Physiology. 1967 August; 191(3): 699-711. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6051798
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Visual feedback in hand tremor. Author(s): Merton PA, Morton HB, Rashbass C. Source: Nature. 1967 November 11; 216(115): 583-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5583501
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CHAPTER 2. ALTERNATIVE MEDICINE AND HAND TREMOR Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to hand tremor. 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 hand tremor 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 “hand tremor” (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 hand tremor: •
A clinical study on the effect of reinforcement of kidney on senile brain functions. Author(s): Wang X, Xie Z. Source: J Tradit Chin Med. 1997 June; 17(2): 92-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437173
•
A curvilinear relationship between alcoholic withdrawal tremor and personality. Author(s): Smith RB, Burgess AE, Guinee VJ, Reifsnider LC. Source: Journal of Clinical Psychology. 1979 January; 35(1): 199-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=370154
•
Biomechanical study of the final push-pull in archery. Author(s): Leroyer P, Van Hoecke J, Helal JN.
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Source: Journal of Sports Sciences. 1993 February; 11(1): 63-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8450588 •
Brief communication: electromagnetic fields improve visuospatial performance and reverse agraphia in a parkinsonian patient. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1996 November; 87(3-4): 209-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9003981
•
Convulsant effects of some xanthine derivatives in genetically epilepsy-prone rats. Author(s): De Sarro A, Grasso S, Zappala M, Nava F, De Sarro G. Source: Naunyn-Schmiedeberg's Archives of Pharmacology. 1997 July; 356(1): 48-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9228189
•
Electromyographic (EMG) biofeedback in the comprehensive treatment of central pain and ataxic tremor following thalamic stroke. Author(s): Edwards CL, Sudhakar S, Scales MT, Applegate KL, Webster W, Dunn RH. Source: Applied Psychophysiology and Biofeedback. 2000 December; 25(4): 229-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11218924
•
Ergonomics applied to the practice of microsurgery. Author(s): Patkin M. Source: The Australian and New Zealand Journal of Surgery. 1977 June; 47(3): 320-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=269702
•
External stimuli in the form of vibratory massage after heart or lung transplantation. Author(s): Doering TJ, Fieguth HG, Steuernagel B, Brix J, Konitzer M, Schneider B, Fischer GC. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 1999 March-April; 78(2): 108-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10088583
•
General pharmacological studies on N-(2,6-dimethylphenyl)-8pyrrolizidineacetamide hydrochloride hemihydrate. 1st communication: effect on the central nervous system. Author(s): Hirotsu I, Kihara T, Nakamura S, Hattori Y, Hatta M, Kitakaze Y, Takahama K, Hashimoto Y, Miyata T, Ishihara T, et al. Source: Arzneimittel-Forschung. 1988 October; 38(10): 1398-409. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3196380
•
Meige's disease misdiagnosed as anxiety disorder. Author(s): Cairns SL, LeBow MD.
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Source: Journal of Behavior Therapy and Experimental Psychiatry. 1991 September; 22(3): 221-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1804856 •
Physiologic tremor and microsurgery. Author(s): Harwell RC, Ferguson RL. Source: Microsurgery. 1983; 4(3): 187-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6669016
•
Repetitive paired-pulse transcranial magnetic stimulation affects corticospinal excitability and finger tapping in Parkinson's disease. Author(s): Sommer M, Kamm T, Tergau F, Ulm G, Paulus W. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2002 June; 113(6): 944-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048055
•
Single-pulse transcranial magnetic stimulation reset the rhythm of essential tremor but not heart beat. Author(s): Yu HY, Chen JT, Lee YC, Guo YC, Kao CD, Shan DE, Liao KK. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2001 May; 64(5): 271-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11499336
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Some specific features of exercise stress in athletes. Author(s): Derevenco P, Marin G, Duma E, Baban A, Don F. Source: Physiologie. 1986 April-June; 23(2): 107-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3088614
•
Suppressed sympathetic skin response in Parkinson disease. Author(s): Haapaniemi TH, Korpelainen JT, Tolonen U, Suominen K, Sotaniemi KA, Myllyla VV. Source: Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society. 2000 December; 10(6): 337-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11324989
•
The effect of arm exercise and ocular massage on postural hand tremor. Author(s): Holmes JM, Toleikis SC, Jay WM. Source: Ann Ophthalmol. 1992 April; 24(4): 156-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1590638
•
The effect of cannabis on tremor in patients with multiple sclerosis. Author(s): Fox P, Bain PG, Glickman S, Carroll C, Zajicek J.
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Source: Neurology. 2004 April 13; 62(7): 1105-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15079008 •
There is no simple temporal relationship between the initiation of rapid reactive hand movements and the phase of an enhanced physiological tremor in man. Author(s): Lakie M, Combes N. Source: The Journal of Physiology. 2000 March 1; 523 Pt 2: 515-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10699093
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Upper cervical chiropractic management of a patient with Parkinson's disease: a case report. Author(s): Elster EL. Source: Journal of Manipulative and Physiological Therapeutics. 2000 October; 23(8): 573-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11050615
•
Vibrations and sounds from evoked muscle twitches. Author(s): Barry DT. Source: Electromyogr Clin Neurophysiol. 1992 January-February; 32(1-2): 35-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1541245
•
Visual effects on finger tremor in normal subjects and anxious patients. Author(s): Carrie JR. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1965 December; 111(481): 1181-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5892491
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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WebMDHealth: 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/
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 3. PATENTS ON HAND TREMOR Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.4 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “hand tremor” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on hand tremor, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Hand Tremor By performing a patent search focusing on hand tremor, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 4Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on hand tremor: •
Camera having a vibration correction lens and a method for correcting image vibration Inventor(s): Imafuji; Kazuharu (Kawasaki, JP), Ohishi; Sueyuki (Tokyo, JP), Okano; Hiroshi (Tokyo, JP), Sato; Susumu (Chiba, JP) Assignee(s): Nikon Corporation (Tokyo, JP) Patent Number: 5,634,142 Date filed: June 6, 1994 Abstract: A camera having a vibration correction lens to correct image vibration in the imaging plane, the vibration correction lens being driven within a lens barrel according to the output of a sensor for detecting hand tremor of the camera. The camera also has a memory unit, such as an EEPROM, to store information on the position of the vibration correction lens within the lens barrel, the position of best optical performance of the vibration correction lens and the position of the drive range limits and similar information. Prior to the camera correcting for image vibration, the vibration correction lens is moved to the position of best optical performance, this position being the one where the optical axis of the vibration correction lens coincides with an optical axis of another optical lens system in the camera. Excerpt(s): The present invention relates to a camera having a vibration correction lens and a method for correcting image vibration, such that at least one portion of the vibration correction lens can move in a direction of the optical axis of the camera or in a direction orthogonal to the optical axis and, more particularly, to a camera having a movable lens suitable as the vibration correction lens to prevent image vibration on the imaging plane of the camera. Cameras have been made markedly more electronic in recent times, to include automatic exposure functions and autofocus functions, with a high degree of automation. However, in these types of automated cameras, one aspect of automation in which attempts have been insufficient is that of countermeasures against image vibration due to hand tremor and the like arising during hand-held photography. Various vibration correction devices have been proposed to incorporate such countermeasures, particularly those countermeasures preventing image deflections arising from the tilting of the camera. These various vibration correction devices detect the vibrations or vibratory motions of the camera, and based on the result of this detection, image vibrations in the imaging plane are prevented. Web site: http://www.delphion.com/details?pn=US05634142__
•
Camera having anti-vibration function Inventor(s): Imafuji; Kazuharu (Kawasaki, JP), Imura; Yoshio (Kawasaki, JP) Assignee(s): Nikon Corporation (Tokyo, JP) Patent Number: 5,585,875 Date filed: April 3, 1996 Abstract: A vibration correction system in a camera which detects vibration of the camera caused, e.g., by a hand tremor, and corrects for the vibration of an image in an image plane caused by vibration of the camera. The vibration correction system includes
Patents 19
a vibration sensor which detects vibration of the camera, and a vibration correction optical system which is driven to correct for the detected vibration. When an anomaly occurs in the vibration detection sensor, in the vibration correction optical system, or in the drive system of the vibration correction optical system, the operation of the vibration correction optical system is inhibited. The vibration correction optical system also adjusts for correction error resulting from chatter in a gear mechanism of the drive system of the vibration correction optical system by controlling shutter timing. The vibration correction optical system further adjusts for correction error resulting from a delay in the output of the vibration detection sensor by controlling shutter timing in order to minimize the error caused by the delay. Excerpt(s): The present invention relates to a camera having an anti-vibration function which corrects for the vibration of a camera such that image vibration does not occur, and, more particularly, to a camera which compensates for anomalies which arise when the anti-vibration function is being performed. Cameras are known which provide an anti-vibration function to counteract image vibration due to hand tremors and the like which occur during hand-held photography. Specifically, the known types of cameras having an anti-vibration function include a vibration correction device which prevents image vibration from occurring due to vibration of the camera, and particularly, due to vibration of the camera caused by tilting or shaking motions. The vibration correction device detects a force received when a body rotates ("coriolis force") by using acceleration sensors and like vibration detection sensors, such as angular velocity sensors or piezoelectric elements. Based upon the result of the detection by the sensors, a main optical system of the camera comprising a photographic lens system, or a portion of the optical system, such as an optical system for vibration correction, is shifted to compensate for vibration in a plane which is orthogonal relative to the optical axis of the main optical system. In operation, a camera having the above-described anti-vibration function corrects for vibration caused, e.g., by a hand tremor, by detecting the angular velocity of the camera or the acceleration of the vibration of the camera when the hand tremor occurs. An appropriate correction quantity for correcting the image vibration in an imaging plane due to the hand tremor is calculated by a microcomputer or like calculating device based upon the detected angular velocity or acceleration. A lens system for vibration correction which is disposed in a lens barrel of the camera is moved in an up/down, left/right direction, via a drive mechanism, in accordance with the calculated correction quantity to perform a correction of the photographic optical path such that the image in the imaging plane becomes stationary. The above-described vibration correction device utilizes a solenoid, an electromotive motor, or the like as an actuator in order to drive a lens system or prism for vibration correction. Web site: http://www.delphion.com/details?pn=US05585875__ •
Camera having hand tremor correction mechanism Inventor(s): Iijima; Shuji (Yokohama, JP), Kato; Minoru (Kawasaki, JP), Miyamoto; Hidenori (Urayasu, JP), Omi; Junichi (Kawasaki, JP), Soshi; Isao (Tokyo, JP), Wakabayashi; Hiroshi (Yokohama, JP) Assignee(s): Nikon Corporation (Tokyo, JP) Patent Number: 5,666,563 Date filed: July 12, 1994 Abstract: A camera having a hand tremor correction mechanism with improved positioning of the hand tremor correction mechanism. The camera includes a
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Hand Tremor
photographic lens which moves along the optical axis of the photographic optical system. A vibration detection unit detects camera vibration, such as from hand tremor, and produces a corresponding output signal. A vibration correction mechanism, coupled to the external periphery of the photographic lens and electrically connected to the vibration detection unit via a flexible printed circuit board, receives the output signal of the vibration detection unit and compensates for the vibration detected by the vibration detection unit. The camera can also have a vibration correction mechanism which is coupled to the external periphery of the photographic lens and which shifts the photographic lens to compensate for the effects of vibration, the vibration correction mechanism having a thickness or width in the optical axis direction which is less than or equal to the thickness or width of the photographic lens in the optical axis direction. Excerpt(s): The present invention relates to vibration correction mechanisms in cameras, such as camera hand tremor correction mechanisms, and, more particularly, to improved positioning within the camera of a hand tremor correction mechanism. Conventional cameras are equipped with hand tremor correction mechanisms; however, conventional hand tremor correction mechanisms require a large lens barrel to hold various components of the hand tremor correction mechanism, thereby increasing camera size and cost. Also, conventional hand tremor correction mechanisms hinder the movement along the optical axis of photographic lenses within the photographic lens barrel. Accordingly, it is an object of the present invention to reduce the size of the lens barrel of a camera having a hand tremor correction mechanism. Web site: http://www.delphion.com/details?pn=US05666563__ •
Hand tremor compensating apparatus using magnets Inventor(s): Lee; Jeong-kwan (Kyungki-do, KR), Lee; Sung-hee (Suwon, KR), Moon; Jaeho (Seoul, KR) Assignee(s): Samsung Electronics Co., LTD. (Kyungki-Do, KR) Patent Number: 5,956,529 Date filed: July 7, 1998 Abstract: A hand tremor compensating apparatus for a video camera has a bobbin for supporting and protecting a mirror section. The bobbin has a contact portion with a groove provided therein. A barrel is disposed at an outside of the bobbin. The barrel has a boss in which a post is inserted. The bobbin is slidably mounted on the boss. A rotation restraining section employs a magnetic force to restrain the movement of the bobbin. The magnetic force is an attractive force generated between magnets respectively fixed to the bobbin and the post. Excerpt(s): The present invention relates in general to a hand tremor compensating apparatus for a video camera using magnets, and more particularly to a hand tremor compensating apparatus for a video camera, wherein a mirror section of the hand tremor compensating apparatus is secured by a magnetic force, so that the mirror section is restrained from rotating in the circumferential direction thereof when a bobbin is driven, thereby effectively compensating the hand tremor phenomenon. A video camera shoots, records and reproduces a picture. The video camera is manufactured in a small size to permit the user to easily carry the video camera. Since the user manually takes a picture, a hand tremor phenomenon occurs that causes reproduced images to be dispersed. The hand tremor phenomenon can be reduced by various camera techniques. However, the phenomenon still scatters the focus of the reproduced images. In
Patents 21
particular, when the reproduced image is magnified and projected onto a large screen, a distinct picture cannot be obtained due to the hand tremor phenomenon. Web site: http://www.delphion.com/details?pn=US05956529__
Patent Applications on Hand Tremor As of December 2000, U.S. patent applications are open to public viewing.5 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to hand tremor: •
Adjustable and tunable hand tremor stabilizer Inventor(s): Kalvert, Michael A.; (New City, NY) Correspondence: Greenblum & Bernstein, P.L.C.; 1950 Roland Clarke Place; Reston; VA; 20191; US Patent Application Number: 20030236475 Date filed: June 24, 2002 Abstract: A tunable and adjustable device for stabilizing tremors includes a rigid splint for receiving a patient's hand, wrist and forearm, and at least one gyroscope removably and rigidly attachable to said splint and positionable for countereffecting the tremors. Also, a method for tuning and adjusting the device is provided which includes assessing the dynamic characteristics of the patient's tremors, assessing at least one activity the patient intends to perform with his/her hand, wrist, and arm which is subject to tremors, attaching the splint to the patient's hand, wrist, and arm that he/she intends to use for the at least one activity, and attaching and positioning the at least one gyroscope to the splint at least one location which countereffects the patient's tremors. Excerpt(s): The present invention relates to a medical device intended to be worn by a person suffering from severe debilitating dyskinesia (shaking, tremors). In particular, the present invention is a hand tremor stabilizer which utilizes a gyroscope to counteract unwanted and uncontrollable movements that a person's arms are subject to due to dyskinesia. There are many individuals who are unable to manage many of the routines of daily living due to the fact that their arms shake uncontrollably. These men and women suffer from a variety of ailments that have a common symptom, severe debilitating dyskinesia (shaking, tremors). Individuals with this problem do not have enough stability and control of their hands to allow them to perform seemingly simple tasks, such as: holding a glass of water without spilling it, eating without the embarrassment of bringing a fork to their mouth while dropping the food, holding and reading a newspaper without it shaking uncontrollably, or signing one's own name. Currently, there is a known device that has been designed to prevent uncontrollable tremors, i.e., U.S. Pat. No. 5,058,571, which provides a gyroscope that is held against the backside of the human hand by a VELCRO strap to reduce or eliminate the effect of tremors. The gyroscope is driven by an electric motor energized by batteries. The batteries are mounted near the periphery of the gyroscope to enhance the gyroscopic action. In a modified form of the known device, the motor is not mounted on the
5
This has been a common practice outside the United States prior to December 2000.
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backside of the hand but is a separate unit to which the gyroscope can be readily coupled and uncoupled when required. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Instrument for compensating for hand tremor during the manipulation of fine structures Inventor(s): Peer, Ferdinand; (Hamburg, DE) Correspondence: Michael A. Goodwin, ESQ.; Klaas, Law, O'meara & Malkin, P.C.; Suite 2225; 1999 Broadway; Denver; CO; 80202; US Patent Application Number: 20010012932 Date filed: April 16, 2001 Abstract: The invention relates to an instrument for the manipulation of fine structures, said instrument detecting hand tremor and compensating for this hand tremor by effecting counter-movements of the working tip. The main area of application will probably lie in the field of microsurgery, since the operations performed in said field can be made difficult by the hand tremor of the operating surgeon. Here, the tremor is detected by movement sensors, by repeated analysis of the position of the handheld part (1) of the instrument, or by deriving electromyographic signals from the forearm of the operator. Intentional and unintentional movements are differentiated from one another on the basis of one or more criteria, such as movement amplitude, speed, frequency and direction. To compensate for undesired movements, signals are sent to an arrangement of actuators (3) which cause deflections of the movable part (4) of the instrument, which deflections at the tip of the instrument compensate for the hand tremor. When the instrument is used as a needle holder in surgery, the actuators (3) can also be controlled by push button in such a way that, by oscillations, they facilitate the penetration of the suture needle into the area being worked on. Excerpt(s): Manual work on fine structures is made much more difficult by the contraction of antagonistic muscles occurring involuntarily, and in largely rhythmic succession, and referred to as tremor. This is noticeable particularly in microsurgery when suturing fine nerves or vessels, prolongs the duration of the operation and reduces the quality of the result. However, in order to be able to perform filigree work, use is made, for example, of supports for the hands, or micromanipulators, which convert relatively rough movements into fine deflections. The object of the invention is to make available a handheld instrument for the manual manipulation of fine structures, in which undesired movements, for example tremor, have no effect, or at least less effect, on the manipulation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with hand tremor, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “hand tremor” (or synonyms) into
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the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on hand tremor. You can also use this procedure to view pending patent applications concerning hand tremor. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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APPENDICES
27
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 Institute6: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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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
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
6
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/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
29
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 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:8 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
7
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). 8 See http://www.nlm.nih.gov/databases/databases.html.
30
Hand Tremor
•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway9 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.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “hand tremor” (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 1003 9 597 2 139 1750
HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 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.13 Simply search by “hand tremor” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
9
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
10
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). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13
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.
Physician Resources
31
Coffee Break: Tutorials for Biologists14 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.15 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.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
14 Adapted 15
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. 16 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.
33
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 hand tremor 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 hand tremor. 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 hand tremor. 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 “hand tremor”:
34
Hand Tremor
Degenerative Nerve Diseases http://www.nlm.nih.gov/medlineplus/degenerativenervediseases.html Movement Disorders http://www.nlm.nih.gov/medlineplus/movementdisorders.html Parkinson's Disease http://www.nlm.nih.gov/medlineplus/parkinsonsdisease.html Tremor http://www.nlm.nih.gov/medlineplus/tremor.html West Nile Virus http://www.nlm.nih.gov/medlineplus/westnilevirus.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The 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 hand tremor. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
Patient Resources
35
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to hand tremor. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with hand tremor. 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 hand tremor. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “hand tremor” (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 “hand tremor”. 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 “hand tremor” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
36
Hand Tremor
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 “hand tremor” (or a synonym) into the search box, and click “Submit Query.”
37
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.17
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
17
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
38
Hand Tremor
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)18: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
18
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
39
•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
40
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
41
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
42
Hand Tremor
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
43
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on hand tremor: •
Basic Guidelines for Hand Tremor Hand tremor Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003192.htm
•
Signs & Symptoms for Hand Tremor Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Excitement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Muscle rigidity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm
44
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Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm •
Diagnostics and Tests for Hand Tremor Blood differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Cocaine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm EMG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003929.htm Glucose test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003482.htm Head CT scan Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003786.htm MRI of the head Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003791.htm Nerve conduction studies Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003927.htm Thyroid function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003444.htm
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Nutrition for Hand Tremor Coffee Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm
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Background Topics for Hand Tremor Alcohol abuse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Alcohol consumption Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Lithium toxicity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002667.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm
Online Glossaries 45
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
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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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HAND TREMOR DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Adduction: The rotation of an eye toward the midline (nasally). [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agraphia: A pathological lack or loss of the ability to write, usually resulting from a brain lesion. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] 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] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH]
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Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aqueous: Having to do with water. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Astringents: Agents, usually topical, that cause the contraction of tissues for the control of bleeding or secretions. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [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] 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] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] 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] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] 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
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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] 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] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] 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] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple
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mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [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] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coriolis: The physiological effects (nausea, vertigo, dizziness, etc.) felt by a person moving radially in a rotating system, as a rotating space station. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments,
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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] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] 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] Diagnostic procedure: A method used to identify a disease. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissection: Cutting up of an organism for study. [NIH] Diuresis: Increased excretion of urine. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Electromagnetic Fields: Fields representing the joint interplay of electric and magnetic forces. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH]
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Fat: Total lipids including phospholipids. [NIH] Forearm: The part between the elbow and the wrist. [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]
Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hormones: Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various endocrine glands and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] 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] 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] 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] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended
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between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Light microscope: A microscope (device to magnify small objects) in which objects are lit directly by white light. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lung Transplantation: The transference of either one or both of the lungs from one human or animal to another. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] 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] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Micromanipulation: The performance of dissections, injections, surgery, etc., by the use of micromanipulators (attachments to a microscope that manipulate tiny instruments). [NIH] Micromanipulators: A high precision instrument used in microinjection or chromosome dissection activities. [NIH] Microsurgery: Surgical procedures on the cellular level; a light microscope and miniaturized instruments are used. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Multiple sclerosis: A disorder of the central nervous system marked by weakness,
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numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Pharmacists: Those persons legally qualified by education and training to engage in the practice of pharmacy. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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]
Pigmentation: Coloration or discoloration of a part by a pigment. [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] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment
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for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Postural: Pertaining to posture or position. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prone: Having the front portion of the body downwards. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] 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] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [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] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
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] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH]
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Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] 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] 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] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] 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] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH]
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Splint: A rigid appliance used for the immobilization of a part or for the correction of deformity. [NIH] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Stereotactic: Radiotherapy that treats brain tumors by using a special frame affixed directly to the patient's cranium. By aiming the X-ray source with respect to the rigid frame, technicians can position the beam extremely precisely during each treatment. [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] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] 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] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Torticollis: Wryneck; a contracted state of the cervical muscles, producing twisting of the
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neck and an unnatural position of the head. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Vitreoretinal: A rare familial condition characterized by a clear vitreous, except for preretinal filaments and veils which have been loosened from the retina, a dense hyaloid membrane which is perforated and detached, and masses of peripheral retinal pigmentation inters. [NIH] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] 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]
Dictionary 59
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] Xanthine: An urinary calculus. [NIH]
61
INDEX A Acne, 3, 47 Adduction, 6, 47 Adrenergic, 47, 51, 55 Adverse Effect, 47, 56 Agonist, 47, 51, 54 Agraphia, 12, 47 Alertness, 47, 48 Algorithms, 4, 47, 48 Alkaloid, 47, 49, 54 Alternative medicine, 47 Amphetamines, 47, 49 Amygdala, 47, 57 Angina, 47, 55 Angina Pectoris, 47, 55 Anomalies, 19, 47 Antagonism, 47, 48 Anti-inflammatory, 47, 52, 55 Anxiety, 12, 43, 48, 55 Aqueous, 48, 53 Arteries, 48, 51, 53, 54 Artery, 48, 51, 55, 58 Astringents, 48, 53 Autoimmune disease, 48, 54 B Bacteria, 48, 51, 53, 58 Bile, 48, 53, 57 Biotechnology, 5, 29, 48 Bladder, 48, 54 Blood vessel, 48, 56, 57, 58 C Caffeine, 9, 48 Calcium, 48, 50 Cannabis, 13, 48 Carcinogenic, 48, 52, 57 Cardiac, 48, 51, 54, 57 Cardioselective, 48, 55 Case report, 14, 48, 49 Case series, 48, 49 Cell, 4, 47, 48, 49, 50, 51, 52, 54, 57 Central Nervous System, 12, 47, 48, 49, 52, 53 Cerebellar, 7, 49, 58 Cerebellar Diseases, 49, 58 Cerebellum, 49 Cerebral, 7, 49 Cerebrum, 49 Cervical, 14, 49, 57
Cervix, 49 Chiropractic, 14, 49 Cholesterol, 48, 49, 57 Cholinergic, 49, 54 Chromosome, 49, 53 Clinical study, 11, 49 Clinical trial, 4, 29, 49, 50, 51, 55 Cloning, 48, 49 Coca, 49 Cocaine, 9, 44, 49 Complement, 50 Complementary and alternative medicine, 11, 15, 50 Complementary medicine, 11, 50 Computational Biology, 29, 50 Conduction, 44, 50 Contraindications, ii, 50 Controlled study, 6, 50 Coordination, 49, 50, 54 Coriolis, 19, 50 Coronary, 47, 50, 51, 53, 54 Coronary Thrombosis, 51, 53, 54 Cortisone, 51, 55 Cyclic, 48, 51 D Diagnostic procedure, 17, 51 Direct, iii, 51, 55 Dissection, 51, 53 Diuresis, 48, 51 Dizziness, 50, 51, 58 Dopamine, 50, 51 Double-blind, 6, 51 Drive, ii, vi, 18, 19, 51 Dyskinesia, 21, 51 E Electromagnetic Fields, 12, 51 Embolus, 51, 52 Environmental Health, 8, 28, 30, 51 Essential Tremor, 13, 51 Excitability, 13, 51 F Facial, 4, 51 Family Planning, 29, 51 Fat, 51, 52, 53, 54 Forearm, 9, 21, 22, 52 G Gene, 48, 52 Glucocorticoid, 52, 55
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Gonadal, 52, 57 Governing Board, 52, 55 H Headache, 48, 52 Hemorrhage, 7, 52, 57 Hormones, 52, 57 Hypertension, 52, 55 Hyperthyroidism, 52, 55 I In vitro, 5, 52 In vivo, 5, 52 Infarction, 7, 52 Inflammation, 47, 52, 55 Initiation, 14, 52 Inorganic, 8, 52 Insulator, 52, 54 Intoxication, 52, 59 Intracellular, 48, 52 Involuntary, 51, 52, 54, 55, 56 K Kb, 28, 52 L Lens, 18, 19, 20, 52 Lesion, 47, 53 Light microscope, 53 Lipid, 53, 54 Liver, 48, 53, 55 Loop, 5, 53 Lung Transplantation, 12, 53 Lymph, 49, 53 Lymph node, 49, 53 M MEDLINE, 29, 53 Membrane, 50, 51, 53, 55, 58 Memory, 18, 53 Meninges, 49, 53 Menopause, 53, 55 Mental, iv, 4, 14, 28, 30, 53, 56 Mercury, 7, 8, 53 MI, 45, 53 Microbe, 53, 58 Micromanipulation, 4, 53 Micromanipulators, 4, 22, 53 Microsurgery, 4, 8, 12, 13, 22, 53 Molecular, 29, 31, 48, 50, 53, 58 Multiple sclerosis, 13, 53 Myelin, 54 Myocardial infarction, 51, 53, 54, 55 Myocardium, 47, 53, 54 N Nausea, 50, 54 Necrosis, 52, 53, 54
Nerve, 34, 44, 47, 49, 54, 55, 56, 57 Nervous System, 49, 54, 57 Neural, 9, 54 Neurons, 50, 54, 57 Nicotine, 8, 54 Nucleus, 7, 51, 54, 57 O Ocular, 13, 54 P Pharmacists, 4, 54 Pharmacologic, 54, 58 Physiologic, 9, 13, 47, 54, 58 Pigmentation, 54, 58 Plants, 47, 49, 54, 56, 58 Platinum, 53, 54 Pneumonia, 50, 55 Poisoning, 52, 53, 54, 55 Postural, 5, 8, 9, 10, 13, 55 Practice Guidelines, 30, 55 Prednisolone, 55 Prednisone, 3, 55 Progesterone, 55, 57 Prone, 12, 55 Propranolol, 9, 55 Protein S, 48, 55 Psychoactive, 55, 59 Public Policy, 29, 55 Pulse, 13, 55 R Randomized, 5, 6, 55 Refer, 1, 50, 51, 55, 58 Reflex, 5, 55 Retina, 53, 55, 56, 58 Retinal, 56, 58 S Saponins, 56, 57 Schizoid, 56, 59 Schizophrenia, 56, 59 Schizotypal Personality Disorder, 56, 59 Sclerosis, 54, 56 Screening, 49, 56 Senile, 11, 56 Sensor, 18, 19, 56 Side effect, 3, 47, 56, 58 Skull, 56, 57 Smooth muscle, 47, 48, 56 Sound wave, 50, 56 Spasm, 56 Spasmodic, 8, 56 Specialist, 35, 56 Spinal cord, 49, 53, 54, 55, 56 Splint, 21, 57
63
Stabilizer, 21, 57 Stereotactic, 7, 57 Steroid, 3, 51, 56, 57 Stimulant, 48, 57 Stimulus, 51, 55, 57 Stress, 13, 44, 54, 57 Stroke, 7, 12, 28, 57 Synaptic, 54, 57 Synaptic Transmission, 54, 57 T Temporal, 14, 47, 57 Thalamic, 7, 12, 57 Threshold, 51, 52, 57 Thrombosis, 55, 57 Thrombus, 51, 52, 57 Tissue, 48, 51, 53, 54, 55, 56, 57 Torsion, 52, 57 Torticollis, 8, 57 Toxic, iv, 54, 58 Toxicity, 44, 53, 58
Toxicology, 30, 58 Toxin, 6, 58 Transfection, 48, 58 U Urinary, 58, 59 Uterus, 49, 55, 58 V Vascular, 52, 57, 58 Ventricle, 47, 55, 58 Vertigo, 50, 58 Veterinary Medicine, 29, 58 Virulence, 58 Vitreoretinal, 4, 58 Vitreous, 53, 55, 58 Vitro, 58 Vivo, 58 W Withdrawal, 11, 59 X Xanthine, 12, 59
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